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  #1  
Old 01-07-2013, 12:13 AM
Running11 Running11 is offline
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Join Date: Jan 2013
Posts: 187
Default Does a wait and see approach hurt ?

Hi all.

I am a newie so forgive me for asking. Does a wait a see approach further damage your disks? I think my symptoms and pain is worse .does that mean my disks are? Most people say about 95 percent of disks heal. Can mine?
__________________
disc bulges C 4-5 and C 5-6
EMG evidence nerve root blockage at C6, C8 and L5
Cogential moderate-severe cervical/lumbar stenosis
Cervical compression with clinical myelopathy with Hoffman's
Tests; MRI's, EMG/NC studies, discogram, CT scan
Pain management; tens unit, ice and heat, physical therapy, chiropratic care, and spinal epidural treatments.
Blue Cross / Blue Shield of Ohio external third party approved Pro-C ADR at C 5-6 on 4/3/13
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  #2  
Old 01-09-2013, 02:49 PM
JeffR JeffR is offline
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Join Date: May 2012
Posts: 356
Default

I am not a doctor but the general consensus is to give 6 months of conservative treatment a chance before even considering surgery. Now to answer your question yes waiting can hurt if you wait too long I.e. you can get sciatic nerve damage, facet problems etc., but that is if you wait quite a long time usually (longer than 6 months most likely). There is no way to tell if your disc will heal on its own besides doing the conservative treatments and seeing what happens unfortunately.
__________________
Lifelong history of back issues from a young age, spasms etc.
1995 - Weightlifting injury
1997 - Hip Injury
2009 - Trampoline injury (just bounced down on my butt)
2009-2011 Physiotherapy and medication, progress but no lasting pain relief
2010 - X-Ray DDD L5-S1, L4-L5, L4-L3
2010 - MRI Herniation L5-S1, Bulges L4-L5, L4-L3
2011 - Epidurals - No relief
2012 - Facet Injections - No relief
2012 - Discogram TBI - positive L3-S1

L3-S1 ADR M6-L w Clavel 11/28/2012
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  #3  
Old 01-09-2013, 11:31 PM
Lillyth's Avatar
Lillyth Lillyth is offline
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Join Date: Nov 2012
Posts: 679
Default

I wouldn't wait more than six months to a year at most. It's been a decade for me now. I am just praying that the ghastly amount of money I am shelling out for this procedure will make the pain go away.

I'm just speaking from my own experience. Mine never got any better. Sometimes they do, but if they don't...
__________________
Multiple traumas to spine starting age 13.
1st American to have 6 ADR's in one surgery. C3-4 - C/7, & L5-S1 - L3-4.
Surgery w/ Dr. Clavel, 3/18/13, M6.
Before surgery: severe spinal stenosis C5/C6 (cord "flattened" per stateside doc), + for Hoffman's & Babinsky's.
At time of surgery: 5 yrs MAX before ending up in wheelchair.
Clavel found L5-S1 partially fused. Had to cut it apart to put in M6.
Please excuse brevity - SEVERE carpel tunnel.
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  #4  
Old 01-10-2013, 11:40 PM
JEVE19 JEVE19 is offline
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Join Date: Feb 2006
Posts: 359
Default Depends

Depends on what is wrong with your disc.
A degenerated disc isn't going to heal itself.
Many members have waited extended periods of time due to the fact that we had to
get the monies for the surgery first. Now that I had my surgery done, after waiting and suffering for ten years, I would never do this again.
If another disc goes, I will get another M6 if a jiffy. I would not go through that agony again!
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L5-S1 Lumbar M6 by Nick Boeree
10-14-2011
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  #5  
Old 01-11-2013, 10:07 AM
CanadianDean CanadianDean is offline
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Join Date: Oct 2012
Posts: 80
Default I agree

I agree with Vicki, if the disc is dead (DDD) it needs replacing as long as it's causing the your pain. If you wait too long you can cause damage to the end plates of the vertabrates and than possibly ADR will not be an option and fusion is your fix. These are my thoughts, I'm obviously not a doc. I would recommend you send your info (MRI, x rays etc.) off to several surgeons for their opinion along with an in depth discussion about your symptoms. This will help you with your decision.

Best of luck!

