Hello everyone. I am trying to find out some information for me fiancé. It’s a long story of what he’s been through – here are some details:

-27 year old male
-Degenerative Disk Disease
-Isthmic Spondylolisthesis at L5-S1, Grade I
-Bilateral pars defect (fracture) at L5-S1
-Enlarged, arthritic facet joints
-Disk tears at L3, L4 and L5
-May 2002 – cortisone shot, pain still present
-July 2002 – spinal epidural shot – made pain much worse.
-December 2002 – PT for about 2 weeks, he started having worse pain, and numbness in right leg. He has had constant pain in both his feet.
-A surgeon recommended 360-degree fusion at L5 S1 using cages, screws and rods or Anterior fusion only using cages. The surgeon elected not to do the surgery and referred my fiancé to another surgeon.
- He went to the other surgeon and the doctor spent 3 hours with him, evaluating him and looking over his films and test results. After all the discussion, the surgeon said it would require him to have a 3 level fusion for his back to be fixed. The surgeon said the success rate is very poor for 3 level fusions, and that his life “would be ruined”. The surgeon said that he wouldn't recommend surgery because of the low success rate and wasn't convinced it would eliminate his back pain. The surgeon said that when people do not respond well to steroid epidural shots, usually the pain isn’t eliminated if fusions are done. He recommended conservative treatment. He also said to my fiancée that he was “seriously disabled”.

He currently uses a heating pad about once a day. Occasionally, he will use an ice pack. We are apprehensive about starting PT again because of the increased pain it caused him before, now responsible for his present-state of misery (which was NOT the case before doing PT). Anti-Inflamatories (Celebrex and Bextra) don’t work with him – because of allergic reactions (swollen hands/feet, stomach issues). He isn't taking any pain medication at this time.

He’s been in very bad pain for the past 14 months, and I’m trying to do as much research as possible. I'm looking for any general advice on what he can do.

Thank you for listening.

I think I'd get a 3rd opinion, with a neuro surgeon.

I have DDD, and lived in pain for about 15 years. I waited way tooooo long to do what needed to be done. I had a L5-S1 fusion 2 months ago and am going great. My particular surgeon said he did not want to fuse L4 and L3 as generally when they fuse the lower level, it helps statilize the upper ones. It does put more stress on them, but hopefully won't have to worry about that for some time.

I did NOT respond to epidural shots (cortizone)!! I feel so much better after my surger I can't believe it. I can now sit down for longer than 15 minutes, stand up for longer, everything is much better. The only residual affects I have, (and everyone is different please remember) is the bottom of my left foot has pins and needles 24x7, and if I move wrong I can feel pain in L5.

What kind of tests had he had? Has he had a discogram? The usually tells a surgeon exactly what is bad. This last doctor sounds a bit off.

I'd get another neuro surgeon's opinion. When you are dealing with something like this you want to be extremely careful and know exactly what is what.

Hope he feels better.

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47 Years Old - Female
15 Years of Pain (I waited too long!)
L5-S1 fusion 3/27/03
L4 Disk - torn, ruptured
L3 Disk - torn, ruptured

Thank you, Theresagreen, for responding. This board is so great. I've learned so much from reading everyone's posts. I hope that everyone has pain free days ahead for them.

He has had a discogram, which indicated his problems with his other disks. He's been to 4 ortho surgeons and 1 neuro surgeon. We are going to continue to look for other doctors. It's difficult because we have gone to almost all the "best" doctors in a 60 mile radius.

Again, thank you for your encouraging response. Have a good day.

Dear Backsupport:
I am 5 weeks post-op from a 3 level fusion of L3/4thru S1. I was told that I had to have a 3 level because of the fact that L3/4 was not good in addition to the rest being "gone". I am 45 yr female, was very athletic before injury. My doctor also told me that the sucess rate goes down with more than 1 level, but being that I don't smoke, very healthy, and in good shape, not overweight, my chances at success were good. I had tried everything, was in agony for 15 months, to the point where I was in bed (couldn't walk pretty much) I decided after much denial that I didn't want to live in the pain that I was in, so I made the decision to have it done. I am a success. I don't have any of the prior pain, just bone healing. I had to have cadevar bone (too many levels to take hip bone) and the BMP. Rods, screws and much pain, but now I can say it was worth it. Please get another opinion. There are doctors out there who know what they are doing and are good at it. Good Luck
Elise

I would also urge further opinions. Anything mentioned on ADR(disc replacement for future) How about a spinal stimulator for pain?

Is he working all day? How much is his life restricted?

I know that 3 level fusions are rare and although there are some success stories most of the prominent surgeons would highly recommend against it b/c of its failure rate and the long term effects. That was my only route also besides pain meds, stimulator or waiting for disc replacement. I am going for a stimulator for now and going to see if I can hold off for disc replacement. Right now, it doesn't sound like your fiance would be a candidate in US for disc replacement but may be in a year or two. Overseas is always an option.

The biggest question one should have is how it is affecting one's life. Then go from there. I have struggled with back pain for years and finally can't any longer. But up until last year wouldn't even consider back surgery.

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Auto Accident Aug 1988
L3-4 disectomy 1989
L3-4 now re-herniated
L4-5 DDD
L5-S1 herniated
5/14--trial stimulator implant(went well enough for full implant)
6/11/03--scheduled for full implant(medtronic)
Hopefully to hold on for ADR

Hi Backsupport: The others have given you great advice. I quickly (I'm used up for today) would like to add that your spouse may try looking into pain management for now, as well. This type of severe pain (I have 3 torn disks in lumbar spine, when upright, whole spine crushes down, creating servere burning nerve pain; neck is multi-level disk diseased, and T5-6 is messed up and who knows what else) needs proper pain management. Severe pain is hard on the body, causes higher blood pressure, let alone the mental torture plus lack of sleep. Have him go to his family doctor. Actually an internist handles ongoing adult problems and is most appropriate. (should he need to find a doctor.) (Our 27 year old son has disk disease as well, plus born without L2 pedicle {one side of one of his lumbar vertebre]) Then ask request a referral to a pain management. I'd suggest him getting on opiate medication, if he can tolerate them and if he is willing to take these meds. If all it takes is one little pill to take care of this type of pain, and of course, if managed properly without abuse (they are addictive--don't let anyone say that they are not), to give someone comfort, then I say take the pill. I take them. Spinal nerve pain is absolute agony; it is a pain that no one should be forced to live with. If he cannot take opiates for some reason, then he'd have to go to the drug class of demoral, darvon, etc., which too are addictive. I hope a doctor would be willing to prescribe these drugs, should your spouse decide on them. The only problem I could see is that he is rather young. I am 54; age does make a differece. Perhaps someone out there is young and does get these meds and perhaps he/she could post as well.

Please take this as a suggestion only. Your spouse appears to desperately need pain control for his condition. This is whether he elects to have surgery or not. Surgery is only necessary to decompress nerves. Also, the disks themselves can generate pain without pinching any nerves. Take care and good luck. My prayers are with you. Patmg

[This message has been edited by Patmg (edited 05-26-2003).]