Xlif

[lionHeart60]

i new here,
I am scheduled for an XLIF on feb 21st. GOT to tell u nervous as H***. Had 3 previous C3 fusion thru the front of my neck . Laminteomy L4 92 in 94 back into L4 AND L5 was very unhappy with resulsts
Now have bone on bone at T1 T2 and L4 S1 L5S1 XLIf at L4S1 At southeastern spine institue worried wither I made the right decision

[dshobbies]

Hi lionheart60 and welcome to the forum

You've already had spinal surgeries so you know it's not easy, though I've heard cervical surgeries are a bit easier than lumbar. You are very naturally nervous and jumping out of your skin as we all were.

As for making the right decision - the only questions are have you explored all your possible remedies and are you satisfied with your understanding of your condition and what is going to happen with this surgery, the pluses, minuses, healing, etc. If you can answer yes to both answers - you made the best decision possible for your circumstances. If not, for both your sanity and your health, you might want to postpone your upcoming surgery to ensure you are making the best decision possible, which can only be done when you know all the facts.

I would like to ask, have you been advised, for certain reasons, that ADR is not a possible remedy for your situation? Is your doctor well versed in all spinal fixes? Does he believe in ADRs? How many has he performed? Did you get other opinions before deciding on both your previous and your current fusions?

Perhaps you can tell us a little more about our situation.

Dale

[lionHeart60]

HI, Dr Ewards at peedee ortho in floorence wanted to cut me two yrs ago L4S1 L5S1 I said NO Already been cut there. I put it oof till NOW. I saw their ad on Tv and contacted : Southeaster SPine institue they ONLY do SPINE > ALL their training is working on the spine. I am not letting ANYONE cut my back again. I was looking for other options. From everything I have researched this is as good an option to avoid cutting my back muscles again.
Do I trust surgeons , NO.. The last guy who cut me came in the room where i was waking up and LAUGHED and says HAHA BET U R in a LOT of PAIN I REALLY CUT U. Could thing I couldn't get up or Id probably still be in JAIL.

I am very physical I simply put off getting "something" done for too long already. I haven't seen any other answers for bone on bone than SOME TYPE of surgery. I am NOT liking all the PREP they r calling for prior to surgery day? I certainly am NOT expecting it to be a piece of cake. But they claim the PAIN level isn't as bad as ur back and recovery time is much shorter. NO PT about 8 to 12 weeks down time. the 12 weeks r more becuas eof what I do. the NORMAl down time is 8 to MAYBE 10.

[mmglobal]

LionHeart... sorry about your troubles. I don't think they can do an XLIF down to S1. You may be having something different or I may be wrong. I think the pelvis is in the way for the XLIF approach at L5-S1.

If you can, please discover all your options before surgery.

Mark

[lionHeart60]

HI MMGLOBAL U r correct . they r doing the L4S1 he was going to do BOTH the XLIF than turn me over and do the L5S1 but he changed his mind. But warned me the XLIF MAY NOT fix the PAIN. That I "MAY" (read pretty darn sure) I will need firther intervention later. AS PAINFULL as the 1st idea would be Id just as soon get it over with . I am NOT young as I get older will be less able to bounce back. At least now due to my ocupation I am in fairly good shape. I don't know if I will be able to say that a yr or more down the road. The answer to that is most likely NOT!
I have the T1 T2 area bone on bone For the most part till I get active it doesn't bothe rme but BOY when I do it can take my breath away.
When my hips r bad i can barely take a deep breath.
I KNOW I NEED HELP BUT SIGH This sucks

[mmglobal]

Remember... I'm a layperson, not a doctor, so don't take anything I say as anything other than the opinion of a layperson.

Was discography done? How did they decide to rule out L5-S1? If there is some reason to believe that most of your pain comes from L4-5 and the L5-S1 is NOT a significant pain generator, then proceeding as planned may make some sense. (IMHO)

However, if this is based on wishful thinking and on the idea that XLIF is so minimally invasive that it’s like a ‘freebie’, then this is another story.

Remember the vaudeville joke….

“what are you looking for?”

“my keys”

“where did you lose them?”

“over there”

“why are you looking over here?”

“Because the light is better over here.”

If they are doing XLIF because the light is better there, then???

Less surgery is better than more surgery. Less invasive surgeries are only better than more invasive surgeries if the compromises of less invasive surgeries are worth the trade-offs, and there are significant trade-offs. MISS is not always better. One surgery is better than two. (Unless of course you are the one being paid for two surgeries instead of one.)

All the best.

