mlawler24MemberOctober 9, 2011 at 12:04 amPost count: 3
Dr. Corenman, I am going to be having my L5-S1 Fused together hopefully next month. I am only 26, will I have to have more fusions down the road if i start having them now? I have been dealing with my pain caused by my sciatic nerve for about 2 1/2 years, and i have been told by my Nero Surgeon that i am a surgical candidate. I do however have a Kyphosis in my spine as well, can this cause problems with having this type of surgery? I have been going through Phsycal Therapy as well, will this ensure a faster recovery and a better one like my PT doctor has told me? I am just doing some research to make my decision easier on everyone around me.. I am all for the fusion, most people around me are not, mainly because of my Kyphosis. Any Suggestions?? ThanksDonald Corenman, MD, DCModeratorOctober 9, 2011 at 10:49 pmPost count: 8507
At the age of 26, you are planning to have a fusion of L5-S1 next month. You explain that you have had sciatic pain for 2 1/2 years. You also note “kyphosis” but not where the kyphosis is or how it affects the spine.
I have many questions. What is your main complaint? Do you have buttock and leg pain as your greatest pain or back pain as the most problematic pain? If you have leg pain as the biggest complaint, why is a fusion the surgery of choice? Fusion is important if you have an isthmic spondylolisthesis, angular collapse of the L5 on S1 vertebra causing foraminal stenosis or instability from degenerative spondylolisthesis (see web site for those topics). Fusion is usually not necessary if this is just a simple compression of a nerve root from spur or disc herniation.
Where is the kyphosis of the spine? Is it at L5-S1 and if so, why? There are many causes of kyphosis. Some that need to be addressed and some that can be left alone and watched.
Dr. Corenmanmlawler24MemberOctober 10, 2011 at 6:30 amPost count: 3
I do have pain running down my leg through my calf, and pain in the butt.
This “isthmic spondylolisthesis” is actually what my surgeon called it. My disk is completely flattened and my 2 vertabres are fractured and pushing on that disk, which is causing the disk to bulge and push on my nerve.
My kyphosis is in my middle back. i have a hump in that area.. not bad enough for rods to be put in my spine though. I looked into that when i was a teenager.
Does this make any sense?Donald Corenman, MD, DCModeratorOctober 10, 2011 at 7:58 amPost count: 8507
You have leg pain from foraminal stenosis secondary to an isthmic spondylolisthesis. The L5 vertebra has shifted forward and the disc has become degenerative (this is typical). You probably also have a pedicle spur that is compressing the nerve root.
If that is the case, then you are a candidate for a fusion. With your pathology, I would suggest a TLIF to restore the disc height (see website).
You probably also have Scheuermann’s disorder (see website) which is causing the kyphosis.
Dr. Corenmanmlawler24MemberOctober 10, 2011 at 10:09 pmPost count: 3
What exactly is “TLIF” is that a replacement for the flattened disk?
What exactly is Scheuermann’s disorder? I have never heard of that before.
Do you have any patient that has had the fursion surgery done and was not satisfied with it? or it didn’t work for that person?
I did see the testimonials page on the website, which is great, but is there anyone that has had the fusion go wrong?Donald Corenman, MD, DCModeratorOctober 11, 2011 at 12:05 amPost count: 8507
Please review the website. It is full of answers for your questions and is much more thorough than I can be here on the forum.
A TLIF reconstructs the disc height for fusion purposes which restores the foraminal height- necessary for decompression of the nerve root.
TLIF fusion rate in my hands is 98%. That is not satisfaction rate however. I tell my patients that there is a 90% satisfaction rate for 2/3 relief of pain. The others at least at this point are no worse and most are somewhat better but 10% of patients do not reach the 90% satisfaction rate. The reason is that some patients have chronic radiculopathy from the original pathology (see website) and 2% do not get a solid fusion.
There is always the chance that surgery can make your symptoms worse, but in good hands, that chance is small.
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