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Old 12-07-2012, 08:19 AM   #1
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Back pain - what to do?

Hello,

I'm 32 years old and have a very 'contrary' back.

I had a herniated disc at L4-L5 back in 2010 and had a micro disectomy to remove the disc. Having been in absolute agony for months and unable to lie on my back and in the end, get into any kind of comfortable position, the relief after the op was incredible. Prior to the surgery, my left leg was numb and in the final few days, had turned purplish blue.

Following the surgery, I was able to lie on my back. I had a period of burning in my left leg but it was all manageable. Since then, I've had periods where I've been fine and then periods of pain. I still have some numbness in the left leg.

The issue is that things are still not 'right'. For the past few months I've had periods of terrible pain.The pain comes from sitting down mostly. When I try and stand up, I'm bent forwards and to the left and I have to walk on tiptoes for about 15 ft before I can get upright again and walk normally. Sneezing can make me feel like my back is going to pop open. Some days I can walk for a couple of hours, others, the pressure in my lower back is terrible and I have to sit down. Sometimes it even hurts just to get out of bed or try to turn over. I often have trouble getting up and down off the sofa.

I have been to the Wooridul Spinal Centre in Dubai and following MRIs and x-rays, they have said that part of the disc that was removed is still protruding, I have reduced space between L4-L5 and the gap is not straight so I have developed mild scoliosis. He has diagnosed DDD and suggested an ALIF at L4-L5. The surgeon is meant to be one of the best, having performed 8,500 of these surgeries and Wooridul is an international centre for spinal care.

The thing I'm bothered about it that I'm not in agony all the time so is this surgery completely necessary? I've been told that physio is not an option. I'm 32 but often feel about 92 I'm so stiff and restricted, even though I have always been very active and flexible. I just want to be able to feel like I can live my life, swim, pick my nieces up, sit at my desk, and in the future have a healthy pregnancy and natural delivery, without having this pain hanging over me. I've had back problems on and off now for 5 years as I was diagnosed with disc bulges at 27.

A friend of a friend was in exactly the same situation as me and had the fusion. She said it was the best thing she did, despite not being in agony and not on painkillers at the time (she too had a microdisectomy 2 years before). I can manage most of the time without painkillers, apart from the most recent 'flair' for which I was taking myenol and voltarin. The issue is that these painkillers shred my stomach and I end up with chronic stomach ache and passing blood. Other painkillers mean I'm unable to work - something I have to do! I was taking painkillers because I had family to stay so I was more active than usual but would be perfectly average for anyone else, which makes me think I'm currently living a very sendentary lifestyle to prevent the pain coming.

Has anyone else been in the same situation? Can I at least think that a ALIF won't make it any worse, if not better? Any advice would be greatly received. I'm due to get second and third opinions this week from a US and European clinics, but I'll need to make a decision soon.

Thanks so much!!

Last edited by Desertalison; 12-07-2012 at 08:22 AM.

 
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Old 12-07-2012, 11:55 AM   #2
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Re: Back pain - what to do?

I imagine that you have a bit of spondylolisthesis going on in addition to what you are terming "scoliosis." This is a slippage where one vertebra slides over the top of the adjacent vertebra. If you look at a normal side view of the lumbar spine, you will note that the edges of the bones more-or-less line up. With a spondylolisthesis, you will note that one segment will be indented from the edge line-up (if that makes any sense?) It can be a very small amount or enough to cause problems. It can create some instability which can account for pain going from one leg to the other, or pain in both legs. This would also explain why you are not in pain all the time. Sometimes when you move, you are experiencing some nerve compression. When you move another way, it relieves that pressure. (You can look up spondylolisthesis online and find pictures of this that will help you to visualize what is going on!)

This was my problem prior to surgery. I got horrid sciatic pain when on my feet, but as soon as I sat or lay down, it would go away. When the pain comes and goes, it is hard to decide to have a major surgery that cannot be "undone."

Chances are, your surgery will turn out well, but you would be foolish not to think about the consequences of a less than perfect outcome. There are no guarantees with spine surgery....For this reason it is important to take your time to research the topic, to determine that surgery is necessary for you and that there are no other options, and then, if you decide to have surgery, that you have found the best trained, most experienced spine surgeon that is available to you...and that the hospital is well-rated, too and has a low rate of infection in the surgical suites.

I have to go for now. I've had two lumbar fusions and would be happy to try to answer questions that come up as you think more about the process. Don't let anyone push you into surgery. It is a big decision and you must be aware that it will not return you to the way you were prior to any onset of injury or pain. You should be better...but you will never have your "old spine" back.

 
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