Being Smart About the Next Spinal Fusion

I’ve already told you I have adjacent segment disease. All of us with fusions will likely end up with this at some point. Especially if you’re young when you have your first fusion.

This means eventually I’ll need another fusion of the part that’s disintegrating. For me, so far, it’s my SI joints. I’m already am getting injections, but I try to not get them too often. It’s a short-term fix.

Next, at some point, the area above the fusion will need fusing too, but so far, it’s not hurting as bad at the SI joints.

So, here’s the question: When is the right time for a second fusion? For me, I’m staying active and being reasonable. I run 10ks and have “retired” from longer runs such as half marathons. I work hard to maintain a healthy, low weight and keep my core muscles strong (I know, I know…I owe you a point on those awesome core exercises I’m always talking about).

But all this doesn’t change the fact that something is structurally wrong and will require surgical intervention.

I’ve decided for now to put it off for as long as possible. For me, that’s when I start losing the ability to walk on a “normal” day. (I have trouble walking after running 13 miles or a particularly hard day of hiking right now. But I can account for that.)

I think it’s important to balance an invasive, intense procedure like a fusion with your life choices.

Your next fusion should come when you can no longer stay as active as you need to maintain your first fusion.

Here’s hoping I have a few more years. (In 2 years, I’ll be at my 10 year anniversary. )

Tarah Neujahr Bryan

I'm from Montana and despite living in six different states, Montana is still my heart's home. I have passion for many things in life, including my beautiful daughter and son, my amazing husband, Nebraska Football, playing softball, hiking, healthcare policy, aviation, running, yoga, reading, outdoor life, animals, hiking, sports, and so much more. It's always growing and changing. I have a BA in History, with a minor in Sociology from Montana State- Billings and an MA in Journalism and Mass Communications (specialization in Marketing, Communications, and Advertising) from the University of Nebraska.

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View Comments

fearfullyandwonderfullymade says:

February 26, 2018 at 9:45 am

I have only one level that is buggered - L5-S1. Otherwise, my spine is in great shape. No spondy. I had a discectomy and partial laminectomy done December 2014, but it didn't give me long-term relief. The severe nerve pain was greatly diminished, thank God for that! The nerve pain I deal with now is...liveable. I think if that's all I was dealing with I could manage without medication. But I have significant pain because there's no cushion left between vertebrae there. I've been offered a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) to give me some space and keep the vertebrae from rubbing on each other; stability. I'm 48, so young enough to need further surgical interventions on my spine down the road if I go through with this, but also too young to give up on a life outside of my bed! Much to weigh. It seems to me, from what I'm finding on the www, that those who commit to making their surgery as successful as possible with proper exercise and weight management fare better. To Kim: have you consulted with surgeons on the matter? Perhaps there is a minimally invasive option for you to pursue?
Kim Laughon says:

August 22, 2015 at 12:05 pm

Hi - Thanks for your blog I am considering fusion for the first time and used to be very active including Ashtanga yoga, running, weight lifting, etc. I was looking forward to your promised 3rd post regarding back-bends etc.. does the fact that you have not posted mean not possible ???? Just curious .... Also, how is the yoga routine holding up currently???

My questions are because I have a lot of nerve pain currently due to degeneration in my back, but I'm trying to balance that with the real possibility that things might be worse if I have surgery .. trying to make as informed a decision as possible ..

any thoughts would be appreciated
- Tarah Neujahr Bryan says:
  
  August 22, 2015 at 12:35 pm
  
  Hi Kim:
  No. It's possible. It just means I'm lazy. :) It's coming. Now that you've mentioned it, I'll make it a priority.
  
  To be honest, I don't recommend a fusion for nerve pain. A laminectomy would probably be a better bet. I had one of those too; it's where they open the space around the nerve to relieve pressure. Of course, take whatever I say with a grain of salt since I'm not a doctor. But I highly recommend getting 2nd and 3rd opinions. Once you have a fusion, your life changes forever, there WILL be ramifications, and you can never go back. I had my fusion because the spinal processes were broken and the spine was slipping off itself. I was slowly going paralyzed. I would never have had it if I had a choice. I've seen it fail too many times when I worked in the ER (people said their pain only got worse).
  
  In fact, I believe the latest medical literature recommends against a fusion for nerve pain. I'll research that for you and post on it soon.
  
  I hope you get help and relief. I'm so, so sorry that you're suffering and going through this. But you're very strong. You can do it.