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Its been awhile since I last posted so to recap I have suffered lower back pain on and off for years until March 2007 when the back pain arrived and never left. It also brought with it numbess in my left hip, thigh, calf and foot which has now turned into severe burning sensations. I have since been through 3 rounds of PT, had 2 MRI's, a pelvic scan, a myelogram, and 6 injections (1 epidural, 2 SI joint, 1 local cortizone injection, and 2 facet injections) I have been to 2 Neurosurgeons, 1 ortho, 1 PM doctor, 1 Physical Medicine doctor, and 1 family doctor. I have been diagnosed with DDD and SI joint dysfunction and my latest MRI shows no change in the last 6 months even with all of the PT and injections. The 2nd Neuro recommended ALIF surgery and a back brace. I feel like I have no other options since I have not been able to do anything that I used to enjoy and I seem to have turned into a sour person since I hurt daily. Before March 07 I wore 3 inch heels and speed walked every day and now I cant wear a shoe with a 1/4 inch heel. I have been unable to work since April of 2007. My Neuro said that recovery is short and that I should be able to do normal activities that I have not been able to do since March about 8 weeks after surgery and he also said I would only stay about 2 days in the hospital post op. Wish me luck the operation is scheduled for Dec 27th.

I just hope this allows me to be active again!!!!!!!
My thoughts and prayers are with you . You will be fine . My husband is going in January of 2008 for lower back surgery . He had a herniaed disc surgery in August of 2006 of the sixth cervical disc the last time and now the lower back disc is bulging . He is in paid and taking Physical Therapy for now that is helping him some , but he still needs surgery.

He also has burning in the legs . My husband will be home at least 5to 6 weeks recovery and we are hopful . Keep us posted here.

Blessings,
Thanks for your replies and encouragement. I just hope the surgery is a success because I am 36 years old and I feel like I am about 65 years old right now and I am starting to look years older because of the contant pain and depression that this has kept me in. I look forward to being able to throw ball with my 12 year old son again or just play fight in the house without saying "stop that is hurting my back"
Byramgirl, couple questions -- what's ALIF surgery? What did the other neurosurgeon and ortho say, do they recommend surgery as well?

Only reason I'm asking -- I had disk surgery (diskectomy) after having only seen one orthopedic surgeon. I was looking for a quick fix, but it didn't help. I have gotten worse since the surgery, but I don't know if that's from the surgery or just the natural progression of my DDD. Since that time, I have seen two university spine specialists and one neurosurgeon. One ortho was ready to go forward with a spinal fusion; but the other two doctors said it wouldn't help and could make it worse.

I'm NOT saying you won't be helped by the surgery -- you are way younger than I am and probably have completely different issues. But what I might do, if I had to do it again, is get a second opinion before I went through with the first surgery. And now, thanks to the people on this board, I am a lot more educated on what to look for in credentials -- board-certified, fellowship in spine surgery. Good luck to you!
Hi....I'm sorry you're having so much trouble; still, I think you should get a second opinion. Since you don't have any ruptured disc and no bone-on-bone from degeneration, I wouldn't rush into surgery. There is a procedure that can help with the pain from the SI joint.....it's called Radio Frequency Nerve Ablation and it burns the small nerves in the area which keeps the pain signal from reaching the brain.

Of course, this is your decision, but I do hate for anyone to go into a lst surgery without a 2nd opinion and with no stone left unturned to find a way to control your pain.I hope you will at least give it some thought.

Carol
Just chiming in to say that if it really is your SI Joint then I'm a FIRM believer that it's a matter of finding the correction exercises that allow you to put your own SI Joint back into place often (a couple times a day or more). Then you are increasing aligned, allowing ligaments to heal, your muscles can relearn proper functioning while aligned, and inflammation can subside. It's working for me. Took 10 mos to find the right exercises! I now have two methods that put me right back in, after a year of trying all kinds of options. After about 6 weeks of using those exercises regularly I am definitely getting better and using very few meds (just naproxen).

You can search for a PT who specializes in pelvic floor disorders using Physical Therapist associate sites. You can also check out Richard DonTigny on the web, one of the most knowledgeable in the SIJD area. He basically says the SI prob comes first - before the disk issues. Or find a PT who trained at Michigan State - known for the SI program both in curriculum and post-grad seminars.

I have also heard excellent things about RF, radiofrequency ablation. NO big deal, and some have great SI pain relief. Potential for 3-12 mos of relief. And not permanent like surgery. I was about to schedule it when I started to feel better.

Again - just chiming in. I'm an active, healthy 36 yr old too, so I totally relate to the depression of having a young life halted by a mysterious condition where all the docs seem to be guessing. Either way, I wish you ALL the best, and I'm sure you will find the answer that is best for you. :)
Thanks for the advise from all. I thnk I will get a second opinion before surgery because I don't want to be cut on and then be worse afterwards. I am just frustrated that the burning in my left leg is getting worse. I started taking Lyrica today but I feel really drunk in a bad way and I cant even walk straight (I hope this side affect goes away in a day or 2). My first Neuro said not to have surgery but I have tried everything and that is why I scheduled a surgery based on the 2nd Neuros recommendation

Avalon, ALIF stands for Anterior Lumbar Interbody Fusioin and they go in from the front and basically put a type of metal cage in the disc space between my l5 and s1 and then it will have something that makes the bones fuse. I have read alot about it on the internet and it sounds like I am a good candidate for this but I think I will ask my Physical Med doctor to refer me to another Neuro for a 3rd opinion.
Byram, I can completely relate -- you want to believe the surgeon who thinks he/she can fix it. Couple more questions -- you said you have also seen an ortho, what did he/she recommend? Also, why did the first neuro advise against surgery?

