Hello everyone

[BlueLudeDude]

I just wanted to introduce myself to the group say how happy I am to have found a site that focuses on ADR support.

Hmm let's see... where do I start? Well, my name is Kevin, I am currently 25 years old, and I'm from Raleigh, NC. I have a computer science degree from NC State University (go Pack!), so I spend most of my days in a chair at a desk. I've been living with back pain since the summer of 2001, and it has gotten progressively worse over the years. I believe the incident that caused all of my problems was my girlfriend at the time walking on my back. Yes, I know, it sounds crazy, but that's what happened. She had me walk on her back from time to time to pop it for her, and my back felt a bit tight when I came home from work one day, so I asked her to return the favor. Big mistake! I was fine for a couple of weeks, but then I started to have pain in one of my lower ribs and also in my lower back.

I went to see a doctor, and she had me go visit a physical therapist, but the treatments that I received didn't seem to help at all. I had x-rays done, got evaluated by a chiropractor, but I hesitated to have any adjustments done because I didn't want to risk making things worse.

Eventually I did go see a chiropractor, and I went through the standard regimen of electrical stimulation of the muscles in my lower back (I never noticed any effect from these treatments) and adjustments. Looking back, I still remember the third or fourth adjustment that I ever had - the pain that I felt was completely gone... I could bend over and touch my toes and stretch in every direction imaginable without any pain or muscle tightness whatsoever. It was wonderful and I finally felt hopeful. Unforunately, though, as things settled back into place, my pain would always return within a few hours. I continued to visit the chiropractor a couple of times a week over a six month period or so, but the adjustments never seemed to help as much after that. Even though the pain felt like it was around the middle of my lumbar spine, the chiropractor seemed convinced that the problem was in my SI joints. Every time that he did an adjustment, he focused on that area, but the pain never completely went away like I was hoping it would. Eventually the chiropractor said that his treatments were probably not doing much to help me, and I was given a referral to the Carolina Back Institute (CBI).

On my first visit to the CBI, I saw Dr. Gwinn - he's a great doc, and he's the one who went over my second set of MRI films with me today. On my first visit, he did a series of physical tests on me, asked a bunch of questions, and I believe that I had some x-rays taken. To make a long story short, I've had two MRIs, gone through another cycle of PT, had three epidural injections, taken oral steroids, Celebrex, and Vioxx, but nothing has seemed to help all that much. The only things that I've done that may have worsened my condition are playing racquetball for several months about a year ago and going bowling a couple of times. Other than that, I've always stuck to low-impact aerobic activity to try to keep myself in decent shape.

Here are the findings from the first set of films that I had done:

7/8/03 - X-Ray of lower back:
Normal alignment of lumbar spine. Moderate disc space narrowing at L3/4. No significant hypertrophic change or osteophyosis. Facets are normal. No fracture. Incidentally noted is an unfused posterior spinous process at S1 (that doesn't sound good, but I never followed up and asked about that... feel free to comment).
Impression: Mild DDD L3/4. Otherwise negative. MRI may be helpful if patient has continued back pain to exclude herniated discs.

8/3/03 - first MRI of lumbar spine:
Vertebral body alignment is normal. End-plate degenerative changes at L3/4, which shows mild disc space height loss and disc desiccation. No evidence for disc herniation.
Impression: No evidence for disc herniation or canal stenosis. End-plate degenerative changes at L3/4.

Now, at this point, I was thinking okay, at least I know where the culprit is now - one bad disc at L3/4 - I can handle this. I'll just keep stretching and go back and see the chiropractor if I feel inclined to. I remember going back to the chiropractor a few times, but the adjustments that I received didn't seem to help at all - I think they may have actually made things worse, because soon I felt a large knot forming at the top of my pelvic bone on the right side of my body, and I also began to feel numbness and tingling in my right foot/toes and a painful sharp, ripping sensation in my lower back, especially to the right side. In fact, even to this day, my left side seems 99% normal - most of the trouble seems to be in my spine itself and off to the right (and down my right leg). Could the chiropractor's continued focus on my SI joints have caused a problem to appear where nothing was previously wrong? To this day I still wonder, and you'll see why when I go over my latest MRI film that was taken this past Sunday.

