Forthcoming ADR - Life and golf afterwards

[Karl 8744]

Dear All,

Please excuse me but I am new member of the forum from the UK. I am a 36 year old male and I am due to have level 1 ADR surgery on L4 S1 on Monday 14th January by Dr Ian Shackleford in Bupa North Cheshire Hospital.

My problems stem from an injury that i suffered whilst a Police Officer some years ago. Since then I my back has plagued me with gradually worsening pain. I have tried a selection of Chiropractors, Osteopaths, Physiotherapists and even underwent a lady who performed the Bowen Technique on me!!!! Don't ask please.

I am an active father of two young girls and managed my pain until October 2006 when I could not take any more. I was in London with work and could not work or walk and was finding myself looking for benches to lie prone across to try and achieve some relief. From this point I knew that I could not go on for the rest of my life like this.

More painkillers were prescribed but I hate taking them for fear of becoming dependent. I manage my pain through managing my mind and only take pills as an absolute last resort.

I play sports - soccer, tennis, gym work etc but my love is golf. I know that this has not helped my back over the years but I live for the game....sad I know. I desperately want to know if i will be able to play again and if so, within what timeframe? Are there any other keen golfers within this community who have had surgery and recovered to play? Please help.

My consultant told me about this site and i have really enjoyed reading all of the stories and comments that people have posted. I know that not all have a happy ending but most do and i take heart from this and also become aware about the pitfalls of my imminent surgery.

I am really interested to hear from anyone who has been under Mr Shackleford as a consultant and how their surgery went. For that matter I would love to hear from anyone with useful hints and tips about speeding up their recovery. Please tell me that i am doing the right thing because right now i am not 100% sure....

Right now, I just want to get back to being a proper father to my children whist taking part in the activities that i enjoy and hope to share with them in future years

Thank you for taking the time to read my ramble and I would welcome any constructive comments you might have.

Karl

[annapurna]

I have a good friend and coworker who plays golf well enough with a single level fusion to have everyone commenting when he loses a bet on the course. ADR shouldn't slow that down, if you don't run into facet problems. I'd spend extra time between now and then asking about the condition of your facets and reading up on some of the concerns posted here. Any surgery is a risk and anyone who tells you that you have a guarantee of success is lying, but that seems to be the most common recent cause for ADR failures and the torque put on your back during a golf swing may influence your understanding of your risks. You might, though, find that the torso muscles to power that swing actually act to stabilize your spine and prevent facet damage. Beats me what could happen but you deserve the best speculation we've got.

[Karl 8744]

Dear annapurna,

Thank you so much for your post. It is great to hear about your colleague and I can only hope that i too suffer from those type of comments - post op.

As you may be able to tell, I am not hugely well read on all aspects of the surgery but can you tell me what facet problems are and how they may manifest them?

Thanks in anticipation.

[annapurna]

Facet problems 99 (not quite 101):
Facets joints make up the 'spiney' part of the back of the vertebrae. There are two 'wings' that interact with the wings of the vertebrae above and below. The joints are sliding joints with enough slop to allow you to turn to one side before the facet on the opposite side touch. Normally the natural disk and the support structure around the disk provides some resistance to the turning motion and lots of stability. If you replace the disk with an ADR, you cut into those structures and replace the disk with something that provides no resistance to the turning motion. The ADR rotates freely. There are many theories as to why and how much, but it is fairly accepted that the loads on the facets on the level with the ADR go up. The loads on adjacent level facets either go up or down depending on which paper you believe. Fusion is the opposite. Loads on the facets on the fused level drop as the level can't move but the loads on adjacent levels go up sharply.

All of that presumes that you have a perfect spine, other than the ADR or fusion of course. Practically, no one really knows how to predict what will happen in a real spine. If the loads are too high for your facets, you'll start developing damage in the facets. The damage may cause pain or not and may continue to increase or not. Sometimes, just taking a bad disk out and replacing it with and ADR permits the facets to recover. Other times, even with a perfect placement, the facets just roll over and die way too fast. We have posters on ADRSupport that have experienced both.