In my case, the one ortho recommended a "transforaminal lumbar interbody fusion" at L4-5 and decompression at L3-4. The only reason I didn't go forward with the surgery is he didn't take my insurance, and I would've had to put $4K out-of-pocket! Once I found that out, I went to another top spine surgeon, and he's the one who shocked me by saying "there's nothing I can do...you need to go to a pain management specialist". Later, I went to a neuro for a THIRD opinion, and he agreed with the second ortho.

The funny thing is, months later I asked for a copy of the medical report from the surgeon who wanted to do the surgery. The last sentence was something like, "My greatest fear is that she won't get any relief from her pain"! Whaaattt???!!! He never said that to me! While he did not guarantee anything, he definitely thought it would help and even said if it was his wife, he'd tell her to do it. If he had made that greatest-fear statement to me, it would've raised a red flag and I would've definitely thought twice about it....but he didn't. In retrospect, I am glad the insurance issue came up. It forced me to go get second and third opinions before I jumped into a very huge surgery with a long recovery period.

I certainly don't mean to discourage you, but since the one neuro recommended against it, I think it would be wise to go get additional opinions from top spine experts just to be on the safe side.
I'm not trying to be negative to you. I just think your doctor is sugar coating this to you. This is a very major major surgery. DOn't think in eight weeks your gonna be back up and fine again ok. I am nine months out and life is not back to normal. At eight weeks you might be able to manage some everyday life things but real recovery is really about a year. This is fusion. This is the majorest of the majorest when it comes to back surgery.

When you are going into this surgery been informed, do your research, get several opinions, and don't have a belief that your gonna be better in 8 weeks. Now fusion isn't the worst thing in the world either. Alot of us here have had it, but I just didn't want you to think something other than what it is.

I to have or had whatever DDD and leg pain etc. I hope he tld you that the surgery does not promise that this will cure the problem either. It can take up to a year to even know if this will go away. Thats what I am going through myself. would I do it again, Yes. Why? Because its my only hope to see if I can get thorugh this, I tried everything else first and waited and had been off work forever and waited until my leg barely even worked anymore.

Now I don't know how bad yours is, but if I were you and if you have any choice at all...I would look into the artificial disc first and avoid fusion at all cost. I would find the top surgeons in your area who have the most expereicne doing this as it has only been approved by the fda for a few years now. You want someone with the most expereince, you can check like charite or prodisc and look and see their surgeons and see if your insurance covers there doctors.

In my case by the time the fda approved it, my ddd had advanced to far and turned into spondyolethesis where my vertebrae had started slipping so I was ruled out.

the reason for this is (sorry if you already know this) in fusion your spine can't move anymore so other levels overcompensate and then the "dominoe" effect can happen and alot of people end up with lots of back surgerys.

The artifical disc aka adr moves and flexes with your spine eliminating this. They have been doing it in germany for over ten years with great success. I would really explore that avenue. I wish I could have went that route, I was just ruled out.

good luck, and ofcourse make sure surgery is the last resort.

vette
Thanks to all the replys and advice. I saw my Physical Medicine Dr today and he wants me to go back to my first Neuro for another opinion. He knows the Neuro that wants to do my surgery and he didn't have a bad opinion of him and even said he had good hands but if it was his wife he would only let my 2nd Neuro do surgery if he could watch and dictate what procedures he performed, so I think I will see my 1st Neuro again and see what he says.
Another update. I went back to my family doctor who referred me to both of my Neurosurgeons and he said that the only reason the physical med dr thinks I should go back to the 1st Neuro is because they work in a group referring patients to each other. My Family doc said that the 1st Neuro. PM. and physical med doctor have all just tossed me around to the next person for the past 8 months and I have done nothing but get worse. He said my 2nd neuro is one of the buisiest Neuros in my city and that he has a very good success rate. he also just operated on the son of my family doctors nurse and it was a brain surgery and she said her son has been fine. So I think that I am going to give this a try since it is a level 1 fusion at the l5 s1. please wish me well on December 27th and wish the doctor well also so he can have very steady hands.
[QUOTE=yvette777;3351046]I really hope you take the time to look into Artificial disc.[/QUOTE]

Thank you Yvette, I am researching the artificial disc and comparing the pros and cons of each. I have an appointment next week to get fitted for my back brace and I am going to ask about it then
Byram, when people were suggesting a 3rd opinion, they meant an entirely different neurosurgeon or orthopedic surgeon -- not another opinion from a doctor you had already seen, or a doctor who's not a specialist in spine surgery. I know it is frustrating and annoying to have everyone throwing advice at you, but the people here are just looking out for you. Spinal fusion surgery is not something to be taken lightly, and the recovery time is not to be minimized.

