For now gave the Surgery green light...

[longroadahead]

Met with the Texas Back Institute today and have decided to go forward with the surgery planning.

Next steps are:

1. Get new MRI and DEXA (Will be done next week).
2. Decide if Hybrid (Stalif L5/S1; Prodisc L4/5) or single level fusion (Stalif L5/S1).
3. Schedule and get cash to pay for it.

The discogram on March 2010 showed one syptematic disc L5/S1 but the L4/5 didn't look all that great. Thinking now about having this done in May depending on what happens.

[Jstuckey]

Would love to know the cost, if you are willing to share. I'm planning a Stalif L5-S1 and M6 L4/5 in the fall in the UK, but would love to know if the cost is comparable when paying cash. (Insurance is no longer in my loop, unless I want to sue them).
Very best wishes, and I would love to know how your recovery goes! I was going to have this done next month, but it didn't work for the surgeon.... so I'm postponing until after summer.

[longroadahead]

The insurance will pay for the fusion so I am just out the disc. I was told the cost would be $21,500.

[longroadahead]

This weekend I was feeling a little better so was able to do some light jogging and football throwing. Sure can't move very fast. Sunday didn't take any pain meds and am going to stop taking them for awhile and see what happens. Boy are my legs sore.

The back pain is still constant but is about a 2-3 and still have the annoying right leg pain when trying to extend my right leg. The right leg hurts amazingly when trying to extend it straight out when sitting on the floor or stretching.

Not sure if I should have surgery or not.

[Jstuckey]

Originally Posted by longroadahead

Not sure if I should have surgery or not.

I can relate, and I have this question frequently. As others have told me, that's such a personal question that only you and a physician you've grown to trust can answer. On good days, I think, "I really don't need surgery. Why would I put myself through such an expensive and difficult process that has no absolutes? I don't feel so bad". But then on bad days, I remember the long list of things wrong with my spine from my MRIs, CT scans, and feel the pain that prevents me from enjoying time with my family. This usually scares me into realizing my "window of opportunity" is closing, and if I'm serious about doing something, it needs to be in the near future.
Keep doing research, because although it changes your mind 100 times and makes you feel a little obsessed and crazy sometimes - you feel more confident in your decisions the more you learn.

[longroadahead]

Got another MRI yesterday and went to see another surgeon for a recommendation. It's the first MRI since I had the Fibrin injections at 3 levels. Still waiting on the report but the L5/S1 appears to be worst and is now pressing on the nerve.

His recommendation is a TLIF at L5/S1 and leave L4/5 alone. He doesn't do ADR.

So still waiting for an updated Dr's opinion from the new MRI but his initial recommendation was L5/S1 Stalif and L4/5 Prodisc based upon MRI from 2009 and 2010 Discogram/CT Scan.

[longroadahead]

MRI 3/2011 Results:

L5/S1 - 4mm annular disk protrusion but with a superimposted 8mm right paracentral disk extrusion resulting in slight displacment of the right L5/S1 nerve root sleeves.

L4/5 - 2 mm annular disk bulge at L4/5 without central spinal stenosis. There is mild bilateral foramina stenosis.

Diminished disk signal intensity without loss of disk height at L4/5 and L5/S1.

[longroadahead]

Had a Bone Scan last month and didn't think my results were that bad but it looks like TBI no longer considers me a candidate for the prodisc.

My T Scores:

L1 -2.2
L2 -1.7
L3 -2.4
L4 -2.1


Wondering if this can be the root cause to my lumbar pain. Can find differing opinions on the internet.

Still looking at a microdiscectomy but now do not know.

[annapurna]

I don't have my results in front of me to compare but that sounds like osteopenia or borderline for osteopenia. Off the top of my head, I'd doubt that osteopenia of that level could cause pain by itself. On the other hand, if I remember correctly you're a middle aged male and not too likely to have problems with osteoporosis and it's precursor of osteopenia. I wouldn't put it too unlikely if you found that whatever led to faster degeneration of your spine, poor response to fibrin, pain, etc. might be related to what gave you or put you in the position to develop osteopenia. If I were you'd I'd investigate this as you can to see if there might be a systemic underlying cause or series of links behind you conditions. There's no promise that addressing that links will fix your back but it would likely help in any post-surgical recovery and make it that much less likely that you'll have to do this again in a few years when something else goes bad.

[Harrison]

Longroad, you may have seen this topic a while ago, but it's really meaty -- lots of pertinent info there:

Spine Osteoporosis

Pls note that it is a multipage topic. Now I am straining my noodle to recall if the T Score readings are different for keeled devices than cleated -- they should be!? Tell us more about what TBI said about the disqualification?