Mark

[lionHeart60]

mmglobal, EXACTLY, not that make sme feel any better. He has (IMO) mad eit pretty clear that I will need further surgery. That HE can't quarntee that THIS will fix the pain. But maybe this will FIX the worst of it and MAYBE we can MANAGE the pain with (I GUESS) shots? OR "I" will be putting MORE money in his pocket. BUT cutting me at that location AGAIN is NOT an OPTION> Been there done that TWICE. I devolped scar tissue so bad it caused as much pain as the orginal issue. IF this doesn't get the majority of it I will seek laser . I simply dont see how anything but a SPACER will do anything with Bone on bone. They r going to but the spacer in and screws above and below. Thats the problem that doesn't fix L5S1 or the bulge and narowing lower down. Thats not his fault. The full surgery the XLIF AND the L5 S1 would have meant two surgery's over 8 hrs long. THe ting I am upset about there is he said ORGINAL thats what HE THOUGHT was BEST> But he said we may do it the same time or take u back to OR the next morning cause it is so long I frowned on that said if you r going to do 2 "I'd" prefer while ur in there GET EER DONE! If I wake up in pain then they say they want to do more Id panic and say NO!
Rehab woulld have been awfull but at least they SHOULD have been able to take care of the worst of my ill's. WHAT upsets me about that is did "THEY" change their minds for the right reasons. Cause he had said before he didn't KNOW IF THEY would have enough time to do BOTH cause they have so MANY to do in one day UH HELLO than u need to schedule differently! Take care of MY problem right than go on to the next paitent. I am having to WAIT OVER A MONTH as it is.

[Maria]

I have had 2 discectomies w/2nd one leaving me in horrendous pain for at least 5 years followed by another 7 years or so of pain that was at times tolerable tho mostly because of addition of pain meds and ESIs, followed by a leveling off of pain which I can handle w/one medication now (or at least so far).

In early 2000's a 3 level global fusion was offered, then 2003 2 level ADR, then 2006 a hybrid surgery with ADR at L4 and fusion at L5S1.

Want to know why I didn't do any of the surgeries? Because I was worried about more or increased pain and creating more probs. If someone told me as they once did with the 3 level global fusion I may need more surgery as in fusing all the way up the lumbar spine that was enough to make seriously question doing that particular surgery (and not do it as I thought there were other options).

With the latter two surgeries offered I just didn't think they would fit the bill. I had doubts.. I didn't do either. I probably would have if I could have traveled to Europe to do surgery tho there were reasons I didn't . Currently I'm not unsatisfied with my decision however am open to the idea of spine surgery again should it become absolutely necessary.

If you're active and have more time to investigate your options a bit more perhaps you should. The more surgery performed the more potential for scar tissue I would imagine. You have to live with the results.. the surgeon doesn't so hopefully you'll really believe in what you're doing or not doing. Good luck..

[dshobbies]

As I see it, you're not too trusting of your doctors and their decisions on what surgery(s) are best for you. IMHO, you are not ready for surgery until both of situations are resolved.

I know you're scheduled in two weeks and the mental preperation is already taking place but your concerns are not being satisfied. You still have questions. You want one, not two surgeries yet you're being advised two might by necessary.

I don't know your personal insurance and/or financial situation but I will tell you - you have only one back and can't afford to make wrong decisions. You already regret your last surgery and this might be your final attempt at becoming pain free. You don't have to agree to thing until you're satisfied that all your pain and concerns are being addressed.

Please, let Mark know where you are so he can recommend another doctor for a second opinion. After this surgery, it just might be too late.

Having said all that, what your current doctors are advising may be the correct solution for you. However, if you're not sure, you should wait until you are.

Dale

[cherylstewart67]

what is XLIF?

[lionHeart60]

Cherylstwert67
XLIF is eXTreme Lateral Interbody Fusion.instead of cutting the major back muscles they go thru ur side with two small inseions to implant the spacer and screws Goggle it They r advertising them The place on tv which is how I found them. Southeastern spinal institue
I have put the surgery off for over 2 yrs already. The pain level has gotten to the point Its hard to get thru the day. I am not good at taking pills and I dont like to chance the side effects. My family doctor put me on Lyrcia which worked really well but it isn't meant to be on LONG term. I quit cold turkey HUGE MISTAKE I was SICK for 3 weeks I mean want to crawl in a HOLE and pull it in after me sick. Trying to work when u feel that bad AND IN PAIN NOT GOOD> I DID BUT WHEW I work on two horse farms very physical work. Then they recalled darvect MY backd octor just gave me Tramadoll made me sick. After the last two back surgeies and ALL the pain mangement I went thru (WHAT A LAUGH) thatw as more torture than pain releive. I AM DEATHLY afraid of needles.

