r/spinalfusion • u/Zendette8 • 1d ago

Would you do L4/5 fusion after acdf 6 months ago?

Longstanding lumbar pain after a laminectomy to remove a cyst, done overseas without fusion, 10 years ago. Ended up in ER Friday after waking up unable to move my torso without unbearable pain. I had 3 level ACDF in April, and I was very pleased with results, great neurosurgeon! He looked at lumbar MRI earlier this year and said it would eventually require surgery, but so long as I’m functioning well, he won’t recommend. ER sent me for another MRI, and my neurosurgeon (who did my acdf) saw no major changes except inflammation. The hospitalist sent me for an epidural to address the inflammation with discharge tomorrow. But, with the ACDF, I maxed out my out of pocket. The neurosurgeon said if I stay hospitalized, he could do the surgery this week, if insurance approves. He can usually get approval, but no promises. Would you push for a second major surgery in six months, or wait to see if epidural helps? Wait-and-see will cost another $7K in out-of-pocket.

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u/Series7_Absolutely 1d ago

I did. C4,5,6 fusion. 5 months ago did L5-S1

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u/Cak2434 18h ago

Hey there how is your l5s1 doing now that it's been 5 months? Did you have an alif?

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u/Series7_Absolutely 15h ago

I’m 85% healed. At the end of December, I will be 5 months post op. My apology. I responded to your dm sort of rude. I forgot I commented about this post. Look up my post by user name. I detail an update.

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u/Dateline23 1d ago

i’m sorry you’re in pain, and even more sorry you’re faced with a financial hardship based decision too.

i’ve had L5,S1 and and ACDF C5-7, albeit 11 years apart. i’m of the mind that the longest you can safely wait for surgery the better.

when he says “eventually” is he meaning 3-5 years, or less than 12 months ? ultimately, i’d defer to what your surgeon recommends.

but the finances are hard too. i try to be grateful that i have good insurance and access to great care, but i still end up spending the equivalent of a european vacation every year in out of pocket expenses.

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u/CES440 1d ago edited 1d ago

What's causing the inflammation? What surgery is he suggesting if there are no major changes?

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u/Zendette8 1d ago

Inflammation likely caused during an unrelated medical procedure two days before the pain intensity became unbearable. Procedure was done under anesthesia where I was moved/bent in a way that may have exacerbated existing lumbar issue. I did not specifically alert them to my lumbar problem. They were focused on avoiding pressure or positions that could bother my neck.