Seeing as how I now had a significant amount of pain in the right side of my lower back/hip, I had x-rays taken on 7/8/2004. The results were negative, however, and the radiologist's report indicated that everything was completely normal. Dr. Gwinn then had me go get injected with dye and have a bone scan done to rule out any fractures, but, again, everything came back negative - I remember feeling a bit relieved yet frustrated at the same time because I wanted to know what the heck was causing the pain, even if it was some sort of dark diagnosis of some complex problem that would be difficult to treat.

That brings me to the present time. I have been doing most of my exercising on a stationary bike or simply walking around the block, and the pain has slowly gotten worse and worse. I went to see a neurosurgeon about having a fusion done - he took one look at my old MRI and immediately said that he would not hesitate to fuse the joint together based on my symptoms and history. He told me to call him if I wanted to schedule a fusion, but I never did... it's just too scary at my age when I have my whole life ahead of me to think about having fusions every 10 or 15 years to replace worn out adjacent discs. That's when I turned to ADR.

I was ecstatic to find that clinical trials had finished up and that the FDA approved the Charite. I felt that I would probably be considered a perfect candidate except for the fact that I was so young. I didn't show signs of any of the contraindications for ADR surgery, and my years of attempted treatment of my problem hadn't seemed to help. After my visit to see Dr. Gwinn today, though, I'm a bit discouraged, and I don't know what to do.

I had my second set of MRIs done this past Sunday in a mobile MRI unit housed inside an 18-wheeler that they pull up in the parking lot of the CBI. I felt sure that the L3-L4 degeneration might be a bit worse than it was a year and a half ago but that nothing else would be wrong. I'm still mortified by the results that Dr. Gwinn shared with me today, however:

L3-L4: moderate loss of disc space height with a mild diffuse disc bulge with minimal effacement of the thecal sac.
L5-S1: small posterior central protrusion-type disc herniation is present, with quite minimal effacement of the thecal sac.
Impression: Minimal degenerative disc disease.

Yikes! Two discs now have problems. I guess that takes me out of the running for an ADR procedure here in the States, so I'm bummed about that. At least maybe this explains the pain that I'm having in my right hip... if I lay on my left side in bed and try to pull my right foot down to the floor in front of my left foot, there is a deep aching sensation right around where the knot is on the right side of my back, and it radiates all throughout my right hip. Perhaps the two are related. Dr. Gwinn gave me a whole sample box of Celebrex today, did a trigger point injection into the knot itself, and sent me on my way.

I'm so frustrated... I wish I either a) had a time machine so that I could go back in time and stop my girlfriend from stepping on my back or b) could trade in my body for a new one.

I also started having really bad TMJ pain in October of 2003, probably caused by hitting my face on a sidewalk after an altercation back in '98. On top of that, my cervical spine has been going haywire the last six months or so. I have a vertebrae or two in my neck that I can move around fairly freely without even moving my neck, and when I do turn my neck to one side or the other, the two vertabrae make a REALLY loud popping sound. When I wake up in the morning, my neck is often stiff, and if I try to turn it side to side, there is a crunching, grinding noise. I had an x-ray done, and the report said that all of the spacing between my cervical vertabrae is normal, so I'm going to go through PT and see if I feel any relief. I've got an MRI order from an oral surgeon for my TMJ problem, and, who knows, since I've already met my deductible I may be having an MRI of my cervical spine done before the end of the year.

Well, that's me - I apologize for the length of this post, and I want to thank anyone who actually read the entire thing. I look forward to getting to know you all better.

Kevin

[Harrison]

Kevin, welcome to the community! And thanks for your thoughtful, well-written post. I hope we can help you; there are lots of smart, helpful people here!

[Sabrine]

Hello Kevin!
Your story and symptoms sounds very similar to mine( although I haven't tried the "backwalking thing )
Have you had any discogram taken?
I'm 24 years old and are going to have a 2-level surgery with Dr.Bertagnoli in Germany in April.

Anyway, I just wanted to welcome you to the community, it's a great place

PS: I also have problem with my cervical spine-it makes all sorts of noise. It started after I began having trouble with my back, so I guess it's related. I hate it, like it wasn't enough with the pain from the back. I am keeping my fingers crossed that it will be better when my back is fixed.

