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L4-L5 and L5-S1 Fusion

This is a discussion on L4-L5 and L5-S1 Fusion within the Spinal Fusion (Including Discectomy & Laminectomy Procedures) forums, part of the Spine Surgery Support category; Hello all. I finally had a doctor accept me for the fusion. THANK THE LORD!!! I am 24, now on ...

  1. #1
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    Default L4-L5 and L5-S1 Fusion

    Hello all. I finally had a doctor accept me for the fusion. THANK THE LORD!!! I am 24, now on a medical personal leave from work, and basically trapped in my own apartment because I am on the second floor with no elevator and my leg weakness is getting to the point where I can barely get down the stairs. My doctor is Dr. Salib at the Low Back and Neck Institute in Minneapolis MN. This guy is wonderful. He talks like it is. No hims or haws or maybe this or maybe that. I like him a lot. And to top it off he is a big pioneer in fusions from the abdomen. They have to some from the back but most through the abdomen. Which is super scary for me... I just keep thinking 'Great one sneeze and I won't have kids'. We are in the process of making all the preparations and have my final look see May 6, then we can set a date. I know this is my only option to me but I am starting to get the cold feet. I am not a candidate for ADR, because they took out my facet joints on my back... which in hind sight I should have never have done, but oh well... what done is done. I am just hoping that this is the right thing to do and that it works... 9 years of pain and suffering is enough... I want my life back. Don't I finally deserve it? I am approaching my one year anniversary of my marriage with my husband and both of us are really going baby crazy. He even bought a baby name book! I am just really excited to finally get my life going in the right direction for once.
    Age 15- Diagnosed with 2 herniated discs L4-L5 and L5-S1
    Sept 2001- Microdiscectomy on L5-S1 (Age 15)
    Nov 2004- Emergency microdisectomy L4-L5 (Age 19)
    May 2008- Discectomy, laminectomy all on my left side of both L4-L5 and L5-S1 (Age 23)

    Current MRI count is 17. Current injection count is 6 (all failed). Current pills a day 8 (vicodin and tramadol).

    L4,5 L5,S1 Fusion ---June 1 2010!!!

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    Senior Member ajj1001's Avatar
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    Default re: L4-L5 and L5-S1 Fusion

    Hi Jessi, its good to hear that you have a way forward with your problems. How is the fusion to be done? ie instrumentation, bone grafts etc? Has he said it is a particular type of fusion. If not its all stuff you can ask when you go back to sort stuff out in May.
    Alison 46 year old female
    2012 Doing Rehab
    2011 Sept 3rd Op Removal of old instrumentation and PLIF L4/L5 - L5/S1 both adr in situ
    2010 May Discogram on L2/L3 & L3/L4
    2009 May 2nd Op Failed revision fusion on L5/S1 with Charite ADR in situ
    2008 Caudal epidural exacerbated nerve symptoms. Prolapse L2/L3
    2007 L5/S1 Facet deterioration
    2002 March 1st Op ADR Charite - L4/5, L5/S1
    2000 Disc prolapses L4/5, L5/S1

  3. #3
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    Default re: L4-L5 and L5-S1 Fusion

    No, he has not said yet. I am assuming that is what he will tell me in May. I had to have another CAT scan so he could see how and what all needs to be done. All he did know and say was it will be a 360 fusion on both levels because it is so weak without the facet joints on the left side.
    Age 15- Diagnosed with 2 herniated discs L4-L5 and L5-S1
    Sept 2001- Microdiscectomy on L5-S1 (Age 15)
    Nov 2004- Emergency microdisectomy L4-L5 (Age 19)
    May 2008- Discectomy, laminectomy all on my left side of both L4-L5 and L5-S1 (Age 23)

    Current MRI count is 17. Current injection count is 6 (all failed). Current pills a day 8 (vicodin and tramadol).

    L4,5 L5,S1 Fusion ---June 1 2010!!!

  4. #4
    Moderator Cindylou's Avatar
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    Default re: L4-L5 and L5-S1 Fusion

    Welcome Jessi! Thought I would just chime in since I am practically your neighbor. Dr. Salib has been my back doctor for years and did my ALIF fusion at my L6-S1 level (I have an extra vertebra) almost two years ago in July. He is a wonderful surgeon. You should be quite pleased with him. Do you mind me asking how you found him? Small world, no? I was just there at their Plymouth office last week. I hope this surgery gives you the relief you so deserve! Good luck. Don't hesitate to PM me or ask me any questions on the site here.

    Best,

    Cindylou
    • January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
    • June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
    • April 2006 right hip, labral tear and repair
    • April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
    • July 2, 2008 ALIF & Laminectomy @ L6/S1
    • July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
    • August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
    • March 10, 2009 Right SI Joint Fusion
    • April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
    • September 30, 2010 lumbar facet rhizotomy
    • December 9, 2010 12 bilateral lumbar trigger point and steroid injections
    • December 23, 2010 12 more bilateral trigger point injections w/o steroid
    • February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
    Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
    July 18, 2011

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    Default re: L4-L5 and L5-S1 Fusion

    A coworker of mine is going to him. Both of us are from Northern MN and she really liked that he had done stuff in Grand Rapids. I was having no luck with the University of Minnesota and got denied from the Mayo, so I decided to switch. He seems like a good guy and takes care of you. He says he is even active in the recovery physical therapy which I was extremely happy for. Its not like they other surgeons in which once you are off their table they are done with you.
    Age 15- Diagnosed with 2 herniated discs L4-L5 and L5-S1
    Sept 2001- Microdiscectomy on L5-S1 (Age 15)
    Nov 2004- Emergency microdisectomy L4-L5 (Age 19)
    May 2008- Discectomy, laminectomy all on my left side of both L4-L5 and L5-S1 (Age 23)

    Current MRI count is 17. Current injection count is 6 (all failed). Current pills a day 8 (vicodin and tramadol).

