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If you were 28 yrs old with my spine, what would you do?

JamieDeanneJJamieDeanne Posts: 1
edited 01/31/2014 - 6:54 AM in Chronic Pain
I herniated L4-L5 and L5-Si with annular tears falling from a horse in ’05 and had an open decompression (laminectomy + discectomy) in ’07. My back pain was always worse than my radicular leg pain but bad enough to do the decompression surgery. The first surgery didn’t relieve anything, and we decided to re-operate in ’08. I had a horrible recovery and spent 9 weeks barely able to walk. I am 5’6 and 114 lbs so not overweight and I am quite active (walking, gardening, etc, since my back is so painful I can’t do much else) I quit riding horses 5 years ago. I used to be a professional dressage trainer and rode upwards of 6-10 horses per day.

I have had several rounds of ultrasound-guided facet joint injections to try to ease some of the pain in my lumbar spine but as it hasn’t been too much help, we decided to take a CT to see what my back looks like since the last surgery, and the results were shocking, to say the least (in my opinion). The last images I had before my last surgery showed the herniations at L4-L5 and L5-S1 impinging on the S-1 nerve root with the annular tear, with disc degeneration. (it was an MRI).

This recent CT shows L3-L4 circumferential disc herniation effacing the thecal sac moderate bilateral degeneration of the facet joints, and hypertrophy of the ligamentum flavum, L4-L5 shows circumferential disc herniation effacing the thecal sac, moderate bilateral degeneration of the facet joints, hypertrophy of the of the ligamentum flavum, and this coupled with the disc herniation creates spinal stenosis at the L4-L5 level. L5-S1 shows circumferential disc herniation mildly effacing the thecal sac and impinging on the S1 nerve root, moderate bilateral degeneration of the facet joints, and hypertrophy of the ligamentum flavum.

So, now my L-3-L4 is affected, my facet joints are buggered, I have spinal stenosis already showing on CT, and the herniations are all back.

If you were 28 years old, wanted to have children in the next few years, and were in pain every day (which I know almost every single one of you are) what would you do? would you opt for fusion? I have a referral in to my neurosurgeon to go over this scan and to talk about my options, but I want to go in with confidence and looking forward to my life. I don't want to think "this is the best I am ever going to feel" and "I should have done something while I had the chance"

I feel if I do nothing, degeneration is just going to continue and my spine is going to get worse and worse. and this IS the best it will ever be. and that scares the hell outta me.


  • LizLiz Posts: 9,706
    edited 01/31/2014 - 7:10 AM
    Please take the time to read this post and refer to it when you have questions

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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • dilaurodilauro ConnecticutPosts: 13,425
    Welcome to Spine-Health - How to get started

    Jamie, a few things to start with, the present is never the best it will ever be! You always need to maintain a positive and bright outlook. There are so many different type of treatments that can help you. I was heading towards life in a wheel chair, but I was fortunate, that my physiatrist recommended me to this little Thai massage person. His traditional style of deep tissue and soft tissue massage (very painful) help me along. Adding to that, some other Eastern medicine techniques (aroma / candle / music relaxation therapy really helped. I firmly believe a combination of Western and Eastern medicine can help anyone. So, dont seal you fate...

    From what described, it does appear that things will degenerate over time. I had my first lumbar surgery when I was 28 in 1978., 6 more spinal surgeries and 4 total joint replacements and I am still going as strong as I can. I live with cervical and thoracic stenosis , Denigrating Disc Disease, and Osteoarthritis that has ripped through my joints and is now heading down to my knees.

    If the surgery now is going to help your back and provide you with more stability, then I would say go for it. I'd have to weigh all the pros and cons about having or not having this surgery. Having surgery is a personal decision, its something that you, your family, loved ones and your doctor need to talk about.

