scotty12
05-25-2006, 11:21 AM
Does anyone experience severe aching in the calves?
my pain dr says im too young to have Neurogenic Claudication but ive read that it is quite common with Spondylolisthesis.
It has become so bad that even when i get out of bed in the morning it feels sa though ive been walking uphill for miles.climbing stairs is just horrible.
anyone have any helpfull input?
scott
my pain dr says im too young to have Neurogenic Claudication but ive read that it is quite common with Spondylolisthesis.
It has become so bad that even when i get out of bed in the morning it feels sa though ive been walking uphill for miles.climbing stairs is just horrible.
anyone have any helpfull input?
scott
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Shoreline
05-25-2006, 03:36 PM
Hey SCott, Sounds like a mighty big leap if that's your only symptom. Spondyliotheisis can be seen easily in Xrays, Stenosis is ca completely different problem and requires an MRI to DX. Without the tests, it's hard to say it's if it's from a spinal disorder or anything more than something bananas or a little magnesium wouldn't cure. You can scare the crap out of yourself thinking of every thing that migt cause leg pain. MD, MS, auto imune disorders or even bone cancer?
Hopefully it's nothing that severe, Dave
Hopefully it's nothing that severe, Dave
scotty12
05-25-2006, 10:04 PM
hey dave,good to hear from you.
i do have grade 2 spondy and stenosis along with adjacent disc degeneration,the 2 levels above slip.
the aching or tiredness in my legs has just gotten horrible.the only time it eases is when i elevate my legs like putting a pillow under my knees.
Im just trying to educate myself because i have read that epidurals may help and being as my pain dr doesnt think NC is my problem id rather be fairly sure that the injections may help asthe last one i had hurt so bad i yelped when he started injecting the meds.
i havent given up yet but for the first time i really am considering surgery.
im just tired of all of it,the back pain,the leg pain,and this achiness in my lower legs has just gotten to me.
hope all is well,scott
i do have grade 2 spondy and stenosis along with adjacent disc degeneration,the 2 levels above slip.
the aching or tiredness in my legs has just gotten horrible.the only time it eases is when i elevate my legs like putting a pillow under my knees.
Im just trying to educate myself because i have read that epidurals may help and being as my pain dr doesnt think NC is my problem id rather be fairly sure that the injections may help asthe last one i had hurt so bad i yelped when he started injecting the meds.
i havent given up yet but for the first time i really am considering surgery.
im just tired of all of it,the back pain,the leg pain,and this achiness in my lower legs has just gotten to me.
hope all is well,scott
Shoreline
05-26-2006, 08:20 AM
Sorry Scotty, I didn't make the connection to what I'm sure you have already told us about your spine condition. My last post to shawley has 5 links regarding spondy treatment options and bracing is actually one worth tryng if you haven't had a fusion yet and can't slip your turtle shell back on to see if it helps. I'll make it easy and move the post over here.
Take care, Dave
Take care, Dave
Shoreline
05-26-2006, 08:29 AM
Spondyliothesis is when a section of vertabrea fused or not slips forward, off the top of the vertabrea below or out from under the vertabrea above. The Xrays in the article below show exactly what it is. Spondy does mean he has instability or his spine woudn't be shifting forward. Whether it progresses or not is something they just observe over time. Surgery is usually indicated when you reach grade 2 or you have significant neuro impairmant.
http://www.spineuniverse.com/displayarticle.php/article2442.html
These films below show corection and realignment of lumbarsacral spondy using a posterior fusion and the second article shows the use of posterior hardware and cages inserted from the front. IMO this is a more stable way to go because the sacrum is softer than a vertebral body and may not hold a screw as I have learned. Both pedicle screws in my sacrum pull out when I bend forward or walk. Due to non union at L5-S1 the screws crank back and forth so now the holes are about 25% larger than the actual screws. Instead of the screws holding things in place, they just hang in the holes untill I bend or walk which causes crunching and grinding making the holes even larger.
http://www.spineuniverse.com/displayarticle.php/article2444.html
http://www.spineuniverse.com/displayarticle.php/article2446.html
More on spondy
http://www.spineuniverse.com/displayarticle.php/article1430.html
The correct grading of spondy
Grade 1: 25%
Grade 2: 25% to 49%
Grade 3: 50% to 74%
Grade 4: 75% to 99%
*Grade 5: 100%*
*Complete vertebral slippage is known as spondyloptosis.
