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Please any advice/help lower back spinal fusion


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Old 09-04-2017, 10:05 PM   #1
Chris503316
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Please any advice/help lower back spinal fusion

Hello,
My name is Christopher I am 28 years old and played sports my entire life. I have been dealing with lower back pain for the last 5-6 years and I have reached a point where I just cannot take it anymore. The pain is on my left side and right side directly where the underwear line starts. It does not shoot down my legs or anywhere else. If I am just laying down usually I do not have pain. The pain starts to kick in when I am walking for 5 or more minutes. It is just unbearable. I work out religiously I am in very good shape and this just prevents me from doing so much more in life. I cannot run on a treadmill for more then 2 minutes without constant throbbing and shooting pain in the 2 areas. Feels like hot and just shooting sharp pains forcing me to stop and just sit down.
I have had several epidurals, facet joint shots, as well as a few other procedures and nothing has worked at all. I seen a surgeon he has suggested spinal fusion surgery and told me it will only last me 12-16 months. I took an MRI here are the results.
L1-L2 mild bulge without focal protrusion or stenosis. L2-L3 mild bulge without focal protrusion or stenosis or central canal stenosis. Together bulge and facet hypertrophy cause mild bilateral Foraminal Stenosis. L3-L4 mild bulge without focal protrusion or stenosis or central canal stenosis. Together bulge and facet hypertrophy cause mild bilateral Foraminal Stenosis. L4-L5 mild bulge together with facet hypertrophy cause mild to moderate bilateral foraminal stenosis. L5-S1 mild bulge together with facet hypertrophy cause mild to moderate bilateral foraminal stenosis.
T11 -T12 right paracentral disc protrusion.

I'm literally at a loss of words, I do not know what else to do. I have read and heard nightmares about fusion spine surgery. My own pain management doctor told me if the surgeon wanted to do fusion or rods not to get it done.
Anyone have this type of pain or any help at all.
Thank you so much and for all of those who tell you it's not so bad they have no idea what we are going through.

 
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Old 09-05-2017, 07:51 AM   #2
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Re: Please any advice/help lower back spinal fusion

Have you consulted with a second spine surgeon? If the first consult was with a neurosurgeon, I would suggest seeing an orthopedic spine surgeon for a second opinion.

From just looking at the radiology report, I would agree with your pain management doctor that a fusion is not a solution to your issues. Frankly, I doubt your insurance carrier would approve a fusion surgery based on this report, as it does not indicate any instability or specific nerve compression...which are the key reasons for performing a fusion.

One reason fusion has such a reputation for failure is because the surgeon has not selected the patients who need the procedure carefully, using the proper criteria. It cannot be done for back pain alone. Research has proven that patients who only have back pain but no pain that radiates out to a limb have a lower rate of success.

Members of Healthboards are not doctors so keep that in mind as you read. The only issues I can see that would be causing you pain is the foraminal stenosis at L4-5 and L5-S1. The foramina are openings located at each vertebral level that allow the spinal nerve to exit the spine and go out to the area of the body it innervates. When something like a bulging disc or enlarged facet joint pushes into the opening, it causes some stress (compression) on the nerve. This nerve compression can cause pain, tingling and numbness can be felt at the site of nerve irritation or anywhere along the path of the nerve.

In a MRI of the spine, radiologists use specific words to describe an issue. They are: minimal, mild, moderate and severe. Often when findings are minimal or mild, the doctor will tell the patient everything is fine or normal. Moderate causes the doctor to take a closer look and may require some sort of conservative treatment. Severe means severe...often will cause the surgeon to consider whether surgery is appropriate.

In the case of a disc bulge, mild means there is a small bulge. In your case the small disc bulge combined with a small amount of facet joint hypertrophy (enlargement) are causing a little narrowing in the foramina and I suspect this is causing your pain.

It may be that another surgeon would recommend a procedure to clean out this narrowing to make more room for the nerves without a need for fusion. I would get a second opinion!

 
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Old 09-05-2017, 11:02 AM   #3
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Re: Please any advice/help lower back spinal fusion

Thank you, I seen the surgeon today. He suggest I get a spinal Cord stimulator trial for 5-7 days to see if this works. If this works he will plant it in me permanently. Does this sound like the better route to go down?

 
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Old 09-06-2017, 07:45 AM   #4
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Re: Please any advice/help lower back spinal fusion

I'm probably not the one to respond to the question about the neurostimulator. Back when I had my first fusion (2005) the spinal cord stimulator was a device that was implanted as a "last resort." ...meaning that when all other options had been tried and failed, it was worth a try. Now, and I attribute this to the huge rise in the number of pain clinics and doctors who have gone into pain management as a lucrative practice, a SCS is suggested early in treatment and presented to the patient in a way that suggests it is without risk. Doctors tell patients "try it." "If it works, we'll implant it permanently". They rarely go into the details...but let me ask you this. If you think pain is keeping you from doing the athletic things you once did, what will life be like with something implanted into your spine, with a battery pack that you have to recharge, with leads that may travel and may need re-implanting, etc.? Something you are constantly aware of 24/7?

