Hi Folks--Like many of you, I am considering nucleoplasty even though the track record, based on people here, is spotty at best. I have seen a neurosurgeon who does nucleo, PED, and open surgery, so he's familiar with the variety of options. He thinks it may be worth trying nucleo, even though open surgery may what I'll finally need. He gives nucleo about a 50-50 chance of being useful in my particular case.

Beyond that, I'm struck by how different his aftercare descriptions are. Rather than the two weeks of bracing, etc., he talks about "taking it easy" for a few weeks, but does not require a brace of much else that is very specific beyond listening to one's own body. That's certainly very unlike some of what people here have described.

Following MPT, I'll probably call the company and see what their general recommendations are. But I toss this out for your thoughts.

Ken Hoff specifically--I hope you're doing somewhat better. I know you've had the "full monty" in terms of aftercare.

Best to all,

Standingman

Hi Standingman!

I will be posting sometime tomorrow evening...but, I'm finally approved! Only by my not taking the hospital lady's word for it that my insurance flat out refuses the Nucleoplasty. Not true. Anyway....

What you say about aftercare is interesting. The Surgical Coord who I spoke w/ today said that she may be calling me back to schedule a fitting for a back brace and Physical Therapy PRIOR to surgery. I'm already doing PT at my request for core strengthening....but, apparently ~ this is new to their protocol...including Physical Therapy. I think it SHOULD be required as much as anyone can do it to help their outcome.

The back brace? She said that - up until now....it wasn't required for the Nucleoplasty - but was mandatory for Kyphoplasty (I think that's what she said). She said that she's heard "rumblings" that the back brace Will Be Mandatory for Nucleoplasty - so will get back to me. Well....let me say that, if there is even a Question as to it being necessary....I am going to request my doctor to order it.

That said.... I think that the Nucleoplasty may be still 'new' in the bigger scheme of back surgeries...and so is in the infantile stage...or learning curve. Personally, I would rather err on the conservative side.

How much disc heighth have you lost, do you know?

Happy Thanksgiving! Will check in tomorrow! :)

Karen

Karen--A quick word; I think I'm losing disk height even as I type! :)

I don't know the specific number for me re: disk height, but two "nucleoplasters" both thought I was a candidate in that regard. For me, the ambiguity comes in the fact that my compression is also partly related to hypertrophied facet joints--e.g., arthritic changes. So it's not clear whether shrinking the disk will do enough to open things up. That's why laminectomy also being seriously considered--where both bone and, often, part of disk gets removed. Of course, much more invasive and all that goes with that.

I entirely agree with what you say re: learning curve. Probably IDET went through a similar process, and we could probably learn if we knew that history. As much as I personally would rather avoid corsets (see Tennisnut's posts on this), it's probably the way to go, if you get nuked. What you say about doing whatever possible to strengthen core before (and,eventually, after) makes
complete sense. That's the name of the game, in many ways.

Look forward to your next report.


Standingman

Hi Vib Man--I agree about surgery, of course. I do get upper leg pain at times that corresponds with my upper lumbar main problem--it's more groin/hip/quad pain than calf/foot stuff. Left low back pain from sitting, however, is the big problem, and that has severely limited my life. It's actually not the pain itself, but "biting the bullet" leading to more significant set backs and recurring nerve injury. I _did_ have nerve damage when my injury first occurred (upper leg weakness) and while it got better, it never entirely recovered (surgeon thinks it probably is too late to get that back, even with surgery). A clear indication for surgery for me will be if things appear to get worse in that regard (weakness). Most likely, the surgery would be a laminectomy. It's a gamble whatever one does, but this surgeon remains on the side of not doing anything unless things do get worse. At the same time, he'd be "willing" given how significantly "staying in the box" has limited my life.

The real question is: At this point, what path is most likely to widen the boundaries of that box and/or prevent it from becoming narrower still? Not simple!

Standingman