I'm new to this forum as well as several others dealing with spinal conditions. I'm trying to do as much research as possible both online and in reading books in order to determine MY best course of action for my problem.
I'm a 39-year old male (soon to be the big 4-0) and about a year ago had a sudden onset of excruciating lower back pain. Along with that, I have radiculopathy into my groin, legs and feet with the groin pain being the worst. I've had two MRIs now a year apart and there's been no change. I have DDD at a couple of levels with the worst being at L5-S1 where I also have a annular tear making contact with the S1 nerve root. I should point out that this could be genetic as I have a parent who underwent a double-level laminectomy/fusion about 3.5 years ago.
I've tried PT (still doing that), drugs and two rounds of ESIs. The first round of ESIs worked like a charm and I was pretty much pain-free for a good 3 months. As the pain and other symptoms slowly started returning, I underwent another ESI the difference being the first one was done bi-laterally and the second was only on one side...the side where more of my symptoms are present. It did absolutely nothing!! At that point the pain management specialist dismissed me back to the neurosurgeon. I was told that I'm a candidate for a artificial disc replacement and that would be his surgery of choice. However, his take was to wait until I am basically unable to work and completely disabled before undergoing major surgery. While I appreciated the very conservative approach, I'm already to the point where I have days that I can't function. Being in any one position for too long aggravates things. That means I usually wake up in the middle of the night in pain from laying flat for too long (even with pillows under my knees) or I wake up starting my day off in pain. Either way it's impacting my quality of sleep. It seems as long as I'm moving in some fashion I'm better. I'm fortunate in that I work from home when I'm not traveling but I also have a fairly heavy travel load each year and a physically demanding job at times. This is all draining and I'm quickly becoming emotionally as well as physically worn out. My PT reminded me that in effect I am disabled because there are days where I just cannot work and working from home I can kind of get by putting things off until I'm feeling better to pick them up but then I'm scrambling to meet deadlines on a scrambled brain.
In doing a lot of research, initially I thought I wanted to go the ADR route vs. fusion. At 40, fusing of my spine just doesn't seem like a good thing. However, the more I've read in recent days and some videos I've seen online from people in very similar situations as mine, maybe fusion isn't so bad...especially at L5-S1. I know the procedure is no picnic but my insurance will not cover ADR anyway because there isn't enough long-term data to substantiate that it has significant advantages over fusion. I certainly cannot afford to pay for ADR surgery out-of-pocket!!
So I'm at a crossroads of sorts. Do I continue to be miserable until miserable is beyond miserable or do I just do surgery while I'm young and get it over with? I'm confused, scared and drained. I'm trying to get into a highly-credentialed neurosurgeon at Stanford (I'm in the San Francisco area) for a third opinion. They specialize in the latest 3D-guided MIS fusion procedures there as well as ADR. They are also highly-rated in the country for neurosurgery and neurospine. I know I can try to appeal to my insurance for the ADR but now I'm concerned about it wearing out and having to have MORE surgery to repair it. Of course then there's a chance of more surgery to repair additional levels impacted by the stress of fusion too! So much information overload to weed through and make a decision.
I guess that's it. I'm sure there are LOTS of folks here in my same or similar situation. I look forward to hearing from you as well as exploring this forum. I hope everyone's pain is manageable.