[johnb]

I had the dynesys done in May so I'm almost at 7 months. I've had it in long enough to feel the spacers that limit extension loosen up a bit. Now I wish the cord that limits flexion would loosen up a little, I'd feel better as I could use some flexion, I feel, to open up the L5/S1 disc space which is still giving me trouble due to some central stenosis due to low disc height and facet enlargement. Seems that laminotomy didn't open it up enough. I feel that the cord is so tight, it has been responsible for the spacers losing stiffness. MaCafee has a bunch of baboons for studies that he has tested the dynesys on. Their cords loosened up 25%. I'd like to see more data on the baboons as far as screw breakage etc. Had little leg pain after surgery and lots of backpain, a new type, that I associate from the screws in the bone. At about 4 days the right side leg pain came back mildly. As I mentioned, I was decompressed and had an L4/L5 left bulge removed and laminotomies done at that level and L5/S1. Due to bulge on the left side, that muscle that connects to right spine, top of the hip and bottom of the rib cage would tighten to make room for the bulge. That is how the physiatrist explained it years ago. Only one who explained the dynamics of how the spinal muscles can gaurd to make room for neural impingement. However, my L5/S1 disc space collapsed a bit after the IDET in 2001. So this pulling on the top right hip would pull my hip out of whack and compressed the foramen cuasing sciatic right pain even though I had left bulge. It is amazing how many surgeons don't understand the dynamics of the spine "right" itself during neural impingement. Whenever the left bulge would hit, my spine would spasm to guard it.

At 12 weeks, the pain shifted to the left side then sort of settled in the middle with bilateral leg pain. It would get bad when i walked and for about a month, I was wondering if this contraption was squeezing my nerves somehow. I'd always used flexion before to open up the disc space. If any of those baboons felt like I did, they would have been rattling their cages for sure. Did a steroid pack then waited until the 4 month mark and had a cuadal injection. I had an MRI and surgeon said everything looked okay, no reherniation. Got on Lyrica and it finally settled down at about 5 months. Since then, it has been up and down and I've had more weakness and tingling bilaterally than I had before surgery. My facets feel unloaded but the tingling and weakness bother me a bit, especially since they were in the distribution of where it was real painful before. I don't look forward to having my paraspinal muscles torn up again but I'm not sure if I'm gonna leave the implant in. After April, my insurance is changing. I'll have HIPAA protection for pre existing conditions but I've got a little more research to do to make sure I'll have coverage in case the implant system needs maintenance. I'm not sure if the lack of flexion is cuasing my problems L5/S1. Additionally, sure wish their was more long term data the system. I do enjoy my facets being unloaded. I'm wondering how much of lower back pain was coming from my facets? My discogram didn't reproduce high pain levels. I was originally lookin at the charite and am sort of glad insurance didnt come through as my L5/S1 has been short for awhile so I know the facets have had some adjusting to do. The L5/S1 facets have been atrophied since 94 and were listed as "degenerated" on the most recent MRI. Many questions still unanswered. Is the dynesys aggravating the central stenosis? How much benefit is from the dynesys and how much from the decompression procedure that was done with it? I'll try and find that link that interviewed MacAfee. He has some interesting comments on it.

JohnB