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Old 08-03-2003, 12:06 PM   #1
Nelka
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Post Lumbar Stenosis & Micro-endoscopic laminotomy

Hello, everyone. I'm new to the board.

It seems that many of you have/had disc herniations and slippages. My problem is a little different -- arthritis on the facet joints (at L4/L5 and L5/S1), thereby causing central canal stenosis and nerve impingement. The main symptoms are the classic nerve pain down the legs and on the bottoms of the feet. Until the symptoms became unbearable in February, I had been playing tennis 3-4 times weekly.

After the "conservative" treatments of physical therapy, medications, and 2 epidural injections, I sought the opinions of two neurosurgeons. Both recommend surgery: one suggests a simple laminectomy, the other a laminectomy and two-level fusion. Like many of you, I am fighting the idea of invasive surgery and/or major medications. My long-term objective is to get back on the tennis courts, at the competitive level if possible!

So, in my search for alternatives, I came across a place called the MicroSpine Center in Florida. They use minimally invasive spinal surgery using arthroscopic techniques. Sounds like just the ticket for a surgery-averse creature like me!

So, my question -- Have any of you had the opportunity to explore the treatment offered at the MicroSpine Center. Am I being sold snake oil, or can these guys be for real?

Cordially,
Nelka


[This message has been edited by moderator2 (edited 08-03-2003).]

 
Old 08-03-2003, 01:35 PM   #2
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Nelka,I went searching on the net and seems I may have found the place you are talking about I'm not sure I don't have any first hand knowledge for,you have you checked the web site and checked the procedures they are talking of out at some of the other spine centers
I'm sure others on here may know more about the procedure you are talking of then me youmight try putting the procedure in the search and see if any post come up,I'd like to welcome you to the boards and wish you much luck and keep us posted.
Linda

 
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Old 08-03-2003, 08:52 PM   #3
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Take a look at MicroSpine's research results at [url="http://www.doctorbuzz.com/Research_java.htm"]www.doctorbuzz.com/Research_java.htm[/url] . This tells the whole story. For example, for a lumbar partial discectomy they give the statistic that 68% of their patients have had good to excellent results. I think this is a bit better than the national average for micro endoscopic discectomy, which is about 60%. But the success rate of microdiscectomy/laminotomy is over 95%. Feel free to choose a minimally invasive technique, but be aware that they have much lower success rates. That is, you may need a second "invasive" surgery to resolve your symptoms. On the other hand, it is true that the recovery time for minimally invasive surgery is shorter. It is a trade off. You can get a shorter recovery time if you risk having an unsuccessful surgery.
__________________
HNP at L4-5 late Sept 2002
3 months PT and Ibuprofen
Reherniation late Feb 2003
Nerve block mid March 2003
Microdiscectomy 4 April 2003
3 months PT (trunk stabilization)
Walk 4 miles daily from now on.

 
Old 08-05-2003, 05:32 AM   #4
Nelka
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Thanks for your replies.

It seems that spinal surgery is a never-ending list of trade-offs. There are pros and cons to every approach. For example, a two-level decompression plus fusion will probably take care of the current symptoms, but you face a very expensive operation, a long recovery, and the risk of scar tissue problems, hardware problems, and a weakened spine in the years ahead. In contrast, MIS (minimally invasive surgery) promises a lower-cost procedure and a short recovery, but only one level/side can be done at a time, thus requiring multiple procedures, and there is the possibility that the stenosis will recur within 5-10 years.

To those who have suffered years of pain and disability with your spine ailments, I extend my sympathy. I have faced this pain for only a few months, and I'm already quite weary of being a good sport.

Cordially,
Nelka

 
Old 10-13-2003, 05:05 AM   #5
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Dear Nelka,
Like you I love tennis and I had to stop playing due to stenosis. I am heading towards a posible laminectomy in 2 weeks(awaiting results of Myelogram). Frankly I would rather undergo a more invasive procedure and bear with a more challenging recovery period if that is what it takes. I am curious what you decided or your outcome. I have had pain in my leg and back for about 2 1/2 years .

