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Suggest effective alternative surgeries for lumbar spinal fusion

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Posted on Wed, 27 May 2015
Question: Md is considering another lumbar spinal fusion. Wondering if any alternatives. 15 mo post PLIF l4/5. Laminectomy for severe stenosis. CT scan this week shows very little bone growth and essentially unchanged since July 2014. 4.4mm spondiolithesis l4 on 5. Flextion extension shows slight movemebt - 2-3mm. Emg - chronic involvement but no acute nerve involvement. Instumentayion still intake. SX- low back pain with frequent bilateral sciatica. Bit worse on left. Spinal injections work for 4-5 weeks. Have 1 set of injections left this year. Have been wearing bone stimulator for last 12 months (on second one). Take forteo since last July. Any alternatives to another surgery?
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Answered by Dr. Naveen Kumar Sharma (28 minutes later)
Brief Answer:
You can wear lumbosacral frame

Detailed Answer:
Hello,
I have studied your case. I think that your surgery was not successful so you are not able to achieve fusion in the spinal column. So I would recommend you to get a repeat surgery where doctor will put lit of bone graft to achieve fusion. Back pain can not be relieved without fusion.
I would also suggest you to wear lumbosacral frame. This will help in supporting your back and prevent further progression of lysthesis.This will prevent some back pain. You should avoid travelling, weight lifting and sudden jerky activities.
I hope this answer will be useful for you. Let me know if there is any other followup questions.
thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Naveen Kumar Sharma (18 minutes later)
I have been on a 10# lifting restriction and have continued to wear the lumbosacral frame all day except for sleeping. Without it im in extreme pain. Im curious about travel. I fly 5-6 times a year for work or pleasure. I live in hawaii so long trip whereever i go. I usually fly first class and get up and walk at least ince an hour. Curious why i should avoid travel .
doctor
Answered by Dr. Naveen Kumar Sharma (33 hours later)
Brief Answer:
No problem with Air travel

Detailed Answer:
Hello,
Thanks for replying. It is good that you are using lumbosacral frame. Just make sure that it is stronger one and not just belt. Strong one has three aluminium rods in the back side.
I asked you to avoid travel by bus or car. Because some time jerky travel can increase your lysthesis. Air travel is not a problem.
Let me know if there is any other followup questions. thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

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Suggest effective alternative surgeries for lumbar spinal fusion

Brief Answer: You can wear lumbosacral frame Detailed Answer: Hello, I have studied your case. I think that your surgery was not successful so you are not able to achieve fusion in the spinal column. So I would recommend you to get a repeat surgery where doctor will put lit of bone graft to achieve fusion. Back pain can not be relieved without fusion. I would also suggest you to wear lumbosacral frame. This will help in supporting your back and prevent further progression of lysthesis.This will prevent some back pain. You should avoid travelling, weight lifting and sudden jerky activities. I hope this answer will be useful for you. Let me know if there is any other followup questions. thanks