My Story: If I knew then what I know now, would I……

My Story: If I knew then what I know now, would I……

Kerry Smith

Kerry Smith

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—-

Authored by: Kerry Smith

There are 7 comments for this article
  1. Phil Mandel at 9:19 am

    It’s too bad that this article cannot[?] be distributed in the mass media. I firmly believe that people considering lumbar spinal fusion would think twice before having it.

    I have had 6 spinal surgeries since 1985, 3 cervical with fusion and 3 lumbar with the last one being a FBS or Failed Back Surgery which left me with drop foot and nerve damage in the right dorsal area. Five of the surgeries were done by a world class surgeon which left me with amazing neck rotation capability and periods of NO pain which allowed my wife and I to travel. However, the last surgeon, my other surgeon has retired, lied to me about my problem and the outcome as other doctors viewed my post-surgical MRI and denied the statement of the operating surgeon.

    A fusion for my back is out of the question as I have severe spinal stenosis and arthritis of the spine but I would not have done it if I could. The tales of people who have had it are not good to say the least. Hopefully, you, and others like you can find some relief from your pain to be able to live the best quality of life given the issues you face. Aquatherapy and meditation have helped me deal with my lingering pain so you may want to give them a try.

  2. Shawn at 8:41 am

    I took a look at my pre surgery papers and the only thing I see it says options, Surgery, other options, No Surgery that’s all I got

  3. Elly at 6:24 am

    I have no discs in L3, L4 and L5 (Spondylosis)and was told during my first or second trip to my spinal specialist that the adjacent discs would be effected over time after surgery. He didn’t ever say they wouldn’t be, just to what extent they would be effected.

    I’m only 31 and therefore prolonging surgery is by far the best choice using any method necessary. It’s really a determination of the lesser of two evils and to be honest, no one can tell me what would happen with OR without the surgery so I guess, at the time, you do whatever you think is the right choice and later down the track there’s no point really wondering if it was the right one since there’s no way of telling if it would’ve been the better alternative.

    Thank you for your post though, it’s almost exactly what I’ll probably be going through and it’s nice (though unfortunate) to know of people in the same boat. I wish you all the best!

  4. Angie at 4:31 am

    Thank you for your story and research Kerry Smith.
    I understand and can relate to your story and those of other comments.
    I feel that being informed with results from surveys etc, I then understand better why I have pain still after back surgery/fusions 20/30 years later.
    Regard Angie

  5. D R Lepsig at 7:54 pm

    I’ve been through 8 back surgeries. First two were on c3 and c5 and they went very well. The pain in my arms was gone strength in the arms back. My life improved a great deal. I was born with a Spondolosis Spondylolisys ? Of the L4L5 area. I had a fusion by a neurosurgeon in 2007 that left me with left leg weakness where I would fall while walking. Involuntary nerve reaction to the fusion. After several falls I was required to use a walker for 1 year and the had 5 additional surgeries to correct (loose term) the fusion. I now have left leg pain that never gets better than a 5 and is often a 10+ level of pain. I walk with a cane to prevent falling and have spasms at night when I do too much activity. I would only go to a doctor that has had over 1000 surgies of the type my back required. Make sure the doctor has experience with your type of surgery but understand that all backs a radically different and no surgery is going to fix the problem. It will create its own set of new issues and hopefully you can live with the results.

  6. lorraine at 10:55 am

    Yes I understand your concern and also wasn’t informed further surgery would be needed after my first lumber fusionssurgery. L5-6 L4-3 L2-3 & S1 all done. Now I understand that after all these fusions the SI joints tend to have have problems from the fusions andbelieve you do thepain is excruciating and travels through the hios and down the outside of the leg, cant telk which is worse the arthritis that has filled the spinal canal or the SI joints.

  7. Marian Medvec at 9:10 am

    I have had three back surgeries. Two of those, the first and third, were by one doctor, and the second was by another. The two done first and third were not fusions. The doctor simply (or not so simply) went in and cleaned up the problem. In the first case it was a monumental herniated disc, the disc material sort of exploded onto the nerve roots and I was left to agony on the floor, I could not walk, sit, anything. He cleaned up the disc material and that is all he did for the fix. It worked very well, I was amazed that I could walk again.

    The second doctor, who did a fusion, performed a surgery that was largely unsuccessful. He was apparently not listening to me when I told him my symptoms, he just did the fusion, and my groin pain became so bad after the surgery that I could hardly get up out of chairs and stand. He denied that the groin pain had anything to do with the back.

    So finally, three years later, full of pain, I again go back to my first surgeon. He removed some bone spurs at L1 that were pressing on the cord, he did two laminectomies, and that was it. No fusion. This surgery was 100 percent successful. All of the areas that had been painful were repaired.

    My point is that back surgery can be successfully done without fusion. Backs do not usually get better, they only get worse, but the fusion creates a non-movable area in the spine and the spine is not meant to work that way. Once this non-movable part is created, it is more likely for problems to occur around the fusion.