Thread: Should I do it?
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Old 08-10-2020, 11:01 AM
kaifram kaifram is offline
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Join Date: Jul 2020
Posts: 2
Default Should I do it?

Hi all,

I've been reading lots of your stories over the past several weeks and I am both inspired by what I see and worried (which I see as a good thing). I am considering having ADR in December 2020 with Dr. Zigler at TBI, but I thought I would see what folks in this community might think.

A bit of background:
I've had back pain for about 11 years now. It started with yard work in my late 20s and has been triggered by all sorts of things since then. For several years, I went without a diagnosis or imaging, so I just thought I had to deal with back pain. I've been going to a chiropractor at least once a month since 2010 maybe. Then, the "back attacks" started getting a bit more frequent (2-3 times per year) and took longer to recover from. I had imaging done in 2018 that showed herniation at L4-L5 and DDD at L3-L4. Injections ordered, but not received due to insurance and other complications. My back got marginally better, so I just went on. I completed PT that summer/fall and it helped a bit. (As a side note, I've been in PT three times since then with good/ok results.)

Latest issue:
December 26, 2019, my back "went out" for the 20th time (that's just a guess - maybe it's been more). However, this recovery hasn't been like the others. For several weeks, I was walking with a cane, didn't sleep well, and needed lots of oral steroids, ibuprofen, etc. In February, I was referred to a neurosurgeon at my university hospital. He ordered more imaging which showed basically the same thing as two years ago (herniation at L4-L5 and DDD at L3-L4). He said I was not a candidate for any kind of surgery and to call me when (not if) my back went out again. [He is known for being very, very conservative in his approach.]

I had two steroid injections in May and they helped for a couple of days. I started PT again in May as well and it has helped a bit, but I am still not as active and mobile as an average person in their late 30s. I have a current prescription for meloxicam and tizanidine, and I use them periodically (not together) when I'm having a bad day.

Several weeks ago, I contacted Texas Back Institute and spoke with Dr. Zigler. He's offering a two-level ADR (more below). Right after that, I contacted a highly-rated orthopedic surgeon in my area who said he could offer me a minimally-invasive fusion procedure. He told me he knew of the research being done by Zigler et al. at TBI and respected their work. While the ortho surgeon doesn't do ADR himself, he did say he would agree that I'm a good candidate for the surgery.

Today:
As I mentioned, my day-to-day is not what it was even a year ago. I'm not in a ton of pain every day, but my quality of life is diminished. I met with Dr. Zigler via telehealth and he suggested a two-level ADR of L3-L4 and L4-L5 using ActivL with keels. His opinion is that I am a good candidate for this procedure given my age and other factors. He also said we could go the hybrid route if necessitated by insurance, but I am not inclined to do that.

As a side note, all the folks at Texas Back have been incredible to work with so far. They are very responsive, courteous, and kind. I have met with Dr. Zigler twice now, the second time to ask a ton of questions about the procedure (subsidence, adverse events, the device, etc.). His bedside manner is second to none, he is empathetic, and he obviously knows is stuff. It's comforting to know that he's done so many of these procedures and that he's right here in the US should I need him again. The second time I met with him, he asked about my back, of course, but also about how I was doing in Covid and how my campus (I'm a professor) was returning to class, etc. He is really SO nice!

tl;dr:
I've had back pain for years. Two-level ADR using ActivL has been recommended for me by Dr. Zigler. Should I go forward with the surgery?

Thanks for any feedback, suggestions, or advice!

Kevin
__________________
Kevin

History of LBP since 2009
2018 MRI showed herniation at L4-L5 and DDD at L3-L4
2020 MRI showed basically the same
Considering ADR in December 2020 with Dr. Zigler
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