L5/S1 ProDisc Replacement on Dec 13 - Need your help. Should I do it??
 

Hi,

I am new to the ADR Support site and I've been amazed by the amount of information available here and the level of help and support members provide to each other.

I need your advice in helping me decide on my next step but before I do that let me introduce my case:

* 10 years of lower back pain (L5/S1 herniation)
* Physical therapy, chiropractor, spinal decompression (DRX9000 and traction) didn't help
* Microdiscectomy and laminectomy Dec 2009
* Reinjured myself 3 weeks after surgery with shooting pain in my left leg
* epidural and selective nerve root injections didn't help
* MRI I did post surgery injury showed that I do have herniation and narrowing disc space but surgeon said that it will get better with time
* Surgeon recommended pilates and inversion table and if nothing helped we will assess my options
* leg pain is much better but my foot still hurts - actually it feels like sunburnt
* I have back pain especially when I stand for a long time like an hour or more
* When I wake up in the morning, I don't have any pain at all but after I start walking and doing activities I feel the pain/numbness/tingling traveling down my left leg until it settles in my foot
* Sitting makes my leg pain worse

I am an active person and I do currently work out (pilates, running, weights, hiking etc) but with leg and back pain. Saw the surgeon couple of months ago and decided to do disc replacement on my L5/S1 (Prodisc - L). My other discs are fine but L3/L4 is little dehydrated.

Insurance approved the surgery and all I have to pay is $250 (if I push surgery to next year I'll have to pay 10% surgery of the cost of surgery due to new insurance). My surgery is scheduled on Dec 13, 2010 and I am on the fence (hence my username :)). Lots of my friends and family are concerned due to the risks of the surgery. There's no guarantee that I will feel 100% after surgery especially after reading some of the people's experiences on this site.

So my question is, should I go ahead and take risk and do it? Or since my pain is manageable should I suck it up and postpone or cancel surgery until pain is totally unbearable?

Thanks for your help.
ps: I will be seeing couple more surgeons for second opinion and one of them is Dr Yu-po Lee who is the sidekick of Dr Steven Garfin of UCSD

Mate it's up to you, you've done the research and know the risks.

It probably comes down to how much the pain is impacting your life. I can't run or hike anymore, but I used to, but towards the end I was kidding myself, I hiked a 5 dayer felt like I had a knife in my back. But at least I did it while I still could.

If you just have niggle and can stay functional, I say deal with it. If it's a lot more than that and non-responsive after time and physio... well, it's a different matter.

I would say don't wait until it is totally unbearable as I don't think it's good for you mentally.

Remember, you can always postpone the surgery. The condition is pretty static. There's no reason you can't come back in a year and do it. But once it's done, it's done, and there's no going back.

Good luck.

Just IMO,

I disagree with that doctor (but surgeon said that it will get better with time). Disc herniation's just don't get better with time, nor does narrowing disc space. DDD will continue to degenerate, the only question is, how long before it starts to auto fuse.
The question I think you need to ask yourself is: How much is pain affecting my life, how am I able to function, how long do I want to live like I am?

I have had back pain for 13 years just like you, except a little more disability, but I too had to make this tough decision and will have ADR this coming Jan.

If your insurance approved it, than you are more than fortunate than 90% of everyone who has ADR because most of the time insurance refuses to cover it. Consider yourself very fortunate.

What I have learned is that no one can tell you to do it or not. You have to be the one that comes to a peaceful place inside that this is your best option, and then find the best doc, hospital, etc... to do it. I would recommend the DVD "Getting Back on Their Feet" that Harrison made about others who had to make the same decision too and their stories. It may give you some solace.

Good luck!
Ken

One suggestion: treat this as two questions, not one. 1) Do you wish to try surgical options or are the non-surgical approaches you're trying still enough to buy you the life you want to live? (2) Is ADR the right surgical approach for you? By splitting the question like that you can step back from ADR's questions and complications and concentrate on how you feel about where you are today and how your life is trending. Are you truly holding steady or are you finding that things get to you more or trigger more pain or more frequent pain? Only you can answer the question but you need to decide if you want surgery, any surgery, then decide if ADR is right second.

