[arrierito]

Hi!

I’ve been reading many of the posts on this site and wanted to introduce myself and post a few questions. First some background: I’m a 31 year old male who up until 10 months ago enjoyed a very active lifestyle. To give you an idea, I routinely ran 60+ miles a week and went on long bike rides (100+ miles) as well. I’m attaching a picture (I’m on the right) of a race from last summer where I ran the mile in 4:57… not bad for a 30 year old!

Alas, 10 months ago, in a spur of the moment decision I joined a soccer match where I slipped and herniated the left side of my L5/S1 disc. Ouch. My symptoms were severe sciatica pain with tingling in my left calf and glute. 10 weeks after the injury I had an MRI, and on February 3rd 2016 I underwent microdiscectomy surgery. The surgery itself was properly done but my recovery was slow. My nerve took approximately 5 months to heal from the original symptoms and the shock of the surgery.

Unfortunately 6.5 months post-surgery I have developed a different set of symptoms. Now I have sciatica pain in both of my legs - particularly calfs and glutes. The pain location is actually slightly different from the original injury. I’m lucky in that I have no back pain, just pain and tingling in both my legs. Also, sitting down for any period of time is painful on my hamstrings. I’m a attaching a picture of a recent MRI which I’ve cleverly manipulated to show all the side views from right to left. As well as one shot from the front. The file size is limited - wish I could share it in larger size.

I believe the good news are:
- With the exception of L5/S1 all the other discs are tall (~10 mm), full of water, and well within the vertebrae boundary.

- There is still some space between L5-S1 and there doesn’t appear to be any partial fusion or bone chipping.

- The general curvature of the spine good.

- I have no back pain so it’s safe to assume my facet joints are in good shape.

- I’m very healthy otherwise.

In contrast, the bad news are:
- L5/S1 has almost no water left.

- The bottom of my L5 vertebrae is a very irregular surface. It is concave from left-to-right with a through-to-peak distance of roughly 6 mm. It is S-shaped front-to-back with a peak-to-peak distance of roughly 3 millimeters. Obviously it had too much to drink.

- Consequently, what remains of my disc is ~8.5 mm tall at the center but only ~2.5 mm tall on the sides.

I believe the disc being only 2.5 milimeters tall on the sides is causing pinching of the nerves directly by the vertebras. Based on this I’m considering an M6-L ADR. My questions are the following:

- With the top of the artificial disc being completely flat and my L5 surface being so irregular I’m worried the keels of the M6 disc would just barely make contact. Additionally, because the M6 is 10 mm tall, suddenly raising the space between the vertebras by a full 7.5 mm would probably miss-align my facet joints. My question is whether any of the doctors would consider ‘filing’ or flattening the surface of the vertebrae by 2-3 millimeters such that the artificial disc can catch/fix, and the facet joints aren’t all of a sudden misaligned?

- Second, am I good candidate for ADR even if I have no back pain? Most of the stories I read are of people with chronic back pain so I’m not sure if I can be considered solely because of sciatica and tingling on both legs.

Thank you, I truly appreciate any color you can provide.
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"Permanence, perseverance and persistence in spite of all obstacles, discouragements, and impossibilities: It is this, that in all things distinguishes the strong soul from the weak." -Thomas Carlyle

"We fall, but we get up because the ground is no place for a champion." -Dustin Poirier