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Is Spinal Fusion Surgery my best Treatment Option?

bbvanbbbbvanb Posts: 2
edited 11/03/2015 - 5:47 PM in New Member Introductions
i'm bailey, a 26 year old female. i currently work as a veterinary assistant in the lovely state of north carolina. i'm also a certified horseback rider and trainer, but i currently do not practice the sport at this time.

my problem is primarily wrapped around grade ii spondylolisthesis at l5-s1.

my spondylolisthesis was more than likely brought on by trauma as a (younger) child. i was very active, participating in many extra curricular actives: track & field, soccer, basketball, dance, and horseback riding. i was also a very competitive gymnast starting before grade school all the way throughout early high school. i was around 13 when i did have to quit the sport of gymnastics due to lower back pain (2000-2001). at that time my parents took me to see a chiropractor who said i had a "stress fracture" and that i shouldn't continue with the sport. so that is as early back as my back pain goes.

years later (2010), while i was attending an equestrian trade school, i was thrown from an unruly horse. i landed on my right side and i'm fairly certain i broke 2 or 3 ribs. i did not go to the doctor and i continued to ride even after. however, after this incident my back was never 100%. since then i've had to quit working my initial trade and move to working with smaller animals. i've been working with small animals for the past 3 years while seeing a chiropractor regularly.

more recently (starting a month ago or in early october of this year 2015) i started to get one of my typical lower back flare ups and chiropractic care didn't seem to help much. i just popped over the counter nsaids and continued working. my pain started to get worse and i started to develop a pain in my back with every step i took and i started to limp. i kept working anyway and developed numbness in my right foot. i still kept working up until my entire right side of my body from my lower back down to my foot went into spasm and ended up at urgent care. i didn't know it at the time, but i lost all feeling along part of my l4 and all of my l5 nerve root as a consequence. no medication other than narcotics touched the pain i was in at this time. even then they only helped me sleep more than got rid of the pain. needless to say i had to take time off work.

i saw my chiropractor for 3 weeks straight (every other day) before he suggested i see an orthopaedic to get an mri. then i went to see a do who told me i needed flexion/extension radiographs and a mri. i got both done. i also started physical therapy while waiting to get my mri scheduled. my results are as follows:.

findings/impression: bilateral l5 spondylolysis with associated
approximately 10 mm of l5-s1 anterolisthesis, unchanged with flexion or
extension. there is multilevel degenerative disc disease, including at l4-5
and l5-s1.

mri lumbar spine without contrast:
findings: conventional lumbar numbering. loss of normal intervertebral t2
disc signal and disc height loss is noted at the l4-l5 and l5-s1 levels.
there is mild retrolisthesis of l4 on l5 and mild anterolisthesis of l5 on
s1. bilateral l5 pars defects are present. conus terminates at l1-l2. the
visualized spinal cord morphology and signal, and the cauda equina appear
normal. the vertebral bodies demonstrate no evidence for fracture with
normal alignment and marrow signal. negative for epidural hematoma. the
sacroiliac joints and surrounding paraspinal and retroperitoneal soft
tissues are normal.

--t12-l1: sagittal imaging only. there is no evidence of spinal stenosis,
disc bulge or neural foraminal narrowing. no facet degenerative disease.
--l1-l2: sagittal imaging only. there is no evidence of spinal stenosis,
disc bulge or neural foraminal narrowing. no facet degenerative disease.
--l2-l3: there is no evidence of spinal stenosis, disc bulge or neural
foraminal narrowing. no facet degenerative disease.
--l3-l4: there is no evidence of spinal stenosis, disc bulge or neural
foraminal narrowing. no facet degenerative disease.
--l4-l5: mild retrolisthesis of l4 on l5. mild diffuse disc bulging with
superimposed large right subarticular disc extrusion with caudal migration
with associated moderate right lateral recess narrowing. this impinges upon
the descending right l5 nerve root. no significant canal or neural
foraminal stenosis. mild facet degenerative disease.
--l5-s1: mild anterolisthesis of l5 on s1. diffuse mild disc height loss
with associated degenerative endplate changes. there is unroofing of the
disc with mild superimposed diffuse disc bulge. this combines with mild
facet degeneration cause moderate right neural foraminal stenosis. no canal

