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Questions to ask spine surgeon- 15 year old with chronic back pain

Hi everyone. I really need some help and advice here :(. At this point he's been struggling with pain for over 2 years and have decided to make an appointment with a spine surgeon in New York City. Please help us and read his symptoms below and offer us advice on what questions we should ask the surgeon.

My son is 15 years old and he's been suffering from lower back pain for two years now. It started after an awkward fall during a soccer game and he's back pain has continued to worsen and evolve over the following years.

Our last MRI, CT, and X-rays were a year ago and revealed grade 1 spondylolisthesis and bilateral spondylolysis at L5-S1 and a bulging disc at L4.

Two years ago his pain was just in his lower left side of his lower back (an ache and that hurt really bad walking and getting out of chairs). Over time his pain has greatly changed.

Now, he complains about a widespread ache across his lower back, back of his glutes, back of thighs, and into his calves and bottom of both of his feet. He also describes the pain as "burning and tingling". He has more intense burning down his left leg in his calf and big toe which is a different kind of pain than his right leg. Bending forward produces an ache in the same lower left part of his back (closer to his si joint) as 2 years ago.

He's been out of physical education for a year and a half. Running, jumping, any kind of impact activity reproduces the ache in both sides of his back and worsens that widespread tingling and aching across his lower back and thighs.

Every morning before school, after he comes home from school, and before going to sleep he takes a quick hot shower. He says this helps so much with all the burning and tingling across his lower back and legs. However, the effect is only temporary and all his pain returns.

He says he can't sit for longer than 10 minutes before the burning and aching starts to worsen. Talking walking breaks every 30 minutes during class helps but he still experiences pain.

Biking, elliptical, speed walking, even his core exercises (planks) worsen his back pain.

His pain is at its lowest in the morning.

Also, when he lays down flat on his back with this feet flat on the floor and let's both feet drop to the right side, he says he feels a heavy "pop" in his si joint area like it released a giant air bubble (like cracking your knuckes). On his other SI joint he feels like a joint keeps popping into and out of place, like when he puts on his clothes he can feel something pop out or in (not like cracking your knuckles).

Walking in the pool greatly relieves most of his pain temporarily.

At this point, were worried that this back pain will continue to worsen and plague him for the rest of his life if we don't successfully address it soon. He often feels depressed about not even being able to participate in schools physical education or any sports, but just getting through the day without having his back pain constantly on his mind. He says how it feels like it's become a part of his life and is always clawing at him. At school, he stresses about when he should take his walk breaks, if he should go to the nurse and ice it, just how to control his pain.

He almost forgot what it's like to have a normal life. We've heard about spinal fusion surgery but after two years of having this be a part of his life, he's very skeptical of him ever getting better or getting "back to normal" (or more normal).

He says he wants to be able to live without constantly worrying about his back pain and being so restricted by it. He wants to be able to run, workout, dance, ride his bike, just be able to live like his friends again.

We've tried physical therapy, acupuncture, bracing, anti inflammatory medications, etc. with minimal relief.

What should we do? What should we expect from the doctor's appointment? What questions should we ask him? Thoughts on the possibilities of surgery? We've been to many doctors and spine doctors but this one is a spine surgeon in a very renowned hospital in New York.

Thank you so much everyone and I wish you all the best of health.



  • SavageSavage United StatesPosts: 5,476
    edited 01/16/2016 - 8:50 AM
    Curious what the other doctors and spine doctors had to say?

    Using the search on this site, upper right on page, you can look up.. How to prepare for doctors appointment.
    It might also be under preparing for pain management doctor.

    There are also articles and videos re your concerns that may help you form your questions for doctor.
    It may be helpful to bring along all the CDs of previous testings, and summary of what other doctor's have said...or done.
    My experience is that doctor prefers to review actual CD instead of just reading the written impressions.

    I wish you the best with your future consult with spine surgeon.
    If the doctor decides your son is not a candidate for surgery, I would ask for what is your next step?
    Maybe a pain management doctor to help monitor the spine and his symptoms?

