41year old active male with DDD @l4-S1
 

Hello all

First of all want to say what a great website i have found it very helpful.

I'm a 41 year old active male, Ok so some history, first hurt my back sometime around 2002 in the gym and have had lower back pain pretty much since then to varying degrees.

I had my first MRI in 2012 where i was told i had DDD at L4-L5 and L5-S1, since 2012 i have had a number of injections, epidural injections, caudal blocks and in December 2016 i had discogel injected into both these discs.

As i have now exhausted all options for pain relief it is time to decide on my next step......SURGERY :(.

My symptoms appear to be slightly different from everyone else that i read about, i generally can walk and sit for extended periods of time, again standing is not a problem but i definitely feel it the next day if i have been standing for extended periods of time the day before.

My pain comes from movement, so bending forward, going from a sitting to standing position and vice versa, getting in and out of cars, lifting heavy objects etc, i am like a very old man straightening up. Any physical activity leave me in severe pain for days afterwards.

My pain is very localised to just my lower back, i don't have any nerve pain in either leg, my back pain varies from 3 up to about a 7 or an 8 (out of 10), i feel now like i have had enough of living with the pain.

I have had contact with various Dr's, Clavel, Bertangnoli, Ritter Lang, Rischke and all have said i am a candidate for ADR at both levels, haven't had a Dexa scan or allergy tests to confirm but based on MRI & CT scan they believe i am a candidate.

I have full medical insurance which would cover the costs so whats holding me back from the surgery?

Well its the confusion as to how long the recovery will be, i read 3 months to 6 months recovery then i read it will take at least a year. Confusion as to what level of sports i can go back to, i read nothing is out of bounds when recovered then i read that there are lots of things such as weight training that i will never be able to do, the confusion is never ending, some say the recovery is ok with some up and walking around the day after surgery etc then others say the recovery is a real slog.

i genuinely have no idea what to do, one day i think i will go with the surgery, the next day i think i couldn't think of anything worse.

Welcome to the forum irishbrads.

Different people experience different symptoms however with DDD it would seem that without effective treatment the long term prospect is for symptoms to worsen over time. The rate at which this happens will vary on the individual and their lifestyle.

Time and time again the advice to me has been to manage the symptoms build your strength with regular core training and don't do anything too stupid in the gym. Ultimately when things get intolerable there is the option of fusion (that was the option given to me by at least two consultants).

So it seems it's down to lifestyle choices here - tune down the activity and if and when things get really bad there is the option of surgery based on the sound advice of an experienced consultant.

Where are you at on this journey?

I think one thing that has changed in recent years is the real option of disc replacement but there is a limited window for this as the degeneration process advances.

You also have to weigh this up against opinion - many consultants are not pro ADR and there are different reasons for this based on experience in their specialist fields.

For me the decision point was when my legs began to function less efficiently affecting my knees and then my right ankle and realised something needed to be done. I opted for disc replacement - it's been a week and a half since my surgery.

Questions over recovery time didn't seem so important in making the decision but of course are a concern as like you I want to get back to work as soon as possible (next week if I can) but something had to get done. Summer is a great time for down time as business slows down in most sectors.

As far as return to sports activities, you'd expect it to get better than where you are right now but don't let the recovery time put you off your decision. We all recover at different rates depending on our physical state and age. Assuming a complication free surgery, the fitter and healthier you are, the chances of a quicker recovery will be greater.

All the best with your decision!

Hi Joolsy thanks for your reply

i know that realistically my only option is surgery if i want a change from my current circumstances which is low back pain, you ask where i am it with this well i think once it is 100% confirmed that i can have ADR at both levels it is up to me to decide to go ahead with the surgery.

you say about getting back to work next week, have you had surgery?

I had my L4/L5 disk replaced last Monday with an M6-L. I live in the U.K. and that's what Inthink is predominantly used in Europe these days now it's been around for a few years.

OK - here is some feedback on recovery after 11 days if it's any help.

In the the first week you'll be on pain killers, you'll begin to experience some swelling around the incision area, maybe some brusiting if you bruise easily. Your abdomen will be sore and tight - you won't be able to pull yourself up. There will be some other post operative trauma where your discs were removed but the source of pain will be a bit fuzzy based on the fact you are still on pain killers and the pain will radiate. Some people mention the SI joints for example but you might feel it's your facets. You need to understand that the space between your vertebrae just got stretched too - my left thigh was completely numb to one side when I can round and sensation is gradually returning. Believe it or not, I seem to have gained around 10mm in height which I'm sure will settle down in time.

I've been off the pain killers since Monday but I do take something at night or I won't get to sleep very easily. I was discharged from hospital after 2 nights and was able to walk a few miles towards the end of the week. By the evening my back is very tired. It's small steps to recovery I'm afraid but you do need to keep things moving but not in any excess.

My abdomen is a little better now and I can just about do a double leg raise but with my knees bent - there are still internal dissolving stitches in there holding things together so need to take things easy. Being off the pain killers in the day provides me with the feedback I need. I don't think I'm really ready for double leg raises right now.

If I go back to work on Monday I can't see myself sitting for a full day - we'll see how things go next week but I need to show my face in the office.

were you told no bending, lifting,twisting? were you to NSAIDs to prevent HO? good luck in your recovery. Don't be too eager to go back to work

No bending, lifting or twisting for six weeks until the plates have bonded to the vertebrae. Ibuprophen is fine - I'll probably need something next week if I'm back in the office.

I second Joolsy's comments above. My experience was quite similar. It did take me 3 weeks to return to work, but I had two levels replaced, so I guess it makes it slightly more invasive for the body. Did not touch a single pain killer after the 3 weeks (ok, I have taken 1 ibuprofen for a headache within the last 6 months, but nothing for my back). After 6 weeks you are free to do anything, but you most likely don't feel really like going all-out at once. At 3 months out, I was already feeling good enough to say that "life is good" and do almost anything.

Hi Blizagga & Joolsy

thats incredible, back at awork after several weeks, Blizzaga you felt ready for anything after 3 months. I see you had the Active-L disc, did you have it done in the UK? is three months the norm, are you fully healed at three months or is that more like the six month period?

I had it done in Germany. You can find my post in the surgical outcome forum. It is very hard for me to say when one is "fully healed", because different people will have different definitions of what a full heal is. A surgery is still a surgery, so it may still be that your back will never feel exactly like the healthy back of a teenager doing parkour.

The recovery is a gradual process. If all works well, you will gradually be able to endure more and more strenuous activities and the painful feelings in your back will gradually decrease.

Imho
 

3 months if your in shape n goes well 6 months if your fat bald and out of shape like me