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What Surgery Should I Go With?

I am 31 years old and I am extremely active. I play baseball, go to the gym, train in Muay Thai and Boxing, and I run in the Tough Mudders (10-12 mile extreme obstacle courses) whenever I can. I hurt my back at work and now have been getting treated for the back pain for about a year and a half. My L5 is torn and degenerating and leaking. The first doctor told me (before the MRI) it was a pinched nerve and said to stretch and get treatment through massage. After about 6 months and no change I told them to get an MRI done and as I thought it was more serious. I have gone through the series of shots and nothing has helped. Physical therapy is great because it makes me feel more stable, and it actually gives me a workout. Now the doctor is recommending a fusion. I am not really too educated on the matter, but from what he said is that it will give me a few good years and then I will need another surgery and I assume that cycle will continue. I am about to have my first child in April so I want to do whatever is going to be best long term. I was thinking of getting an artificial disc because it feels less permanent. I can get that and if the technology gets better then I might still be able to "upgrade" rather than a fusion leaving me with nowhere to go. I have also heard of Traction. A woman I know does that and had her nerve endings burned to stop the pain and she is waiting for some new treatments to come out. But I feel like if I mask the pain I still won't be able to go back to training without making it so much worse. I realize I will have to alter my training habits, but I want to at least be able to get back out there. I am not depressed from it, but I am extremely frustrated by it. I can't sleep and have constant head aches. I am like a shark... I have to always be moving. I get anxiety when I am not being active. Any recommendations for an athlete? Also I am in Southern California if anybody has any good doctors in the area to recommend they can message me. Thank you in advance everybody.


  • Upgrade after having artificial disc ? Like upgrading to a newer car ? You beter read up about artificial disc then,

    I was in same boat as you back in 2004 with disc leak, I wanted to avoid fusion like crazy to be able to go back to construction work and golfing and so on play sports,

    I opted for the clinical trial flexicore artificial disc in 2004. They go in from the front and if the arrificial disc fails by some chance its very hard and dangerious to go back in from the front and most doctors wont unless its very serious,

    So dont kid yourself, its not so simple to simply upgrade ADR.

    I ended up with nerve damage after my implant posibly due to stuff that leaks from the disc can fuse itself to the nerve and while removing the original disc along with what leaked out on to the nerve and attached itself to it while having to remove it can cause nerve damage,

    Nobody is a 100% sure this was the cause but many other causes is posible, They would not remove the disc due to the severe nerve pain after surgery so 2 years later another dr fused the level leaving the ADR in,

    So the norm is if ADR issues instead of removing it they fuse the level usualy, So i dont believe an upgrade is an option to simply upgrade,

    Its posible i could of avoided nerve damage by simply having the fusion from the start, I will never know,

    Read up on the artificial disc surgery as many doctors after my complications of having mine in my l4l5 said its beter results in the neck vs lumbar !

    Some have good results even on there back using artificial disc but many of us also have complications after this surgery,
    Talk to your doctor and find the best of the best as there is a risk with every surgery and when artificial disc is implanted its not at all simple to remove it and most doctors avoid going back in from the front due to scar tissue near a main artery,

    Best of luck, Hope this helps !
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • PaulPPaul Posts: 713
    edited 01/30/2013 - 7:15 PM
    I hate to tell you, but you likely will have to limit how much you use that disc from now on. Once they malfunction, they are never the same. If you keep hurting it, it's just gonna keep failing and eventually the "solution" gets more and more drastic.

    Your doc went right to fusion. That means it's bad or he's not conservative. Like any other profession, there are good ones, bad ones and everything in between. Try to get a few more opinions. I got 8! I took my MRIs and "shopped" them around to 8 different spine surgeons (both neuros and orthos) in NorCal, SoCal and even Arizona. Some said micro-d, some said 360° fusion, some said laser ablation, some said PLIF, some said ALIF.

    I found the one that I deemed best for me in Beverly Hills. He did microdiscectomies on me. If I had been a candidate for lumbar ADRs I was going to go to the ADR guy in Santa Monica or to Germany where they do many of them.