The pictures in figure 4 are the closest thing I have seen to the junkyard in my spine. The risks are so great and the likelyhood of relievinng any pain are so poor that unless I loose neurologic function such as bowel and bladder control, it's simply not worth the risk to correct. A corection would look exactly like the 4th picture in fig 4 below. Except they would also remove 4 ribs to use as donar bone and to clear a way for more instrumentation higher up and run a bar from hip to hip to use as a foundation for the ladder they would build up my spine. see link below
http://www.spineuniverse.com/displayarticle.php/article2516.html
This link also shows crosslinking which is horizontal stabilization to prevent any twisting movement. I allready have crosslinking at 4 levels so a repair at this point isn't likely to do anything more than prevent further slippage and would likely leave me in more pain than I have now.
The amount of pain someone is in does not determine surgical success. Success is based on mechanical stability. If they revise my fusion from L1-S1 to T10-S1 as long as everything is stable in an XRay it wold be called a success if the Xrays show stability under flexion and extension.
Seeing what spondy is makes things much clearer, cut and paste those addys into your browser and show Dan. They can certainly try to correct the spondy and pull things into alignment, but there isn't a gaurentee it will relieve pain. They do know the longer he lives like this, the less likely it will relieve pain. Surgery would simply be to prevent further slipage and if any pain relief was gained it would just be an added bonus. You are supposed to be greatful for what they did by preventing further slipage, compression and stretching of nerves.
There is also the posibility that spondy will develop above or bellow the fusion or further disc damage can occur above or below the fusion as seen in the last article.
There really isn't an absolute answer other than your willingness to try again or ability to cope with your present condition.
I hope this helps, Dave
http://www.spineuniverse.com/displayarticle.php/article2442.html
These films below show corection and realignment of lumbarsacral spondy using a posterior fusion and the second article shows the use of posterior hardware and cages inserted from the front. IMO this is a more stable way to go because the sacrum is softer than a vertebral body and may not hold a screw as I have learned. Both pedicle screws in my sacrum pull out when I bend forward or walk. Due to non union at L5-S1 the screws crank back and forth so now the holes are about 25% larger than the actual screws. Instead of the screws holding things in place, they just hang in the holes untill I bend or walk which causes crunching and grinding making the holes even larger.
http://www.spineuniverse.com/displayarticle.php/article2444.html
http://www.spineuniverse.com/displayarticle.php/article2446.html
More on spondy
http://www.spineuniverse.com/displayarticle.php/article1430.html
The correct grading of spondy
Grade 1: 25%
Grade 2: 25% to 49%
Grade 3: 50% to 74%
Grade 4: 75% to 99%
*Grade 5: 100%*
*Complete vertebral slippage is known as spondyloptosis.
The pictures in figure 4 are the closest thing I have seen to the junkyard in my spine. The risks are so great and the likelyhood of relievinng any pain are so poor that unless I loose neurologic function such as bowel and bladder control, it's simply not worth the risk to correct. A corection would look exactly like the 4th picture in fig 4 below. Except they would also remove 4 ribs to use as donar bone and to clear a way for more instrumentation higher up and run a bar from hip to hip to use as a foundation for the ladder they would build up my spine. see link below
http://www.spineuniverse.com/displayarticle.php/article2516.html
This link also shows crosslinking which is horizontal stabilization to prevent any twisting movement. I allready have crosslinking at 4 levels so a repair at this point isn't likely to do anything more than prevent further slippage and would likely leave me in more pain than I have now.
