Lumbar Fusion - One Level

[81150 CAFB]

I just want to see if I understand the regs properly - please correct me if I am reading it wrong. I had a diskectomy just over three months ago and never got better. Recent post-op Myleogram showed same disk reruptured again on both sides so I had a fusion at the L4-L5 level. If I am reading the regs correctly... the compensation is still based on range of motion (pain of motion) and not ankylosis since the entire lumbar section is not fused. Is this correct? Doesn't the fusion automatically limit ROM (two weeks post-op- definately does)? Any back fusion people on the site- how are you doing long- term?

Thanks for any replies.

81150 CAFB

[vmo]

A high dose of Ibuprophen can hurt more than narcotics. Except for being high and getting addicted naroctics won't kill you, but the Ibuprophen use over long period can burn holes in your guts.

You are correct about the high dose ibuprofen. Unfortunately, most meds do have some type side effect. My physician monitors the dosage. Also, I have had periodic endoscopy's to prevent complications. In addition, the ibuprofen can decrease inflammation---narcotic treats just the pain. Yes, there have been bad pain times where I have requested and been provided the narcotics. Most narcotics prevent or caution you about driving, but not high dose ibuprofen. I used the narcotics pre and post surgery on a limited basis. Ibuprofen is not recommended post surgery until well after the fusion was completed. I think maybe it was one year post surgery before I started on it. So far, so good!

[81150 CAFB]

"I think I got it...use code for arthritis with spinal fusion code and all based on pain of motion."

Correct?

Nothing automatic for fusion...same as disketomy regarding range of motion. Isn't range of motion limited auromaticallt even with the one level fusion?

81150

[blackbird]

I too had disectomy and laminectomy at L4-L5 in 1996 since pain did not deminish, a fusion was done in 1998. It took about 12 to 18 months to get over the surgery part, which the surgeon had told me to expect. There is a big difference in recovery from a lumbar fusion than a discectomy. The therapy helped a lot. Also twisting should definitly be avoided from now on.

As far the rating, it will be on range of motion, but a fusion will limit your ROM more than a discectomy will. I've had two additional back surgeries (disectomy)on L2-L3 since 1998 fusion and 5 cervical surgeries to fuse 6 levels. The cervical fusions really limit ROM, but they each helped with the pain. The post pain is nothing compared to the presurgical pain.

Edited December 31, 2009 by blackbird

[jbasser]

81150, look at the 4.71 for the range of motion chart for the Back. I posted a link if you need it. It will tell you what the ranges are at normal.

http://ecfr.gpoaccess.gov/cgi/t/text/text-...idno=38;cc=ecfr

J

Edited December 29, 2009 by jbasser

[john999]

Is a lower back fusion as painful as I think it is? My orthopod suggested that if my back was really drving me up the wall that a fusion would be the only thing that would work. I am on plenty of pain meds now and I don't like it, but the thought of 18 month recovery after surgery makes me equally unhappy. I am so screwed up I should spend the rest of my life in PT. I am 60 and have the mobility of an 80 year old. I can walk but that is with pain and I can't walk 6 blocks two days in a row due to need for recovery.

[vmo]

Lower back fusion is painful. I had L5-S1 fusion in Feb.,2004. I used narcotics for about 3-weeks after the fusion. Never had physical therapy post surgery. Surgeon told me to walk as much as I could tolerate. I started walking in a swimming pool in addition to outside. Back is not perfect. However, I am much better off. I was a total invalid before the surgery. Pretty much a cripple. The fusion gave me my life back. Unfortunately, I am developing the same problems in the cervical area. I too, am 60 yrs old. The surgery was a "no alternative" for me as I started losing control of my left foot and quite a lot of sciatic numbness, burning, and pain.