I had a back fusion at l4-s1 now have anterlothesis of l4 on l5, do I need surgery?
I am a 35 yr old female. I had a back fusion at l4-s1 about 4 yrs ago. I have recently been having a lot of pain when I bend forward and try to straighten back up. It feels like it locks on me. So I had an xray done, and it shows that I have anterlothesis of l4 on l5, and it increases with flexion. My pain doctor referred me to a surgeon because he said it should not be moving like that due to it being fused there. Is he right? Is this abnormal movement?
If your surgery was fusion of l4 l5 andl5 s1 as a whole then it should not be moving..
Anterior slippage of the vertebrae can have complications on your lower limbs and even the spinal cord .
The degree of slippage differs in treatment ..
If it is 1st degree then physiotherapy is enough with behaviour modification .
If it is 2nd or 3rd degree then another surgery may be needed ..
First fusion for any number of vertebra can cause the above or below verebra to slide ( spondylolisthesis ) usually anteriorly or develop a disk lesion (as one vertebra doing 5 vertebras work) , i recommend that you do a motion X ray to check if it us really moving with motion or it has moved few milimeters and that is it
If it is moving then immediately do another surgery , if not you have options
Unfortunately in both cases with fusion physical therapy effect can be temporary unless you lose lots of trunk weight, if you won t do physio or lose lots of abdominal weight then do the surgery
By the way spondylolisthesis should not (could not ) happen after a fusion
Something really wrong here
Bone is fixed by metal , how does it slide ?!!
My farther had the same thing and it was a complication in surgery, is this a couinsidence or do you have the same thing?
its a paradox actually.
once the L4-S1 have been fused,then listhesis should not occur actually.
get a neurosurgeon opinion before getting a 2nd surgery done on your spine.
it will lead to lot of complications.
He is totally right,
Such complication rarely happens.. but it happens
Discuss ot with your surgeon , he must have either an explanation or an apology