Thought I'd just start another thread........
We have two kinds fusion with our family diseases. Autoinfusion and Surgical.
Autoinfusion can be caused either by disease "Ankylosing Spondylitis" or by reaction to constant inflammation. We spend thousands of dollars and hundreds of hours to avoid this fusion, Once it happens you either commit yourself to a long daily routine of stretching, exercise, and other painful and inconvenient stuff or your muscles will slowly atrophy causing lots of pain because of instability that leads to nerve pressure, add to that the fact the disease and aging don't stop so you develop stenosis causing more pain, but of course you are fused so there is very little that can be done to reverse it. short of literally removing parts of your spine and replacing it with live bone grafts which of course have to extend above and beyond the original fusion make more fusion and starting the whole process over.
Fortunately those days are pretty much over. The old bamboo spine and camels hump is pretty much a thing of the past. We have learned how to control inflammation well enough to slow or stop auto infusion and Biological drugs have done much the same for Ankylosing Spondylitis.
There was a time not so long ago that spinal surgery was a huge deal. It was hours long and you frankly felt lucky sometimes to get your patient off the table alive. That all change with the "scope" Laminectomys became routine day surgery, all of this based of course on faulty science that back pain was caused by bulging and even herniated discs (its pretty clear NOW this is rarley the case in fact we knew that was the case when we quit using traction) Spinal Surgeons popped up all over and they opened their own surgicenters. These guys started becoming millionaires. Then it really went ballistic when they could start using a lazer instead of a knife.
Well guess what happened? They started making unstable spines causing huge propblems. But these guys had huge bills to pay motgages , equipment etc so laminectomys were replace by laminotomy and discectomy (even faster) where they only took a piece of the disc out leaving the spine stable. Of course the area is flooded with local anesthetic and steroids to prevent swelling (and damage) and Voila the pain is gone - for a while. Now I'm not saying all back surgery of this type is bad just most of it and probably not the vast majority of it not refereed by a neurologist (not neuro surgeon) and actual demonstrable nerve damage)
But one lie (bulging discs) has been replaced with another. We can fix your back pain "stabilizing your spine" better known as the elective fusion. SI's are the most common and th recently the cervical spine through Arthrodesis is popular. They claim there is little loss of flexibility because its only two connected. Yes occasionaly there is a need for this surgery. BUT there is there is NO DOUBT and a positive mylogram..... Remember what I was was saying about auto-fusion? It applies here. You are guaranteeing pain and stiffness which can be HELPED by extensive exercise and PT. there is another lie. PT shouldn't hurt. This apparently the same lie we used to tell our children about going to the doctor to get them there. If you have ever played a sport seriously there is pain.
I had some scaffolding collapse a number of years ago and crushed two vertebrae. In order to prevent permanent paralysis I was fitted with a brace. The swelling eventually went down and I got function of my legs back and was able to leave the hospital while the bones mended. Eventually after six months I was able to give up the brace. Thats when the pain REALLY started. THose six months in the brace destroyed any muscle tone I had. Now I should have known what was going on but I just took muscle relaxants and pain pills LOTS of both. My life was living hell. Finally I ended up at a spinal rehab center. My lead lead therapist almost wet her pants laughing when I told her PT wasn't supposed to hurt. But you know it took TWO YEARS of 2 hours a day PT to get things back to normal (which BTW wasn't great Ialready had the AS diagnoses. The pain from therapy receeded pretty quickly. But I Still cringe when I see those big blue therapy balls or milk jugs next to a pool. ALL of that pain came from "fusion"
One of the problems we have as PsA/AS patients is a quick fix whether it be surgery, pill or magic potion. If it isn't quick enough we are content to sit on our butt waiting for a quick fix loudly proclaiming we would do more to help ourselves except...... We of course also are content to wait for our docs to come up with a fix living in denial we have a problem.....When we wake up we REALLY have a problem.
The other problem is we are willing to do what it takes so willing we can be sold just about any solution. Its estimated by some that as many as 80% of out patient spinal surgeries (averaging 30-80 grand and more) are unecessary.
My question is if we work so hard to avoid fusion from disease because it cripples us and causes new and permanent pain, why in the sam hell would we pay some millionaire 30 grand to do it for us??
