23 Year old Male, Wanting All Opinions

[KinTN]

Hello all, Unfortunately I am here at this point looking for opinions/experiences. I currently work as a trainer at a gym, Ive had pain for 9 months now, I 've tried 3 epidural blocks (1 with 2 sites at once), antinflamatorys, PT, and the latest chiropractors eh dont get me started.

I have a herniated disk at l5-s1 and its causing pain at my hips down my legs, making my feet cramp, my knees are getting weak, and getting up to pee all the time is not a young mans game..

So, Im ready to get this past me so I can be my extremely active self again, I can barely make it through summer school at the moment, i hoped i could make it to december so I can graduate but it doesnt look that way, so heres the deal. My Neurosurgeon (ditched the ortho), has pretty much said im the perfect candidate for an ADR.. My problem is that because of my age we know it wont last my lifetime, and they cant replace it yet correct? The risks?Failure, the whole site of incision and potential complications of a "male incision" , meaning cutting nerves leading to things that I need to have a family? What would you all suggest? I hear a fusion is what happens anyway when the disk fails, and the movement would be fine bythe hips, but will there be a relief from the constant sciatica, and other pain? will it cause problems to the other disks? Can I be active again? I need you alls opinions and I appreciate them all.. Sorry for that Essay..

[Amapola]

In describing your pain, you did not mention any back pain. Do you have any? Did you see your MRI and x-rays? Have you been diagnosed with Degenerative Disc Disease?

If your pain is only in your legs and your disc height and disc water content look alright on your MRI and x-rays, it sounds to me like a microdiscectomy is in order and not disc replacement or fusion.

I herniated my L5-S1 as well. I have some pain down my leg, but 80% of my pain is in my back. My MRI shows that disc as a very dark grey, almost black. That indicates that there is very little water content in the disc. All my other discs are a healthy white. My x-ray showed that the disc height is less than half that of my other discs. All these factors combined to complete the diagnosis of DDD and I was given an option of ADR or fusion.

I ended up seeing a number of doctors to seek out many opinions. Not one doctor here recommended getting fusion. Although there are some opinions out there that at L5-S1 level, there is not much movement, therefore fusion is not that limiting. There are also issues with this procedure for males with retrograde ejaculation (I think this happens in less than 1% of the cases). I'm female, so I don't have to worry about that. Fusion is very final and cannot be reversed. The Prodisc has been in use for almost 20 years. Although no one really knows how long it will last, indications are very good that it can last a lifetime. I figure that worst case scenario is if in 20 or 30 years it starts to fail, I can always go in for a revision surgery and who knows what new miracle technology will be available by then.

My advice is to do your homework. I've read almost every post on this website. There are some other websites out there as well, but I found this one the most useful. See several doctors and get many opinions. If you choose to go with ADR, the vascular surgeon you use for the anterior approach to the lumbar will be very key. You didn't list where you are, but the vascular surgeon who has probably done more of these surgeries than anyone else in the US is Dr. Willis Wagner in Los Angeles. All of the ADR surgeons use him and he is considered one of the best.

Good luck to you! But first you need to question why you are being recommended for ADR and not microdiscectomy.

Of course, I'm not a doctor so take my advice as just someone who has recently gone through all of this.

[KinTN]

I didnt want to add more but ok then, yea my back hurts as well , it causes me quite a bit of discomfort when I sleep, sit, or stand, when im at work and i lean down i can almost feel it clicking.. I have seen 3 different doctors and yes am doing my homework. The disk replacement is great but im a realist its gonna be replaced , 5-15 years what? My doctors, ortho, neuro have told me theres no way it will last my lifetime..

I have seen my xrays and MRI, all my disks are white except for l5-S1, which appears quite compressed, it is absolutely black, so no fluid..

Oh and pills have no effect, tramadol, hydrocodone, lyrica (latest)..

I just feel as if I cannot wait any longer as it'sjust getting worse..