The reason why I question golf is the power inherent in the swing. In the absence of a natural disk and in a compromised spine, which even with ADR is the best you can be said to have, facets will take much of the load of the rotation. You might find that leads to premature degeneration. Alternatively, you might find that building strong torso muscles leads to them providing the stability that your spine needs and the facets do fine.

BTW, you can Google facets and find more information about them on sites like spineuniverse.com. They aren't as up to date on ADR and other cutting edge techniques but they are good for general knowledge.

Please, make sure you ask your surgeon what condition your facets are in. It greatly affects the potential for success and really needs to be considered in your estimation of the risks.

[berry]

Hi Karl

I am a patient of Mr Shackleford and I highly recommend him, he is a fantastic surgeon whose skills and expertise improved the qality of my life beyond belief. He has a great bedside manner and sense of humour too.

I had double lumbar TDR in Feb 2004 and have no regrets whatsoever. It is a big op and recovery does take time but when you think of what is involved you can't expect it to be easy. I'd say I took about six months to feel better so don't be rushing back to golf. Mr Shackleford is a golfer, have you asked his views on golfing post-op? I don't play golf but I do swim and cycle with my children.

Have you seen the UK site? Here's a link. It is new site and is in its infancy but there's some good information and support there.
http://z6.invisionfree.com/adrsuppor...x.php?&CODE=00


Adr Support UK[/URL]

I fully understand your apprehension as the surgery date approaches, I felt exactly the same and no one knows what the outcome of their surgery is going to be until they go through with it. For me it was no where near as bad as I'd imagined.

Preparing for recovery?? Post-op only eat something very light the first day as gas can play havoc with the intestines. Limiting your intake to fluids (soup and ice cream/ jelly type diet) initially can help. You may find the pain-relivers and being immobile make you constipated so dring plenty of fluids - prune juice even!

Do you have someone to help you? Putting socks and shoes on is difficult, shoes which you can slip rather than having to bend to fasten can make things easier.

Have as much as pos to hand rather than having to bend for things. I am lucky as I have six children all of whom were happy to fetch and carry for me in the post op period.

Good luck with your operation. You are in good hands, Mr Shackleford is an experienced surgeon and has an excellent reputation.

Regards

Lynda

[Mark / Australia]

Annapurna - regarding your info/advice above, would you say that if a person had ADR surgury and never put any torsional load on their spine (even if this is unlikely in reality) that their facet joints would not be any further damaged?

Or is it more correct to say that torsional load is just the worst possible thing for it, and that facet damage may occur regardless?

I realise this may be a "grey area" question, but any input would be great.

Cheers,
Mark

[WILLIAM]

Hi Berry.....good to hear your encouraging words....as a matter of interest did Mr Shackleford use the PRODISC or the Activ L back in 2004 ? and how are your pain levels now ?

[berry]

Hi there
Mr Shackleford used ProDiscs in 2004 but now uses Activ L. My back is doing great, I do get some slight back pain if I overdo things but that is likely due to further degeneration at L3/4 (the level above my two ProDiscs). It is nothing compared to the pre-op pains I endured and is being monitored by my consultant.
I also have cervical DDD and will be having Activ C surgery at C5/6 & C6/7 in the not too distant future under the care of Mr Shackleford.

[annapurna]

Originally posted by Mark / Australia:
Annapurna - regarding your info/advice above, would you say that if a person had ADR surgury and never put any torsional load on their spine (even if this is unlikely in reality) that their facet joints would not be any further damaged?

Or is it more correct to say that torsional load is just the worst possible thing for it, and that facet damage may occur regardless?

I don't know how much loading is contributed by what but it would seem like most people suffering from facet problems don't spend time turning with some force side to side but still end up with the problems. I really can't say how much faster or slower it would be if you decided to live your life as if packed in cotton but if you did to avoid facet problems, I'd wonder why you wanted to get ADR rather than fusion.

That may have sounded harsh but the logic behind it is that you are theoretically pursuing ADR because it permits you to remain active. If you change your life to reduce those loads after ADR, then it would seem like you could consider fusion.

[Karl 8744]

Dear Lynda,

do you know why Mr SHackleford is now using Active L discs as opposed to Prodiscs? What are the pros and cons of each and what are the experiences of other forum members who have had Active L discs fitted?

Karl