OnTheFence,

Welcome, and condolences on the long term pain you've had to endure.

Let me say first off, I don't know if you should go ahead with the surgery before end of the year, or wait until you can't live like you pretty much want to, or wait until you can no longer bear the pain. You've received a lot of good input in this thread; and each reply-ee is, I believe, a lumbar patient. I can say that that is a terrible situation in which to find yourself; that is financials being such a large input rather than an afterthought.

An additional thing to consider that I've not seen mentioned; it is possible for long term impingement of root nerves to cause irreversible damage to those nerves. Some people can suffer for 20 years and be 100% symptom free from the first hour after surgery, while others have surgery six months after the onset of symptoms and still retain the symptoms that the surgery was expected to eliminate. With this problem, surgery now or later is kind of a roll of the dice.

Good luck, Jeff

Hiya,
Just to add my 10c worth- I'm having the surgery next week (so you know what I decided). You of course have to be comfortable with your decision.
I got to mine because I have always been very active (much like yourself) but thought I could tough it out. I finally ended up in hospital for pain relief in June of this year. I was literally curled in a ball weeping as I couldn't cope with the pain. I have had leg trouble e and relentless pain since then and nothing would/will relieve it. You really don't want to get to the stage (if you can avoid it) where every day is a battle against back pain. It impacts your mental as well as physical well being.
It sounds like you're not in a "hell hole" of pain (which is great) but have enough pain which on occasions stops you doing what you want to do. In your shoes (and if I had my time again) I would get a second opinion from a Doc who's done lots of ADR. Tell him you want to avoid surgery (which I think you do) but that you want to maintain an active life. See what he says.

In the end you will know if something needs to be done. The you have to decide what has to be done. (as annapura suggested above - it's two questions).

Good luck with whatever you do decide. Whatever happens, write in this thread what you do decide. Everybody's story helps the next person who's likely in exactly the same quandary as you.

Good luck!!

Before and After MRIs
 

Hi,

Thank you so much for taking time and responding to my post. I am posting 3 MRIs (one before my microdiscectomy/laminectomy surgery, one right after I reinjured myself and one couple of months ago) hopefully this will give you a better idea on my situation. I saw a laser spine surgeon yesterday for a revision laser spine surgery and he can try to fix the leg/back pain but it's not guaranteed since I had previous surgery (not to mention that insurance doesn't cover it and for $22k a pop, I'll pass). I have couple more appointments/2nd opinions coming up before my Dec 13 surgery which would hopefully help me make an informed decision.

I heard of something called prolotherapy. Did anyone hear anything about it and how effective it is?

Good luck with your surgery danzintommy and keep us posted on your recovery.

Thanks everyone

http://i955.photobucket.com/albums/a...dAfterMRIs.jpg

Hey O T F,
I tried prolo, it is suppose to cause the ligaments and tendons repair themselves by injecting sugar water into them. It did not help me and cost a couple of G’s. Of course the Doc that was doing the treatment said he had success in hundreds of other patients. That maybe true or not, however I also tried acupuncture with no success where others have had great success. So I’m not sure if it was just me or if it has any benefit. As far as your ADR, I wish you the best. I had two Prodiscs with things not working out for me; I’m in more pain now than before the surgeries. However lots have had great success and if I was in less pain now, I would tell you to go ahead. There are new things coming out every day, did you see the articles about stem cells? I think if I had it to do over I would have waited longer before “jumping into the fire”, but that’s the great thing about hindsight!
Your friend in pain,

Stem Cell
 

Thanks Rob for your insight and I am sorry to hear about your pain! Stem cell sounds promising but I was just wondering how it would help with back pain when the issue is the facet joints?

Make sure you know where the pain is coming from