Re: Spinal Fusion q's
Hi,
I'm an PA in Ortho surgery. I work Trauma now but used to work spine surgery. Many questions come to mind with this case.
Has he had any relief of his symptoms with epidural injects? Even for a very short period of time following?
Has he had a discogram to try and confirm that the L5-S1 Disc recreates his symptoms?
Has he had EMG and nerve conduction studies to confirm where the nerve issues are coming from? (This can also point to the disc and level).
If yes to all the above...
The disc replacement is new and offers very promising results...but it was only studied with 2 year outcomes. We don't really know how long it lasts. Also, if it does wear out, what do you do next? This question has not been answered in the research.
Also, it is not indicated for sciatic pain, although many surgeons use it for this with good results. It's FDA approived indication is for mechanical low back pain, one level and a virgin back (no previous surgery). But, many spine surgeons in my area have used it for "off-label" uses.
Sounds to me like he is mentally ready for surgery however. Bottom line, knowing what I know and have seen, if it were my back, I would try the disc replacement (if the above questions were all yes).
Nursing News