Re: Lumbar Spinal Stenosis?
Actually, Bracing would be a good indicator. They wrap you in plaster like a body cast to make the mold for the plastic brace and then trim it down. But being wrapped and totally stable felt wonderful prior to may last surgery, I asked if I could have the brace when it was complete but the way it was arranged by the doc , they delivered the day you had surgery to the hoptital room. Lots of fun sitting up hours after surgery to try a brace on. The brace would lkely prevent further progression of the spondy but stenosis needs to be surgically corected, the brace wouldn't do much if that was the cause of radiculopothy in your legs.
Bracing was offered as an alternative 2 years ago for my spondy and instability, but my fear was becoming dependent on the brace to stand and walk, where I have done a good job keeping my core muscles as strong as possible, that would be lost of I depended on a brace.
Even that is a tough decison, I would need a new brace, but doubt it's going to have a huge impact on standing endurance and function, more likely it would relieve the crunching and grinding when I sit up or walk and prevent the spondy from getting worse. I have grade 11 at boththe thoracic/lumbar junction and the lumbar sacral junction.
IF you looked at the last link figure 4, They would pretty much do the same thing, extend my fusion from L1-S1 to T10 to S1 plus some other work. I can walk now and taking the chance of loosing that, given the odds has made it intelectually an aeasy decision but there is always that nagging guilt telling me I should try anything possible to get my lfe back despite the odds or risks. As far as function, the only thing I have left to lose is the abilty to walk and contrlol my bladder and bowels. That surgery could take that too and the likelyhood merely stabalizing my spine, corecting the spondy and revising the fusion stastistically isn't likely to relieve the pain.
In the last 6 years every doc I have seen has comented they have never seen such a mess in someones back that could still walk. So I'm suposed to be greatful for that. Although It really never made me feel much better to have someone say, at least you can walk.
Untill some new technology comes along where they can inject sometype of bone cement into the areas that should have fused, I really don't see more surgery as an option. They do have the bone cement, rhBMP2, but it's not used for that and I haven't been able to convince anyone to try it. Even if they could just inject the holes in my scarum where the screws toggle, that would be an improvement. Maybe someday.
Scotty, with 2 progressive problems, meaning they will likely get worse, the pain will get harder and harder to manage, your dose will need to be increased as it progresses and you will reach a point where you can't tolerate the constipation, urinary retention and sedation to the point where you simply can't increase without being zomked all the time. When that happens there isn't much more that can be done. You live with your disabilities and a lot of pain that simply can't be managed because you reach a point where you can't tolerate any further side effects and meds for side effects no longer work or are no longer safe. Taking aderall because someone is incoharent from opiates isn't a reasonable request nor would it be healthy or effective.
Even if you don't have the UA problems, ED or constipation problems, living sedated isn't living. I could have my pump cranked up and drop my pain from barely tolerable to a smile on my face when I'm awake, but that's no way to live, My wife wouldn't put up with it and I don't want my daughter coming home to a dad that's passed out and can't be woken.
It's true there is no absolute ceiling on the amount of opiates someone can take, but there is a ceiling on the side effects different people are willing to except and how much relief you can obtain as problems progress. Stenosis is likely to get worse and spondy may or may not get worse. The good news is those have obvious ways to correct. They increase the size of the outlets for the nerves and fuse you to pull you back into alignment.
First time around odds of succes aren't that bad, but the percentage that fail can end up even worse off than now. At least you can attempt to stabalize and relieve problems that you know are going to get worse with reasonable odds of success.
Good luck, Dave
Last edited by Shoreline; 05-26-2006 at 10:40 AM.