I had a back fusion at l4-s1 now have anterlothesis of l4 on l5, do I need surgery?

I am a 35 yr old female. I had a back fusion at l4-s1 about 4 yrs ago. I have recently been having a lot of pain when I bend forward and try to straighten back up. It feels like it locks on me. So I had an xray done, and it shows that I have anterlothesis of l4 on l5, and it increases with flexion. My pain doctor referred me to a surgeon because he said it should not be moving like that due to it being fused there. Is he right? Is this abnormal movement?

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Ayman Darrag
6:59 am

If your surgery was fusion of l4 l5 andl5 s1 as a whole then it should not be moving..
Anterior slippage of the vertebrae can have complications on your lower limbs and even the spinal cord .
The degree of slippage differs in treatment ..
If it is 1st degree then physiotherapy is enough with behaviour modification .
If it is 2nd or 3rd degree then another surgery may be needed ..

Ahmed Fawzy
9:59 am

Hi First fusion for any number of vertebra can cause the above or below verebra to slide ( spondylolisthesis ) usually anteriorly or develop a disk lesion (as one vertebra doing 5 vertebras work) , i recommend that you do a motion X ray to check if it us really moving with motion or it has moved few milimeters and that is it If it is moving then immediately do another surgery , if not you have options Unfortunately in both cases with fusion physical therapy effect can be temporary unless you lose lots of trunk weight, if you won… Read more »

Ahmed Fawzy
2:48 pm

By the way spondylolisthesis should not (could not ) happen after a fusion
Something really wrong here
Bone is fixed by metal , how does it slide ?!!

Luke Hale
Luke Hale
4:55 am

My farther had the same thing and it was a complication in surgery, is this a couinsidence or do you have the same thing?

7:33 am

its a paradox actually.
once the L4-S1 have been fused,then listhesis should not occur actually.
get a neurosurgeon opinion before getting a 2nd surgery done on your spine.
it will lead to lot of complications.

Masr Fawzy
1:29 pm

He is totally right,
Such complication rarely happens.. but it happens

Discuss ot with your surgeon , he must have either an explanation or an apology