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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

I've just been informed that I have two more discs in my spine that need intervention. I'm still healing from a third cervical surgery and now am looking at the lumbar-sacral area. Since I've already had 3 spine surguries, you can imagine that I'm not too keen on rushing into this. I've had four levels done in my neck with two anterior approaches. These failed to fuse and a posterior approach was used to redo everything and all new instrumentation. My neck is better but not out of the woods yet. After complaining for about 3 years, the docs are just now looking at my lower lumbar area (wish they'd done it all at once, so I might have been able to go back to work by now). I've had chronic pain in my lower back, calves, and feet that's aggravated by walking around only for a while. To complicate things, I also have AS (ankylosing spondylitis), so, my sacroiliac joints are often sore, especially during a flare. Sometimes, it's hard to tell what hurts in my back.
Bottom line: CT shows mild spondylotic changes of lumbar, w/stable minimal disc bulge at L4-5, and a broad-based central posterior disc protrusion at L5-S1; no canal or foraminal stenosis observed in this position. Today I had an EMG which confirms a chronic bilateral L5 radiculopathy as the most concerning finding; peripheral neuropathy was ruled-out (thank goodness!). One orthopedic surgeon has recommended fusion w/instrumentation as the only alternative to a constant chain of rhizotomies (spelling?) at that level. I had one rhizotomy and it only lasted 3 mos. before the nerves regenerated; this would be too expensive in the long-run. A second orthopedic surgeon is still on the fence until I have a discogram which is scheduled in two weeks [I cannot have an MRI due to a cardiac pacemaker].
My question to you, friends, is does anyone have opinions or ideas about what surgical APPROACH will probably be taken if surgery is decided on? From what I've read, there are several posterior, posterior lateral, and anterior approaches for the L4-5, L5-S1 area. Anyone have ideas on potential drawbacks and benefits to compare these surgical approaches? Is one approach initially more painful but more likely to be effective in the long run?
Signed, Tired of Being Cut UP

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