[KurtSFO72]

Hello!

I'm a newbie here and very glad to have found this forum. It looks like I'm faced with what I consider to be a difficult and tough decision so having support from people that have been there will be critical for me.

I'm a 39-year old male who, about a year ago, had sudden onset (no known injury) of severe lower back pain coupled with groin and leg pain and some tingling/numbness in my calves and feet. It's always been more pronounced on my right side vs. my left. I ended up in the ER one night it was so bad and the following week had my first MRI that showed DDD at multiple levels. To date I've tried PT and two series of ESIs in the L5-S1 space which seems to be where most of my pain is coming from.

The MRI results showed DDD and facet arthopathy with dextroscoliosis and retrolisthesis at L3-4, L4-5, and L5-S1. Broad-based bulges were noted at L3-4, L4-5, and L5-S1. Canal stenosis was reported at L3-4 (mild) but L5-S1 showed the most severe DDD process. Disc dehydration, height loss, anterior spondylosis and endplate marrow change were all noted...honestly, half of that I'm not even sure what it means. There is a definite annular fissure at L5-S1 in contact with the S1 nerve root on the left side. What doesn't add up is most of my pain and symptoms are on the right so that's been very confusing for me but several Dr's have said, "It is common". I should also point out that some of this might be hereditary as a family member went through a bi-level fusion of L4-5, L5-S1 about 4 years ago.

My first rounds of ESIs were done bi-laterally in Oct 2011 and I felt GREAT! I felt the best I'd felt in over 6 months and was so hopeful that would be the end of my misery. I was active again and loving life. However, after about 3-4 months my symptoms slowly started returning. While nowhere near the severity of the first onset of symptoms, I agreed to another round of ESIs in L5-S1 that did absolutely nothing. The pain management specialist referred me back to my neurosurgeon saying that since the last round of ESI didn't work, he basically had nothing else to offer.

My daily pain consists of a sharp "bite" in my lower mid-right back at hip level along with varying degrees of groin pain, leg pain, and tingling in thighs, calves and feet...more on my right side as before. Daily pain ranges from 2-4 on a scale of 10 so just enough to be constantly on my mind and it’s far worse at night. Being in any one position for too long is agony and often I wake up in the night and have to take pain medication to go back to sleep.
I saw my neurosurgeon this week (4/9/12) and in reviewing the fluoroscopy images sent to him by the pain management Dr that were taken during my ESI procedures, I said I’m pretty much bone-on-bone at L5-S1. He feels my pain is from two sources: the bones in contact with each other and then what’s left of the disc protruding into the nerve root space. He advised that at some point I’m going to be faced with surgery it’s just a matter of when. He recommended ADR surgery with the Prodisc-L. However, his feeling was as long as the pain is manageable and I’m able to work, I should hold off but I don’t want to be in pain at all. I don’t have a high tolerance for it and I don’t want to be addicted to pain killers…I already can tell I’m building a tolerance to them (Diluadid). I’m not able to be as active as I used to be with daily gym workouts, bike riding, hiking, etc. My job is becoming increasing hard to do as I travel extensively so sitting on planes for extended periods not to mention a lot of standing, bending, stooping and sometimes even crawling (I’m a computer network certification engineer) really makes the pain worse. Luckily I work from home when I’m not traveling so I’m able to lay down if I need to, take pain meds if I need to, etc. but when I’m traveling to customer sites, I cannot do that as I have to be “on” all the time.

I’m quickly becoming more and more depressed by all of this especially now knowing that I’m faced with surgery at some point. I know I don’t want fusion at my age because I’m fearful of other levels above it having problems from the added stress placed on them. The neurosurgeon confirmed that possibility. I think it’s important to maintain as flexible of a spine as I can for as long as I can.

The surgery sounds absolutely awful going in anterior and I’m wondering how people reached the decision to do it. Obviously pain and immobility are huge factors but I’m struggling with being at a pain level of 2-4 is it really worth putting myself through that. I know only I can decide that but feel I’m on the cusp of should I shouldn’t I. Part of me feels I should knock it out while I’m still relatively young (I’ll be 40 this year) but the other part of me feels like I should wait until I just can’t stand the pain anymore and am really seriously incapacitated by it.

Conflicted…