Editor’s Note: Kerry Smith is a former minister, a professional artist, and has suffered with chronic pain for 14 years. He has lectured and written on the topic of chronic pain for several years. He is a contributor to the National Pain Report.
At the time of the writing of this article, I am up in the middle of the night trying to get a grip on my latest upheaval of pain. Yesterday I celebrated my 2 year anniversary from a lumbar spinal fusion. In honor of this special occasion, on Tuesday, I will celebrate by having a date with a CT scan machine and an x-ray machine. Two plus years ago, a discogram of my lumbar spine revealed that I had several discs which were the source of my lumbar and leg pain. I had been diagnosed with spondylolysthesis in my lumbar region much earlier and my pain was an around the clock level of 10 plus. The evidence and need for fusion surgery certainly seemed worthwhile at the time according to my neurosurgeons.
Now, two years after the lumbar fusion surgery, to the exact day, I am experiencing intense pain once again except now in a different leg. I cannot sleep at night due to the pain and where the pain had shot down my left leg before the lumbar fusion, it is now going down the right side, into my hip, running down my leg, into my foot and toes. The sensation is one of a stabbing pain that starts right at the segment below my fusion. Dermatomes show that the kind of pain I am having has at its source the segment below the fused area. If this is the case, it could, be something known as ASD which is Adjacent Segment Disease as a result of my fusion.
It seems that ASD happens when the discs and segments of a person’s spine are weakened below and or above the fused area with more stress and pressure being put on those areas due to the fusion resulting in new neurological issues. Dependent of course on my tests, these issues may have to be addressed now some 2 years after one of the hellish surgeries I have ever had. Or, it could be that the hardware in my back is now loose and creating issues that are giving me the new pain.
What this new pain has left me with is a questioning of my own decision making process when I was contemplating lumbar fusion back in 2013. Did I ever hear of possible complications later down the road related to this surgery from the mouth of my surgeon or for that matter, anyone else when I was contemplating “going under the knife”? And if I did, would I have listened, given my pain levels at the time, and rethought lumbar fusion surgery?
I can honestly say, gut level honest, that I just don’t know. I don’t. As I head towards Tuesday, now questioning the undertaking of this surgery, I wondered if studies had been done on the efficacy of lumbar fusion surgery, as if now it is going to make a difference in my own situation. Perhaps at least my own research could help those of you who are considering this surgery.
What I found was from a 2010 study described in the PubMed Central, a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM). The research group, as evidenced in the web address at the end of my article, gathered information on 64 cases of multilevel fusion for degenerative diseases of the lumbar spine. What they discovered was that 35 of the 64 cases showed signs of pedicle screw loosening.( Pedicle screws are screws that hold fusion rods in place against the spine.) This was 54% of the surveyed group having some form of hardware problems after the surgery. Of those 35, 24 required a revision surgery and of the 24, ASD (Adjacent Segment Disease) was found in 16 cases.
What this says more than anything else is that complications can be expected in at least 50% of multilevel lumbar fusion surgeries. As I said earlier, I am not exactly sure what I would have done if someone would have said to me, “about 50% of these kinds of surgeries will result in complications and yours would be one of them two years down the road”.
In the final analysis, I have been banging my head, wondering if I heard the words of risk or even if I would have acted on them given my feelings of desperation. I know for a fact that I was told there would be a risk of complications, but a 50-50 risk?
I believe that in the case of having such extensive surgeries, more information is better than less when it comes to making such a decision. Knowing now what I wish I would have known then, I wonder if—-