Dean
__________________
44 yo
Very active until major back problems Nov2010
PT
Massage, chiro
4 shots, no relief
Ct, 3mri's
all activities stopped, day by day
DDD @ L5 S1
Examined by 3 surgeons,
Consulted with 2 out of country surg, all reco ADR
Surgery Oct. 26, 2012 by Dr. Bouchard, Pro Disc L
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  #6  
Old 01-14-2013, 06:15 PM
Slackwater Slackwater is offline
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Join Date: Aug 2007
Posts: 782
Default

Quote:
Originally Posted by Vicki_in_Florida View Post
Depends on what is wrong with your disc.
A degenerated disc isn't going to heal itself.
You asked if a wait and see approach hurts.
I agree with both on the above:
a. depends
b. healing is short of full function

There are "red flags" where surgery is indicated. I am not a physician, but ... Foot Drop is a red flag and surgery is needed within 7-14 days, get it done (L4/L5). There is a quality of life consideration mentioned in the below video.

Conservative treatment (waiting) is the standard practice. Many symptoms resolve in the short to medium term. You have cervical and lumbar MRI's so your symptoms passed a threshhold and you possibly have a surgeon's writing saying "surgical candidate".

The surgical timing is debated & researched by professionals in the field. The best reference is SPORT (spine patients outcomes research trial). Dr. Weinstein/Dartmouth is often noted as an author, see pubmed.LINK. There may have been more than one journal article on the clinical trial regarding timing of surgery.

Look for:

Duration of symptoms resulting from lumbar disc herniation: effect on treatment outcomes: analysis of the Spine Patient Outcomes Research Trial (SPORT).
Rihn JA, Hilibrand AS, Radcliff K, Kurd M, Lurie J, Blood E, Albert TJ, Weinstein JN.
J Bone Joint Surg Am. 2011 Oct 19;93(20):1906-14. doi: 10.2106/JBJS.J.00878.


Predominant leg pain is associated with better surgical outcomes in degenerative spondylolisthesis and spinal stenosis: results from the Spine Patient Outcomes Research Trial (SPORT).

Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial.

Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT).
Weinstein JN, Lurie JD, Tosteson TD, Tosteson AN, Blood EA, Abdu WA, Herkowitz H, Hilibrand A, Albert T, Fischgrund J.
Spine (Phila Pa 1976). 2008 Dec 1;33(25):2789-800. doi: 10.1097/BRS.0b013e31818ed8f4.




Spine surgery may be considered "elective". Surgeons will give you options, alternatives, or differing opinons. Someone wrote get more than one surgical opinon (options?).

Healing occurs to a limited extent wit the disc. The disc (intervertebral disc, or IVD) will scar after a discectomy, to the extent that is healing. The IVD is avascular. There are no IVD blood vessels. Blood vessels supply the normal healing mechanisms and nutrients. The IVD will not heal like our skin or our bones. The IVD will respond after injury. The response may include blood vessel ingrowth to a limited extent or nerve ingrowth (angiogenesis, neurogenesis). New nerves are thought to possibly cause some "discogenic" pain, but I will save you the citations (TMI).

Identifying a pain source is big. Leg pain indicates a type of surgery that has a bit better results than just back pain. I think leg pain means it is easier to identify what is going on, like nerve compression (stenosis) in the foramen or lateral recess, or ... Stenosis is part of the normal aging process in my limited view, like any joint with cartilage, with added biologic variability, exacerbated by toxins (industrial, smoking), injury, trauma (horse/car accidents) etc.

The UCSF medical school television site video is OK+ to watch if you have the time. Two (2) spine surgeons give a 90 minute talk to people in the community, not doctors/surgeons. The surgeons in the video speak to the lumbar region. The injury, trauma and aging issues are similar between the spine and IVD in cervical and lumbar regions.

The treatment options for cervical are also briefly mentioned in the video by Dr. Praveen Mummameni. He is a co-author several papers on cervical and lumbar surgery (pubmed.link). Dr. Dean Chou authors multiple papers, but his name is less unique to give quick references on pubmed.


Low Back Pain: Causes, Conservative Treatment & Surgical Intervention
Causes and treatment of low back pain.
Date: 2/20/2012
Views: 190,247
Time: 89 minutes



-------------
slackwater_sf
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  #7  
Old 01-14-2013, 09:46 PM
bruceminer bruceminer is offline
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Join Date: Jan 2013
Posts: 56
Default

Quote:
Originally Posted by Vicki_in_Florida View Post
Depends on what is wrong with your disc.
A degenerated disc isn't going to heal itself.
Many members have waited extended periods of time due to the fact that we had to
get the monies for the surgery first. Now that I had my surgery done, after waiting and suffering for ten years, I would never do this again.
If another disc goes, I will get another M6 if a jiffy. I would not go through that agony again!
Vicki,

I suffer from the same L5/S1 DDD and not considering between the M6 and Pro Disc. Dr. Bertagnoli recommends against M6 saying that if offers no control over the center of rotation (COR) and promotes accelerated deterioration of facet joints. Can you offer comment on these two different disc types and which surgeon you could recommend. I hear mixed reivews about Dr. Ritter-Lang but many good reviews about Dr. Pablo Clavel.