Thanks Kokomo

 
Old 10-13-2003, 05:50 AM   #6
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Nelka, if it were me and it is I would opt for the minimially invasive procedure first. I'm having mine in November and don't want to be out of commission too long and if it works I haven't run the risk of scar tissue like the other....as much. My DR told me that there is one guarantee whe you have a back operation...chances are you will have another. A common theme in all of the threads is, we all have opinions, but the decision is your's and your DR's. Good luck and take care!

Greg
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Greg

 
Old 10-13-2003, 07:30 AM   #7
Nelka
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Kokomo and Greg,

As your answers indicate, there are strong arguments for either surgical approach to spinal stenosis! Now, where did I put that darn crystal ball??

I haven't made a decision yet. Unfortunately, my symptoms have worsened significantly, with radiculapathy down both hips/legs/feet, which indicates nerve compression on the left side at L5 and S1, and on the right side at L4 and L5. That means if I chose MISS at Microspine, I'd have to go through four different procedures since they can do only one side/level at a time.

I don't know about the rest of you, but as time goes on, and the pain gets worse, and I become more emotional about the situation, I know that I am becoming less able to make a rational decision. I'm usually quite good at sorting through choices, but I really feel twisted around by THESE choices.

Kokomo -- I hope you'll write back after your surgery and let us know your progress. I wish you GREAT SUCCESS! If you are like me, you'll do almost anything to get back onto the tennis court again! I have really suffered withdrawal pains!

 
Old 10-13-2003, 09:53 PM   #8
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Nelka--You make one very important point in your last post; that it can become harder and harder to keep our balance in the decision-making process. Just knowing that can be useful. I think it's true. After a while, we tend to overreact to good days and bad days. It's enormously hard to keep perspective and the "big picture" in mind. I hope you have some other close people to help you with that. It's hard to do it alone, but you have this gang at least!

In terms of the Microspine clinic, I know nothing about them. I do know that there are spine centers that advertise on the web, and it's important to read the "fine print" about outcomes, percentages, and so on. Personally, I am suspicious of centers that pursue a particularly aggressive "marketing" approach, and certainly there are some of those out there.

Keep the faith; keep the wits,

Standingman


 
Old 11-28-2003, 05:49 AM   #9
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Re: Lumbar Stenosis & Micro-endoscopic laminotomy

Nelka-Well I had a laminectomy (open)on November 24. He talked of a laminotomy for right leg only, but opted for the laminectomy as Neurosurgeon says they are very similar. So the pain seems to be coming from the incision alone and a stiff back. I have been walking since the day after surgery and am much more mobile than I thought I would be. I could probably walk a mile(4 days out of surgery) but I won't! They discourage sitting much at all, either walking or lying down. I expect to be out 4 weeks but they say some come back after two. I am going to take it easy. I have felt a considerable difference in the right leg- no pain there at all, and this was the bad one. I stilll have the same amount of pain on the left ankle, but the left was almost an afterthought compared with the right. I don't think I will step onto a tennis court until 2 months are up at the least, but the doctor has said I can do anything after healing, and having asked him twice now I get that same answer. I was trying to avoid anything complex that would necessitate a fusion. The Lam was done at L4-5. I was also advised that there may be some coming out of L2, which is new. Anyway I am quite elated not to have this pain, and not to have any complications at all (yet) I am also hoping to ski this winter, which they said "might " be a possibility, but I am not going to push it.

Good luck and keep me up to date on what you decide and progress.
thanks, Kokomo

QUOTE=Nelka]Kokomo and Greg,

As your answers indicate, there are strong arguments for either surgical approach to spinal stenosis! Now, where did I put that darn crystal ball??

I haven't made a decision yet. Unfortunately, my symptoms have worsened significantly, with radiculapathy down both hips/legs/feet, which indicates nerve compression on the left side at L5 and S1, and on the right side at L4 and L5. That means if I chose MISS at Microspine, I'd have to go through four different procedures since they can do only one side/level at a time.

I don't know about the rest of you, but as time goes on, and the pain gets worse, and I become more emotional about the situation, I know that I am becoming less able to make a rational decision. I'm usually quite good at sorting through choices, but I really feel twisted around by THESE choices.

Kokomo -- I hope you'll write back after your surgery and let us know your progress. I wish you GREAT SUCCESS! If you are like me, you'll do almost anything to get back onto the tennis court again! I have really suffered withdrawal pains![/QUOTE]

 
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