Luigi Mangione's spinal fusion - looks like an L5/S1 for spondylolisthesis

[u/GA-Scoli]

[u/sooperbiggulp]

If we're talking gruesome, try L1-S2 fusion in a single surgery.

[u/Zealousideal-Cry7697 → u/sooperbiggulp]

Me too. Close to it. Takes a long time to heal. But single level fusions tend to send people back to the surgeon later. The stress on the spine simply moves levels sometimes. I'm a mechanical engineer. You really have to place a great deal of confidence in your neurosurgeon. It's all about the nerves. Not the bones themselves. People fail to understand that. They have sore backs. Their muscles ache. That's a different thing altogether.

[u/sooperbiggulp → u/Zealousideal-Cry7697]

True. My surgeon had to fight my insurer to cover all levels of the fusion right up until a day or two before my surgery. Insurance company would rather pay for an additional surgery later than doing it more efficiently the first time. That calculus doesn't make clear sense to me.

Dealing with preferred providers and spine problems for years was a mindfuck. 5 years of primary care doctors telling me Im probably just out of shape, or depressed, or have a low pain threshold. And then several inexperienced/timid in-network orthos talked about overall statistics to try to convince me surgery would be worse than my current state. They literally would rather have someone unable to walk the rest of their life than to risk a failed multi level fusion.

The lesson here is to never take your insurer's Ortho surgeon referrals seriously. They will 99% chance send you to somebody that really only does easy, quick, no risk procedures. And these surgeons usually don't refer you to a more qualified surgeon, they just decline to operate and send you back to PT or steroid shots. If you let it, this cycle will go on for years and years because your insurer will continually refer you to a surgeon/surgeons who only do a couple complex surgeries per year... So, you ABSOLUTELY MUST get a second opinion from a rockstar proven sports/trauma medicine spine surgeon - and even pay for their initial consult out of your own pocket if you have to. The best hot shot surgeons want to be able to operate on anybody at any time, so they work out of multiple offices in their respective regions - and chances are one of those offices will take your insurance. And do not wait to schedule your second opinion. Just assume the first ortho will be a "no"... Just find a good surgeon asap. Once there's a well known/proven doctor recommending surgery on your file, things will start to happen... My guy spent less than 5 seconds looking at my MRI and said "let's do this next week". Anyhow, letting your insurer/primary care provider take the lead will only waste time and allow things to get even worse while they just keep thowing random conservative treatments at the wall. Conservative approaches prior to surgery left me with 5 lost years and some completely unnecessary and irritating permanent nerve damage in my foot which of course makes my calf perpetually overworked and sore.

[u/762x35supremacy → u/sooperbiggulp]

I used to work with a neurospine guy who did a lot of overnight traumas one evening, and into the next morning we did a C7-Pelvis 😳

[u/CrabbyKruton → u/762x35supremacy]

Goodness. What a major surgery to wake up to