Dr. Wise,... Got a question please...

[joyneau]

Dr has stated to me that: " It is not necessary to undergo spinal fusion for a disc herniation in most cases."
Because I have nerve impingement on the thecal sac, is this what is warrenting a fusion?> It has been suggested to me by the ortho that fusion would be best due to the fact that other areas of my spine are slightly problematic and he feels that any other procedure would eventually lead to re-herniation of the disc in question[if I were to have any other procedure], because this disc would work overtime trying to take up slack and just re-injure itself.
Fusion is MAJOR. What is your opinion on this reasoning? Does it sound logical?
The microscopic procedures you mentioned to me in my other post seemed reasonable, does fusion with BAK seem reasonable too?
If I am headed to surgery-I want to get it right the first time and not have to repeat down the road!
Thanks so much. God Bless.
Joyce

[Wise Young]

joyneau,

Everything that you post makes sense. If you have an isolated disc herniation and healthy joints elsewhere, a fusion is not necessary. On the other hand, if you have joint degeneration at multiple levels, a fusion may help stave off problems at the fused levels. However, fusion increases the stiffness of the spinal column and distributes movement to the non-fused joints, resulting in increased wear and tear of the remaining joints. If you have had multiple fusions, this may lead to what is called a failed back syndrome.

There is no easy answer to this situation. The goals are to preserve as many joints in your spine for as long as possible, minimizing the risk to your spinal cord or roots, and at the same time relieve your pain. I would suggest that you get a second opinion from another doctor, preferably one at an academic center. Unfortunately, I don't think I know any neurosurgeon or orthopedic surgeon in Carmichael, California.

If you can travel, I would recommend

Volker Sonntag, M.D.
Professor of Neurosurgery,
Vice-Chairman, Division of Neurological Surgery, Chief Spine Section
Division of Neurosurgery
Barrows Neurological Institute
350 West Thomas Road
Phoenix, Arizona USA 85013
office: 602-406-3458
4104; fax: 602-406-3485.

He is a neurosurgeon's neurosurgeon.

Wise.

[joyneau]

Thanks so much! It is graciously appreciated!
You have relieved a lot of anxiety for me!~
I will get another opinion. Perhaps Dr. Schaffer in Carmicheal who is a neurosurgeon would be the first to see. I have heard from nurses he is the best here.
Many blessings.
Joyce