[Spinal Fusion / Lumbar] MAST TLIF - Lumbar Fusion

[cloner]

Hello, my name is Chris. I am a career Paramedic in the Buffaly new York area. In 2003 I injured my back while at work. Back then I saw a neurologist, he stated that the injury I had, although painful, would not require surgery at that time and he referred me to a pain specialist, whos care I have been under for seven years now. I contiued to work as a Paramedic even now whole dealign with the pain.
I have been on numerous pain medications over the years. i started out with the lortabs, seven years ago, and have now worked my way up to heavier pain management medications. Ia m tired of taking the medicaiton, so I began the process of doing all of the testing for a implanted pain pump. While during the testing, the MRI showed that I have a 7mm shift in my spin between L5 and S1. I was immediatly re-directed to the neuro surgeon for evaluation. He recommended that I have surgery to fix the issue. The proceedure is called a MAST TLIF, I am wondering if there is anyone out there who has gone through this proceedure. Im concerned about being able to returnt o work upon healing, the amount of time it takes to heal, and just about anyting else I should be aware of. Thank you in advance to anyone who answeres back.

[lolenona]

Hi Chris,

welcome to the forum. I am new here too and I think you will find many friendly people with good advice. I haven't had the procedure that you are talking about and can't offer much help, but I wanted to welcome you and say that you are among friends. Good luck and keep posting

[Justin]

Hi Chris, welcome to the Spine Patient Society.

Man...I am sorry that you are in pain and being a paramedic must be difficult on your spine. I completely understand being sick of the meds--the side-effects can be pronounced at high doses.

The TLIF is a refinement of the PLIF --> see this for more information Patient's Guide to Posterior Lumbar Interbody Fusion

"The TLIF technique involves approaching the spine in a similar manner as the PLIF approach but more from the side of the spinal canal through a midline incision in the patient’s back. This approach reduces the amount of surgical muscle dissection and minimizes the nerve manipulation required to access the vertebrae, discs and nerves. The TLIF approach is generally less traumatic to the spine, is safer for the nerves, and allows for minimal access and endoscopic techniques to be used for spinal fusion."

The Spine Patient Society Educational Videos might also help: Spine Patient Society Educational Videos (Click on Orthopedics, then Spine...)

I hope this helps you get started. Good luck!

[KBear]

So sorry you find yourself facing surgery. I'm not familiar with that procedure, but wanted to welcome you to the forum. My suggestions would be to get at least 3 surgical opinions before proceeding with any surgery, research, ask questions and then make the best decision you can with the information you have. While none of us want to have spine surgery, for many of us it has given us our life back. Healing does take awhile, took a full year for me to feel a lot better; but it's worth it. Good Luck and I'm sure some more knowledgeable people will pop in soon.

[Keano16]

Can you please explain what is your diagnosis, because I don't understand you fully?

p.s.
Welcome to the forum . My mom recently had less invasive TLIF (not MAST) and she is doing pretty fine.

Although fusion will never be minimally-invasive surgery, recently new technologies have enabled performing spinal fusion in pretty minimally-invasive manner. One of this methods is MAST TLIF. Discectomy is performed via METRx system (minimum exposure tubular retractor - this system is used to avoid muscle damage and cutting while perfoming discectomy) and then screws and rods are placed with SEXTANT system.

[trkdoc714]

Chris,

Welcome! KBear is dead on. Get a few more opinions before agreeing to surgery. I'd embellish on her recommendation only by also consulting an orthopedic surgeon in addition to the neurosurgeon.

I agreed to a discectomy without doing a lot of research. I always wonder if the ADR surgery could have been forstalled or even avoided by getting more opinions/ options before that procedure.

Good luck to you. We're here if you need us (unless you want to borrow $$$, then you're SOL),

Bob

[cloner]

To answer your question the most recent MRi shows that at the L5 S1 level, there is a 7mm anterolisthesis of L5 on S1 due to spondylolysis. There is associated narrowing and degeneration of the L5 S1 disc. The is moderate severity bilateral neural foraminal stenosis.

I have decided to go ahead with the proceedure and am awaiting approval from workers compensation. My understanding of the above is that I am basically one bad lift away from shifting my spinal area at the L5 S1 level completely, which would cause spianl cord damage and ultimatly could end me up in a wheel chair for the rest of my life. At least with this proceedure, I have a strong chance of returning to my current job. If something happens to where I cant, well then since it is a compensation injjury, they will pay for retraining for a different line of work.

I am not sure if I put this in my origional post, but I am not one of those people who likes to just sit. Im worker, have been since I was 14 and plan to continue to be until i retire and buy that awsome mobile home I dream about driving all around the country in. I see this surgery as step at being somewhat normal for the first time in seven years. I just hope and pray it all goes well.

[Susanna]

He recommended that I have surgery to fix the issue. The procedure is called a MAST TLIF, I am wondering if there is anyone out there who has gone through this procedure. I'm concerned about being able to returnt o work upon healing, the amount of time it takes to heal, and just about anything else I should be aware of. Thank you in advance to anyone who answeres back.

Chris,
While I haven't had the procedure, I have a problem in the same area. I can't believe you have gone so long on pain meds and that your pain doctor didn't say anything when you needed an increase in medication. I had four disks in my cervical spine fused in Nov. 2008 and the surgeon said that my L5/S1 was not surgical. I did traction and exercises to relieve the pain. I was on a heavy dose of pain meds due to other injury's so I don't know if that helped, (probably) to mask my back pain.
A year later I took a hard step down and my disk exploded basically. What was once a "slight, non-surgical herniated disk" was now the most painful disk I have ever experienced in my life.

I have been researching fusions and this is one of them. I think it is one of the better fusions for the L5/S1 areas that I have come across with the least amount of healing time! One of the things that I am a bit frustrated with is that it is not covered by most insurance companies.

Good luck with your search.