For your reading entertainment
 

:)Hi everyone. Well, here’s my overly longwinded story. Have always been athletic and also a building do-it-yourselfer. Both have gotten me in trouble. Minor disc bulge episodes in my early 20’s leads to a full L3-4 rupture at age 27 in 1986 while skiing. Laminectomy was successful and after a few months I returned to normal activities. Running/skiing/soccer replaced by lower impact windsurfing/swimming/biking. Always maintained reasonably good core strength and aerobic conditioning but of course not like I was 18.

Made it about 11 years until the lower back really started acting up again. New back symptoms were different. No disc bulge symptoms this time, rather vertebrae instabililty. My back would be fine one minute and give out the next, curving to one side (like someone who has scoliosis) when I tried to stand. No radiating leg pain, but rather an inability to literally support my upper torso. MRI’s show DDD at L3-4 and L4-5 but nothing pushing up on nerves. Doctor’s were not optimistic about more surgery but one suggested trying prolotherapy as a more conservative option.

Received 5 prolo treatments from Dr. Hauser (www.caringmedical.com) in Chicago around 2000 and they provided amazing results for the symptoms I had at the time. Prolotherapy is nothing more than an injected irritant to stimulate ligament/tendon strengthening using the body’s own immune system. Again, this didn’t return me to age 18, but allowed me to get back to most of my activities. Went another successful 9 years.

In 2009 I started to have new back episodes. Not exactly disc bugle, and not exactly ligament laxity. I went for more prolo treatments but they were having a reduced effect. Two prolo treatments last fall might have even pushed me back a few steps.

Currently walking and have no radiating pain but also no ability to lift much, bend forward, or do anything like swim-bike-run-kiteboard without plenty of irritation-weakness-pain. Too much of a good thing with the prolo (zero flexibility)? Continued DDD progression causing other issues? The 2 prolo treatments last fall were only on the right side so maybe they created a mechanical imbalance? No idea, went in for an updated MRI (attached) and x-rays (have previous MRI’s from 2000 and 1993) and will send them out to Boeree and Clavel as well as see someone locally in the Norfolk area next week to discuss and maybe look into a discogram (even that seems pretty intimidating).

Still working with my Prolotheripist and will give it more time, but we are running out of options and I would like to at least consider other options. Realize I might need to tone down the activity expectations no matter what route I take. Still want to be able to swim, bike, boat, etc. Not sure if I’ll be a reasonable candidate for ADR (or other options) or whether all the prior prolo treatments will complicate things (bigger distraction pain?). On the plus side still in good health, 180# at 6 ft, never taken any pain meds other than just after the 1986 surgery.

Amazed/inspired by the brave souls here who have gone the ADR route. Also seems strange that I would consider this if I am not currently grimmicing in pain (I likely would be if I increased the activity level much beyond walking). I do have the benefit of being an early retiree so no work-activity pressure other than the type A syndrome, and insurance coverage is not the primary concern, though it sure would be nice. My part time retirement playjob was kiteboard instructor before the back went south. Attached a couple of homemade waterplay vids I made with my 2 daughters the last couple of summers. Cheers and thanks for reading!
Summer2011B - YouTube
Latest10 2010E - YouTube

Just a thought here: it's not looking like your disks are too dessicated on the MRI. I'm no expert at reading them but that's the impression I got from them. If you respond to prolotherapy, you might also respond to stem cell and stem cell-like treatments. There's a few places that are looking at cultured stem cells for injection into an intact or mostly intact annulus. If the rupture at L34 is mostly healed and you now have a reasonably intact annulus, that might work for you and hold off the need for ADR/fusion. Regenexx is one I might try looking at, even though their office staff is less than impressive.

hi
 

honestly, your disc looks completely fine. do you know how many levels did you have a laminectomy?