The amount of pain someone is in does not determine surgical success. Success is based on mechanical stability. If they revise my fusion from L1-S1 to T10-S1 as long as everything is stable in an XRay it wold be called a success if the Xrays show stability under flexion and extension.
Seeing what spondy is makes things much clearer, cut and paste those addys into your browser and show Dan. They can certainly try to correct the spondy and pull things into alignment, but there isn't a gaurentee it will relieve pain. They do know the longer he lives like this, the less likely it will relieve pain. Surgery would simply be to prevent further slipage and if any pain relief was gained it would just be an added bonus. You are supposed to be greatful for what they did by preventing further slipage, compression and stretching of nerves.
There is also the posibility that spondy will develop above or bellow the fusion or further disc damage can occur above or below the fusion as seen in the last article.
There really isn't an absolute answer other than your willingness to try again or ability to cope with your present condition.
I hope this helps, Dave
scotty12
05-26-2006, 10:10 AM
i find it hard to believe you would feel better with all that hardware.
i think a surgery like that should only be done when you can no longer function but if paralisys is an issue now then i could relate to considering the surgery.
in my cae would wearing a brace mimic a succesful fusion (back pain from the instability)?
i think a surgery like that should only be done when you can no longer function but if paralisys is an issue now then i could relate to considering the surgery.
in my cae would wearing a brace mimic a succesful fusion (back pain from the instability)?
Shoreline
05-26-2006, 01:25 PM
Actually, Bracing would be a good indicator. They wrap you in plaster like a body cast to make the mold for the plastic brace and then trim it down. But being wrapped and totally stable felt wonderful prior to may last surgery, I asked if I could have the brace when it was complete but the way it was arranged by the doc , they delivered the day you had surgery to the hoptital room. Lots of fun sitting up hours after surgery to try a brace on. The brace would lkely prevent further progression of the spondy but stenosis needs to be surgically corected, the brace wouldn't do much if that was the cause of radiculopothy in your legs.
Bracing was offered as an alternative 2 years ago for my spondy and instability, but my fear was becoming dependent on the brace to stand and walk, where I have done a good job keeping my core muscles as strong as possible, that would be lost of I depended on a brace.
Even that is a tough decison, I would need a new brace, but doubt it's going to have a huge impact on standing endurance and function, more likely it would relieve the crunching and grinding when I sit up or walk and prevent the spondy from getting worse. I have grade 11 at boththe thoracic/lumbar junction and the lumbar sacral junction.
IF you looked at the last link figure 4, They would pretty much do the same thing, extend my fusion from L1-S1 to T10 to S1 plus some other work. I can walk now and taking the chance of loosing that, given the odds has made it intelectually an aeasy decision but there is always that nagging guilt telling me I should try anything possible to get my lfe back despite the odds or risks. As far as function, the only thing I have left to lose is the abilty to walk and contrlol my bladder and bowels. That surgery could take that too and the likelyhood merely stabalizing my spine, corecting the spondy and revising the fusion stastistically isn't likely to relieve the pain.
In the last 6 years every doc I have seen has comented they have never seen such a mess in someones back that could still walk. So I'm suposed to be greatful for that. Although It really never made me feel much better to have someone say, at least you can walk.
Untill some new technology comes along where they can inject sometype of bone cement into the areas that should have fused, I really don't see more surgery as an option. They do have the bone cement, rhBMP2, but it's not used for that and I haven't been able to convince anyone to try it. Even if they could just inject the holes in my scarum where the screws toggle, that would be an improvement. Maybe someday.
Scotty, with 2 progressive problems, meaning they will likely get worse, the pain will get harder and harder to manage, your dose will need to be increased as it progresses and you will reach a point where you can't tolerate the constipation, urinary retention and sedation to the point where you simply can't increase without being zomked all the time. When that happens there isn't much more that can be done. You live with your disabilities and a lot of pain that simply can't be managed because you reach a point where you can't tolerate any further side effects and meds for side effects no longer work or are no longer safe. Taking aderall because someone is incoharent from opiates isn't a reasonable request nor would it be healthy or effective.
