[Justin]

Originally Posted by Cindylou

Justin, are you looking at just days ahead for your surgery??

I'm now going to have surgery on 5.14.09.

Only if you have the time, could you explain to me in "very layman terms" just exactly what happened?

To be honest, no one is 100% sure what happened. However, we are all in agreement that when I fractured the L4 vertebral body of my spine during my skiing accident in 1997 that the fracture healed incorrectly. In an attempt to "heal" the fracture, new bone was laid down in this area. This abnormal overgrowth of bone is called an osteophyte, or spondylophyte. Osteophytes are frequently seen in patients with Degenerative Disc Disease (DDD), as they are the body's attempt to help stabilize the spine seen during the degenerative cascade.

The osteophyte that is seen in my case was the direct result of trauma in which the area healed "too well." The interesting thing--I guess, unfortunate for me --is that this abnormal bony growth on my vertebral body is directly compromising the space in my spinal canal. Thus, the spinal cord, which is called the cauda equina at this lumbar level L4, is severely compressed due to this osteophyte--it's as if the cauda equina is being strangled by the overgrowth of bone.

In most cases, severe impingement of the cauda equina is seen following trauma, malignancy or substantial disc prolapse leading to one of the most feared complications in this area of the lumbar spine called cauda equina syndrome:

Luckily, I do not have any bowel or bladder issues and my symptoms did not present suddenly/acutely--these criteria would have required immediate surgical decompression of the impingement. These patients have a window of time in which to be treated in an effort to avoid the possiblity of permanent neurological deficits (bowel/bladder issues) and/or paralysis.

Some of the other stuff presented was over my head, but I really want to understand what has been happening with your spine. And how, what Dr. B is going to perform, will correct things.

Dr. Bertagnoli is going to "decompress" this area of abnormal bony growth through a posterior approach. It is a minimally invasive procedure and the technique used is muscle-sparing and only requires finger dissection of paravertebral muscles. In all honesty, this decompression is going to be very technically challenging. It is understood that Dr. Bertagnoli will probably not be able to remove the entire osteophyte. However, he will be able to remove a significant amount freeing the cauda equina of impingement (and hopefully freeing me of chronic, debilitating pain! )

The wide decompression required will inherently destabilize my spine, so Dr. Bertagnoli is going to place the Dynamic Stabilization System with the non-fusion coupler (DSS-"motion") behind my 2-level ADR. The DSS-"motion" will work in concert with my ADRs: it will continue to allow motion of my spine while providing much needed stability after decompression. The DSS-"motion" also helps eliminate/minimize unnatural flexion and extension.

Artificial discs are truly only "partial disc replacements." Thus, with the DSS behind my artificial discs it will create a "complete disc replacement." I'd be happy to explain what I mean at a later date.

Again, only if you have time. I know your schedule is crazy and pain levels are high. I am relieved that your pain meds were upped, at least for the time being. I do so worry about you Justin, and join Kathy in praying that pain free days are around the corner for you soon.

Thanks for caring about me. It's been extremely draining lately--an emotional roller coaster. The worst part is the uncertainty of my future health. Let's be honest here...I'll be 30 years old in November and this will be my 3rd spine surgery. When I was at Dr. Balderston's office the other day, I was by far the youngest spine patient in the room. This has been a constant in my life, as I've been sitting in waiting rooms regarding my spine since I was 14 years old.

When you get to the other side of all of this, you will be one helluva doctor!! No patient of yours will ever be able to say, "Dr. J just doesn't get pain." Amen to that brother.

Thank you so very much for your kind words. I've always had to work twice as hard as my peers, as I've suffered with chronic pain the greater part of the last 15 years. I will admit it has been a challenge and I've often asked "why me?" but I have to say it has shaped me as a person and will hopefully serve me well during my career. Even though my future spinal health is uncertain and this surgery has no guarantees, I do know that I will keep rolling with the punches.
Many hugs to you,

Cindylou (ps: do tell, do tell of the exciting news!)

About the exciting news: Hopefully, I'll be able to inform everyone sometime this week...I thought it would be much sooner, so we'll see.