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New to the Board

AZmikeyAAZmikey Posts: 39
edited 06/11/2012 - 8:41 AM in New Member Introductions
Good afternoon. I'm new to the forum, yet have been lurking as a non-member for a while just trying to gather information. I'm glad I found the forum and it's good to hear all the viewpoints and have access to tons of information.

A bit about myself:

Average weight

About 5 years ago I noticed that when I laid down in bed at night my legs would start to go numb, primarily from the calf down, mostly on the left leg. This went on for a couple of months and I finally had a checkup with my Primary (hadn't seen a primary doctor in 6 years). Well, he went with the full physical and noticed what appeared to be a slipped disc (now I know it as Spondylolisthesis) and referred me to a spine center. The spine doctor (ortho) ordered an MRI and took more X-rays. Bottom line, about 5 years ago I was diagnosed with stenosis, Retrospondylolisthesis and degeneration at L5-S1. The cause... L4 was naturally fused to L5 forcing the extra pressure down below. He said surgery would be required sometime in my life, it was up to me.

I went through about 8 weeks of physical therapy and the doctor started me on Gabapentin 300mg 3xday. The physical therapy and Gabapentin reduced the numbness to tingling and occasional lower back muscle pains. I have had some of the side effects on Gabpentin, including: mood swings, suicide, irritability and definitely short term memory loss, even on what I now know is a low dosage. But, it has helped the numbness.

I joined a gym and have gone pretty much faithfully 3-4 days a week for the last 3 years. Losing about 25lbs getting down to my target weight and focusing on core strength, stretching and continuing what I learned in PT. Lots of time on the seated bike and the elliptical. The treadmill and long walking hurts too much.

October 2008 - numbness returning, tingling worse, down hips, etc. Had my first steroid injection and another MRI. Vertebrate moved a mm or so further into the spine. Paid a bunch of money for the injection which gave me about 10 days of holy freedom! Did see a different doctor in between, confirmed findings of original spine doctor.

Last 9 months the tingling has gotten to be a constant and now when standing or sitting the left foot just throbs. At night, both legs tingle, both feet throb and eventually go numb. Waking up during the night in pain/discomfort is a frequent event. Now left buttock is hurting all the time as well. Taking NSAIDs for the inflammation. Not working and they make my stomach hurt.

Saw the spine doctor on the 15th, more X-rays, looks like some movement again. Did an MRI on the 22nd, see the doctor for results/consultation on the 8th. She increased my Gabapentin, now I feel more loopy, short term memory.... forget it. We discussed surgery and she says that we'll discuss it on the 8th, but that I would be looking at an L5-S1 fusion, with a disk spacer (something like that) along with removing some bone spurs off the vertebrate and that it would be (learned these acronyms through the forum) a combo- PLIF ALIF surgery. I think that I have tried everything that I can and am to the point that I just want to feel and move normally.

Just checking in. I've seen lots of L5-S1 stories, but if anyone has any specific thoughts or ideas, they'd surely be appreciated. I do feel that I have a good medical team working with me and they have been very willing to try and recommend things outside of surgery.

One question for the forum though. How do you know when it is time for surgery? I know it's a personal decision, but for those that have had surgery, what was the final impetus? For those still in the wings, what is your personal trigger point?


  • hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. so glad you finally stopped by to visit!!! =D> all the best on your doctor visit. :D surgery is such a personal decision. for me, it was the last resort!!! that was the decision maker for me.. your final straw could be very different!! :D all the best and drop by anytime!! you will meet lots of great friends!! :) Jenny :)
  • Sounds like you've done a lot of homework, tried conservative treatment, and have several opinions. I admire you for losing weight and trying everything to avoid surgery. Unfortunately, some of us get to the point you seem to be at.

    For me, I knew it was time because I couldn't work without modifications, couldn't pick up my child, cried from pain, no sleeping. Still tried losing weight, buying new mattress, epidurals, PT, etc. I had a discogram and then I could finally admit to myself surgery had to happen.

    I think when you cannot tolerate the pain is what motivates a lot of folks. If I had severe structural instability, I would move a bit quicker toward surgery than just relying on pain, but that's just my personal opinion.

    If you feel good about your medical pain, I bet you'll have as good an outcome as you can because you seem so motivated to do well. Please keep an update, I'd really like to hear how you do!

  • Compliments to you for a well written intro.

    I had had episodes of 'back strain' along w/ some sciatica for 20+ years when I overdid it. This past April, I went from some back twinges to full blown numbness/weakness/burning, searing, electric jolts type of pain from my lower back to foot overnight. After a month of conservative treatment w/ no improvement, I was referred to an OSS. I learned in very short order, I had a lot more than simple back strain going on when Xrays were done. The neurological deficits I had developed (drop foot, weakness, Tredlenberg gait) were scary and I didn't want to run the risk of permanent damage, never mind trying to function w/ constant pain. I viewed the surgery as a means to an end: an end to pain, an end to the inability to function normally. I'm 52 and have a lot of living to do. After doing my research, made the decision that fusion offered me the best potential for a long-term 'fix' to these issues. I'm coming up to the 8 month mark and consider myself to be about 90% normal. Pain for the most part is gone (occasional twinge - nothing major), leg strength back completely, foot lagging a bit but getting better day by day and I'm functioning more like my normal self w/ day to day activities.