1. large right subarticular disc extrusion at l4-5 with caudal migration
which results in right lateral recess narrowing, impinging upon the
descending right l5 nerve root.
2. bilateral l5 pars defects with associated grade i anterolisthesis of l5
on s1 and minimal compensatory retrolisthesis of l4 on l5. as a result of
the listhesis, there is moderate right neuroforaminal stenosis at l5-s1.

after my mri my do recommended a spinal epidural steroid injection (to reduce inflammation around my nerve root that was being compressed by a disc herniation). i did that as well. i don't think the injection did anything at all, but with lots of rest and nsaids i haven't been in pain (i wasn't in much pain at all prior to my injection either---just lingering leg weakness and numbess at that time were my biggest complaints) however, i continue to have numbness and weakness in my right leg. my do wants to try another injection but has openly said that she is not optimistic about the injections and that i should consider surgery.

i am wondering if surgery is something i should even consider? i understand that my lower spine is unstable which predisposes me to disc herniations, nerve compression and furthering of degenerative disc disease..... is it worth it just to get rid of some numbness??
welcome to spine-health

one of the most important things that members can do is to provide the rest of the community with as much information about themselves as possible. it is so very difficult for anyone to respond when we do not have enough information to go on. this is not meant to indicate that you are doing anything wrong or violated any rule, we are just trying to be pro-active and get the information upfront so that people can start responding and your thread is more effective.

so many times we read about members who have different tests and they all come back negative. the more clues and information you provide, the better chances in finding out what is wrong, the fact that your test results are negative does not mean that you are fine and without any concerns. many times it takes several diagnostic tests and procedures to isolate a specific condition.

here are some questions that you should answer:
  • - when did this first start? . year, your age, etc
- was it the result of an accident or trauma?
- are there others in your family with similar medication conditions?
- what doctors have you seen? (orthopedic, neurosurgeon, spine specialist, etc)
  • . which doctor did you start with? ie primary care physician . who are you currently seeing?
- what conservative treatments have you had? which ones?
  • . physical therapy . ultrasound / tens unit . spinal injections . acupuncture . massage therapy
- what diagnostic tests have you had? and their results (mri, ctscan, xray, emg, etc)
  • . summarize the results, please do not post all details, we cannot analyze them . how many different tests have you had over the years? similar results?
- what medications are you currently using? (details, dosage, frequency, etc)
  • . name of medication . how long have you been using this? . results
- has surgery been discussed as an option? (if so, what kind)
- is there any nerve pain/damage associated?
- what is your doctor’s action plan for treating you?

providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.

please take a look at our forum rules: forum rules

i also strongly suggest that you take a look at our faq (frequently asked questions) which can be found at the top of the forum menu tab or by going to faq there you will find much information that will
  • - help you better utilize the spine-health system- provide pointers on how to make your threads / posts- tips on how to create your avatar (your picture), posting images, etc- general pieces of valuable information

please remember that no one at spine-health is a formally trained medical professional.
everything that is posted here is based on personal experiences and perhaps additional research.
as such, no member is permitted to provide
  • - analysis or interpretation of any diagnostic test (ie mri, ctscan, xray, etc)- medical advice of any kind- recommendations in terms of medications, treatments, exercises, etc

what could be good for someone could spell disaster for another.
you should also consult your doctor to better understand your condition and the do’s and don’t’s.

it is very important that new members (or even seasoned members) provide others with details about their condition(s). it is virtually impossible to help another member when all the details we have are

i’ve had this for years, it hurts, i cant move my shoulder – what could this be, what treatment should i get?

diagnosing spinal problems can be very difficult. in many ways it’s like a game of clue. especially, when the diagnostic tests come back negative – no trouble found! then it’s up to the patient and the doctor to start digging deeper. the doctor is like a detective. they need clues to help them move along. so, you as the patient need to provide the doctor with all sorts of clues. that is like it is here. without having information about a condition, its impossible for anyone here to try to help.

specific comments :

personal opinion, not medical advice :


no on one the spine-health patient forums is medically qualified to provide any advice or
or recommendations on any diagnostic test. however, the following key words can apply
  • mild treated with conservative measures such as physical therapy and mild medications. many times these situations can be cleared up and the condition can be resolved.moderate some more treatments may be needed, ie spinal injections, ultra sound and stronger medications. always a possibility of more aggressive treatment if the conservative measures don't helpsevere need for stronger medications. the requirement for surgery may be necessaryyou need to get the answer to your question from your doctor(s)
--- ron dilauro, spine-health system moderator : 11/03/15 23:46 est

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