What is the prognosis of a fusion of L4.L5.


Q: After having two laminectomy of l4,l5 .I am having another hernia at the same level. The neuro surgeon suggested for a fusion now. I am 65 years old and heatlhy.I experience pain in right buttock thigh and calf.Sitting is the most painful position. The chiro is telling me I have piriformis syndrome and trying with deep massage to resolve it. Not much result yet . The fusion is scary to me . What is the prognosis ? The two neuro surgeons said 5 month to one year of recovery. What is the chance to regain all my mobility and activities.Should i wait until I am not functioning to go for the surgery? Pleas help me . I don't know what to do and I am tired to be in pain all the time. I had the first laminectomie 6 months ago.

Symptoms:  Lower back pain radiating to right thigh,calf.difficulty to sit, riding in a car , walking long distance .

A:   Hello,
Thanks for the query to ATD for an opinion regarding your concerns here,
The typical lower back pain radiating to right thigh with difficulty in sitting and walking for long distances does indicate a spinal nerve compression at the level of L4-L5 lumbar vertebrae either following a disc prolapse or a wedging of vertebrae. If after having under gone two laminectomy procedures earlier and last being 6 months ago, the symptoms have not relieved then it is likely that the disc prolapse has occurred again due to para-spinal ligamental laxity. The best mode of treatment for the same would definitely be fusion of both L4-L5 vertebra with a metallic plate which shall ensure that the inter-vertebral space is maintained and compression of spinal nerve is abated. The procedure has a good success rate and with followed up physiotherapy sessions, patients have been completely treated of their symptoms in next 4-6 months.
Considering that you ave no other co-morbidities for your age, it is the option for your back pain. I hope i have answered your query in detail,
Wishing you good health,

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