Even if you don't have the UA problems, ED or constipation problems, living sedated isn't living. I could have my pump cranked up and drop my pain from barely tolerable to a smile on my face when I'm awake, but that's no way to live, My wife wouldn't put up with it and I don't want my daughter coming home to a dad that's passed out and can't be woken.
It's true there is no absolute ceiling on the amount of opiates someone can take, but there is a ceiling on the side effects different people are willing to except and how much relief you can obtain as problems progress. Stenosis is likely to get worse and spondy may or may not get worse. The good news is those have obvious ways to correct. They increase the size of the outlets for the nerves and fuse you to pull you back into alignment.
First time around odds of succes aren't that bad, but the percentage that fail can end up even worse off than now. At least you can attempt to stabalize and relieve problems that you know are going to get worse with reasonable odds of success.
Good luck, Dave
Bracing was offered as an alternative 2 years ago for my spondy and instability, but my fear was becoming dependent on the brace to stand and walk, where I have done a good job keeping my core muscles as strong as possible, that would be lost of I depended on a brace.
Even that is a tough decison, I would need a new brace, but doubt it's going to have a huge impact on standing endurance and function, more likely it would relieve the crunching and grinding when I sit up or walk and prevent the spondy from getting worse. I have grade 11 at boththe thoracic/lumbar junction and the lumbar sacral junction.
IF you looked at the last link figure 4, They would pretty much do the same thing, extend my fusion from L1-S1 to T10 to S1 plus some other work. I can walk now and taking the chance of loosing that, given the odds has made it intelectually an aeasy decision but there is always that nagging guilt telling me I should try anything possible to get my lfe back despite the odds or risks. As far as function, the only thing I have left to lose is the abilty to walk and contrlol my bladder and bowels. That surgery could take that too and the likelyhood merely stabalizing my spine, corecting the spondy and revising the fusion stastistically isn't likely to relieve the pain.
In the last 6 years every doc I have seen has comented they have never seen such a mess in someones back that could still walk. So I'm suposed to be greatful for that. Although It really never made me feel much better to have someone say, at least you can walk.
Untill some new technology comes along where they can inject sometype of bone cement into the areas that should have fused, I really don't see more surgery as an option. They do have the bone cement, rhBMP2, but it's not used for that and I haven't been able to convince anyone to try it. Even if they could just inject the holes in my scarum where the screws toggle, that would be an improvement. Maybe someday.
Scotty, with 2 progressive problems, meaning they will likely get worse, the pain will get harder and harder to manage, your dose will need to be increased as it progresses and you will reach a point where you can't tolerate the constipation, urinary retention and sedation to the point where you simply can't increase without being zomked all the time. When that happens there isn't much more that can be done. You live with your disabilities and a lot of pain that simply can't be managed because you reach a point where you can't tolerate any further side effects and meds for side effects no longer work or are no longer safe. Taking aderall because someone is incoharent from opiates isn't a reasonable request nor would it be healthy or effective.
Even if you don't have the UA problems, ED or constipation problems, living sedated isn't living. I could have my pump cranked up and drop my pain from barely tolerable to a smile on my face when I'm awake, but that's no way to live, My wife wouldn't put up with it and I don't want my daughter coming home to a dad that's passed out and can't be woken.
It's true there is no absolute ceiling on the amount of opiates someone can take, but there is a ceiling on the side effects different people are willing to except and how much relief you can obtain as problems progress. Stenosis is likely to get worse and spondy may or may not get worse. The good news is those have obvious ways to correct. They increase the size of the outlets for the nerves and fuse you to pull you back into alignment.
First time around odds of succes aren't that bad, but the percentage that fail can end up even worse off than now. At least you can attempt to stabalize and relieve problems that you know are going to get worse with reasonable odds of success.
Good luck, Dave