02-11-2012, 12:52 PM
Join Date: Feb 2012
Location: Newport, Rhode Island
Contemplating PLIF surgery
I am glad to have found this board. I left the Doctor yesterday with many questions. I have been doing my research and found a great deal of what I needed to hear in your posts. If I may, could I ask for some input?
Here is my story:
I am in the Navy. Have been since I was 18. I am 43 now. I "hurt" my back when I was 19 while carrying bags through an airport. Over the next few days it got worse and worse. Over the following two years, I was miserable. I was in constant pain. Sometimes it was so bad it would make me sick. I saw several Navy Doctors an they always told me that nothing was wrong. I was too young for back problems.
When I was 22, I went to a Chiropractor who immediately spotted on the X-ray that my L5 was out of line due to sacrum not being fully integrated into my pelvis. A birth defect. This was causing the disc to bulge.
He showed me exercises a tips to help compensate. Over the next 20 years I battled the pain and focused on staying in shape. Through mostly swimming, I got the pain down to a minimum. Almost zero on most days. In fact, I can say that I am mostly pain free, but it doesn't take much. A slight twist, a missed step, anything can take me out of commission. It's like having a time bomb in me that goes off when I least expect it.
The Navy Doctors are better now and have fully diagnosed it. I am near the end of my career and they have offered me the opportunity to get PLIF surgery by local specialists. The Doctor I met with yesterday. He agrees that my L4/L5 are in bad shape, but does not want to encourage the surgery because I have done so well thus far. He feels that I am too young, even at 43 and that the surgery will cause more problems later down the road.
He has the the option up to me. Given me information to research.
So...here is my dilemma: I am active, I work out. I run, swim and lift light weights. Relatively pain free on most days, but it is always there lurking. Waiting to take me down. A sneeze, a cough, anything can do it. Even though I am in shape, I can't lift anything heavy anymore. At the gym, the 25lb dumbells are my limit and I have to be careful with them. I just can't handle any weight at all.
Will the surgery be worth it? Should I head the Doctors concerns that I am too young and the surgery may not be worth it?
Also, I am alone (by choice). So I would have to recover alone. Tough, but I am a tough old sailor.
Any advice is welcome.
02-14-2012, 11:45 PM
Join Date: Jan 2012
Location: San Francisco, California, United States
Re: Contemplating PLIF surgery
Hi there, tough old sailor. Sorry that you didn't get responses from anyone right away. I think that your situation is tough, because you are able to maintain a good quality of life for the most part.
I had ALIF late 2011; I am younger than you are. I have found that younger folks have an easier time recovering from surgery, so don't let not being "old enough" deter you.
For a long time (high school forward), I had episodic, excruciating back spasms. You might know -- the kind where you can't stand up straight and end up spending four-five days lying on your back with your feet elevated. Or, you wake up one morning and your head falls back. Your mom takes you to the ER because you are holding your head up with your hand. But other than an annual crisis situation, I was fine and never had comprehensive imaging.
The decision to have the fusion was prompted by another crisis. Literally woke up one morning and could feel the spasms coming on. Imaging showed stenosis because of an annular tear at L4-L5, which had probably been there for a long time, but was aggravated by ???. The decision to have the surgery was pretty easy because after that particular event, I started to have daily pain, which was not responding to conservative treatments.
In making the decision whether surgery is right for you, you might want to consider the lifestyle you can expect with and without the surgery. You might also want to think about whether you could financially afford the surgery, with attendant aftercare, either now or in the future. Living alone, you will probably need daily help for at least two weeks post-surgery and some help for several months. For example, I am 11 weeks post-op today, and I am limited to lifting 15 pounds. I avoid bending, so emptying the dishwasher is out of the question. Fortunately, I have help. Otherwise, I would be eating off paper plates and living in a filthy house! I am also not allowed to swim yet, which is a giant bummer.
I would ask the doctors some questions. For example, with your current condition, when your back pain is active, is it causing any long-term damage? Also, I would consider where your pain is. I understand that fusion is typically most successful for resolving radiating pain, rather than pain in the back itself. If you want to continue running, you may consider the extra stress that a fusion will put on the adjoining discs. I would also ask the doctor whether the PLIF would have the same expected outcome for your condition 10 years from now. If you have a lot of osteophytes in the vertebrae adjoining the discs, that might be a sign that your body is attempting autofusion. If that is the case, then you likely want to look at fusing surgically sooner. On the other hand, delaying might bring better long-term studies of artificial discs and new surgical advances. I had hip surgery last year arthroscopically, which even ten years ago would have been an open procedure.
Ultimately, it is going to be a personal decision. If I were 95 percent pain free in my daily living, I would never have had the surgery. But, if the remaining 5 percent is unpredictable and unbearable, it might be worthwhile for you. I have learned to go with my gut, and if you have any doubts, you can probably schedule the surgery later, but you can't undo it once it's done.
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