Best wishes
Sabrine

[Poncho]

Hi Kevin,

So far, I would say that you have made good decisions regarding surgery with your back and doing what you can to avoid it (fusion).

I haven't heard where they are at in the clinical trials currently with the Prodisc and Charite and if they are doing some sort of open enrollment at this time. I myself went abroad to have ADR replacement - 10 months ago. Doing pretty good thus far.

It would be interesting to see where the pain is coming from when you get a discogram (eventually). This will help confirm which disc or disc are your pain generators.

Welcome to the forum!

[Alastair]

Hi Kevin,
It should be possible to do something edoscopically maybe. Look at the Alphaklinik website here
http://www.alphaklinik.de/en

Have a look in the spine section and its described well. Its not all that invasive local anaesthetic and you go home 3 hours later. I don`t know who does this in the USA I live in the UK - - -there will be someone who knows - -ask Mark MM global
Best
Alastair

[Paul]

Kevin, I'm a candidate for a 2 level. I was told by my doc that the one level limit in the US can be worked out. there are folks here that have had 2 levels done in the US. The big hurdle is insurance.

[BlueLudeDude]

Hey guys and gals -

Thanks for all of the warm hellos.

Also, thanks for the suggestion about having a discogram done. I'll bring it up with the ADR surgeon when I go see him on Tuesday.

I'll try to post some photos of my MRIs over the weekend since I have my films with me until my appt on Tuesday... hmm unless I'm not allowed to make copies of my films for some reason. I paid for the MRIs, so even though the films are kept at the back institute, I can take photos of them, right? I would think so...

Oh, also, I did some more research last night on that big knot in my back around the SI joint, and I found an article on something called a "back mouse." It sounds exactly like what I have! Has anyone ever heard of this before? According to the article, doing multiple injections of medication right into the knot itself almost always makes all of the symptoms caused by the knot to go away... permanently! It sounds too good to be true, but the process was tried out on two different individuals with completely different symptoms, and the outcome was extremely positive for both of them. The best part is that the doctor who wrote the article is right here in North Carolina (at UNC), so perhaps I can go see him if all else fails. Here's a link to the article: http://www.findarticles.com/p/articl...49/ai_61855577

I also came across this other article on back mice: http://www.chiroweb.com/archives/22/20/01.html

Perhaps this information will be useful to someone else out there as well... I hope so. Have a great weekend, everyone!

[BlueLudeDude]

Update!

Well, I saw a neurosurgeon here in Raleigh today - his name is Dr. Mikles, and he did his training up in NY. He has done 20 ADR surgeries, but they were all Prodisc procedures, not Charite. He seemed like an intelligent, patient guy, so that was reassuring, assuming I do go ahead and have the surgery eventually and choose him as the one to do the procedure.

He took a couple more x-rays of me there at the office in flexion and extension, and my spinal column was lined up well, so that's good - apparently that makes me a better candidate for surgery.

It looks like the next stop for me will be a discogram followed by a CAT scan at the local hospital sometime within the next month. I'm also going to do some PT on my neck over the next four weeks (and my lower back some more while I'm at it - why not), so we'll see how that goes.

The good news is that the doc was not concerned about the small herniation at L5-S1. He said that if the two degenerative discs were adjacent to each other (rather than being separated by my healthy looking L4/5), then I probably wouldn't be a candidate for surgery. But for now, I appear to have the green light! I'm just keeping my fingers crossed that the discogram yields the desired result - that all of my pain is coming from the pretty obvious DDD at L3/4 and nowhere else.

Also, I mentioned the whole episacral lipoma (aka back mouse... see my last post in this thread) thing to him, and he didn't seem to know what I was talking about. Oh well... I guess I can always get that looked at after I have surgery.

Well, wish me luck! I'll post a couple of shots from my MRIs and one of my x-rays here momentarily.

[BlueLudeDude]

Here are the shots from my x-rays/MRIs that I promised:

[Justin]

Kevin,

Welcome to the forum! I didn't see your post the other day. I had a 2-level ADR in November 2003 with Dr. Bertagnoli at 23 years old.

Feel free to send me a private message or email. Let me know if I can help, I have been in similiar pair of shoes.

The physician you saw in NY--is the 20 number 2-level or single level surgeries?

I am here to help,

Justin