Lod lordy, I know the feeling of just wantingit fixed.
Just abrief description of surgeries and many m,any pann management docsand modalities in between. But the first surgry is 93, a laminectomy /discectomy to releave a large bulge pressing on L3/4 and 4/5 nerve roots, I awoke from surgery with all leg pain relieved which was wonderful, styandard 3 day stay, PCA for 2 days and then oral SA meds for post op.
The laminectomy which is the removal of the spinus process, that hook shaped joint that sticks out the back, they just clip them of which basically creates spia bifida, a whole in the vertabrea so they can see th nerves and cord. You have the wings on he sides and thosa are faccet joints and the hooks in back are the spinous process, Sometimes it needs to be romoved to access the surgical site. Anyway, they removed a little too much doing the Lami and you lost one of the 3 joints holding things in place, It's actually a farely common problem caled post ,lami syndrome. It causes slipage from front to back, the facets secure side to side movement but front to back either presses on the cord and stretches nerve roots of compresses nerve roots.
After lots of PM, then a fusion in 96 L3-4-5. morePT then PM. I never felt right even though doc said it was fine and stable, I sheared off the botttom screw heads and the rods popped of the screws and everything shifted, no fun, so more PM for 3 years, no pain meds eccept for the occaisional flair my GP took care of but all that was offered was non opiate pain management or surgery.
I was back at work and making money and thought just replace the broken hardware and redo the fusion. When I went to sleep at 8 am in 93 I woke up at 8pm and realized it was dark outside and something had obviously gone wrong. The disc above was crushed and impinging, the disc below the same, the vertabre split when they put a screw in L2 so had to hop over it with only one screw in L2 and go to L1. They put horizonatl bars in to stabalize and I ended up fused from L1-S1 with twice as much hardware. All these were posteror but I ended up with what looked like a broken ladder mising 2 wrungs..
I never really recovered from the last surgery, did the turtle shell, did the aqua therapy, but other than leaving to go to Pt I was bed ridden and then my insurance said, you stopped making progress and there is no point in any more. Long story abpout the apeal process but it was a joke. Slowly one screw head as been sheared of after another, the screws in my sacrum toggle in the holes, no bone growth, I did use an exterior bone growth stim, they did add the growth enzyme to the mix od crushed cadavor and harvested, Both sides of my ilac crest have donated to the cause. And basically I was bed ridden untill I had tried every non opiatye method to manage pain you can name.
Once they gave up and I got outside my loop of docs My SSD attorney recpomended a PM doc who was in my network but I assume because he prescribes opiates they wouldn't refer me to him. I had been called an addict, it was all my head, the whole CP nightmare. I went through 3 PM clincs a work hardening program and months ofPT before I was guided to the right doc. It only took 3 surgeries and 6 years to find him.
It took a few months to get the med and dsose right but it's been slow steady improvement as far as pani control and increased function. But I still need to be fixed. When everythning shifts and crunches no amount of meds masks it and self hypnosis isn't going to blot it out either.
I Did the oral med thing for 4+ years, was on a relatively high dose but was stable on whatever med I was taking for the duration until I had a pump implanted in June.
That wasn't short, sorry
Spine world I believe is a sopnsored site and wil create a link to it just by typing it, if it turns green it's a link, If not search for it, spine universe is another to find and you can investigate the technique and any other procedure, piece of hardware and aproach to fixing the problem you want at spine U.
When I look at the mechanics of the spine and think what would be the best way to do a fusion, posterior isn't the answer I get. Fusing the facets, could never be as solid as if you could fuse the large flat areas of the vertabrea together. You have to keep the gap so bone is used, preeferabbly your own, buut cadavor if he's not famliar with rib resections and sees ribs as a souce of bone.
When the fused my dads cervicel vert. can't remeber which level but it was just a single level, the simply re4moved the disac, roughed the two flat surfaces that was designed to collaps on each other and his fusion is rock solid.
I was cocerrned you were looking at a fusion to your sacrum and a posteror aproach looks like the most rediclous cross your fingers attempt you can make. Something I didn't know then, Heck I didn't even have a computer or interest in one. I worked too much.
The sacum is softyer than vertabrea, just diferent bone composition, so it's harder to hold a screw The facets on each side are much farther apart and acturally barely interlock so it's lke trying to glue or fuse two 2X4's together end to end rather than the largest flat area to the largest flat area. It just makes mechancical sense to fuse large flat areas, which can only be done anteriorly .
The problem you may face is what is the shape of the disc at L5-S1. Can it take the brunt of the fusion on top ofit. The fused area looses all mobility, so you over compensate above and below and it puts a beeting on those discs. You may even wake up fused toS1 which any decent doc would tell you up front he's gong to check it out and try to do what's best. A redo takes a lot of pressure of the doc, because you are already screwed up. Not that I have anythng against a doc that can fix another mess. Supermen in my book,. But very few and the techniiques are un proven, non FDA aproved, there are dozens of hardware divices to choose from and who knows what is the best device.
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