How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask 911Doctor Your Own Question

911Doctor
911Doctor, Doctor
Category: Health
Satisfied Customers: 5084
Experience:  Board Certified Emergency Physician
Type Your Health Question Here...
911Doctor is online now
A new question is answered every 9 seconds

We have a family member mid 30s that has S-1 to L-5 degenerative

Resolved Question:

We have a family member mid 30s that has S-1 to L-5 degenerative spondylolisthesis, the L-5 has slipped forward 25-30%. That will require surgery because the disk is flattened and has moved forward. It seems the disk between L-5 to L-4 has turn dark gray as well, and there is a small bulge.

Should I do spinal fusion for the L-5 to L-4? Why or why not. Will doing spinal fusion for the L-5 to L-4, impact the L-4 to L-3 disc due to the L-5 to L-4 disc being so restrictive and not providing any movement due to the fusion. Or will not doing the surgery on the L-5 to L-4 PROTECT my L4 to L-3 disc down the road?
Submitted: 11 months ago.
Category: Health
Expert:  911Doctor replied 11 months ago.

911Doctor :

I assume you have already consulted with a spine surgeon. Is this true?

911Doctor :

I have had an L4L5 fusion myself

911Doctor :

and the general rule is do as few levels as possible

911Doctor :

for

911Doctor :

as you state

911Doctor :

there is a rigidity that comes with every level fused

911Doctor :

and the more levels that are fused the more likely you are to herniate another disc above or below the fusion

911Doctor :

standing by

Customer:

Hello

911Doctor :

how are you?

Customer:

I have already consulted with a spine surgeon.

Customer:

Oh excellent, great to hear from somone with first hand experience.

911Doctor :

does the surgeon want to do two levels? I would be surprised if he did.

Customer:

I have a Dr. Odor from the Spine hospital wants to do both, and says the L-5 to L-4 is needed in order to preserve the L-4 to L-3. Dr. Parkison echoes the same opinion. Dr. Hume from a Southwest Orthopedics, favors only doing the S-1 to L-5, then lose more weight about 40 lbs and strenghten core. He says by not fusing the L-5 to L-4 I will preserve at least some minimal cushing to lengthen the preservation of the vertebrae above it.

911Doctor :

i see

911Doctor :

what do you want to do

911Doctor :

experts often disagree

911Doctor :

and i can see the point from all of your surgeons

911Doctor :

If it were me, I think I would opt for less at this point

Customer:

SO simply put if I do both the bottom fusion the the next on above it will I preserve the third one, or would it be best to only fuse the bottom one, leave the second one alone (its gray) AND THAT will preserve the third one .... It'll all about preserving the third one from the bottom.

Customer:

Okay.

911Doctor :

stand by one second

Customer:

Sure.

Customer:

Take your time.

911Doctor :

I understand

911Doctor :

The thing to remember is that once you get a fusion, if you remain active, you will likely need another at some point in the future

911Doctor :

so it is often the case that the more conservative approach is the best one

911Doctor :

in that technology and technique for spine surgery improves every year

911Doctor :

so in a sense, less is more

911Doctor :

especially at age 35

911Doctor :

I had mine at the same age for the same reasons, but one level higher

911Doctor :

and I have continued to ski and bike, but I am not allowed to run

911Doctor :

no matter what procedure you choose

911Doctor :

you SHOULD follow your restrictions

911Doctor :

standing by

911Doctor :

also,

911Doctor :

I am not in line for any surgery anytime soon and have done quite well

911Doctor :

standing by

Customer:

How old are you now?

Customer:

And how has your back held up?

911Doctor :

48

911Doctor :

I had one herniated disc at age 40 and got a microdiscetomy... was in at 8am and walked out at 11 and have had no more problems.

Customer:

How much did your pain decrease ... I do understand that I may be different.

911Doctor :

before my fusion I couldn't walk or stand more than five minutes without having to crouch to relieve pain.

911Doctor :

I was better than that 3 days after surgery

911Doctor :

the recovery is tedious

911Doctor :

but I have not had appreciable back pain since, with the exception of the one herniated disc

Customer:

How are your discs below and above your fusion?

911Doctor :

I herniated the one below

911Doctor :

but other than that they are fine... a little loss of disc height which was there previously

Customer:

Was the due in part to the spinal fusion?

911Doctor :

yes, a fusion at one level stresses the level above and below

911Doctor :

a multi level fusion

911Doctor :

stresses the levels above and below to a greater degree

911Doctor :

standing by

Customer:

How long after your spinal fusion did you herniate your disc, and did it just come out of the blue, or were you engaging in physical activities of some sort? In essence did you push it too much?

911Doctor :

four years after... it was during a long bike ride, knew it immediately

Customer:

I see .. this has been very educaitonal, I'll be sharing our chat with the Mrs., thank you very much. I have surgery tomorrow, and have to decide before I walk in.

911Doctor :

wow, does your decision also decide which surgeon is going to do it?

Customer:

I've decided on Dr. Hume, he had the most conservative ... he just answered all of my questions and took the time to answer them. The other doctors didn't make me feel that way, and seem or at least gave an impression to me that this was just a job for them. So I went with the doctor that would answer all of my crazy questions, and digging.

911Doctor :

that's a good choice

911Doctor :

personally, i like the one level and weight loss, core strengthening....

911Doctor :

either way

911Doctor :

I wish you the best result possible

Customer:

yes me too, I just wanted a reassurance

Customer:

thanks

911Doctor :

Thank you so much for your question. It was a pleasure talking with you. Should you need my assistance in the future simply start your question with ‘for 911doc only’.


Positive feedback is always appreciated.


Be Well


911Doc

911Doctor, Doctor
Category: Health
Satisfied Customers: 5084
Experience: Board Certified Emergency Physician
911Doctor and 4 other Health Specialists are ready to help you
Expert:  911Doctor replied 11 months ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery
 
 
 

Related Health Questions