Of course I can't tell much about your symptoms and how they affect you from just reading the MRI report, but if this were my report, I personally would do everything I could to find a doctor who could give me an accurate diagnosis and a plan for treatment. To me, it looks like you should be able to find some solution to resolve your symptoms/pain short of a fusion surgery. Perhaps there is an alternate therapy/bodywork that would help....

The fact that you have had lower back pain for more than five years and that you didn't just have a sudden injury that caused this pain leads me to think that some type of therapy might be of more use than having surgery...since the MRI does not indicate any nerve compression. I'm not convinced your symptoms are severe enough for you to get aboard the surgery train...because once you have back surgery, particularly at your age, you can just about count on having further surgeries down the road. I don't know anyone who has had just one surgery! (I'm going in for my fourth on Sept. 22).

I think you need to keep looking for someone who can help you. It might not be a doctor...I can't tell you because I don't know what types of therapy are available in your area...but someone who does bodywork like myofascial release or ART ( active release technique). Perhaps a chiropractor or ???

Last edited by teteri66; 09-06-2017 at 09:23 AM.

 
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Old 09-12-2017, 11:51 PM   #5
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Re: Please any advice/help lower back spinal fusion

[QUOTE=teteri66;5467918]I'm probably not the one to respond to the question about the neurostimulator. Back when I had my first fusion (2005) the spinal cord stimulator was a device that was implanted as a "last resort." ...meaning that when all other options had been tried and failed, it was worth a try. Now, and I attribute this to the huge rise in the number of pain clinics and doctors who have gone into pain management as a lucrative practice, a SCS is suggested early in treatment and presented to the patient in a way that suggests it is without risk. Doctors tell patients "try it." "If it works, we'll implant it permanently". They rarely go into the details...but let me ask you this. If you think pain is keeping you from doing the athletic things you once did, what will life be like with something implanted into your spine, with a battery pack that you have to recharge, with leads that may travel and may need re-implanting, etc.? Something you are constantly aware of 24/7?

Of course I can't tell much about your symptoms and how they affect you from just reading the MRI report, but if this were my report, I personally would do everything I could to find a doctor who could give me an accurate diagnosis and a plan for treatment. To me, it looks like you should be able to find some solution to resolve your symptoms/pain short of a fusion surgery. Perhaps there is an alternate therapy/bodywork that would help....

The fact that you have had lower back pain for more than five years and that you didn't just have a sudden injury that caused this pain leads me to think that some type of therapy might be of more use than having surgery...since the MRI does not indicate any nerve compression. I'm not convinced your symptoms are severe enough for you to get aboard the surgery train...because once you have back surgery, particularly at your age, you can just about count on having further surgeries down the road. I don't know anyone who has had just one surgery! (I'm going in for my fourth on Sept. 22).

I think you need to keep looking for someone who can help you. It might not be a doctor...I can't tell you because I don't know what types of therapy are available in your area...but someone who does bodywork like myofascial release or ART ( active release technique). Perhaps a chiropractor or ???[/QUOTE]

I appreciate the long detailed responses from you. I seen a chiropractor and honestly I think they are just a big scam. He wanted to do 10 sessions $100 each of decompression or compression something like that on my spine. Stretching me massage etc I felt I was being taken for a ride. My back doctor is very up front with me he said I will not have no limitations after the SCS Is in me. Recovery time around 4-6 weeks but after that I will be fine. I made sure this was correct as I asked him several times. I have done a lot of research and heard good and bad about it just like anything else. So I'm just stuck right now not knowing what other options I have. I did a sport professionally that took a toll on my back over the years from falling on it over and over again. So my pain kicks in mainly when I walk for more then 5-10 min at a steady continuous pace. Like just walking around the mall. The pain is just throbbing it feels like I have to sit right away. Stabbing pains sharp hot throbbing. It's hard to explain I can almost say it's like touching an opened wound. Just so much pressure hits it. And it's only on the left and right side of my lower back. Doesent go up arms or legs etc it stays right there and it just Kills

 
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Old 09-13-2017, 06:23 AM   #6
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Re: Please any advice/help lower back spinal fusion

That type of pain when walking that you describe is usually caused by spinal stenosis...when the central canal is compressed for some reason and the nerves of the cauda equina (the lumbar extension of the spinal cord) are squished. Sometimes people are born with a smaller than normal spinal canal (me, for example) and as they age and a bit of arthritis sets in and joints enlarge, there is less room for the spinal nerves. This results in a feeling of heaviness in the legs and pain when walking and standing. Unfortunately the MRI says there is no central canal stenosis, so I can't explain the cause of your symptoms.

I can suggest an exercise that helps me. It is a form of natural traction and helps to maintain structural alignment.

Lie flat on the floor with knees bent, feet flat on the floor. Be sure you are lined up straight! Place arms close to the sides, palms facing up. Do a pelvic tilt to be sure pelvis is in a neutral position ( neither tipped forward or back). Now relax and breathe deeply from the belly so you can see the belly rise and fall. Do this for two minutes or a bit longer if desired.

