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  #1  
Old 07-30-2008, 12:58 PM
ryegal ryegal is offline
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Join Date: Jun 2008
Posts: 7
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Hi everyone,

I've been reading this enormous set of posts for weeks now, and have laughed and cried over everyone's very moving stories. I've also learned a lot -- many thanks.

Here's my story: I'm a 48-yr-old woman, mom of two. I've had lower back pain for over two decades. I've always been extremely active physically, and have had my share of accidents, but nothing specific to blame for the pain. Constant throbbing pain in the lumbar-to-sacral region, with pain in the right buttock and hip. Every few months I'd have an "episode" and be flat on my back for a few days. Had chiropractic treatment for many years.Over the years, especially after two pregnancies, the pain intensified. Nothing relieved the pain.

I visited an ortho in January, 2006. Pain on my right side was major, and pain was also starting up on my left side. Had x-rays; diagnosis was DDD; I was sent for PT. PT was way too vigorous. Early in February, I got up one morning and started to wash my face, leaning slightly forward over the sink, heard a loud "pop," and felt the worst pain in the world shooting down the back of my right leg (and I've done natural childbirth). Was screaming, rolling on the floor. Crawled to the sofa, got the ortho on phone, was given heavy drugs which knocked me out, but didn't affect the pain. After two days of lying on the couch, I had slightly less pain, but was completely numb from buttock to knee on my right side.

MRI showed hernia at L5-S1, right side. Disc was flattened, dessicated. Also grade one retrolysthesis, foraminal narrowing. Disc bulge on left at L4-L5. Also have a "transitional" spine because of lumbarization of the sacrum. This is a birth defect in which the top part of my sacrum is not completely fused, so it forms an extra little vertabrae. Supposedly this makes my spine inherently less stable and more prone to DDD.

After the February incident, I was unable to sit down at all; the sciatic pain was excrutiating. I had weakness in the numb leg and could only walk with baby steps and a shuffling, leg-dragging kind of gait. I also could not look down without exacerbating my back and leg symptoms. My ortho prescribed "conservative" treatment, because the hernia was not massive. He felt the numbness would probably resolve itself. I found a better PT --more gentle exercises, lots of disc traction, training in daily tasks. Had a series of epidurals, took oral steriods. I was a model patient, but improvement was nill after an initial, minimal improvement. Also, the symptoms on my left side started to worsen, probably from the traction always pulling to that side. I switched doctors when, after six months of no improvement, the ortho still counseled "patience." Had an electro-myelogram of my nerves -- it confirmed the dead nerve and the source at the L5-S1 nerve rootlet. December 18, 2006, I had a microdiscectomy at L5-S1, right side, performed by neurosurgeon Chima Ohaegbulam of the Boston Spine Group at New England Baptist Hospital in Boston. He found a lot of "disc material" encrusted on my nerve root; it had been hidden in the MRI. He also shaved off some of the arthritic growths in the foramen.

I found recuperation very long. It was six months before I noticed the numbness and leg pain beginning to recede slightly. By October, 2007, I was beginning to be able to sit for up to 20 minutes without too severe sciatic pain. I could walk more normally. The weird sciatic symptoms in my calf, ankle, and foot were improving. I was beginning to feel alive again.

By December, 2007, many of the improvements had eroded. A series of minor mishaps may have reinjured the disc. An MRI done January, 2008 looked about the same as my presurgery one. Currently I am not quite as bad off as I was in spring 2006, but I cannot sit above 30 seconds, cannot drive, must lie down several hours each day to relieve disc compression from standing. I cannot open a window or lift even a half-gallon of milk. I cannot reach my calves or feet, have difficulty using the toilet, dressing, cannot do any but the lightest of household chores. I am basically housebound, cannot play the piano, do any sports, or care for my children the way they deserve. (Imagine living in the suburbs with a mom who can't drive!) My current self-treatment is walking (back to the small-steps), traction by boosting myself with my hands on counter-tops, and natural anti-inflammatories. My surgeon is offering me a choice of repeating the microdiscectomy, or doing a fusion. But I don't see the point of dealing with the pain and recuperation of a microdiscectomy again, especially since it can only address the right side (they can only do one side at a time), and I now have personal experience of how temporary the results can be. My doc is saying he'll be more aggressive this time, dig out more space in the foramin for the nerve root. But my PT says that what would really help would be to regain the proper disc space. I have to agree.

