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hello
this is an update to my old thread
http://www.healthboards.com/boards/back-problems/1018278-grade-1-spondylolisthesis-l4-l5-doctor-suggests-2-level-fusion.html

I have new XRays done on 12/27/16 and here are the reports:

XR Lumber Spine flexion/extension 2/3 views:
FINDINGS:
The vertebral body heights are maintained. Anterolisthesis of L4
on L5 approximately 10 mm in flexion and 8 mm in extension. Grade
1 anterolisthesis of L3 on L4 approximately 1.5 mm in flexion,
reducing on extension. Disc space narrowing at L4-L5 and L5-S1.
Minor marginal osteophytosis. Facet arthropathy lower lumbar
spine.

IMPRESSION:
- Anterolisthesis of L4 on L5 approximately 10 mm in flexion and 8
mm in extension.
- Grade 1 anterolisthesis of L3 on L4 of approximately 1.5 mm in
flexion, reducing completely on extension.

XR Spine Scoliosis standing 1 view:
FINDINGS: 11 paired rib bearing thoracic vertebra. While there
are 6 nonrib-bearing lumbar type vertebra, to maintain
consistency the last lumbar type vertebra, a transitional
vertebra, will be labeled L5. Partial pseudoarticulation of the
expanded right transverse process of L5 with the sacrum. No
significant scoliosis. The right iliac crest is approximately 6
mm higher than the left. No appreciable congenital vertebral
anomaly.

IMPRESSION:
Transitional lumbosacral vertebra. Nomenclature as mentioned
above. No scoliosis. The right iliac crest is approximately 6 mm than the left.

My current status:
- pain level increased, sciatica mainly on left leg
- pin/needles on legs and feet
- bladder acting up - have issue emptying it, not all the time though

concerns:
- new DS Spondy on L3/4, do I need to fuse that level too since it's unstable too?


surgical options:
- Dr. has 20+ years of spine surgeries
- minimum invasive approach-less blood loss and smaller incision
- single level TLIF on L4/L5
- very high score on spine surgery
Cons:
- long wait for follow up appt-7/25/17
- long wait for surgery date - mostly likely october
- not my provider so need to get preauthorization on everything

Pros:
- surgery available in mid June
- single level PLF on L4/L5
Cons:
- very young and new, his fellow-trained in Harvard was completed in 2013
- open approach
- hospital has very low score on spine surgery

Since my last thread in March 2016, I am trying to avoid surgery but I come to the decision that I need fusion to stabilize my spine or it will get worse.

I would greatly appreciate any feedback/advices.
thansk,
gabriela
Hello Teteri66,
thanks for your advices.
questions on the Dec 2016 flexion/extension XRays:
1) Anterolisthesis of L4 on L5 approximately 10 mm in flexion and 8 mm in extension
- I think my previous xray was 7mm in flexion. Your comment of "Your spondylolisthesis is pretty minimal and your symptoms aren't all that debilitating." So 10mm in flexion/8mm in extension are considered minimal? I read other sources saying 10mm is a big slip that requires immediate fusion surgery.

2)Grade 1 anterolisthesis of L3 on L4 approximately 1.5 mm in flexion, reducing on extension.
- would this eventually be like L4/5?

3)Disc space narrowing at L4-L5 and L5-S1
- so should I replace the disc at L4/5 as in TLIF?
please advise.

I am not in constant debilitating pain, they come and go. Certain activities(walking/sitting/standing) will aggravate the pains and numbness. Certain movements also cause shooting pain from back to foot(sitting up from bed, getting up from chair, and changing positions). But once I rest in bed for a few hours, the pain subside and I feel better.

But knowing I need fusion sooner or later, I am more incline to go with Dr. Ravi on an open Posterolateral lumbar fusion on L4/5 and decompression. My son's graduation is a month away and I hope I can attend the ceremony before the surgery.

thanks again for all your advices.
gabriela





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