Collapsed L5

[Nicola]

Hi I am new to this forum. Desperately trying to do research on diagnosis of collapsed L5 - this is what my sister has been diagnosed with and doctor is saying it is bone on bone.

Please can anyone tell me even if just header words all proposed or known solutions to this.
She is having an MRI tomorrow to confirm it but they are advising they will operate. Before they do so I would love to know if there are alternative therapies as from what little I have read back operations never fix the back??

She already had a laminectomy a year ago - the pain never went the doctor said she was fine and nothing more they could do for her.

Please help

Kind regards

Nicola

[Maria]

I don't know what your sister's symptoms are however if it's not emergent that she have surgery as in loss of use of her extremity, severe weakness, numbness etc then I suggest she take the time to get opinions regarding what kind of surgery might be available or an option for her.

Standardly what is offered is a fusion at the L5S1 level but it is possible she may be a candidate for a Artificial disc replacement instead.

Once she has her MRI done and gets the results that information then she can check out her options. Whether she would get a fusion or ADR there are a few more diagnostic tests to be done in terms of candidacy for either surgery.

I hope whomever she's seeing now might be proficient in both types of surgery if she would be a candidate for either. Sometimes someone that only does fusion will say that ADR isn't an option or not a good option or a number of other things when in fact it's just that the surgeon doesn't even do artificial disc replacement surgery.

I've had two spine surgeries and neither were emergent and both were discectomies that lead to more problems and at one time I was a candidate for artificial disc replacement but didn't get it or fusion .. however what I did was say that I wanted to get a 2nd opinion (and a 3rd, 4th, etc) and all insurances have to allow for that much at least (2nd surgical opinion). So with this in mind then it's important to look for someone that does both types of surgery and is highly qualified, reputable and with a number of both types of surgery under his or her belt. I wouldn't take a 2nd surgical opinion referral from the 1st surgeon as it will likely be someone that knows the 1st surgeon and will agree with him or her.

It is very common for a laminectomy/discectomy to not really help or if it does not for too long and for more spine surgery to be suggested. It's my belief that one spine surgery begets another but then again not necessarily though I personally believe with fusion this is more likely. At least at the L5 level supposedly there is not much motion so this is a better level for fusion than perhaps higher levels. I guess all that however is relative to the skill of the surgeon and the patient's ability to recover.

Good luck to your sister and keep asking questions. Also mmglobal (Mark Mintzer) would be a good person to talk to about this and his contact information is here on the site.

Maria

[mmglobal]

Nicola, I'm sorry that you sister is facing spine surgery. She'll be facing the same set of decisions that so many of us have been through. Sadly, our decisions are overshadowed by non-medical issues like insurance reimbursement and other impediments to getting the most appropriate technology.

Your question is about alternative treatments. Anything she can do to increase her fitness, flexibility and core strength may help her stave off surgery. I've not seen much success with 'decompression' therapy and other treatments that don't address the source of the problem. I'm not suggesting that surgery is a must... depending on what is being offered, it should be a last resort. Your sister will be weighing the chance of success vs the risk of complications. The problem is getting accurate and appropriate info on the options.

Be careful... don't hurry into anything unless there is some real risk that adds urgency. Do the homework... make informed decisions!

Good luck!

Mark

[Maria]

I'm sorry I missed that part! As I mentioned I did not have more spine surgery post my 2nd discectomy which was in 1992. I was still working at the time until 2000.

While I was still working I basically went thru a number of courses of PT. I also had what is called low velocity manipulations/treatment by Osteopathic doctors. I tried Acupuncture without too much success. I did very limited yoga positions for about 4 years that helped as well as the Core building exercises I learned in PT.

When I stopped working in 2000 I started Pain Management in 2001 and getting lumbar Epidural Steroid treatments and daily low dose pain medication. I did seek surgical opinions however 2003-2005/6 and had recommendations for everything from fusion at 3 lumbar levels to Artificial discs at 2 lumbar levels to hybrid surgery with ADR and fusion (L4 and L5S1).

I decided not to have more surgery at least thus far given my L5S1 area started to autofuse or fuse naturally on it's own which helped limited the movement in that area and the pain.

I did keep my weight down and walk pretty regularly for exercise which I think was very helpful at least to keep arthritic changes from bothering me so much, some people might prefer other types of exercise though like swimming, etc.

I now get an injection of Toradol 60mg once/mo for spasms which really helps quite a bit especially if super locked up in spasms.

Well this sort of covers it for what I've used over the years between my last surgery and now. I would love to never have another back surgery again and hope that is possible however I'm a realist so I know I'm Ok for now and will just have to see what the future brings!

Hope this was helpful. My best to your sister! Maria

[vnf]

Nicola

Sadly, you're about to find out IF your insurance covers anything.
If you don't have money to travel overseas, then you may have to go with what your insurance will cover.
You're doing the first important part and that's researching.
The surgeon is the most important part.
Don't just take the doctor's word on anything.
Read, read, read!
Best advice I can give you.
Be very educated about what happens to your body..