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2 surgeries later, destabilizing back.

JohnAustinTxJJohnAustinTx Posts: 2
edited 12/27/2014 - 5:35 AM in Lower Back Pain
First time newbie to the site, I have a Dr appt monday to discuss the results of the MRI I had Friday 19th Dec.

MRI Results..

L3-L4: Generalized disc bulge. Mild facet hypertrophy. The central canal and bilateral neural foramina are mildly narrowed.
L4-L5: Shallow central disc protrusion. Facet arthropathy. The central canal and bilateral neural foramina are mildly narrowed.
L5-S1: Central disc protrusion. Facet arthropathy. The central canal and bilateral neural foramina are mildly narrowed.
S1-S2: Facet hypertrophy. Mild retrolisthesis. Central canal and bilateral neural foramina are mildly narrowed. Sacrum: The terminal thecal sac and visualized sacrum are within normal limits.
Soft tissues: The paraspinous soft tissues and visualized portions of the retroperitoneum are unremarkable.
1. Lumbar edema in the spinous process of S1 is new compared to previous MRI of 05/09/2011. This may be the
result of previous surgical intervention.
2. Multilevel mild spondylosis as described above resulting in mild spinal stenosis.
3. Mild degenerative retrolisthesis at S1-S2.


I had a car accident Feb 2011 where I was rear ended, not a major impact but damage to my car and theirs, Instantly I had pain in my lower back and neck.

Initial diagnostic methods over the course of 2 years determined no root cause for the significant pain, I had multiple MRI's CT's X-Rays, nothing. I had been diagnosed with DDD and was simply told I had to live with it, I went finally to spine specialist in Austin and during an x-ray guided injection he correctly identified Bertolotti's syndrome, L5-S1 left side transverse process had fused to my hip and had in the accident cracked and never healed properly.

After PT, drugs and steroidal injections I became a candidate for surgery, I had a partial laminectomy of the L5 transverse process, leaving the bone bridge, partial fusion intact (Nov '12)
Recovery from the surgery went incredibly well and I was pain free for about 6 months at which time the pain came back incrementally until it was rare to have a day without pain, PT again, anti-inflammatory pills, steroidal injection. No help.
Discogram eliminated the discs as a cause for pain and no disc protrusion was seen in any of the previous MRI's.
Second surgery, April 2014, Went in more aggressively and removed the bone bridge between the hip and L5, Bone showed regrowth and was spongy. Dr stated he didnt want to get too close to the hip due to bleeding risk.
(Option was given for either fusion on more aggressive laminectomy, I went with the quicker recovery time)

Surgery went well, again quick recovery, back at the gym for light walking 2 weeks post surgery, however there was no relief from the pain.

X-rays and Steroidal injection showed no sign of bone growth, was advised no further surgical options, I continued to have pain and disagreed with pain management stating the pain was singular, what I class as bone pain, deep and you can press on the spot at the hip, lower back and can isolate. Pain management had led me down 2 years of non diagnosis and I did not want to go that route again, I pressed for a follow up MRI and the results are above.

My take on the results are that my lower back has destabilized post surgery, the freeing of the segment and removal of the ligament between the transverse process and the hip has had negative effects.

I would like to be prepared with questions as I have taken as much information in as possible over the past couple of years, I have copies of all my MRI's / scans and try to read up on treatment options so I can better prepare for them.

I am unable to exercise due to the pain, have gained about 20lbs since the surgery, physical therapy has not helped, neither have the meds or other treatments.

Am I right in thinking that fusion is looking more like the correct option here? Any other suggestions or questions I should ask?

Thanks in advance.



  • http://www.spine-health.com/forum/announcements/spine-health-announcements/welcome-spine-health-how-get-started

    No one is qualified or permitted to comment on your MRI report or treatment options. That information should come from your doctor.

    That being said, what makes you believe that your spine has destabilized? We can't suggest what recommendations any doctor may or may not make given your current status. Why did y ou return to the gym two weeks post op? Most surgeons, no matter what surgery is done on the spine restrict that type of activity until you are well into the post op recovery phase, at least 12 weeks, and then at restricted levels and activities.
    Resuming activities not yet cleared by your surgeon or not taking the time to recover from the surgery, and allow the tissues to heal, as well as the muscles, ligaments and nerves to recover, can change the results of any spine surgery.
    I hope that your surgeon has an answer for you and suggestions as to something that can ease y our pain...
  • What's up? I am 39 yes old and 2 years ago in April I had a fusion done! My L-3 through S-1!!! I am now the proud owner of 9 screws, 3 rods, and 6 posts! I was not doing too bad until a few weeks ago! I think I am having problems with my lower left screw(s)! When I push right on the screw it seems to help! Still waiting to go for an x-ray! I tried to consider a pulled muscle or something but I think I know my own body! Good luck to ya!!!
  • Thanks for the reply, I understand no one is qualified to comment or take the place of the Dr, that is why I am seeing him monday. I was asking simply if anyone else had anything similar and what steps they had gone through, I should have been clearer.
    It was advised to walk post surgery and I did that by going to the gym. No lifting just light walking.
    In all of my previous scans there had never been any disc related problems, my Dr had mentioned the possibility of destabilization post surgery and seeing the results of the scan it looked (to me) clear that it had.
    I have researched extensively marrow edema, spinal stenosis and the disc protusions, all of which I did not have prior to the second surgery. I just want to be prepared is all.
  • Researching terms can somtimes lead you into thinking one thing, when it's another. I don't know how old you are, but in general terms, discs can bulge as we get older, and add more wear and tear to our spines . Not all terms you see listed on MRI's have significant meaning. Narrowing of the foramina does not necessary mean that there is impingement of the nerve. Stenosis is simply a term for narrowing of a pathway.
    I'm sure that your surgeon will go over everything with you, when you see him and give you some recommended treatment options...........best of luck
  • edited 12/27/2014 - 8:58 AM
    Yeah John the way i did it to loose weight while being in debilitating pain was taking fiber and eating a low fat diet. Im actually way skinnier than when i was in high school.
  • JS1980JJS1980 Posts: 1
    edited 01/31/2015 - 8:56 AM
    I was diagnosed with BS 3 years ago when I was 31. I was overseas and had joint/cortisone injections, a cortisone infusion, capsaicin patches along my back and down my left leg, trigger shots and a trial and error of medications.My pain management doctor had me on oxycodone, extended release 3 times a day. 60mg in the morning , 40 MG in the afternoon and 60mg at bedtime. The medication kept my pain away as I did my PT and aqua therapy.
    Moving back to the US this October, I had my amounts decreased, and the pain management doctor here along with my PCP, want to take me off all medication. We're doing cortisone injections again, and now they want me to have the procedure to put electronic nodes on my spine. Both my PCP and PM docs have not treated anyone like this before. I feel like they're taking away what works. I was told that my Gdoctor overseas was irresponsible for dosing me that high. I was told that the last resort would be surgery and that they'll send me to a surgeon who's "done back surgeries." I want a doctor who is familiar with the disease and knows what they're doing. Does anyone know of a doc familiar with treating BS in the northeast? I feel like I'm at my wits end!
  • John...
    How is your back now??
    I have a similar condition.
    my bertolotti has partially fused L5 to s1
    i am just about to have the surgery to have this removed.
    did you ever have your back checked for instabilty?
    Xrays taken standing sitting and bending would accurately diagnose any instability.
    i do hope that you have improved!
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