Well I made to my, lets see, what to call it, I guess my 2nd opinion today with an amazing Ortho Spine Surgeon. As you know I had an ALIF L4/5 on 8/24/10 and have been a mess every since. My wonderful NS who performed the surgery discharged me at 4.5 months and said sorry. Sorry your not better, sorry your worse, sorry you can not work or even function. I don't blame him for my outcome but right now, I am PO'd!
I did find another NS to follow me for the past few months, who had recommended bilateral decompression foramanotomies & posterior screws. After all I've been through I had to confirm his thought process and get another opinion.
Today, I had ext/flex x-rays (all the mri's, ct scans, myelogram...post op - no one took plain film???) The ortho spent a good 20 min reviewing all the film I brought in plus the x-rays he took and provided me with a very comprehensive consultation 45 min worth. I feel validated - strange & odd but true. I had begun to doubt myself lately and started thinking I am a freak and hopless.
The deal is, I have not fused he called it fibrous non union (if anybody is familiar please reply, couldn't find much online)he said there is a fault line??? and on top of that I have significant micro motion within the segment and this is causing a lot of my back pain.
He also feels that the nerve was stretched a little too much, my wedge & cage are perhaps just a little to big for me. Which may be why my emg/ncs are now positive. This issue is one that only time will tell if the nerve pains will ever fix! He said could take up to 2 years. Again, if any of you have heard of this, please share.
I had met this surgeon prior to my fusion, my NS actually sent me to see him for an opinion... So he knows my surgeon and has worked with him on many cases. Obviously he was cautious with his words.
He seemed to genuinely care on finding a solution for me. He will present my case to some other board certified surgeons and brainstorm, finally an advocate!
he did offer me surgery but did not push. He said if I wanna wait a few weeks a couple of months... ok.
He wants to do a plate behind the spinous process (sort of where they place an Xstop device) with little screws fixed into facets and add bone grafts posteriorily also widen up the foramans. Due to my build (I am very small, he would not use regular screws, which is one of the reasons I went the ALIF route) He said its not radical and although it sounds like a lot it's not, said 1-1.5 inch incision & 2 small screw cuts.
While I consider this he has placed back on NO BLT's and wants me to wear my brace throughout the day. He is debating a bone stimulator but isn't sure at this point if it will help. He said every time I move, slight bend or twist I am causing trauma to that level and aggravating the nerve.
The other NS said I was ok to do light swimming with a kick board as I am unable to do much of anything else, the Ortho today said NO do not swim, if you want to walk in the pool that would be ok but no swimming or exercise at this stage. SO Confused!
Part of me wants to just get her done! but the rational side of me is in defensive mode! He was clear that due to the two issues, he could not give me more then 50% success rate, the nerve problems might not fix with this. but he can stabilize my spine.
He has ordered my records from pain mgmt, neurologist and blood work from rheumatologist. He is keen on getting my SED rate??? I am not sure if that had been tested last week with all the other blood work.
Overall I am pleased with his assessment and his plan but I am scared to death to go through this again! But I cant continue to exist like I am either.
We did review my cervical issues, but will post that in a later thread... too much info, sorry for the long post.
Thank you for reading and please any input is greatly appreciated!