New and in need of advice

[TB33]

Hello to all my fellow spine warriors!

The last few days I have found this site and have been reading your stories. I have related with many and wish you all the best.

Here is my story and the things I need your assistance on.

At the age of 24 I injured my back and was in extreme pain. My MRI results were either a torn disc or DDD. At the time my Dr. told me I was too young to undergo a fusion as I would be back ever 7-8 years to do another level. His advice was to go out and live life as best I could. When I couldn't take the pain anymore we could do surgery. Well here I am 15 years later and I am considering the surgery option.

Recently my back pain started turning into more of a burning sensation. Occasionally the pain goes into my hips and leg but most days it is just a constant dull ache in my lower back. I went to my primary physician and he took an X-ray. Basically he said my disc at L5-S1 was gone and I was near bone on bone. I contacted my old WC Dr and have an appointment on Monday after not seeing him in 14 years.

Other than my constant back pain that I drag around with me like an anchor, I am very healthy. Up until a week ago I worked out 4-5 times a week and am in the best shape of my life. Sometimes I think to myself how long have I been blocking out the pain. Like many others the pain stops me from living life to the fullest and I have had my share of helpless moments and bouts of depression.

My question for all my spine warriors is what tests should I ask for my Dr. to run?

I highly doubt my WC will authorize a disc replacement and I am very seriously considering going to Germany for what I may need.

Any help or advice is greatly appreciated. I wish you all a pain free day.

Tom

[Maria]

Well Tom .. sorry you need to be included in the Spiney Warrior club however want to welcome you anyway!

I originally injured my back when I was 28 and much like you was told nothing could be done, live with it etc... until my back kept going out and I was bedridden more than upright and doing anything so my first surgery was about 9 years after original injury (at that time L3, L4, L5S1 involved).

Your Doctor will mostly likely do an exam on you and I imagine bare minimum if you already have a very recent xray will possibly order an updated MRI on you given the duration of your injury and complaints.

I wouldn't give any information that might even hint at the possibility you may have injured your back at anything else other than just "living" since it's WC related. If you do want to mention working out I'd stick to just saying something like you walk or swim on a regular basis, not weight lifting and such or anything that might be construed as a possible new injury... (this is just my advice after dealing with CA WC since 1982).

I don't know if you will be offered PT as a conservative trial or injections or anything as I imagine after the initial examination your doctor might want a more detailed idea of what's going on in your spine currently which I would imagine an updated MRI would provide.

I do wish you the very best and please let us know how things go with your doctor's visit if you have the time and inclination!

Maria

[TB33]

Thanks for the advice Maria.

Dr. appointment went well. Pretty typical as he advised PT and to come back and see him in a month to work on getting a updated MRI.

I think I am leaning towards the more conservative approach. After doing more research and reading some of my fellow spine warriors stories I now realize just how unpredictable spine surgeries can be.

I wish the best to anyone that finds this message.

Tom

[TB33]

Maria,

Reading through some of your other post I see your L5-S1 autofused. I am hoping for the same result as I am now very near bone on bone in that area. I know this is a tough question to answer but how long do you think it took to autofuse once you were near bone on bone?

I'm hoping to hold out and praying my body heals itself.

Tom

[Maria]

Tom,
I originally injured my back in '82 at the age of 28.
Had annular tear at L3, disc bulge L4 and L5S1
First discectomy on L5S1 in '89. Did Ok for about a year and a half. Then more probs and L4 bulged too.
Second discectomy on L4 in '92 failed surgery and pain became chronic and really horrific. Back then it wasn't common to get pain meds for chronic pain though I think that would have greatly helped me but was put on Elavil (off label use for burning pain in buttocks and lower extremities that was constant and bone gnawing in feeling and super bad along with awful back pain, pain in buttocks (piraformis pain bilat) and so much more. Elavil became ineffective and in '98 started Neurontin (off label use) for neuropathies (burning pain).

Around 2000 I was offered a 3 level global fusion (front and back). I hesitated as I heard of Mark getting ready to go to Europe for a 2 level ADR (thru another spine forum we both used to be on). I was excited by this possibility. Mark did really well and shared his progress with fellow spineys. Met him in person around 2001.

I started opioid pain medication (thankfully) in 2001 and epidural steroid injections. Still on Neurontin 1800mg/day as well.

2003 was authorized by WC to be part of a trial for 2 level ADR in San Francisco. Trial closed down before I could have a surgical date. Had to wait until 2005 to get another authorization for ADR. By this time not a candidate for 2 level ADR rather ADR at L4 and fusion at L5S1. I wasn't keen on fusion and also was concerned about L3 with the annular tear and the fact I had osteopenia and wondered if vertebroplasty would be helpful (Dr. Bertagnoli was performing this in Germany with some of the people I heard of getting ADR with osteopenia).

2006 I just decided not to have more surgery as I was afraid basically. Still on low dose daily opioid pain med.

2010 I was able to stop the Neurontin.

2011 My OSS said I was starting to autofuse at L5S1 based on my x rays (or the facets were fusing) which would help with the L5S1 pain although L4 still problematic.

2015 OSS said L5S1 autofused based on xray. First MRI done last Friday since 2005 (I have not yet gotten results). Still on low dose opioid pain med.

So from point of original injury in '82 to basically 2011 was 29 years plus 4 more years.. 33 years. Yeah.. really long time and believe me I went thru all kinds of pain and limitations getting here and early retirement and so much more.

I too am hoping and praying for autofusion at L4 .. that'd be great tho so far I'm still symptomatic at that level, my back still goes out and I have to be on bedrest or off my feet from a few days to really limited to a few weeks or more every so often. I cannot sit long periods of time (means an hour or less usually) and I basically only really walk for exercise ...

You are still pretty young for autofusion. Do your research and keep asking questions, get opinions and keep your options open. I do wish you all the best... you'll find your way on this spiney journey that best suits you.

The only thing about waiting is that time alone and the natural wear and tear of the spinal parts limits options so keep that in mind. Now the only thing I'd be a candidate for at this point would be fusion. The only good part about that is I'm this much older so I hope I can get away in this life with either no more spine surgery or perhaps only one more should I have go that route in the future.

I personally believe one spine surgery begets another then again I also believe there are times when spine surgery is a good option if it's the right surgery with the right surgeon or as best as one get it given their individual options (insurance, personal funds, help/support in terms of surgery/recovery etc).

Please keep us posted if you're so inclined. I'm interested to hear how you're doing and what you decide even if your mind or opinion or decisions change every so often. It's whatever you decide to do based on where you're at in your own situation! Wishing you all the best!

Maria