After 12 months on waiting list, I have an appointment to see my
Orthopaedic Surgeon next week to discuss spinal fusion with instrumentation and bone grafts.
Not sure what to expect or ask.
I have had xrays, cat scans and Mri's, according to these my problems are.. rudimentary disc present S1-S2, Mild degenerative change in facet joints bilaterally at L4-L5, Bilateral pars defects L5-S1, Grade 1 anterolisthesis of L5 with respect to S1, mild posterior broad based disc bulge, Severe compression of the L5 nerve roots, Mild to moderate spinal stenosis, and a transitional S1 verterbrae.
I have had "back problems" for over 20 years but the last few years it has got so bad I can't walk very far at all. Need to crouch down to relieve pain. I have had to give up work, luckily I have a very understanding husband.
I have tried everything conventional and unconventional, and am starting to think surgery is my last resort. The worse part is when my legs and feet go numb.
Would like to hear from others thinking of surgery, or have had surgery, basically would like to hear any advice at all
I'm new to the list, and have been looking around for others with similar issues. JoanneB, you're the closest match I've ever found to my symptoms and diagnosis. I know it's been many years since you've written on these forums (6 or so?), but if you end up reading this, I'd love to know what happened to you. Did you go for surgery or find relief via other means?
ps. here are my details, for those interested:
MRI results: "Grade 1 anterolisthesis (bilateral pars defects) and prominent L5-L1 disc degenerative change. The right neural exit forman is obliterated and there is a compression of the exiting right L5 nerve root."
Symptoms: hip/sciatic pain and foot numbness on the right side whenever I'm not significantly bent at the hip. Lying on my back or stomach, standing, walking... all cause pain. Depending on the day/pain levels, I can walk/stand for 1-5 minutes at a time before the pain forces me to stop (crouching or sitting for a while allows me to continue). Any kind of backwards bending (and to a lesser degree, arching to the right) aggravates it immediately. Lifting is a no-no. On bad nights I take T3s to help me sleep.
History: Lost the ability to lie on my back/front about four years ago due to back pain, though nothing was referred to my hip. X-ray showed L5-S1 spondylolithesis. I tried physio, osteo and massage over the course of a year with little change. Learned to live with it as it mainly impacted my sleeping position. My daughter was born 13 months ago. Within days of holding her (7 lbs), I was getting bad nerve/muscle-pinching in my upper right buttocks and numbness in my foot. This went on for months. 10 months ago I helped a friend move. Nothing too heavy, but still, big mistake. The next day the whole area around my hip was in pain. Saw my doctor and started physio again. Over the course of the past 10 months I've seen 2 physios, 1 chiro, 2 massage therapists (1 cranio-sacral, 1 shiatsu), tried IMS, anti-inflammatories, pain killers, glucosamine/msm/chondritin supplements, tons of gentle stretching and core exercises, ice & heat, etc, etc. Nothing seems to have helped. I'm waiting to try daily traction at the local hospital, but in the meantime, I'm trying to get the ball rolling on appointments with specialists (eg. neurosurgeon).
Welcome to the board. I don't know what ever happened to the original poster, but I can give you some thoughts on your condition. As you probably know the amount of slippage is graded from 1 to 4 (25% increments) with 4 being the worst. A grade 1 spondylolisthesis can be relatively benign or it can compress a nerve and cause a great deal of pain, as you are experiencing.
Your report indicates that the foramen on the right side is obliterated, which means that it is blocked. The foramen should be an opening through which the spinal nerve exits the spine at a particular level of vertebrae. In your case, the main issue is at the base of your spine, the lumbar 5 and sacral 1 vertebrae. The nerve that does not have enough space to function properly is the L-5 nerve root.
This nerve exits from this vertebral pairing (L5-S1), where it becomes part of a large bundle of nerves called the cauda equina. This branches into each leg and forms the sciatic nerve which is the largest nerve in the body. The L5 nerve sends signals across the buttock over to the hip area, down the leg, running down the outside of the leg, wrapping around toward the front of the foot at the ankle and into the middle toes (generally speaking...and in most people). The pinching off of this nerve is what is causing all that pain that keeps you from being able to stand or walk for more than a short period.