You've had one neuro tell you NOT to have surgery, and one neuro tell you to have it. There must be a reason the first neuro thought the surgery wouldn't help -- that would be my concern, if I were you. For that reason, I would definitely go to an entirely different board-certified fellowship-trained spine surgeon for a "tie-breaker" opinion. You do NOT want to just close your eyes and hope for the best....not with THIS surgery. You are way too young and the rest of your life can be affected. I hope you reconsider before going forward on the 27th. That is just my opinion, as someone who leaped too quickly into spinal surgery. Good luck either way.
[QUOTE=Avalon;3351273]Byram, when people were suggesting a 3rd opinion, they meant an entirely different neurosurgeon or orthopedic surgeon -- not another opinion from a doctor you had already seen, or a doctor who's not a specialist in spine surgery. I know it is frustrating and annoying to have everyone throwing advice at you, but the people here are just looking out for you. Spinal fusion surgery is not something to be taken lightly, and the recovery time is not to be minimized.

You've had one neuro tell you NOT to have surgery, and one neuro tell you to have it. There must be a reason the first neuro thought the surgery wouldn't help -- that would be my concern, if I were you. For that reason, I would definitely go to an entirely different board-certified fellowship-trained spine surgeon for a "tie-breaker" opinion. You do NOT want to just close your eyes and hope for the best....not with THIS surgery. You are way too young and the rest of your life can be affected. I hope you reconsider before going forward on the 27th. That is just my opinion, as someone who leaped too quickly into spinal surgery. Good luck either way.[/QUOTE]

Thank you Avalon, the 1st Neuro said no to surgery back in July before I finished 2 more rounds of PT and before I had 5 more injections but for some reason I could not get back into see him (I ticked off his nurse and she blackballed me from getting into see him again I think). My 2nd Neuro also mentioned Microdiscectomy in the letter he wrote to my family doctor, would that be something worth trying 1st? I have to do something fast because my body is aging faster than I am and I was looking at photos from last Christmas and my face has aged about 10 years in the last several months and I never laugh or smile anymore because of the depression caused by this pain. (sorry to whine)
Oh Byram, I completely understand how the pain ruins your quality of life. I am depressed, miserable and snippy most of the time as well.

I am not an expert or medical professional so please don't take my word as gospel. That said, my understanding was that a micro-diskectomy was the least complicated surgery and the one they usually try before the more drastic step of a fusion. In my case, the diskectomy didn't help at all, and I'm not a candidate for spinal fusion because all of my disks are degenerated.

Sounds like Neuro 2 didn't think a diskectomy would help...? What does he say in the letter about it?
[QUOTE=Avalon;3351425]Oh Byram, I completely understand how the pain ruins your quality of life. I am depressed, miserable and snippy most of the time as well.

I am not an expert or medical professional so please don't take my word as gospel. That said, my understanding was that a micro-diskectomy was the least complicated surgery and the one they usually try before the more drastic step of a fusion. In my case, the diskectomy didn't help at all, and I'm not a candidate for spinal fusion because all of my disks are degenerated.

Sounds like Neuro 2 didn't think a diskectomy would help...? What does he say in the letter about it?[/QUOTE]

The letter is long but near the end it says the options of back bracing and a trial of Lyrica were presented to the patient. The options include microdiscectomy, anterior lumbar interbody fusion, posterior lumbar fusion, and TranS1 AxiaLIF. The patient will undergo a trial of back bracing with Lyrica. Should the Symptoms persist, I would recommend a Lumbar Fusion at the L5/S1 segment as the best option to eliminate the back and leg pain.

I guess I was probably the one who said "when can we do it" since all of my out of pocket has been met for the year and the surgery will not cost me a dime, but he was the one who aggreed to do it on Dec 27th but he also saw the pain on my face and in my voice.

My mother has had many back surgeries including 3 disc removed over time and I know the recovery is long and the pain is probably lifelong because she still has back problems but she said that after her 1st back surgery (unsure what was done) she was still in alot of pain but when she went for her 2nd back surgery about 25 years ago (it was a fusion of the L5/S1) she said she thinks she got about 8 good years without cronic pain and if I can get that I will be happy, of course I'll take as many years as I can get.
I gotcha -- I've sometimes felt that way myself (any amount of time with no pain would be worth the risk of surgery). In the end, you've got to feel comfortable with your decision and your doctor. I hope it relieves your pain and please keep us posted. Good luck, Byram!
[QUOTE=Avalon;3351617]I gotcha -- I've sometimes felt that way myself (any amount of time with no pain would be worth the risk of surgery). In the end, you've got to feel comfortable with your decision and your doctor. I hope it relieves your pain and please keep us posted. Good luck, Byram![/QUOTE]

Thank you, I really feel confident about this, even though I can't do anything right now, my body is in fairly good shape and I quit smoking 22 months ago so that should help with the healing. I am scared though because other than childbirth I have never been in the hospital myself and I have never had stitches or a broken bone so this will be very new to me.





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