Hello all. New to the forum. Just want to introduce myself and give a little history.
1991: At the age of 19, I had a Spinal Fusion at L5-S1 using bone autograft, with no hardware. Done to address Spondylolisthesis pain due to birth defect. Pain not present until my mid-teens when I
stupidly carried a friend on my shoulders for a mile. Discovered that my L5 vertebra wasn't fully formed. After conservative treatment failed, I considered surgical options. My surgeon, Dr. Michael Neuwirth, explained Spondylolisthesis can progress and cause more difficulties later in life. He said I was young and strong, so had a great chance at healing to a full recovery. So, in order to address the pain I had at that time and prevent my Grade 1 Spondylolisthesis from progressing, I underwent the fusion. Amazingly, that operation was a complete success and afforded me over 20 years of active, relatively pain-free living.
2011: Began experiencing sciatica symptoms after running long distances. Latest MRI results as of November 2011:
- The vertebral bodies are normal in height and signal intensity...The conus is normal in position and signal...
- At L1-2, L2-3 and L3-4, there is no focal disk herniation, spinal or foraminal stenosis...
- There is mild loss of disk signal at L4-5, compatible with DDD...At L4-5, there is a broad-based central disk herniation impinging upon the ventral thecal sac...In addition, there is mild facet hypertrophy with mild foraminal narrowing...
- At L5-S1, there is Grade 1 Spondylolisthesis...No evidence of focal disk herniation or significant stenosis.
EMG in December revealed no abnormalities.
2012: Sciatica mostly resolved. In mid-July, I
stupidly performed twisting exercises which must have aggravated my herniation, and I began experiencing sciatica again. Started PT which began to help until I
stupidly pushed the Mckenzie extension exercises too far one week ago (August 6). Increase in back pain, big set-back with PT. Today (August 12) doing much better, but still have abnormal pain and stiffness, and sciatica is still present, actually a little worse than before the set-back. Appointments with Ortho surgeon and Neurologist for early next week.
I was afraid (and still am a little) that I may have damaged my fusion with those Mckenzie extensions. I'm hoping that if I did that I'd be in much more pain and have much greater disability than I currently do.
Would you agree that is probably the case? I need an updated MRI to see what's going on now. I need another EMG as well. My goal is to work with my doctors to find out exactly what/where the pain generators are in my back:
- Is my fusion still OK?
- Where are the nerves being compressed?
- Is the sciatica pain coming solely from the herniation?
- Is the foraminal narrowing contributing to the sciatica?
- How much is the facet hypertrophy contributing to my overall pain?
- How much is the L4-5 disc itself contributing to my overall pain?
I need these questions answered, so I know what I can and cannot do, and so that I can get proper treatment.
If any of you know the proper diagnostic tests to get those answers, please let me know.
DDD is progressive, so I anticipate that sooner or later I will need a surgery at L4-5. I do not want another fusion if I can avoid it. My fusion has been successful, but I did lose ROM, and I'm quite confident that it hastened my DDD at L4-5. I don't want to continue the DDD cascade up my spine.
So, I'm here to learn as much as I can about artificial disc replacements. Obviously, the Spinal Kinetics M6-L is a standout, but it's so new and revision in case of a problem looks very dangerous. NuVasive's NeoDisc looks like it might revise easier, but that's only for the cervical spine as far as I can tell.
Are there other lumbar adr devices I should be considering?
I want to do everything I can to delay surgery, but my research on this forum and others tells me that I don't want to wait
too long to have a surgery (if it's inevitable), because the longer one waits, the more likely irreparable damage will occur to nerves and boney structures, thereby ensuring chronic pain despite surgery.
I welcome any advice or insights you have on my situation.
Thanks a lot,
z
