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  • curtisjoanne
    Member
    Post count: 3

    Dr. Corenman,
    For the last 5 months I have been experiencing severe lower back pain. Four years ago I had a surgery and the dr. did a fusion of the L4L5 and L5S1 vertabre. My recent MRI has shown that I have a bulging disc at L3L4 another one at L4L5 and a tear in the disc at L5S1. Is this possible? I was told the dr removed the disc at L4L5 due to degenerative disc. I am not sure what to do can you please give me some advice.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    You must have had significant lower back pain for a fusion of L4-S1 four years ago. If the surgeon performed PLFs (posterior lumbar fusions) but did not perform TLIFs (where the disc space is also fused), the disc remains intact. Hopefully the spine is fused in the back which prevents some load and immobilizes the spine. How did you initially do after this surgery?

    Any tears or bulges in the disc will remain after the PLF (unless the bulge is removed during the PLF surgery). If you have a solid fusion of L4-S1, your pain should be generated by the disc at L3-4. If you do not have a solid fusion (pseudoarthrosis), then the pain could be generated by the non-fused disc space.

    You need a good workup by an experienced spine surgeon to determine what is causing your pain.

    Dr. Corenman

    curtisjoanne
    Member
    Post count: 3

    I did pretty good afer the surgery. I could not do all the things I had done prior to the surgery. I could not pick up anything over 15lbs without hurting or go on long rides. The surgeon I am currently seeing is the same surgeon that did the surgery but he does nto seem to want to listen to where my pain is.

    I am not sure if he did the TLIFs i cannot find my surgery notes that i had.. I will have to do some diggin and see what i can find.
    Thank you for your help

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    TLIFs would be obvious on X-ray as the disc space would have a “spacer” (cage) in it. If the MRI report notes disc bulges and tears in the surgical levels, you would not have had a TLIF.

    No being able to lift more than 15 pounds after you healed makes me think that you did not have a successful fusion but with a posterolateral fusion only (PLF), the weight restrictions occasionally can be limiting.

    Dr. Corenman

    curtisjoanne
    Member
    Post count: 3

    We’ll I have answers now. Went to see a new surgeon. He ordered a ct scan , the fusion at L4L5 did not fuse. So I have a non union as he called it. I go to meet with both surgeons in that office tomorrow to schedule surgery to fix the problem. Thank you so much for the advice.

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