    L4,5 L5,S1 Fusion ---June 1 2010!!!

  6. #6
    Senior Member Gilbert P's Avatar
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    Default re: L4-L5 and L5-S1 Fusion

    Hi Jessi
    You deserve to get your life back, sounds like you found the right place. I wish you the best


    Keep moving forward

    Gil
    Last edited by Gilbert P; 04-15-2010 at 12:16 PM. Reason: spelling
    L5-S1 lam 1994
    L2 to L5 DDD
    L3 -L4 hern Dec 2007.
    L4-L5 Annular fissure with mild central stenosis and moderate facet hypertrophy.
    L5-S1 bilaterial neural foraminal narrowing with inferior effacement.
    L2-L3 Right-sided neural foraminal narrowing
    L3-L4 related to posterolateral hypertrophic spurs and facet hypertrophy.
    C3-C4 limited DDD
    15 injections Depo. P.T. 18 months 9 dose packs,
    Nerve Block Injections.4 ESI S1
    L5-S1 Foraminotomy 09
    L4-L5 Microdiscectomy 09 ReHerniation 4-2010
    Surgery 6-29-11 L4-L5-S1 Decompression Fusion L5-S1 and Coflex F implants


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    Senior Member ajj1001's Avatar
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    Default re: L4-L5 and L5-S1 Fusion

    Quote Originally Posted by Night Butterfly View Post
    No, he has not said yet. I am assuming that is what he will tell me in May. I had to have another CAT scan so he could see how and what all needs to be done. All he did know and say was it will be a 360 fusion on both levels because it is so weak without the facet joints on the left side.
    Sure you'll get lots of information if you search for 360 fusion.

    A bit of prep before your op will make things alot easier afterwards as fusion recovery is a bit restrictive. Its worth it to get a good fusion and things strong enough ready for your future to start.

    Start a list of questions to ask when you go!
    Alison 46 year old female
    2012 Doing Rehab
    2011 Sept 3rd Op Removal of old instrumentation and PLIF L4/L5 - L5/S1 both adr in situ
    2010 May Discogram on L2/L3 & L3/L4
    2009 May 2nd Op Failed revision fusion on L5/S1 with Charite ADR in situ
    2008 Caudal epidural exacerbated nerve symptoms. Prolapse L2/L3
    2007 L5/S1 Facet deterioration
    2002 March 1st Op ADR Charite - L4/5, L5/S1
    2000 Disc prolapses L4/5, L5/S1

  8. #8
    Senior Member WPKat's Avatar
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    Default re: L4-L5 and L5-S1 Fusion



    My goodness ... you have been through so much already! You are obviously a STRONG person and I wish you the absolute very best.

    Although you are clearly a veteran already, I posted a "surgical checklist" a while back that you might be interested in. If you'd like to take a look at it, I'll post it here for you.



    Kathleen
    Diagnosis
    L2/L3 bilateral facet joint arthropathy - sclerotic (B-FJA-S)
    L3/L4 M6-L ADR; severe B-FJA-S; mod foraminal stenosis (R)
    L4/L5 M6-L ADR; severe B-FJA-S; posterior decompression
    L5/S1 bilateral hemisacralized; B-FJA-S

    Procedures or Diagnostics
    3/09 L3.L5 Laminectomy; L4/L5 w Disectomy
    7/09 FJI, Radiofrequency Thermocoagulation (4 L)
    4/10 Discogram

    6/10 L3.L5 M6-L ADR
    8/11 L4/L5 Epidural Steriod Inj (L)
    10/11 CT Myleogram
    12/11 Medial Branch Blocks (8)

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    Default re: L4-L5 and L5-S1 Fusion

    Dear Jessi,
    Welcome. I am so excited you have a surgeon you like and have a plan for the future. Good Luck and keep us posted!
    CD
    44 year old female
    LBP for more than three years
    DDD at L4/L5
    annular tears and bulge
    PT, ESI, chiropractic, massage -unsuccessful
    MRI & discography July 2009-positive @ L4/L5
    3 denials from UHC
    Enrolled in Axiomed Freedom Lumbar Trial
    Freedom disc @ L4/L5 by Dr. Zigler on 2/18/10

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    Default re: L4-L5 and L5-S1 Fusion

    Jessi,

    WOW! What a coincedence of circumstances. I too am 24 years old and just finally got approved for my fusion at L4/L5 & L5/S1. My pain has been ongoing for about as long as you.....so needless to say, I know how you feel. I hope everything works out well. Looks like my surgery could be May 14 unless he doesnt have enough time than its 2 more weeks until the 28th. But it's been 8 years so what a couple more weeks if need be? Oh wait.....I know, LIVING HELL! Enough about me.....

    Now that I actually have a date and there is no turning back after the fusion I am starting to tingle a little with cold feet. But I know the Dr who is helping me is excellent at what he does so the confidence I see in him is helping ease my nervousness. Just think.....once it's all said and done, pain goes away, pills go away and you dont have to worry about your leg pain, it'll all be worth it. I may be in NC but I feel like I'll be in the room next door

    I hope everything works out and if you dont feel comfortable/confused or just not sure about this, talk to the dr. Ultimately you are in control and you make the decisions. Talk to the Dr & do the research to make sure this is right for you. It sounds like you have been through a lot already so I wish you the best of luck....you'll be in good hands

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