    My feeling is that its better to be proactive than to just sit back and wait for things to happen.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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  • does NOT have good outcomes, and far too often results in even more problems down the road, usually a very short time after having adr placed in the lumbar spine, and any deterioration in the facet joints is grounds for not going ahead with it to begin with. Any surgeon who offers adr to a patient with facet joint degeneration of any degree is setting them up for further problems down the road.......
    You don't say how the doctor rated the stenosis, or where it is located, since it can be foraminal, or central canal , and the facet joint problems , also you didn't give any rating on, mild, moderate or severe. It does factor in greatly in what options might be available for you, and what your surgeon might suggest as treatment options.
    As far as the decision to undergo surgery or not, first, knowing the type of surgery is a large part of the decision making process....but there are many options, laminectomy, hemi laminectomies, fusion, x stop and others , depending on the severity of your condition overall and the findings of the imaging studies, as well as what your surgeon's exam shows.
    The thing that you might want to discuss with him, is the severity, the likelihood of further deterioration and how fast he feels you might be facing it, and what options he wants to consider with you as far as surgery or not goes.
    While avoiding surgery can sometimes occur, others, the longer you wait, the further the problems can progress and cause even more down the road.
  • I researched, for more than two years adr when my own back problems surfaced again, and have continued to keep up with the research since then......I am pretty well versed in most things related to spine surgery, since I have been dealing with these problems since the early 90's.....I like to know what my options are, and who is at the top of their fields and more importantly why......I never said that all adr's failed, I said that the ones implanted in the lumbar spine don't necessarily turn out well for many patients. I also never said that I didn't speak to patients who had successful adr's, but those were not quite as often the result as those who had "complications" . I spoke to several hundreds of people, those who were successful and those who weren't as well.......as I said, I did my research and read peer reviewed studies once they became available , not just those put out by those paid by the companies who they were compensated by...
    There are a few, ethical surgeons here in the US that I would go see, who have done adr and quite successfully, and more importantly are amongst the few who actually know how to do the revisions/removals if I were going to get one....
    I strongly encourage every patient, no matter what options they are facing surgically or otherwise to do their homework and research, research and research.....
  • Hi Jamie,

    I don't think age is really relevant. It really sucks to be dealing with all this in your twenties, I know. I'm 23. I just don't think it comes into the decision about what to do. Perhaps it means more is at stake. You will have to live with your spine for longer than someone who is 80. But I don't don't really see how it should guide treatment decisions.

    I wish you the best of luck with whatever further treatment you choose. :)
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  • dilaurodilauro ConnecticutPosts: 13,425
    Not that spinal problems discriminate. Because that can happen to anyone at any age.

    Its one thing if you start to have a spinal problem when you are 60. There will be more conservative approaches taken because there are other risks associated with age. The surgeons take into account the ability for older people to recovery from surgery.

    Younger people need to look at the future. That plays a big role in deciding to have surgery or not. Plus, it is widely accepted that younger people have the ability to bounce back quicker from surgery than someone 2 or 3 times their age.

    In some countries medical plans, age plays a huge role. A person who is in their 60's or 70's many times would be rejected for a heart or other organ transplant vs a person in their younger years.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • K61KK61 Posts: 20
    edited 02/01/2014 - 4:25 PM
    to be considered before deciding to go for surgery. Being younger does usually mean you can bounce
    back from surgery quicker, but it also means a much longer time with the problems of a bad surgery. I
    have had spinal stenosis in my lower back for over 15 years. I also had it in my neck and had to have
    a 2 level ACDF done. The stenosis in my back was not causing any problems other than pain and I am
    managing that with medication. However the stenosis in my neck had to be fixed due to bouts with paralysis.
    The fusion in my neck was a success and I no longer worry about paralysis, but the pain is worse. One
    surgeon told me honestly that the surgery was to relieve the stenosis and would probably not lessen the
    pain or bring back anything I had already lost. Yes one must stay positive when thinking of surgery, but
    we must be realistic too. I would not have fusion surgery in my back if I could control the pain and live a
    reasonably active life on medications. My orthopedic doctor is treating me for knee problems. I have no
    cartilage left in my left knee. He has told me the only long term solution is a total knee replacement. I am
    using a brace, medication, and steriod shots, but I am still able to work. The surgeon has told me knee
    replacement has a 95% success rate, however my mother died from complications and one of my best
    friends lost his leg after knee surgery. If doctors are doing 100,000 operations a year 5% failure rate is
    5000 patients. All I am saying is you have to decide what you can live with and what is worth the risk.
    Whatever you decide good luck to you.
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