With a spondylolisthesis, you need to avoid any activity that puts your back in extension. You should not lie on your stomach or attempt to bend backwards. This simply pinches the nerve off more. When you bend forward, it opens up that space a bit and is a bit more comfortable. You will even aggravate the condition by swimming any stroke that requires you to swim on your stomach, like freestyle, breast or butterfly....
Sometimes there can be some slippage with this condition that you can actually feel. Sometimes the pain will shift from one leg to the other, for example. Other times, people have this condition and are not aware of it until they have an X-ray for another reason and it is discovered. It is not problematic unless it is compressing a nerve...as it is in your case.
If the pain is really limiting you, it is time to see a spinal specialist. Conservative treatments only go so far. If you should suddenly develop problems with bladder or bowel control or sudden muscle weakness resulting in foot drop, you need to call your specialist immediately, or go to the emergency room of the hospital. These two incidents should be taken seriously as they are symptoms of "cauda equina syndrome" and can cause permanent nerve damage if the nerve is left severely compressed.
At least here in the US, the most common treatment for a spondy that is compressing a nerve is a fusion procedure. Since the spine is unstable, those effected segments are fused to keep the spine from moving in an undesirable direction. L5-S1 is the most common location for a spondylolisthesis, as that segment, along with L4-L5 carry the brunt of the body's movement...and thus, are most often damaged or wear out.
Good luck to you. I hope you find a specialist that will be able to resolve your pain. Please let us know how you are doing as you move through this process.
In the meantime, avoid any activities where you are bending backward, twisting at the waist, pushing, pulling, reaching up overhead or out, and watch lifting anything heavier than about 10 pounds. Also really try to use good body mechanics (no helping friends move!!) and posture...no slouching in front of the TV or at the computer. This will help to protect this unstable joint.
I also have Grade 1 L5 over S1, among a number of other problems. I was shocked to find out that lap swimming was causing so much trouble. Who knew swimming could hurt you?
However, I find lying on my stomach the only position I can find any relief from my back & hip pains. It feels like taking some of the pressure off temporarily & giving it a rest.
I hope I'm not doing more damage since that leaves me with no comfortable way to be in the world at all. Sitting is awful, of course. Lying on my left makes my hip go berserk, lying on my right hurts my neck. Lying on my back aggravates everything.
I slept on my stomach until surgery. I also started sleeping on my stomach 2 days after surgery. It absolutely hurt to lay on my back. Everyone is different. My doctor was concerned I wasn't sleeping, so told me to sleep however I needed to. If you don't get enough rest your body doesn't have any time to recuperate. Anyway spondy of the L4/L5 grade2 or 3 depending on which test you looked at. Mri had it at a 2 while laying flat on my back, standing up it went to a 3 so I was very unstable. Surgery was the only option I had, even though for insurance reasons we had to go through some conservative treatments that all the doctors agreed weren't going to work.
Sometimes there can be some slippage with this condition that you can actually feel. Sometimes the pain will shift from one leg to the other, for example. Other times, people have this condition and are not aware of it until they have an X-ray for another reason and it is discovered. [B]It is not problematic unless it is compressing a nerve.[/B]..as it is in your case.
I will disagree with this statement. I currently have a grade 2 spondy at L5/S1, and as of my last MRI I do not have nerve compression...yet I still suffer from a great deal of back pain. Even though I have no leg pain or numbness, my back hurts every single day. The pain ranges from tightness and/or stiffness, to massive spasms that occur out of the blue...even during sleep. I wake up sore and stiff every single morning and must do stretches in my bed for 20 minutes before I can even think about standing up and walking.
So yes, there are some of us out there that don't have any symptoms of nerve compression, yet still have symptomatic spondylolisthesis.