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Old problem- new user

RblakeRRblake Posts: 3
edited 06/11/2012 - 8:51 AM in Back Surgery and Neck Surgery
Here I am on yet another user forum after surviving cancer in 2007 & 2009 and a couple of heart attacks sandwiched in between (2008 & 2010).
All of the surgeries and recoveries having to do with the prior issues in my health history were made easier with advice and insights offer by other regular folks going through the same things. I am hopeful that remains a truth as I now face back surgery to repair at least one problem and possible as many as three.

Apparently the most urgent issue is a "bone-on-bone" problem at L4/L5 that is infringing on the nerve root and causing some pain. However, to be honest and from my point of view, a problem with my neck is much more irritating and described in the radiology report as:

C2-C3: No significant disc/facet abnormality, spinal stenosis, or foramina stenosis.
C3-C4: Mild disc degeneration with minimal uncovertebral joint spurring on the right. The central canal and foramina are unremarkable.
C4-C5: Mild disc degeneration with mild bulging of disc material out laterally into both foramina. Mild
uncovertebral joint spurring contributes to mild bilateral foraminal narrowing. Small annular
fissure defect seen along the posterior disc margin on the right.
C5-C6: Mild annular left-sided disc bulge narrowing left lateral recess. No spinal cord or exiting nerve
or sleeve compression.
C6-C7: Mild left posterior disc bulge C6-C7 narrowing left lateral recess and slightly compressing
exiting left C7 nerve. Right foramen is clear.
C7-T1: No significant disc/facet abnormality, spinal stenosis, or foraminal stenosis.

CONCLUSION: Mild left-sided disc bulge C6-C7 narrowing left lateral recess and foramen and
slightly compressing exiting left C7 nerve.
My surgeon - on the other hand is very concerned with the lumar report and wants schedule surgery as soon as possible:

L1-L2: Mild disc degeneration. The central canal and foramina are unremarkable.
L2-L3: The disc, central canal and foramina are unremarkable.
L3-L4: Mild disc degeneration. Disc material bulges out laterally into both foramina without exiting
nerve or sleeve compression. The central canal is clear.
L4-L5: Severe disc degeneration and narrowing. Marginal osteophyte formation narrows both
foramina with slight encroachment upon the exiting right L4 nerve. The more significant
narrowing is on the right. Mild bilateral facet joint degeneration
L5-S1: Mild disc degeneration with minimal annular disc bulge. Mild bilateral facet joint degeneration.
The central canal and foramina are unremarkable.

The L4-L5 severity seems to be the driver and he (the surgeon) seems to think realigning my spine with an ALIF will help the Cervical issue without surgical intervention.
I do not have a great deal of intolerable back pain most of the time - saved the couple of time a year when I twist or strain an end up in bed for a week with medication and
cursing the world. I do have trouble sitting for periods of time then trying to get up and getting out of bed each morning is a process that takes some time.

Still, I feel the back pain is somewhat manageable - albeit with massive doses of Vicodin (5x 5-500 on average daily)

The neck pain leading to incredible headaches is another matter.
I chew Vicodcin like candy all day just to keep it in check and use Valium at night to relax enough to sleep.

I am 56 - slightly overweight but not too bad (5'11" @ 240lbs) - nonsmoker, non-drinker other than an occasional beer or two.

Anyone out there faced a similar decision and willing to share advice and outcome?

I am also very interested in input concerning ALIF L4-L5 Fusion recovery time and post-surgical pain?

What is the worst case scenario if I do nothing?

I am also concerned as to the odds of a succedssful outcome given all the chemo and heart meds I have been subjected to - most significantly Plavix.

The neurosurgeon is very insistant that surgery is a must and that - in and of itself - has me concerned.

Thanks to all that take the time.
Very much appreciated.

Personal email link removed for member protection by Moderator haglandc

Thank you all - very much.



  • Sorry to hear of your spine issues. I hope you get a second opinion before surgery. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi RB,

    I'm sorry to hear about all that you're going through. I don't know how helpful I can be, but I can tell you about my ALIF experience...

    I had an ALIF L4-S1 in Oct 2008. I had basically no risk factors- I was 25, thin, didn't smoke- the only risk was the fact that it was multi-level. Anyway, I didn't fuse at L4-L5 so I had to have another surgery (PLF) this past December.

    After my ALIF I returned to work at 8 weeks for a few hours/week, but I wasn't able to be full-time for months, and even then it was a struggle. Because I never really healed I never got off the pain meds. This time around I'm waiting until 12 weeks (mid-March, coming up!) to return to work part time. I'm down to 3 Norco/day and it's been 10 weeks.

    Both recoveries have been long and painful, so because of that I think you definitely want to make SURE you need the surgery (so get a second, third? opinion) and that they agree with treating your back instead of your neck. Also, other doctors may present you with other options that you can try before surgery (PT, injections, acupuncture).

    I don't know if this helped at all. The surgery is major, but then again if your pain is unbearable and there's something that may help, I think it's worth it. Sorry for all the blabbing, and good luck with your decision!!

  • You need to get a second opinion. Have you been to a pain management Doctor Yet? Sometimes they can help without surgery. Do not put your spine issues on a back burner! You could cause irreversible nerve damage or more degeneration than you already have. I too have Migraine headaches with my neck problems, my Dr. keeps telling me that there is no link between the two, I disagree! If you are bone on bone like you said at C4-C5, that level could start to fuse itself together by itself, in which would not be a good thing. This is just my opinion. I am not a Dr. Good luck to you in the future.
  • Thank you all for your replies.

    The pain I currently feel at the lower back level is a 3 at the most. Docs claim I just have a high tolerance . But I know I ain't no hero. If I feel it - I know and so does everyone I think needs to.

    Several times a year - for no apparent reason - I twist or sleep incorrectly and the pain is off the chart causing me to remain motionless in bed for at least a week.

    It is the paradox on low pain to max pain that has me so concerned.
    I mean, if I don't go for the surgery am I risking paralysis? Loss of bodily functions?
    What happens if the nerve root at L4 that is currently at risk?

    Geez - this is the toughest decision yet. At least with the cancer an heart issues the path was clear.

    Sounds to me like this surgery can cause more pain than it cures.

    Thanks again to everyone - research and experience are required and you folks offer the experience.

    Can't thank you enough
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