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New Member Introductions If you just joined, please introduce yourself here. Please add a signature describing your spinal history (use the "User CP) and ask us how we can help you get started. |
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#11
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Spine surgeon in Switzerland!
Hi Hesham, sorry to hear about your accident, and wish you relief from the pain soon. I like Dr. Lauryssen here in the US, and while looking for top spine specialists in Europe I cam across Professor Max Aebi (Bern, Switzerland), though I have not contacted him yet, but thought he might be good for 2nd opinion given the proximity.
Best of luck Dema
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7/2007 Whiplash injury 11/2009 Cervical disc herniation C3-C6 (C5-C6 worse) 2010-2013 Conservative treatments (drugs, PT, epidurals, prolotherapy, acupuncture...etc), little effect on pain Considering surgery (typical questions, which type & which surgeon!) |
#12
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Dreward, do you know of a publication where the L5-S1 controversy is spelled out?
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2009: Injure lower back while doing deadlifts March 2014: MRI shows moderate degeneration at L5-S1 |
#13
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Hanshan, I think the 1st thing you can do is read your mri report. It should mention something about the degree of facet degeneration at L5-S1. If moderate to severe (or grade 3 to 4) then fusion is the optimal option. That is probably the 1st criteria. Beyond that, I also concur with Drew in that right around the time I had my surgery (April this year) I heard of a spine conference in which many of the top spine surgeons world wide attended, adr at L5-S1 was being re-evaluated. It seems that the majority of adr failures do take place at that particular level, L5-S1. Look at yours or any mri and you can see the obvious angle it has as compared to those levels above. From all my research, the majority of successful fusions are at that level, probably because it is not considered a motion segment like those above. I do think based on what I know that the surgeons are being more selective for adr at L5-S1.
If you want a comprehensive understanding, Dr. Zeegers will be happy to explain it. Also, the Activ-L which Dr Zeegers uses has a uniquely designed disc specifically for L5-S1. Hen
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Bad fall on A$$, Feb 2001 ice hockey Lami L4/L5 April 2001, L5/S1 Aug 2001 Severe dislocated coccyx (same fall) Un-diagnosed til 09. (Cannot sit) Low back pain mild until 2011 - pull started a generator from knees. rhizotomy Nov 2011 - zilch Facet joint inj. 18 mo. (no impact) Can only stand/walk for approx. 30 min 21 hrs/day in bed L3-5 Activ-Ls (April 2014) Dr Zeegers - walk every day, swim 3 x week. Pain free, no pain meds. Extremely pleased with my decision |
#14
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Thanks Henry, didn't mean to get this thread off track. Typically if there is a scholarly consensus on a particular topic, such as the viability of ADR at L5-S1, there will be at least one publication out there spelling it out. Hopefully such a publication will come our way sooner rather than later.
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2009: Injure lower back while doing deadlifts March 2014: MRI shows moderate degeneration at L5-S1 |
#15
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Actually I intended the post for Hesham. Hanshan, Hesham I messed up. Please Accept my apology Hesham
Regards, Henshem, I couldn't resist
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Bad fall on A$$, Feb 2001 ice hockey Lami L4/L5 April 2001, L5/S1 Aug 2001 Severe dislocated coccyx (same fall) Un-diagnosed til 09. (Cannot sit) Low back pain mild until 2011 - pull started a generator from knees. rhizotomy Nov 2011 - zilch Facet joint inj. 18 mo. (no impact) Can only stand/walk for approx. 30 min 21 hrs/day in bed L3-5 Activ-Ls (April 2014) Dr Zeegers - walk every day, swim 3 x week. Pain free, no pain meds. Extremely pleased with my decision |
#16
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Dr Clavel mailed me journal articles re the sacral slope. Pelvic incidence is another one you could use on a search engine. I had to get a second X ray for Clavel that included the tops of my exposed femoral heads since that is the data point used in relation to L5/S1 to determine if you are too steep for ADR at that level.
Lots of interesting and rare journal archives that may or may not have been exclusive, but it's something any of these consults can forward to you I am sure. I was steep at a grade > 70 degrees which made Clavel choose that particular route. Dr Laurryson said the same exact thing, as did my Kaiser neurosurgeon. At that point, consensus had been earned and Clavel was first to being the issue up.
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Weightlifter since 12 years old, now mid-40's and figuring out this wasn't such a good idea. Chronic back pain started in 2010 while shrugging weights that a 40 yr. old shouldn't even try. MRI in 2012 showing L4/L5, L5/S1 herniations and L2/L3 bulge. L5/S1 taking on new shape, chronic sciatica, etc. DEXA bone scan performed 5/7/14 showing mild osteopenia. Surgery performed July 9th, 2014, Dr Clavel, hybrid three level lumbar. |
#17
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Bone Growth
Sorry for your injury, and at this age, I have seen personally, people about a decade older than you...
However, if you believe you can go back to work, after 3 weeks, this is not realistic. The ADR has a coating, and this looks like sandpaper, this is called hydroxyapatite, varies, but this will take several weeks, to grow and become strong. You may be able to work for periods, maybe an hour here and there, depends how you respond to the surgery, and how fast you heal. I was to have two M6, but the surgeon could only place one, therefore I had a fusion at the L5-S1 level. Still healing and this has been three months, but I am twice your age. You may consider the MobiC for the Cervical, and go with the M6L, but remember, this is NOT the original, if you catch my drift, it will be much better, but a fall, car accident or other, can damage the disc. Me, I hope they can come up with a better option, or at least, if in 20 years, if need be, they can remove the 'middle', leave the endplates and be done. If you want my surgeon, in Germany, send me a PM, I have not been here in awhile, but will try to get back here.
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Jerry, Somewhere Ohio L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior. |
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