I'm located In memphis TN..
Fusion or Prodisk (the one they would use)

[rhatzy]

Hi,

I had two levels, L4-5 and L3-4. L5-S1 is one of those levels where the decision to go ADR or fusion is a hot topic. You won't really know any limitations at tha tlevel with a fusion but what effect will it have on the levels above? Who knows. I believe it won't do anything. An ADR will last a long time. I have a Maverick which is metal on metal made in Memphis. In testing it has shown no wear for 35 years. The guy with the first Charite is still around with his disc after 25 some years. If you do have a bulge impinging on a nerve then a discectomy will most likely help, but then you have to consider they will cut out some bone and tissue and leave you with some scar tissue. There is a very minimally invasive approach for discectomy done in Dayton Ohio where he uses a tiny scope to go up your spinal canal thru an opening at the base of your spine. From here, he can see your problems and repair them with out removing bone or healthy tissue and leave no scar tissue.

I had two discectomies and if I had the option of ADR earlier, I would have done it.

Mark

[Jessica]

First, let me say that I am sorry you are dealing with this at such a young age.

Have they confirmed that this is your pain generator? I have a disc that looked good on MRI and is causing me significant radiating pain. Discs can be torn and damaged without bulging or thinning out. Were you in an accident or anything? Did the epidurals help?

As far as meds, the only thing that works for me on the nerve pain is a combo of Neurontin (gabapentin) and tramadol or norco. I also use a TENS unit and Ice is my best friend

[AJ]

some people's adr last for ages. mine was good for 6 years and i've just had the bottom one (L5/S1) fused as it has affected my facet joints and stopping my left leg working properly. discs are difficult to get out once in there and i opted to have it fused and left it. the one above it seems to be working ok still but i have a further prolapse (last year) a couple of levels up. saying that i had mainly sciatica before my adr and it cured it straight away. took a while to get use of my legs back and i was left with some permanent numbness but able to stay pretty active.

[KinTN]

No I wasn't in an accident I dont know if it was from working out, which I did religiously 5 days every week. Even did a powerlifting event. I think it was a combination of that and school to be honest. I was accepted into one of our allied health programs here in TN, and the books were the size of websters, 7 of them and I didnt want to be a girl and get a rolly bag. It's gotten worse since then.

Now my only problem is I have to last 2 more weeks im currently in school, and then I can get a break and get this taken care of, Ill ask my doc about the other meds, as nothing has seemed to help at all. My thing is, the disk replacement sounds great but at L5-S1, am I make a smart decision to get it , if its just going to be fused later? Iliterally am going to see my surgeon May 29th next friday.... I appreciate all the feedback guys, I know im young but I cant take it anymore..

Another thing my previous surgeon said my disk is so compressed I pretty much have a fusion? Eh, take it out cut the nerves lets move on,Im kidding but its frustrating not to be the way you are.. Has anyone found that a softer mattress has helped with sleeping? I just cant do firm?

[AJ]

Re mattress, its not a question of soft or hard just how responsive it is to your weight or shape. I am most comfortable in my latex one(with a reflex core), it has a cashmere cover which stops it being too hot or too cold which can be a problem with foam mattresses.

Will they be able to fit a artificial disc if you are nearly fused?

[rhatzy]

KinTN,

If your disc is almost gone and you are bone on bone then it will just fuse itself. However, no the foraminal opening from which the nerves exit is also much narrower and possibly pinching the nerves. In a regular fusion or ADR, they restore the disc space height. An MRI should show whether or not you have foraminal stenosis.

I know a guy who was a weight lifter, body builder, trainer who had L3-4, L4-5 replaced. He is totally pain free and back to squatting 300 pounds and back to his previous weight and training.

Mark

[KinTN]

All I know is my chiro thinks hes gonna heal me, and Im pretty sure were about to have a break up, im going up in pain level probly a 9 now, and getting tired of it.. I see my neuro friday so will be updating, hopefully I can find some medicine that will work for the next 2 weeks im in class, then can take until July off..


Wondering the down times of both procedures...

Well unless I build a time machine in my spare time and figure out how to reverse it, I'll be lurking.. more likely studying though..