I try to do this morning and night, before I go to bed, or any time my back starts to hurt due to being on my feet. I've been known to do it in airports when I just couldn't walk any further!

I would agree with your sentiments regarding the chiropractic!

Last edited by teteri66; 09-13-2017 at 06:26 AM.

 
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Old 09-13-2017, 10:22 AM   #7
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Re: Please any advice/help lower back spinal fusion

[QUOTE=teteri66;5468453]That type of pain when walking that you describe is usually caused by spinal stenosis...when the central canal is compressed for some reason and the nerves of the cauda equina (the lumbar extension of the spinal cord) are squished. Sometimes people are born with a smaller than normal spinal canal (me, for example) and as they age and a bit of arthritis sets in and joints enlarge, there is less room for the spinal nerves. This results in a feeling of heaviness in the legs and pain when walking and standing. Unfortunately the MRI says there is no central canal stenosis, so I can't explain the cause of your symptoms.

I can suggest an exercise that helps me. It is a form of natural traction and helps to maintain structural alignment.

Lie flat on the floor with knees bent, feet flat on the floor. Be sure you are lined up straight! Place arms close to the sides, palms facing up. Do a pelvic tilt to be sure pelvis is in a neutral position ( neither tipped forward or back). Now relax and breathe deeply from the belly so you can see the belly rise and fall. Do this for two minutes or a bit longer if desired.

I try to do this morning and night, before I go to bed, or any time my back starts to hurt due to being on my feet. I've been known to do it in airports when I just couldn't walk any further!

I would agree with your sentiments regarding the chiropractic![/QUOTE]
You don't think I should try the trial scs?

 
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Old 09-13-2017, 06:32 PM   #8
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Re: Please any advice/help lower back spinal fusion

I don't want to influence you one way or the other. All I can say is what the doctor told you about having no limitations after having a SCS implanted runs contra to experiences I've seen with people I know.

Also, from what you've said about what the MRI shows, there doesn't appear to be anything really significant wrong with the lumbar spine. You have some degeneration going on but it is listed as "mild". This is on the scale of minimal, mild, moderate and severe. Personally I would try some more conservative treatments first just as a course of physical therapy, epidural steroid injections, perhaps alternate treatments. I would also consult with a different spine surgeon to see if there isn't another procedure or treatment other than fusion that would resolve the issues, rather than just trying to cover the pain. I can see where a spine surgeon would not think fusion surgery is an option at this point as there is no instability or significant nerve compression.

You say you played sports your whole life. If they were contact sports, it may be that you are developing spinal arthritis and you may have to learn to live with some pain. I think your symptoms are coming from the moderate stenosis in the foramina at L4-5 and at L5-S1. If it gets worse, it may start shooting down your leg. I would think that a spine surgeon could go in and open up the foraminal openings to make room for the nerves and it would resolve your symptoms.

 
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Old 09-13-2017, 06:46 PM   #9
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Re: Please any advice/help lower back spinal fusion

[QUOTE=teteri66;5468514]I don't want to influence you one way or the other. All I can say is what the doctor told you about having no limitations after having a SCS implanted runs contra to experiences I've seen with people I know.

Also, from what you've said about what the MRI shows, there doesn't appear to be anything really significant wrong with the lumbar spine. You have some degeneration going on but it is listed as "mild". This is on the scale of minimal, mild, moderate and severe. Personally I would try some more conservative treatments first just as a course of physical therapy, epidural steroid injections, perhaps alternate treatments. I would also consult with a different spine surgeon to see if there isn't another procedure or treatment other than fusion that would resolve the issues, rather than just trying to cover the pain. I can see where a spine surgeon would not think fusion surgery is an option at this point as there is no instability or significant nerve compression.

You say you played sports your whole life. If they were contact sports, it may be that you are developing spinal arthritis and you may have to learn to live with some pain. I think your symptoms are coming from the moderate stenosis in the foramina at L4-5 and at L5-S1. If it gets worse, it may start shooting down your leg. I would think that a spine surgeon could go in and open up the foraminal openings to make room for the nerves and it would resolve your symptoms.[/QUOTE]
What is that procedure called so I can let him know about that.
Because that's exactly what my surgeon said that it's not opened enough and obstructed.
I had epidural and cortisone shots they did nothing at all.
Epidural, cortisone, facet joint, ac joint procedure, rf abrasion I think it's called.
Radio frequency, they burned the nerves which was suppose to be 6 months lain free dident even give me 6 days free. It's really so weird I can go hard at the gym and I'll only feel like 20% pain at the very end of my work out. But if I walk around the mall for 10 min it kicks in where I cannot bare the pain. So something has to be pressing against something while I'm walking. But what's the name of that procedure to open more room there. I'll ask him about it sure won't hurt to try it out

 
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Old 09-13-2017, 06:56 PM   #10
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Re: Please any advice/help lower back spinal fusion

Is it called foraminotomy ?

 
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Old 09-14-2017, 03:22 PM   #11
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Re: Please any advice/help lower back spinal fusion

Yes, a foraminotomy is a procedure to clear out the neural foraminal openings which is where you have the stenosis (narrowing).

 
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