HI
 

honestly i was feeling kind of unstable after my recent laminectomy. i might consider prolotherapy. would getting it from dr. hauser really make a difference or would a local prolotherapy doctor suffice?

thanks

raj

gotta disagree on the MRI's... i would say that only L5/S1 looks "good" and that's on that 2nd image. the others have varying degrees of degeneration - hard to say on the one view.

ya'll gotta remember - not all MRI sequences are good for looking at discs! the STIR sequence really is best. i can't elaborate on the physics of it, but T1 and T2 aren't as good for looking at discs. they're better at looking at the brain and cord itself, and for infection... but for the disc itself, STIR is where the money is.

you also need to look at the transverse images - those that are cuts through at 90 degrees from those seen. they tell you more about the disc architecture. it would be tough for the non-medically savvy to pull the relevant ones from an MRI.

also gotta remember that MRI doesn't always tell the whole story. i feel like a broken record ;) your MRI is just one of many diagnostic tests used to determine the source of pain and what should be done next.

true DISCOGENIC pain often doesn't come from a nasty disc!!! i can testify to this with 100% certainty, from my experience. as soon as my disc was gone, that awful horrid pain was gone and i haven't had a hint of it since surgery.

I'll definitely do that. Haven't seen much in the way of real study numbers for lumber stem cell replacement, just a few scattered "sponsered" results.

Only at L3-4 but it was a severe rupture (big fragments removed). I believe that the prolotherapy helped to minimize DDD progression as my current MRI doesn't look much different (in my non-medical opinion) from the one in 2000, but really need an expert to make that determination.

The classic contradiction about lumber DDD on MRI's is that you can have horrible looking degenerated discs on an MRI in patients with no back issues at all and almost normal looking discs in patients with severe back pain. That was a key reason prolo was first recommended to me. MRI's are only one tiny part of the story.

Dr. Hauser was recommended to me as one of the most experienced prolotheripists worldwide, so I did not hesitate to travel. $600 for a typical full lumbar treatment plus the travel cost to Chicago. So not that bad in my opinion. I'm not saying to not use someone local, but you'll need to go through the due diligence. My experience with Dr Hauser has been excellent, and although I seem to be hitting a (temporary?) wall with prolo, it gave me 9 great years. I also had carpel tunnel and elbow issues from years of high wind boardsailing and prolo solved those issues as well. Heck, even if I end up doing some alternative procedure I'd still likely return for prolo treatments if warranted.

You took the words right out of my mouth (see my last post)!!!:) I have alot more to do, visit with my local orthapedic expert, continue to work with my prolotherapist, followup testing, and ongoing recovery from the last prolo treatments. I'm in no rush to jump on something new quite yet.

Thanks for all the very helpful responses! Very different from 1986 and 2000 when there wasn't so much info on the internet....

Regenexx is a real pain to work with but if you suffer through some of the office staff to get to speaking with a doctor, you can get a better idea of what they can offer. Their results aren't published but Dr. Shultz of their clinic is actually a spine doc and was very interested in speaking with Laura about her experiences.

As for Hauser, the only two prolotherapists I'm willing to use are Hauser and Dr. Harry Adleson in Park City, UT. The two regularly consult with each other and one's better for somethings and the other's better for other. Both, though, are considered to be among the best internationally.

I'll add to the previous comment: Hauser is extremely thorough at the cost of some pretty serious pain during and immediately afterwards. I had two wrists and a shoulder done at once and spent the rest of the day whining. Laura had a knee, neck, shoulders, and low back done and had the pain ramp up so much that she needed a Lortab and a break in between treatments. Adleson is a lot more gentle but he tends to focus on a specific area rather than treat a whole region the way Hauser does. Both, though, treat far more and far more aggressively than any other prolotherapist we've seen or heard of and both have the experience to tell you what else you'll need to get the most out of the treatments.

hi
 

THANKS JIM AND DAVE. I HAVE Contacted dr. hauser's team at chicago. the office receptionist seemed like a really nice lady. I can't officially get any injections yet since i am still healing from the infection and don't want to risk any further infection in the area. on april i should be good to go and will be flying over there to get the treatment. if this treatment gives me atleast 2 years and more of pain free, i will take it...

raj