    Take a look at the sticky thats at the top of the back surgery forum posts, has a ton of suggestions of what and how to prep yourself & home for post op. Keep posting here w/ any questions or concerns you may have, nothing beats getting input or suggestions from another 'spiney' who knows exactly how you're feeling.

  • Welcome to Spine-Health. I'm glad you found us. Spine-Health has so much great information that research can be really valuable using this site. And the members of the forum are knowledgeable, friendly and supportive.

    I've had both ACDF and TLIF surgeries, the ACDF in Oct. 08 and the TLIF three weeks ago.

    When I discovered that I had three bad discs in my neck, there wasn't any choice whether to have the surgery or not according to my surgeon. (He's a fellowship-trained orthopedic spine surgeon and only works on spines. He's great.) Anyway, my cervical spine was so messed up that I was in danger of permanent paralysis if I were to have a car accident or even a fall. That choice was a no-brainer and I had the surgery as soon as I could schedule it.

    As for the TLIF, it really was a matter of quality of life. If I could or even wanted to sit on my butt all day and do nothing, then I probably wouldn't have had to have surgery. I couldn't stand for any length of time or walk very far without pretty severe pain and just doing normal things like driving, grocery shopping, cooking dinner, etc. created so much pain in my butt hips and legs that when my surgeon said surgery was the only thing he could do to fix all three problems, I told him that we'd better do it then.

    My lumbar spine had a disc bulge at the L4/5 level, but the problems I had stemmed from facet joint inflamation and movement and stenosis. As it turns out, my surgeon told me that when he got in there during surgery, my stenosis was worse than he had seen on the imaging and had to remove more bone than originally planned and that the facet joints were bone on bone and moving so much that my spine was much more unstable than he originally thought. So he was very glad that we did the surgery when we did.

    You've been dealing with all of this a very long time and I commend you on all of the work you've done to try and keep surgery out of the picture. Like you said, surgery is a very personal choice and there isn't a person I know who would have it done if they had a choice, but sometimes the time comes when it's the only choice and everything else is just a bandaid.

    I wish you the best with making the right choice for you. It sounds like you've got a great spine team working with you and I can't tell you how important it is to trust your surgeon and your medical team 100%. It makes a huge difference.

    By the way, the procedure they're suggesting is called a 360 degree fusion and you can read about it here:


    Take care.
  • Thanks for the responses and welcome. Like I said, I've been lurking in the background for a while. The last week or so I have really started to dig through the information on this website. Nice to have a consolidated place to find such a wealth of knowledge. Reading through all the forums, searching etc. Almost feels like a second home.

    Thanks again!
  • Well, since my last post I received the results of the MRI. Sat down with the doctor. There was some further "slippage" on the L5/S1 and now the disk is bulging more so it effects both legs and there is some minor fluid leakage. She set me up with a surgical consult in late feb.

    Late Feb.... Surgical consult was a little overwhelming, yet underwhelming if that makes sense? I asked a lot of questions and received straight forward answers. Bottom line, he says that surgery is still elective, but that we should try one last steroid injection and if pain still persists, then surgery if I want it. He did say that it would just be an ALIF (through the back, right)?

    Well, 10 days ago I had the injections. First two days after it felt like someone had kidney punched me (of course down lower). I then had two beautiful days where the back felt good and only minor tingling/numbness in the legs and feet. Well.... Day 5 came around and everything seemed to be worse than before. It's now day 10 and there is no marked improvement.

    I see the surgeon again on the 22nd. I wish he would just say "You need surgery" and we could be on with it. It's scary to think that I have to decide to I want to be laid up for 6-8 weeks and then will it even work? How long should I have to put up with this? I am sure these are questions everybody asks, and in the end, it's a very personal decision.

    I also need to get a second opinion lined up. There are so many doctors in Phoenix. My insurance was no help, they said look at the online directory and you'll find one. May as well have some beers, put them on a dart board and start whittling them down. I've asked lots of people for references, but nobody I know has any. On an aside..... where I have been treated is a spinal clinic. I have seen multiple doctors there as well as a couple of the surgeons. They all share a similar opinion. Part of me feels that a second opinion isn't required, as I've talked with several, albeit in one clinic. In my mind, I have to think that even though they are all in the same clinic, their reviews are independent. Thoughts on this?
  • Well, I made the decision to go along with my surgeon's recommendation of a 2 level TLIF on L4-S1 because of the constant severe pain I endured 24/7. No amount of medication gave me adequate relief and the simple act of rolling over in bed was painful and difficult. I laid in bed all the time because sitting was also as bad. At that time I also had retrolisthesis (slippage), a recurrent disc herniation despite having surgery 6 months prior, and ongoing sciatic nerve compression.

    I also admire you for having lost weight despite being in the condition you are in. What is your secret? =D>

    I wish I would have gotten better after my fusion but it didn't turn out that way because my pain grew worse. Around 7 months later my MRI results showed scar tissue growing on the nerve roots and my surgeon said that more surgery would be detrimental because it can grow back even worse. I did wind up having surgery again several months later to have a pain pump implanted so that it would help control my pain better.

    Anyway, I hope I'm not scaring you from having surgery. Every person is different and spinal surgery comes with its complications and risks. It is up for you to decide if surgery is right for you and you should feel comfortable making the decision. I really hope that this will bring you relief so that you can resume your normal activities again. Take care :H
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