Am a 52 yr old lady with DDD,spinal stenosis,cervical spondylosis. 1999-Discectomy &interbody fusion from C5 through C7.2005 spinal fusion,pedicle screws & spinal rodsat L4& L5.Laminectomy L4 on L5.
Did fairly well until 8 months ago and had a bad fall. Seemed fine until about 8 wks ago when lower back and left leg pain increased dramatically.Bad numbness from left knee down throughout left foot. Also severe left arm,hand & neck pain.
MRI taken 1 week ago states
central disc bulge L5-S1
deg changes of L5_S1 facet joints bilaterally
4 mm anterolesthesis of L4 on L5
minorcentral disc bulge at L4-L5
right lateral disc protrusion at L3-L4 with mass effect on the right L3 nerve ganglion
concentricdisc bulge at L2-L3
small left-sided paracentral disc protrusion at L1-l2
In regards to the anterolesthesis am I understanding correctly that it could be resulting from the first fusion??? Also if another fusion is recommended isn"t that almost looking for trouble if their is not a truly significant reason to do so? Most neurosurgeons are quick to recommend surgery so first I am going to my new neurologist for his opinion.Any thoughts or comments would be appreciated. Thanks for listening,
"In regards to the anterolesthesis am I understanding correctly that it could be resulting from the first fusion???"
Its possible as you know a fusion stops any motion between the two vertebrae that are fused this has the effect of putting extra stress on the spinal joints below, and above the fused level. This can result in the discs at theses levels bulging or rupturing, and possibly needing a fusion also. However anterolesthesis is not something that is commonly thought to result from a fusion that is near the level of the anterolesthesis.
But anything that changes the mechanics, and the forces that occur in your spine has the potential to cause problems over time.
Because you have many problems at different levels its possible that you have some underlying problem with your spine, and some kind of mechanical dysfunction is likely to be present, it may even be the cause of your problems or it may have predisposed you to these problems that you have, and a traumatic incident such a bad fall or a car smash could have kick started your degenerative spine disease.
"Also if another fusion is recommended isn"t that almost looking for trouble if their is not a truly significant reason to do so?"
Yes i think you are correct, but if a good surgeon is adamant that you need a fusion then you should listen to them, its up to you if want surgery or not. Surgery will not cure the degeneration that your spine has suffered, but it can reduce the symptoms, and somtimes slow or halt the degenerative process. You are also right sometimes there is a really good reason to have surgery like when part of a disc is pressing on the spinal cord so hard that the nerves are being damaged.
sorry to make it all sound so complicated but that's the way i see it and the best way i can explain it.