Lumbar Fusion

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  • Avatarmaxsuarez
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    Hi,
    Thanks for considering my question.

    My doctor is recommending a L L1-4 XLIF and L4-S1 ALIF surgery for my scoliosis. I am 63 years old in pretty good physical condition. I am not in too much pain, I have had no need to take any pain medications, so the surgery is more to prevent getting worse, since my Dad is 88 years old and has very severe scoliosis and his scoliosis progressed very rapidly in less than 10 years.

    Below is the MRI report of my lumbar area.

    FINDINGS:
    Approximately 19 degrees left convex lumbar curvature centered at L3-L4.

    Mild acute degenerative endplate changes at L1-L2 and L4-L5. Otherwise, the marrow signal throughout the lumbar spine is mildly heterogenous without significant focal abnormality on the STIR images.

    The conus medullaris is normal in caliber, signal intensity and location, located at the L1 vertebral level.

    T12-L1:
    Mild loss in the signal. No significant disc bulge or protrusion is identified. The neural foramina and spinal canal are normal in caliber.

    L1-L2:
    A 1 to 2 mm retrolisthesis with 3 mm central bulge. No central spinal canal stenosis with AP diameter measuring 1.2 cm. Patent neural foramen.

    L2-L3:
    A 1 to 2 mm retrolisthesis with 2 mm bulge towards the right side. No central spinal canal stenosis. Disc extends into the right inferior foramen with no indentation of the exiting right L2 nerve within the foramen. The disc does extend far right lateral measuring 9 mm with abutment of the adjacent psoas muscle. Disc extends into the left neural foramen with abutment of the exiting left L2 nerve without visualized compression.

    L3-L4:
    A 1 to 2 mm retrolisthesis with 3 mm rightward bulge abutting and possibly mildly indenting the descending right L4 nerve. Disc abuts the exiting right L3 nerve with no visualized compression. No central spinal canal stenosis.

    L4-L5:
    A Central bulge measures 4 mm with asymmetric right-sided facet hypertrophy with moderate changes also on the left facet. Both lateral recesses are narrowed with abutment of both descending L5 nerves with questionable mild indentation. Moderate to marked right neural foraminal narrowing with mild indentation of the exiting right L4 nerve.

    L5-S1:
    A 2 mm central protrusion results in no spinal canal stenosis. Moderate left neural foraminal narrowing.

    IMPRESSION:
    Allowing for significant differences in technique, no interval change.

    Approximately 19 degrees left convex curvature centered at L3-L4.

    No central spinal canal stenosis.

    At L4-L5, mild indentation of the exiting right L4 nerve and abutment of both descending L5 nerves with questionable mild indentation.

    At L3-L4, questionable mild indentation of the descending right L4 nerve.

    I would like to know if this type of surgery is a good idea at this time. And if it is what will my life be after such a big fusion. Will I be able to stay active after my back heals. Will I be able to hike, bicycle ride, swim and workout. I do not know anyone that had this type of surgery so I don’t know what to expect.

    Thanks in advance,
    Max

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