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Old 12-16-2009, 07:54 AM   #1
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Question Newbie Here with Spine Treatment Questions

Hi all,

I am looking for advice on treatment options.

Brief History to consider: I experienced a fall down accident where I fell down my outside stairs last January and it has been hell since.

It seems like since this accident my lumbar spine keeps degrading. I was diagnosis with L4/5 Grade I Spondy. My ortho said that I have problems with all the lumbar levels, my best level is L2/3 which has a bulge. Also diagnosed with DDD. My last MRI was not encouraging and changed from the MRI done 6 months ago. Now I have S1/L5 mild/moderate focal herniation which moved the S1 nerve root and L3/4 uncontained focal herniation which excudes outside the vertibre and migrated to the 3/4 nerve roots on the left.

Needless to say this was not good news after just recovering from dissectomy for a herniation at L1/2 and C6/7 (fusion).

Ortho says he could do another dissectomy at L3/4 to resolve herniation but is concerned because the lumbar degraded more in the last 6 months. It seems like my discs are popping like blisters. In the last 6 months where I had bulges, I now have focal hernations. He is thinking and talking about a multi level lumbar fusion. He feels left leg pain includes the L4/5 symptoms. He will be doing a diagnostic EPI with Nerve Block at the L3/4 level to isolate the symptoms. He wants to see what symptoms remain after this procedure.

Does anyone have any thoughts . . . suggestion . . .advice
Lumbar fusion is very scary!

Past treatment history does include 4 ESI at various levels of the lumbar, extensive PT, and surgery as noted above.

 
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Old 12-17-2009, 05:30 AM   #2
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Re: Newbie Here with Spine Treatment Questions

[QUOTE=teebone64;4144452]Hi all,

It seems to me, that first surgery was a failure, and now, you considering for another surgery..I think, you should think it over and go for second or third opinion from several Spine Specialist.. If you can cope with the pain, just stay with pain meds...Going for second surgery, might cripple you..Doctors are there to cut you up for practice...








I am looking for advice on treatment options.

Brief History to consider: I experienced a fall down accident where I fell down my outside stairs last January and it has been hell since.

It seems like since this accident my lumbar spine keeps degrading. I was diagnosis with L4/5 Grade I Spondy. My ortho said that I have problems with all the lumbar levels, my best level is L2/3 which has a bulge. Also diagnosed with DDD. My last MRI was not encouraging and changed from the MRI done 6 months ago. Now I have S1/L5 mild/moderate focal herniation which moved the S1 nerve root and L3/4 uncontained focal herniation which excudes outside the vertibre and migrated to the 3/4 nerve roots on the left.

Needless to say this was not good news after just recovering from dissectomy for a herniation at L1/2 and C6/7 (fusion).

Ortho says he could do another dissectomy at L3/4 to resolve herniation but is concerned because the lumbar degraded more in the last 6 months. It seems like my discs are popping like blisters. In the last 6 months where I had bulges, I now have focal hernations. He is thinking and talking about a multi level lumbar fusion. He feels left leg pain includes the L4/5 symptoms. He will be doing a diagnostic EPI with Nerve Block at the L3/4 level to isolate the symptoms. He wants to see what symptoms remain after this procedure.

Does anyone have any thoughts . . . suggestion . . .advice
Lumbar fusion is very scary!

Past treatment history does include 4 ESI at various levels of the lumbar, extensive PT, and surgery as noted above.[/QUOTE]

 
Old 12-17-2009, 03:57 PM   #3
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Re: Newbie Here with Spine Treatment Questions

Tee:

It does sound like a fusion will stabilize the area and possibly relieve many of the symptoms. Granted a fusion is not fun, but I had one 17 years ago that gave me no problems until recently (and the recent problems are more due to structural problems in the spine I was born with).

Based on what you said it seems that there are a variety of levels with problems. Thus addressing one level with a microdecetcomy or something, and then treating another nearby level, etc...just leads to multiple procedures. And the more they go in the more scar tissue develops.
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Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 12-17-2009, 05:12 PM   #4
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Re: Newbie Here with Spine Treatment Questions

Hi AZ

Thanks for responding.

The issue I have with the fusion is that it will be a multi level fusion. The loss of mobility concerns me. It does sound like eventually this surgery will come face to face with me and I will have to take the plunge. So many failed fusion out there . . .I've come to decide that the procedure is the same and maybe the difference is the performing doctor. I believe my ortho is capable. I did speak with one of his recent patients who had a multi and she is doing great.

I was especially glad to hear from you because it sounds like you have had success with your fusion. Thanks it put some light at the end of the tunnel.

