Mobility/flexibility after ADR
 

Mobility/flexibility after ADR
Hello,

I have been going through this site for quite some time now and I would like to thank everyone here for making this journey easier.

Quick facts about me (if you don't want to waste time reading the background, please skip to "my questions" section ):
-27 years old
-133 lbs, 5ft 7" tall
-I had a car accident 10 years ago. My low back problems started then
-last year I had my first MRI; DDD L4-S1 with a few bulges and some facet arthritis at same levels (all "mild" according to the radiologist)
-Disk heights are still considered "adequate"
-I have attached an image of my most recent MRI
-I havent had any surgery procedures or injections as I an conviced they are all just a band aid and ultimately don't do any good
-I have also noticed some problems with my neck but not bad enough to start doing something about it
-My problems are focused on my low back: dull, achy pain, stiffness, loss of mobility and flexibility. Bending to put my shoes on or pick something up off the floor is nearly impossible (not so much bc of pain but because I have lost so much mobility)
-Trying to improve my core strength and flexibility/mobility, I began practicing yoga but it actually sent me into 4 straight months of horrible sciatica on both legs.
-Sciatica problems have resolved after 3 months of PT. Now I keep pain at bay with mild cardio and core strengthening exercises (not taking anything for pain).
-I can foresee my back problems getting worse (as they are not getting any better with time), so I have started to look into ADR surgery
-Although I am not in excruciating pain, I am mild-moderately limited. I have had to put my nursing career on hold due to this.

My Questions:

-for those who have recovered from surgery, has your mobility come back? meaning; are you able to bend, reach, twist without pain or major mechanical stiffness?
-How much pain are you on a "good day" and a "bad day"?
-Do you ever regret getting surgery (fusion or ADR), please keep it real?
-Due to my age and overall good health, would it be wise to "ride it out" and buy some time until I can go no more before I start considering surgery?
-I am terrified that if I go the ADR route now my problems won't be improved, and that if I wait too long my problems will be too bad that surgery won't fix anything

Thank you all for reading and for providing your honest opinion

Hum, good questions. Obviously there is a trade off an once you have a surgery once you have it done, is much more difficult to undo it, so if you can handle take your time before such a big decision. When I was 27 I had my first lumbar. Fusion L5-S1. At that time adr was not available, at least it was out of my radar (maybe some doctors in Europe were in the early days..). The problem with fusion is that it really increases the degenariton speed of the other discs (I had to do another fusion 2 years later). Regarding losing movement after fusion I have 4 fusions and I am way more flexible then most other humans because stretching together with core strengthening is the only thing that alleviate pain. Regarding lumbar ADR I can't give you an answer because I had my first cervical ADR 10 days ago. If I where you, based on my pain experience, my approach would be stretching (not yoga because yoga is uncontrollable, for example my pain only diminishes with stretching bending forwards and increases a lot when bending backwards). So find with exercise alleviate you pain. Together I would try some core strength exercises (most isometric, I do myself at least 10 minutes daily). I learned the exercises that diminish my pain by trying and observing. I always listen to others opinions but is your body that tells you what you might benefit from. While trying this conservative approach you should definitely listen to the opinions of other people who had lumbar ADR and how they feel. If it was my spine, from what I've read I am note sure I would do an ADR at L5-S1 level, maybe fuse L5-S1 and do L4-L5 ADR (hybrid solution), but other people here are much better suted to give you more and better information regarding ADR. Good luck!

Interesting, so your fusion at L5 S1 led to degeneration of l2 l3? Are you sure they were related? I only ask because usually fusion really affects the levels above and below.

I am not sure, because the disc was already a degenerated when I did the l5. -s1 fusion. But fusion does accelerate the process, therefore you should avoid lifting weights and some type of exercises. The ADR surgery on the c6-c7 I just did was likely consequence of the c5-c6 fusion I did 18 years ago (together with the toracic t1-t2 fusion 6 years ago). But make a long story short. Fusion does accelerate the disc degenerative process. But if your other discs look good it can take a very long time, hopefully!

I think for sure the neighbor disc does suffer the most, but it does affect sometimes other levels too! Just one good thing is that as we age, the disc start loosing movement and therefore pain level can diminish (similar to a natural fusion process). That might be happening with my L4 L5 disc, which does cause me some pain, but less then it did a couple of years ago (usually it happens after 40..). Some doctors gave me this information a long time ago. First I didn't believe but now it might be happening. Hope it helps...

interesting, so how does your l4 l5 look? just curious, because I've heard that the movement at l5 s1 is such that if you were to get a fusion, it would be the best level.

It is not very nice but not horrible at an MRI, but remember I also have L2-l3 fusion so there are only 2 discs in between. L3L4 is ok. Currently the L4-L5 Just doesn't allow me to run very fast (play soccer for example, run more then 7km or lift heavy weights, which I would avoid anyway l). But I can cycle (14 hours a week at an intense level), swim etc. If my L4-L5 stay the way it currently is I am a happy person!

That is great. Your l4/l5 sounds like my l5/s1. With any luck, we'll have stem cells to maintain disc health in the next ten years.

I had 2 level PLIF with my facets removed at L4-S1.

My Questions:

-for those who have recovered from surgery, has your mobility come back? meaning; are you able to bend, reach, twist without pain or major mechanical stiffness?
Im a little stiff but my mobility is better than before surgery. I can actually bend w/o always guarding my spine.

-How much pain are you on a "good day" and a "bad day"?
Mostly good days i'd say 1/10
A few bad days in the last 2 years i'd say 5/10

-Do you ever regret getting surgery (fusion or ADR), please keep it real?
No.I'm so much better after surgery.I'll never be perfect but it doesnt stop me from being active and learning to enjoy life again.

-Due to my age and overall good health, would it be wise to "ride it out" and buy some time until I can go no more before I start considering surgery?
The longer you wait in my opinion, the worse your facets can get.
Mine were so bad at age 44, i had no choice but to have a fusion.
Maybe be a bit proactive before you have no options.

-I am terrified that if I go the ADR route now my problems won't be improved, and that if I wait too long my problems will be too bad that surgery won't fix anything.
Honestly you'll know when your ready. When you become afraid to do every day things, stop going out with family for dinner, fearing your back will go out after a long car ride, etc....

Great advice
 

Thank you, I agree with your advice. I find low impact cardio, core strengthening, and gentle stretching work best for me. I am able to function at home without pain if I keep a constant workout routine. My frustration and biggest problem not feeling adequate and physically capable to go back to work. I initially though it was a psychological limitation and fear of getting hurt again but after going back for a few shifts I decided I wasn't able to care for my patients the proper way so I'm back on leave and trying to decide what to do next. It's driving me nuts!