[Spinal Fusion / Lumbar] Anyone had a tri-fusion or 5 level fusion done over time or all at once?

[txbearsfan81]

If I get fusion surgery it may be possible that I get the three thoracic levels and the two lumbar levels fused. Hopefully this isnt the case. Knock on wood I wont need fusion surgery and there will be a technology out by the time that I absolutely need surgery so I wont have to have it done. Like stem cells or regrowing discs or something. The fusions probably wouldnt all be done at once but Im thinking that its a possibility overtime down the road. Would I even be able to move like this? Im going to hold out as long as I can. Has anyone every had 3 or 5 (or more) disc levels fused up? Ive heard very few success storys from people over 10 years post op of fusions. They are out there but they are very few compared to the the many many people still in as much or more pain. They are usually needing more surgeries. Me being young and probably not kicking the bucket anytime soon with more life ahead of me then behind me thats not good news. The people that are happy with the fusions are people 1 year to 8 year post op usually. After that most "are hatin life".

[Hooch]

Gday mate. There would be plenty of scoliosis patients with long fusions, many of them interbody fusions. They can move and are functional, with limitations. The problem is the outcomes in relieving pain for long fusions are spotty. Maybe you can track some of them down and have a chat?

Here's my take on it fwiw.

They're getting pretty good at the lumbar stuff for bad ddd. If you've got very painful and debilitating lumbar degenerative disc disease at 1 or 2 levels the outcomes are quite good. They'll be even better in 5-10 years.

Thoracic discs are a problem, I had a peek at the literature and like they've probably said to you they don't like to go in there for ddd as the outcomes aren't very good, they save it for thoracic nerve impingement and myelopathy etc. The other problem is that a lot less people have thoracic disc problems than do have lumbar or cervical problems, so there is less of a market for the manufacturers to invest in. But with advances in fusion technique they will get more and more willing to include ddd as an indication.

There is very little movement in the thoracic discs, so if they're fused I'm not sure that they're too worried about you doing another level like you can in the lumbar or cervical spine.

If you were to elect for surgery at some stage the lumbar stuff could likely be taken care of with a low risk of adjacent segment degeneration, the same for the thoracic. I think the real problem for you is the success of thoracic surgery, and how much of your pain is caused by those busted thoracic discs.

I wouldn't be particularly worried about turning into someone who will need fusion after fusion until they've got a broomstick back.

[KBear]

Just curious- Have you had a discogram to confirm that all of the levels are indeed pain generators? I had herniations at L5/S1, L4/5 and L3/4; but L4/5 was the worse and the only pain generator. This is pretty common to have several 'bad levels' on imaging, yet not all of them causing pain. We have several who were only operated on levels indicated as painful on discogram and are doing really good. I was really worried about this thinking that why not just fix it all at once, but I'm so glad I didn't.

As far as thoracic, I think exactly what Hooch said is the line of thinking. Initially when I was injured it was my neck and upper back that hurt the worst. I was basically told they don't do thoracic imaging much because it's very unusual to herniate in that area and that even if it was, there wasn't much to be done about it. However, I wouldn't hesitate to fuse that area, since there isn't much movement anyway.

My 60 something year old uncle has several fusions in his c spine and in his lumbar spine, not sure of the exact number, but more than his fair share. He can bend over and touch his toes with his legs straightened, can turn from side to side and said he really hasn't lost much movement and he is pretty much pain free (other than your normal aches and pains) There are also a lot of people with ADR who end up needing more surgery down the road, some of this is just the nature of DDD. There are risks to doing nothing as well, because the disease process continues and further degeneration can occur and/or you can get past the point of help with more conservative methods and/or no longer eligible for ADR and fusion becomes the only choice.