Is there anything that I should speak with my ortho about. I was told be a NS that it would take alot of screws and plates to fix my lumbar. No one mentioned a rod. I have not had a detailed discussion with my ortho because I have been avoiding having this discussion. I thought the discetomy would take care of my problem and believe it or not it did take care of the majority, however to next two herniations happened and symptoms returned to reduce my functioning. Very disapointing. I had two weeks where I said wow I feel like a million bucks. I am hoping to get there again for more than just two weeks lol.

With the fusion is there anything I will need to watch out for? I have read walking walking and more walking to recover. No problems because I like walking. I wish I could do more these days but I walk just about everyday. What was you experience with your recovery? How long?

Sorry for all the questions . . I am really trying to research this until I can get my head wrapped around this..

Thanks again
Tee

 
Old 12-17-2009, 05:24 PM   #5
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Re: Newbie Here with Spine Treatment Questions

Hi Letty,

thanks for your response . . .

I read some of your threads and it seems like you been to hell and back . . . .maybe not quite back.

Very upsetting to hear your doctor did not explain the full procedure, I am not sure why that would happen.

Could you clear this up for me . . did you have multi level fusion? If so what levels? and did your symptoms get better? What would have been the consequence of not going through with the surgery. Could surgery been avoided entirely?

I apologize for all my questions.

Briefly, I did get three opinions. One from a NS who said eventually I would need this big surgery. He thought anywhere from 1 to 3 years out. That was last year. The ortho did not disagree with NS opinion. Also when to PM, and was told that I would need surgery. Usually pain management dr's don't recommend surgery. Also my PT said it's time.

I am really interested to hear what went wrong with your recovery . . if you don't mind letting me know.

I would welcome whatever information you can provide.

Thanks
Tee

 
Old 12-17-2009, 05:50 PM   #6
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Re: Newbie Here with Spine Treatment Questions

Would the surgeon be an Orthopedic Spine Surgeon or a Neurosurgeon ( I think you mentioned both in your note. All of my spine surgeries have been done solely by an Orthopedic Spine Surgeon).

Depending on the technique some use small rods and others use plates. They are basically the same size. I currently have plates but my surgery in February will use rods from what I understand.

Depending on your current activities you may not notice too much loss of flexibility. I was once into gymnastics eons ago but never attempted anything close after fusion. It also depends on what levels and how many levels are going to be fused.

The first activity you may be allowed to do after surgery is walking. The fusion is a tough surgery with a long recovery. At first it may be walking one block and progressing slowly from there.

Some surgeons have you use a brace after surgery. I wore a rigid brace for quite a few months.
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C5-C7 foraminotomy 08

 
Old 12-18-2009, 06:58 AM   #7
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Re: Newbie Here with Spine Treatment Questions

Hello AZ,

I am actively treating with an ortho for the spine. I am not sure exactly how many levels, I imagine the whole lumbar since I was told that all levels have a problem. My main concern is with being able to tollerate sitting down as my job is a desk job. With respect to walking, well I love it too much not to do it even for the sake of recovery.

Could I be right with this thought process . . .I am thinking there is a time when this type of surgery is necessary, if I wait too long then the waiting itself could complicate a positive recovery experience? If waiting is causing more damage/problems then it makes sense to me that I would also need to recover from that damage as well as the surgery. Do I have the right thought process?

I ask because with my ACDF I waited too long and now I have to heal from the damage. Dr said this could take up to one year. No real pain involved, just numbness of the fingers and twitching in the arm that is more annoying then anything else. True that sometimes I have little spasms, but the arm and fingers thing is nothing compared to the problems with both my legs. I feel if I had the surgery when it was recommended then my recovery might have been immediate rather than drawn out.

Thanks for sharing you insights.

Tee

 
Old 12-18-2009, 09:46 AM   #8
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Re: Newbie Here with Spine Treatment Questions

Yes, I think for some people there is a point where you may have waited too long. I did so with my ACDF as well thus I aggressively pursued treatment for my lumbar issues and am heading to surgery in February. Even that is longer than I'd like given I've had severe symptoms since May and been out on STD and then LTD all this time.

You need to get detailed information as to how many levels and what method they'd use for your fusion as there are a variety of different approaches.
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Rt&Lt thumb arthroplasty 2012 ; RT TKR & Bilat CTS 2011
Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 12-20-2009, 01:11 PM   #9
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Re: Newbie Here with Spine Treatment Questions

Hi AZ,

Again thanks for responding.

I just got through my transforaminal ESI for the L3/4 level. They got the right spot because it recreated the basket of symptoms I've been experiencing. Yes there are other symptoms that come into play. Dr said that this would be a nerve block but I have to say nothing was blocked because my symptoms remained if not worse after the injection.

I also have been out on STD/LTD through 2009. I was really hoping to get this nightmare behind me for 2010 but it doesn't seem like that goal will be realistic. I see the dr again on WED and I will ask him more detailed questions if we have to discuss the fusion.

Again thanks
Peace
Tee

 
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