    There also may be other testing that could be valuable.
    My pain management doctor did variety of testing that I didn't hear about before that time.
    The EMG was revealing for some of my spinal issues....and other tests.
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • So I hate to the bearer of bad news but but this exactly how it started for me. But you sound like a parent who takes the child's pains seriously which is an awesome first step. Wish I had that kind of support growing up and maybe I wouldn't be in position I'm in now.
    Let me start by saying that spondy is nothing to take lightly. If he has spondy there's a really good chance he has pars defect. Start by asking about that. And be sure to press it for doctors like to play down spinal injuries of young people in hopes they will just ignore it and the pain will go away . I saw a doctor when I first hurt my back . he told me I was fine and just out of shape with a stick nerve. But in his report he noted I had pars defect with spondy. So I continued my awsome, active lifestyle just to get further injured a couple years later and the shift was too signifanct and a fusion had to be done. And now 5 years later I'm still looking for relief. I'm no doctor but I've been around the block more than a couple times and do lots of research. There are places online where you can access medical information that doctors and nurses receive to get credentials without needing to pay a dime. Not well known because they like to feel smart lol ( I know this from family being in medical fields ) . There is a limited amount of resources and treatment that they can do and it often seems rather unscientific and you start to see why they call "practicing medicine". Because that's exactly what they do. Practice. They are not pros. Even though they get paid like they are. They poke and prod to see what works and doesn't work. Kind of like high school chemistry class or biology. Lets just poke here and see what happens. No, that didn't work. How bout now? No. Lets try again. Try to keep him away from injections if possible. However, most insurance companies require certain procedures to be done in certain sequence. ...Just FYI.
    I wish the best for your son. I really do. Back pain is very much underdiagnosed in young people. And the last thing you want is for him to end up in a pain clinic getting drug tested monthly for drugs that hardly work and become addictive.
    So all in all, press the issue about pars defect. Spondy and pars usually come hand in hand. You for want to wait for nerve damage to happen and end up with CRPS and a spinal stimulator.
  • hvillshhvills Suzhou, ChinaPosts: 728
    From what you describe your son's back issues sound very familiar and most likely he has some sort of nerve impingement in his lower back. If I was in your shoes I would just describe to the surgeon his issues the same way you have above in your text... I'm sure the surgeon will recognize the symptoms and probably order some fresh x-rays and an MRI. If then the surgeon decides to do surgery you should ask enough questions about what and why he's going to do be completely comfortable with his explanations... if you're not then get a second opinion. Read up here on this website or go to Wikipedia and educate yourself BEFORE you visit on the terms "Discectomy" and "Spinal Fusion" as these are two of the most common back surgeries and both have a range of methods for performing them... i.e. PLIF, ALIF, TLIF, etc... In most cases it's not hard to understand the basics... and you're not looking to become an expert... just understand. If possible get your hands on a 3D spine model (most surgeons offices will have them) and ask the surgeon to explain what the problem is and what he/she is going to do... such a model makes it easy to visualize the problems and solutions... and I found it was very helpful in my understanding and learning process. After you understand the basics and if the surgeon has suggested surgery ask the surgeon about his history... how long he has been doing this... how many procedures has he done... ask him for a list of references. He knows what he is doing... but it's all about making YOU feel comfortable and understand. If he/she is not willing to take the time to do this... then you have the wrong surgeon. If you've found the right surgeon and decide to go ahead with the surgery make very sure you understand the recovery process... recovery from back surgery can be a tough/long road. Listen to the surgeon but his explanation is most likely optimistic and double or triple the timeframe of what he says... but more importantly ask if he/she can give you the names and contact info of some former patients to talk to them... they will give you the real story. Better yet research this site for both success and failure stories on back surgery recovery... there is a LOT of people here with lots of firsthand experience... both good and bad. Good luck... and keep us posted.
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • hvillshhvills Suzhou, ChinaPosts: 728
    Prior to the surgery if that's what you decide to do you... you said he gets some relief from hot showers... if you haven't already you might try using an electric heating pad whenever he is sitting or lying down. This won't solve his problem but it may bring some temporary relief. I know for me both before and after surgery I was addicted to using a heating pad whenever I was sitting or laying down... if nothing else it sure feels goods. You also mentioned he got some relief when walking in the pool... have you tried traction therapy?? Like the heating pad this most likely won't solve his problem but it may bring some temporary relief.
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • I am currently 28 years old, but I started having the same issues when I was a sophomore in high school. To make a long story short, I lived with my pain for 11 years before I finally saw a doctor and had my first surgery. My biggest regret was that I waited so long before fixing the problem.

    Surgery can be scary. But at that age, I really think that fixing the issue is your best bet. These types of conditions with nerve impingement will likely only only get worse over time. Additionally, waiting too long before fixing the issue can lead to permanent nerve damage! And no one wants that.
  • gfishggfish Pittsburgh PAPosts: 159
    With him still young and strong. I bet he will bounce back from any surgery. Just make sure you got a Doctor you like. One that you can talk to and call with all the questions you will want answered. As for what to ask him... Write all and anything that comes to your mind, Read. I found Spine Health after my surgery, Wish I did before hand. Your questions can be answered, and you can get questions to ask your doctor. I wish you the best, We all hate when its our children that suffer with pain.
    Greg fisher
  • I'm actually 17 and have had neck and lower back pain for 3 years along with 3 spinal fusions in my cervical spine. I completely understand what your son is going through. For my lower back pain I see a chiropractor but that was after my neurosurgeon recommended it and also with lots of research behind my personal chiropractor. If you would like to get in contact with me then feel free to PM me. I know what he's going through at the same age :)
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