[lionHeart60]

DShobbies, trust surgeons OH H** no it would matter who they r... two of them were such ego manics. The one who did the L4 L5 came in and Laughed at me as I was waking up in my room SAID I BET UR REALLY HURTING THIS TIME I REALLY CUT U. is it any doubt I dont trust them. Lets face it people doing surgery is HOW they make THEIR MONEY! If they told ALL us they could do the surgery but really didn't expect it to work or told us look u just need to PT take some asprin change ur life style and u will be ok they would starve NOT have multi million doallr homes live at the beach drive fancy cars etc etc.
I have bone on ABONE even I understand SOMETHING has to be done but since the XLIF can only get HALF the problem and I will have to go back under the knife LATER is my issue with this. He orginal said hed do BOTH the same day than changed his mind. Because of a couple things he said I have my doubts about WHY he changed his mind and I dont feel they were for MY best interest. H*8 whats it to him if he makes the POINT of telling me U WILL BE back to fix thos eother areas MORE than likely but for NOW!
well bite me

[lionHeart60]

Maria I hear ya and totaly agree. I have been living with the pain at some levels since 85. I have all but crawled home or out of my truck at the end of the day. NOW that I have BONE on Bone Ithink taking pain meds strong enough to deal with this isn't safe I feel "something" has to be done and am trying to make the right dicisions. One good thing happened yesterday. My boss has a x BNL who is a retired ortho surgeon. She said write itall down email me and she would pass it on too him and see what he says. SO I did that last night. Dr Dewy is awesome guy I have met him. He told me 2 yrs ago when ONE surgeon advised the tens machine for me. He said DONT DO IT THAT is the absolute LAST resort anyone should take. SInce i wasn't willing to let them cut me from L4 thru L5S1 which is exactly where the last surgeon was in 94 I have lived with the pain getting increasing stronger. I it would seem is someone who devlopes extensive scar tissue . IT wasn't that the surgries were not successful the SCAR tissue caused as BIG a problem as the orginal issue. SO in THAT sesne the surgery didn't HELP. SO I am needless to say scared to death of them cutting my back AGAIN specialy in the SAME AREA.

right now at 60 I am about 13 pounds over weight but under neath that I am in pretty good shape physicaly. I am also pretty HEALTHY except my back., IF I MUST HAVE SURGERY I think NOW is the time to do it BEFORE I GET OLDER and maybe not as healthy Physical or other wise.
So even though I am expressing doubts deep down I KNOW I need (HAVE) to do something just second guessing myself BUT I have done that ALL MY LIFE in ALL aspects of my life I will see what Dr dewy has to say and decide from there. I dont HAVE to wlak into that OR room unless I want to and dont care how mad THEY GET if i change my mind

[Hooch]

Gday mate, ... I don't trust the buggers either.

You going to leave l5/s1 for the moment? It's not as bad a l4/l5? If you go through the front you could get both, no muscles are cut, there is risk of nerve damage but there is risk of nerve damage from the side as well.

Btw XLIF cuts through your psoas muscle, seen plenty of people say it hurts like all hell in the first few weeks post op as the muscle heals.

Make sure you're decision is well informed, you may need surgery but u don't have to rush into a choice.

Btw most people take longer that 3 months to get back to physical work from what I've seen, more like 6.

[Maria]

My bone on bone fused at L5S1 by itself and it really helped w/the pain at that level so I'm glad I waited however if I had been feeling way worse and doing much less I'm sure I would have pursued surgical options at some point or another. And not to say that I won't at remaining screwed up levels.

I'm not scared of needles at all thankfully just more spine surgeries (I'm 3 years away from 60). You're probably correct about doing something while you're in good health and there haven't been changes that would knock off a few options however still make decision that you have researched well and feel comfortable about.

Good luck w/whatever you end up doing and I hope you'll continue to keep us posted. take care!

[lionHeart60]

the day has finaly arrived. after spending hours trying to get off the throne for good. Morning has arrived and in a couple hr I will be off to get fited for my brace. Than to the hospital to lay THERE for 3 hrs "WAITING" for surgery.
Scheduled for 2:30 lets see if it goes off on time. He is only going to do the XLKIF at L4 L5 Already saying I will definatly need more surgeries. grrrrrrrrrrrrr
OH well I give it to God what ever happens happens

[Maria]

With your surgery today. I know that some things are thought to be predictable however hopefully just because you are told you'll need more surgery in the future doesn't mean you'll have to have it.

I've been told I'd need this or that. That was over 20 years ago. Hasn't happened yet.

Hope you have a wonderfully gifted surgeon operating on you and your surgery and recovery will go as well as it all can.

Take care and post when you're able.. not a minute before!

[dshobbies]

I hope everything goes well and you get the relief you seek from this procedure. If you read this prior to your surgery, I know how nervous and scared you feel but you've done your homework and you're just hours away from the 'other side'.

Sending good vibes your way. When you're able, let us know how it went.

Dale