a big Dilemma -Discogenic pain

[aidin]

hi all

I have DDD at L5/s1 and am 32 years old.
I have only typical discogenic pain and very mild retrolisthesis for over 4 years.

About the ''quality of life'' : I can't sit comfotabely for more than 1 hour at a time. In fact I have to lay down for 2/3 of day because of sitting issue. and less than 45 minutes can tolerate riding in a car.

My oswestry is around 36.

Did you go for ADR if you were in the sitution like mine?


I wonder if anyone knows

''Meanly , after how much time period, the facets will be so degenerated or retrolisthesis progress to the point that I probably disqulify for ADR ?''

any idea or simillar experience will be appreciated.

thanks

[Brad]

aidin,

I fit pretty much in your situation except I did not have to lay down so much. I knew however that with time I would get worse and worse so I did the ADR three weeks ago. So far so good.

Brad

[Juli]

Honestly, if I just needed one level, particularly L5-S1, I would have gone with the fusion as my insurance did not pay for the ADR. Even at the symposium some doctors agreed that fusion was still a valid surgery in certain situations. It certainly sounds like you are at the point where something needs to be done.

Good luck.

[Alastair]

Hi Aidin,
you are typical ADR case, when you sit up the fluid goes out of the disk and compresses, when you lie down, the weight is taken of the disk fluid goes back in it.

If you are approved for ADR and a suitable patient, I would get it done as soon as possible.
Best,
Alastair

[annapurna]

Aidin,
Of course only you can decide whether or not your quality of life has decreased to the point where you would be willing to risk major spine surgery - and that's what ADR is. At the same time, I think that there are now acknowledged conditions that decrease one's chances of a successful ADR outcome - lysthesis and facet degeneration being a significant two.

I think that, having decided you are going to get ADR, I would time the surgery date so as to optimize your chances of success. I waited about a year after having decided I would like ADR and am now struggling with pain from advanced facet arthritis. Maybe my delay had nothing to do with my facet symptoms, but, it is likely that they played a part. If I had it to do over again, I would definitely have acted faster.

I think that the significant risk associated with spinal surgery make the "bad enough" question come up more often. If you had, for instance, a seriously arthritic knee that made walking and fitness activities very painful, you would probably not think twice about getting total knee replacement or similar surgery to restore your ability to walk and stay physically fit. Spine surgery is riskier, with the possibility that one may not only not get better, but may actually get far worse.

There's an interesting quote from a James Bond movie where the villian says, "It's not worth living if you can't feel alive". When you can no longer engage in or find new activities that make you feel alive (whatever they are) then it's probably time to consider taking on some risk.

Best luck in your decision and please keep us posted.
Laura

[Mariaa]

As it's said only you know for sure tho if you're asking me what I'd do in your sitch.. I'd go for it if you're in really bad shape and can't do much.

No doubt technology and experience may improve over the years however, it's doubtful that for most our disc situations will.. so it's weighing the natural degenerative time span our our discs against other factors..

[mmglobal]

Aidin... long time, no see. I'm sorry that you are still suffering.

No great words of wisdom here... people on the cusp have the toughest decision. If you were worse, it would be easy. I suspect that things are bad enough, or you wouldn't still be here. You'll know when it's time.

1. Am I bad enough to justify surgery?
2. Do I have any expectation that things will improve without surgical intervention?
3. What do I risk by waiting.


I hope that you can get good answers from 2 and 3 by being evaluated by several surgeons who have great experience with ADR... and hopefully with other technologies that are available as well. Perhaps a less invasive procedure is possible?

Whatever you decide... good luck!

Mark

[letteski]

Aidin,

I sounded very similar to you as well. But I also had nerve pain in my legs diagnosed stenosis, narrowing of the nerve root pinching of the nerve running from my back to my legs. Do you have this at all?

The longer the nerve is pinched the more chance you have for permanent nerve damage. I had to get the pressure off my nerve waited 10 months and things are much better but I still feel the nerve irritation sometimes. Hopefully in time this will all regenerate but I have seen others that waited years and years have continued nerve problems.

I know you were asking about facets problems but I just wanted to add nerve issues to future problems for those that wait as well.

I would do ADR all over again in a heartbeat but would get through the research time quicker but it is all part of the possess. Keep asking questions and you will know when it�s time.

[aidin]

thanks a lot for your great advices.


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I knew however that with time I would get worse and worse so I did the ADR . Brad
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Brad,
it's funny that I don't get worse with time unfurtonately! it's one of the barriers for me to go to surgery.Of course I know well that the underlying pathology will develop over time.

you are a braveheart, because very few Active L disc are implanted in humankind , over the world yet.


Juli
about the fusion vs. ADR at L5/s1 ,at present there remains a great challenge between spine speciallists.Howevrer in my case , since the onset of DDD was insidiuosly and without any fall or trauma or event ,and there is also a little degeneration at L4/L5 on MRI ,I guess there may be a natural trend for DDD especially at a suspectible level such L4/L5 ,so I think that FUSION at l5/S1 is not a good chooice for me.While some researchers like Crock .et al beleive that AlIF is the best for IDD (INTERNAL DISC DISRUPTION).SEE! it's all a dillemma from any angle!


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you are typical ADR case.
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Alastair
if you remember there was some sitting problem post op in Prodisc patients ,that dissapointed some folks such as ADRDREAMER who is the most similar case to me on the boards.This annoys me.


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There's an interesting quote from a James Bond movie where the villian says, "It's not worth living if you can't feel alive".
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Lura
you noted a great point. I'm a single man. since childhood I have whished to marry with a nice and beautiful woman.this is what I love !
It may seem ineresting or even foolish for some of you...
.
I can give up anything.. hiking ..biking..swimming ...even travelling...but can't give up this one! and this is the sad part of my story..with this inability to sit ,it seems like a dream ...when they become aware of my debiliating back pain ,they try to forget me ASAP ! very sad...
one of them was a beautiful and smart girl ,an internet-nut.after a quick search she said :
''well...but if you end up with a life-threatening revision ,what should I do ?!''....


as you have mentioned I have very slight retrolisthesis and it's a concern with ADR outcome.(as MARK said somewhere).


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Perhaps a less invasive procedure is possible?
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hi ..MARK

I only can go to GERMANY ,and as far as I know there i'nt any minimally invasive procedure for someone with %100 back pain there.do you know any?
As you know even procedures like SED can't treat this condition.(please remember your post about this and ADRDREAMER's response and experience about it.)

Paulette
no I don't have any leg pain or nerve pain.pure back pain.


any thoughts and sugesstions ,please?

[mmglobal]

Aidin,

I think that you are confusing Paul with ADRDreamer. Paul is the SED patient who ultimately got a ProDisc and did not do well. To my knowledge, ADRDreamer has not had surgery.

Do you have a conclusive discogram that demonstrates clear discogenic pain at the affected levels, and no reason to suspect other levels?

Mark