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Rolled my truck in 2009, current diagnostics for L5-S1 "unstable"

Hello from CA,

I posted a similar post in another forum thread thinking it was the right spot. Maybe not as I'm new and wondering about a couple of things.

History: Rolled my truck down a ravine in 2009. Have had flare ups up and down my spine and thru my neck. Some muskular injections of cortisone and PT worked. Also pilates until I couldn't afford them anymore, then tried to keep up with PT exercises but failed on many accounts. In search and rescue with 2 big dogs, so I hike a lot. In the few months began to train hard with my second dog doing trailing vs area (area dog works independent of handler, gridding an area, trailing dog at one of one end of leash pulling/yanking you wherever person trekked, many times over uneven ground, so tripping can be involved).

That being said, figured I was exercising. Also gained weight in the past year....a good 12-15 pounds (which concerned me most with my family's history of diabetes and heart disease) not obese according to the BMI calculator but overweight.

It's been 8 weeks now since the first symptom hit, the hip and butt ache. Then the hamstring pull feeling, along with the middle of the night calf cramps. I finally called my Dr when the leg went from tingling to "asleep" to tingling, thought it was my hip and was soon directed back to my back Dr's.

The pain got worse until finally I was put on Gaborpentin 600mg (went up to 8 pills before a doctor's visit that had him alarmed) and Vicodin, along with PT that was failing me. Rec'd an epidural cortisone shot on the 20th and just a couple of days ago began to feel the pain ebb and I could walk/work (office) for a couple of hours okay. I had also rec'd the okay to get a surgeon consult which came in after my injection.

An MRI showed L5-S1 disc pretty squished (accident), the L4 herniated (age), per the experts. Surgeon had me take some X-rays bending forward and a bit backwards and other varied positions. These new X-rays indicated to him that I was urgently unstable (also the touching of the legs and trying to get my toes to move up against his fingers, etc) and the disc was slowly going to zero, and my nerves were getting squished more and more. Solution: TLIF

So my question or questions:

1) Has anyone rec'd a similar diagnostics and have opted not to do the surgery? (1 week later from injection, leg pain appears to be waning, strength not regained at this point)

2) If pain continues to wane, strength begins to come back (might I be dreaming a positive dream?) will too many epidural injections of coritsone, create brittle bones, exchanging 1 issue for another?

3) I have made small attempts at core strengthening exercises while pain has ebbed some, is this not a good thing at this time?

I will follow this up with the fact that I'm waiting for an appt to be made for my EMG tests.

Hoping this thread gets me some answers, where the other didn't. Again, maybe in the wrong spot and didn't make my point very clear.



  • outdoork9ladyooutdoork9lady Posts: 17
    edited 07/01/2012 - 2:23 PM
    With the shot, changes besides being able to walk with less pain for a few hours, is after those few hours (3 straight sitting and standing vs working in yard, resting, variable other activities, resting, etc) my head begins to feel way too heavy for my neck. My foot never loses it's pain at the arch or across the foot over the arch. My leg can intermittently become numb to "waking up tingling" out of the blue, causing me to just about trip and fall on my face in mid-step, which means my cane is still needed.

    Before and after my shot: full foot movement when trying to exercise pointing out or towards the body, I can sometimes get that movement, though not fully, only once, sometimes twice, then the cramping in my butt begins as well as total fatigue in the leg happens.

    Also 1 week prior to my injection, I accidently stopped taking the Gaborpentin and along with all aches/pains/weaknesses coming back in the left leg from hip down, it also had spread to the right side. Hip and butt pain with the hamstring pull feel and calf cramp on the right side. Taking the pills now at 5 (600mg x 5 = 3000mg) along with the injection, the right side feelings went away and as expressed already, the current leg issues along with back ache (not pain) and "weak neck" to hold up a heavy head is the current situation. At more than 5 pills, I do not receive anymore relief then at 5, but less and the pains etc do increase.
  • I just wanted to write and say that the word unstable in spinal situations is a very imprortant word, when injury occurs to the spine doctors will assess if the spine is stable or not generally looking at the quality of the anterior middle and posterior columns , although yours is L5/S1 and im not sure how it is judges at this junction between lumbar and sacral areas. So my
    point is the word unstable is a clear indiction of the need to have surgery. It sounds as if you have gone to the doctors at all the key times and they have responded well. The leg and nerve pain is concerning and in theory surgery should remove th e pressure on the nerves, and the sooner this is done the more likely hood the the nerves can be innervated again ie a areturn to function, now if it is the PNS nerve system these can usually regenerate, if it is CNS these tend not to regenerate but send extra signals/reroute signals htrough the left over CNS network, hence people who have trauma to their spinal corde can walk again.
  • gaj399ggaj399 Posts: 270
    edited 08/01/2012 - 10:42 PM
    One of the side effects of Gabapentin is weight gain, so you have to watch your diet closely.

    My fusions were both in the neck and worked out quite well, but lumbar fusions can be difficult from what I've heard. Both my lumbar surgeries were discectomy/laminectomy without fusion. My results on these so called less invasive surgeries is I have been left with bad pain caused by scar tissue. However most do really well with fusion surgeries, and it seems you have a good team working with you to get you back on your feet and lose the pain.

    I forgot to add that even though Gabapentin has a tendency to cause weight gain it also has been a godsend to me to reduce nerve pain going down the legs, and without it I wouldn't even be able to walk. So you've got to take the good with the bad. Just watch your diet really close!

    I wish all the best and if you decide to have surgery, make sure you listen to your doctors instructions and follow them to the T.
  • I'm doing well the hardest thing is to not over do things. I feel so good that it's hard to remember I'm healing and need to rest and follow Dr's orders. From MRI June 18th, X-rays on the 28th, then in July the 23rd surgery, my disc went from a "squished jelly donut like" herniation, to almost nothing to only fiber left at surgery date. My vertebrae slipped from noticeable, to grade 2 and near off come surgery. My 2 week post op has the slipped vertebrae almost back to alignment and nerves and muscles untangled and set for proper healing. Still on Gabby 3000mg at bedtime with some left leg pain and better physical results with toes pushing against Dr's hands, etc.. I'm thrilled and doing my best to follow all instructions to a T

    BTW what is CNS and PNS muscles?
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