Bruce
__________________
2005: L5/S1 discectomy
2010: L5/S1 nucleoplasty
April 24, 2013: L5/S1 M6 ADR with Clavel

Bruce
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  #8  
Old 01-14-2013, 11:44 PM
JeffR JeffR is offline
Senior Member
 
Join Date: May 2012
Posts: 356
Default

FYI Dr. B has a financial stake in prodisc so take what he says with a VERY large grain of salt. M6 most definitely has better facet outcomes relative to pro disc because the over extension issues are irrelevant and the biomechanics are much closer to a normal disc. Do some more independent research and understand some if the underling motivations of the doctors pushing various discs.
__________________
Lifelong history of back issues from a young age, spasms etc.
1995 - Weightlifting injury
1997 - Hip Injury
2009 - Trampoline injury (just bounced down on my butt)
2009-2011 Physiotherapy and medication, progress but no lasting pain relief
2010 - X-Ray DDD L5-S1, L4-L5, L4-L3
2010 - MRI Herniation L5-S1, Bulges L4-L5, L4-L3
2011 - Epidurals - No relief
2012 - Facet Injections - No relief
2012 - Discogram TBI - positive L3-S1

L3-S1 ADR M6-L w Clavel 11/28/2012
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  #9  
Old 01-15-2013, 08:29 AM
JEVE19 JEVE19 is offline
Senior Member
 
Join Date: Feb 2006
Posts: 359
Default Don't just take the docs opinion

Bruce,

This forum has such a wealth of information on it.
So does google, etc.
Go to google and type in prodisc lawsuits.
You will see actual patients with lawsuits.
If you type in m6 lawsuits, you will see lawsuits between
M6 and Prodisc. Search Dr. B's name too, especially after surgery care.
After you do more reading, I think you'll sway away from Dr. B.

It's scary enough to go overseas for a surgery but imagine having a problem when you
get back and you can't get in touch with your doctor.
You want to be able to reach the doctor..not the nurse, or staff but the doctor.

You are doing the right thing by researching on your own.
Back surgeries are the doctor's "business". This is where the money lies.
You want what is best for you not what's best for them.
Keep reading and asking questions.
I personally would never get a Prodisc. Read too many bad things about it.

The best part about this forum is everyone shares their experiences.
The surgical outcome section is great to read as many people have tried to keep up many years of posts. Good luck with your decision. Keep reading
__________________
L5-S1 Lumbar M6 by Nick Boeree
10-14-2011
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  #10  
Old 01-15-2013, 06:38 PM
bruceminer bruceminer is offline
Member
 
Join Date: Jan 2013
Posts: 56
Default

Quote:
Originally Posted by Vicki_in_Florida View Post
Bruce,

This forum has such a wealth of information on it.
So does google, etc.
Go to google and type in prodisc lawsuits.
You will see actual patients with lawsuits.
If you type in m6 lawsuits, you will see lawsuits between
M6 and Prodisc. Search Dr. B's name too, especially after surgery care.
After you do more reading, I think you'll sway away from Dr. B.

It's scary enough to go overseas for a surgery but imagine having a problem when you
get back and you can't get in touch with your doctor.
You want to be able to reach the doctor..not the nurse, or staff but the doctor.

You are doing the right thing by researching on your own.
Back surgeries are the doctor's "business". This is where the money lies.
You want what is best for you not what's best for them.
Keep reading and asking questions.
I personally would never get a Prodisc. Read too many bad things about it.

The best part about this forum is everyone shares their experiences.
The surgical outcome section is great to read as many people have tried to keep up many years of posts. Good luck with your decision. Keep reading
Vicki;

Your spot on with doing a google search for lawsuits for prodisc and M6 . Actually through an initial check I couldn't find any lawsuits from patients for M6 so I anticipate that this speaks to their success and satisfied patients.

How are you making out with your M6 implant?

I've also read that fusion is a reliable option to ADR for the L5/S1 level as this disc level does not provide much movement. Any thoughts?

Kind regards,
Bruce
__________________
2005: L5/S1 discectomy
2010: L5/S1 nucleoplasty
April 24, 2013: L5/S1 M6 ADR with Clavel

Bruce
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