    ADR and fusion are HUGE, life altering surgeries. Don't take them lightly.

    Before my surgeries I tried traction in Hollywood and Santa Barbara. It did give some minor success. I later tried it in LaVerne over by Pomona. Again, it gave me some successful relief. Eventually I bought the Saunders Hometrac traction unit for home use and it helps me still to this day.

    I used to be in kick boxing and that's where I discovered my back problem but stupidly, I just kept going trying to tuff it out. I also used to train Brazilian jiu jitsu at the Gracie academy in Torrance. It was there that I finally came to the realization that I couldn't train anymore. It sucks and I miss training, but I have adapted. I ride my bike for exercise just about every day. It's great

    If you want to get serious about educating yourself about your back problem, I can send you a link to a site with VERY helpful info about it. I can't post it here because the mods delete it. Let me know.

    Good luck, sorry about your troubles, I wish you the best and congratulations on your kid. I don't have any, but my nephews and nieces have kids. They are the greatest joy.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
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  • edited 01/31/2013 - 4:35 AM
    Alex... I didn't mean upgrade as in an easy process, but I meant it as in with ADR I would hope that it would leave me an option later on down the road in case of advancements in treatment. I don't think it is a simple procedure, maybe I chose a bad word to describe it.

    Paul... that link would be awesome. I really appreciate it. How did you deal with the mental side of not being able to train anymore? Training is such a huge part of my life, I honestly feel like I wont be able to cope.

    Thanks for the info guys.
  • PaulPPaul Posts: 713
    edited 01/31/2013 - 1:34 PM
    tallglassofwater007 said:

    Paul... that link would be awesome. I really appreciate it. How did you deal with the mental side of not being able to train anymore? Training is such a huge part of my life, I honestly feel like I wont be able to cope.

    Thanks for the info guys.
    Link sent.

    "Did" deal with it? Past tense! I'm still dealing with it. It's been 10 or so years and I still think about it everyday. On my daily bike ride, my route takes me past an MMA gym and I see them in there in the cage sparring. I want to pull over and jump in but I know it would permanently wreck my back. Sucks but oh well.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Back surgery is no joke, especially in the lumbar region.
    I "only" had a microdiscectomy where they cut the lamina and remove the herniated disc that has come out of the spinal column and compressing the nerve. The surgery failed the first time and I went in for a 're-do'. It was a long 2 years and as others said, I still 'deal' with it daily. I am far better than I was but I do not forget my situation (my leg numbness, and pain flare ups remind me that I have to take care of myself).

    So - what to do? It's really a personal choice but if I had the option to try something other than surgery, that would be my vote.
    Fusion, is permanent - yes so your logic is correct on trying to find something "less" permanent to 'buy' time for technology advances.
    ADR - keep in mind this is not that much less permanent. I also thought it sounded more 'logical' as they replace the shock absorber. I do think long term it has merit but right now? ADR has a life of about 20 years. IF it breaks down before that or has problems there are very few proven studies on how to remove it and/or fuse around it. From all my research, it is better for someone who is older (e.g. for someone that will not outlive the artifical disc). And it is a BIG surgery. Last I researched it (granted, was 2 years ago), they had to go in through the front which means you need a vascular surgeon b/c they are moving organs and it is risky.

    Fusion, they can do through the back.

    I don't know...just do your research, get at least 1 more opinion and talk to some people who have tried various options. You are young and if you get relief from PT, keep trying it and less invasive options. Once you start operating on the back, it's a slippery slope. My biggest fear is that my disc above is now carrying more load and is already degenerating so I do worry that it's just a matter of time before I have an issue at that level.

    Not saying don't do surgery, just saying, research it and make sure you understand the risks. If, despite those risks, you can't be talked out of it...you are probably ready.

    For me, I just knew if I didn't try the revision surgery and went for fusion and something went wrong, I would have regretted it.
    I'm 3 years out of my last surgery. It probably took until a year ago for me to really say "I'm good". I'm not better but I'm good. I'm better than I was the day I got injured but no where near where I thought I'd be. So I'm good.

    Best wishes.
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