So now I am looking into my alternatives. Would a minimally invasive procedure (like laser or sonar microdiscectomy) buy me some time? Or am I fooling myself that anything short of a fusion or ADR will free my nerves and allow me to resume normal activities? Frankly, I'm scared of all the options!

Any thoughts you might have would be appreciated. I know I'm not as bad off as many members, because I can at least manage my pain by cutting back on activities, and I can at least sleep at night. So, thank you all for reading, and I wish everyone here all the best with their own treatment oddyseys!
__________________
48-yr-old female, 20+ years LBP and sciatica
DDD L5/S1 diagnosed 1/2006 - sent for PT
Herniation L5/S1 2/2006 - PT/epidurals/medipacs
Microdiscectomy 12/2006, failed 12/2007
Status: L5/S1 disc completely blown out; vertabra inflamed; back and leg pain; permanently numb in much of right leg and foot; disabled

Scheduled for anterior fusion (STALIF) on 11/06/08 with Dr. Robert Banco of Boston Spine Group
Can't wait to get a life!
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  #2  
Old 07-31-2008, 02:45 AM
cathydownunder cathydownunder is offline
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Join Date: Apr 2006
Posts: 297
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Welcome Ryegal, sorry to hear your sad story.
Your symptoms sound quite debilitating and definitely warrrant further intervention, but as you said ...what...?
Just a thought ... 9 weeks ago I had my second lumbar surgery (L5S1)and my doc combined Lft facet removal to free the nerve combined with a 'soft' fusion. (screws and rods but no plate). It may be possible to do a microdiscectomy/decompression on both sides together if combined with a fusion to stabilise it afterwards.
Just a thought Cathy
__________________
Scoliosis 35*
DDD Everywhere!
The Usual Discograms Epidural Facet Injections etc
Maverick L4/5 Fusion L3/4
July 3 2006

Dynesys Stabilisation L4/5
Lt & Rt Facet Removal +Non-Bone Fusion L5/S1
May 26 2008
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  #3  
Old 07-31-2008, 07:01 AM
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Terry Terry is offline
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Join Date: Oct 2006
Posts: 1,210
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ryegal:

WOW. It sounds like you have been to hell and have not returned yet. It sounds like fusion or ADR might be your best bet as the bony growths (Osteophytes) seem to be developing in that area for you anyway. This might give you enough height in the area to allow the nerve roots to pass through the openings and control the sciatica. Best of luck to you and please keep us informed on your progress. You will get a lot of support from us as we've been there.

Terry Newton
__________________
1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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  #4  
Old 08-03-2008, 11:21 AM
ryegal ryegal is offline
Junior Member
 
Join Date: Jun 2008
Posts: 7
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Dear Cathy and Terry,

Thank you for the warm welcome. You have both been through so much; it is great to have your encouragement. Cathy, I have not heard of the procedure you mention. If you have time, would you mind telling me in a bit more detail what the soft fusion is and why it might be better than a standard fusion or ADR. Also, why is the facet removed? Is the vertebrae okay after that?

Thanks,
Ryegal
__________________
48-yr-old female, 20+ years LBP and sciatica
DDD L5/S1 diagnosed 1/2006 - sent for PT
Herniation L5/S1 2/2006 - PT/epidurals/medipacs
Microdiscectomy 12/2006, failed 12/2007
Status: L5/S1 disc completely blown out; vertabra inflamed; back and leg pain; permanently numb in much of right leg and foot; disabled

Scheduled for anterior fusion (STALIF) on 11/06/08 with Dr. Robert Banco of Boston Spine Group
Can't wait to get a life!
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  #5  
Old 08-04-2008, 08:37 AM
CindyLou's Avatar
CindyLou CindyLou is offline
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Join Date: Mar 2007
Posts: 627
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Ryegal, welcome to the forum, altho not under the best of circumstances. Remember to tell/ask the doctor about some of these other procedures you are learning about here, and has he heard of them, what does he know about them, success/failure rates, etc. Because keep in mind, we are, in my humble opinion, the best ADR site out there, but we are also lay people, not physicians. Altho, let me emphasize again: alot of damn smart folks on this site. So take advantage. You've certainly come to a great site. Keep asking, delving, researching, etc. Welcome, welcome!
__________________
CindyLou
bicycle accident 6/19/01
2 compression fractures, T12, L1;
vertibroplasty @ above levels, 9/15/01
4/06 hip labral tear repair
4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6
7/2/08 ALIF of L6-S1
7/30/08 Removed bone cement.
8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion.
3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
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