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Old 04-10-2014, 02:09 PM
Optimistic Optimistic is offline
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Join Date: Mar 2014
Posts: 81
Default Planning Surgery

I am a new member and have read many posts over several weeks. The discourse has been both interesting & helpful. I am typically an analytic person who researches items thoroughly, and with the stakes so high on my back, even more so. I am also a very active individual who engages in skiing, mountain biking, scuba diving, kayaking, etc.

I have experienced lower back issues, extending down to buttocks, hips and legs beginning >20 years ago with L5/S1. Several years later, L4/L5 was affected and then L3/L4. I have tried conservative treatments ranging from NSAIDS, physical therapy, chiropractic treatment, acupuncture & hydrocodone, all with limited relief. While various neuro and orthopedic surgeons recommended surgery over the years, I found that time (~1 - 3 months after the acute episode) was the best help to alleviate the acute symptoms. I subscribe to the approach of "putting off the surgery if you can live with your symptoms". I have not had any surgery or injections to date.

In the last 6 months, I experienced an increasing amount of pain as well as functional limitations. A new hip pain was examined by a hip specialist who attributed it to my back. While I have not been able to run for some time, now I am unable to jog. Walking sometimes can aggravate my symptoms. I have intermittent pain that restricts me from various activities and social engagements.

I started sharing info with European surgeons (all US docs are recommending fusion at 3 levels from L3 to S1). The opinions are coming back ranging from 1 level fusion to 3 level ADR to hybrid with dynamic stabilization.

My questions for which I am obtaining very different answers from Europe include:
1) Am I a candidate for ADR? Why or why not?
2) Do I have some spontaneous autofusion taking place between vertebrae that can affect the decision for ADR?
3) Do I have any motion (ROM) at the two lower discs? If not, will ADR be able to restore it (assuming that I also exercise the muscles, obtain PT & Chiro, etc.)?
4) If I obtain ADR and my facet joints are contributing to my symptoms, will this be addressed as part of the decompression?
5) Can the segment that is contributing to the pain & weakness be identified and can we isolate it to the neuroforamenial narrowing, disc herniation, stenosis or ligamentous-facetal hypertrophy or a combination?

Like others who have posted, the docs do not agree on the diagnosis or recommendations. I also understand that some members have consistent recommendations from the docs I am now in the final process of selecting a surgeon, approach & technology. I will keep you posted on my selection, the overall experience, my insurance hell and my outcome. If you have any suggestions, please advise. Thanks for your support & wish me luck.
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1989 – herniated disc at L5-S1
1992 – L5-S1 broad bulging; right L5 nerve root compression; impingement on S1 root within spinal canal;
2006 – DDD L3-S1; disk bulge at L3-L4 and mild facet/ligmentous hypertrophy; L4-L5 large herniated disc; facet/ligmentous hypertrophy with stenosis; disc herniation & dessication at L5-S1;
2013/2014 – Dessication and significant disc height loss at L4-L5 & L5-S1; L3-L4 disc bulge with hypertrophy; mild spinal stenosis; Grade 1 anterolisthesis (3mm); L4-L5 - marginal spurring and moderate hypertrophy causing neuroforaminal narrowing; L5-S1 - moderate-severe neuroforaminal narrowing; lumbar lordosis is straightening.

New pains & functional limitations in late 2013 led to exploring ADR procedures. Consulted with 8 surgeons domestically and 9 in Europe.
May 2014 – Anterior and posterior incisions in a 5-hour surgery resulted in 2 M-6s and one facet joint prosthesis (dynamic stabilization system). On the road to full recovery.
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