Any low back surgery success stories???

[kweb]

Low back surgery success stories??

 

I’ve got a herniated L4 and L5 with spinal stenosis. My surgeon is planning on doing a L4 S4 decompression and laminectomy (sp?). Has anyone had this done and how was it. He knows I’m very active and that I want to get back to my activities post surgery. He assures me that I will be able to in time but in still worried about it.

I’ve had back pain for 7 years now with sciatica for the last year. In those 7 years I’ve had to take a good amount of time off from work (delivery driver). I’ve tried PT, chiropractic care (with traction), acupuncture, massage, electrical stimulation, oral steroid packs, hydro therapy and most recently 2 Cortisone injections. Some of those things have helped manage the pain but none have cured it.

With my latest injury (bent down to grab an envelope......”POP”!) I’ve been off work since January. I’ve lost 11 pounds all in which I’m guessing is muscle since I was lifting 3 days a week and doing cardio 2 days a week while working a physically active job. I was 161lbs and 9% body fat pre injury....down to 150 now.

Anyway, I’d like to hear some success stories for this type or similar low back surgery. Im kinda bummed about getting the procedure done but as you can see, I’ve exhausted all my options.

[i_like_sun]

Hey,

 

my mom had the same surgery about 15 years ago. She returned to all of her activities within about a year. She never did any real PT however, and reinjured it about 5 years ago. Again, she's made a full recovery. She's not super active however, so remember that athletes are in a different category all together. They just recover faster and more completely.

 

I'm sorry I can't offer any real technical knowlege about this back surgery, but I do know that physical therapy has come a long way, and that there is a ton that can be done for your recovery. I've done quite a few volunteer hours in PT clinics, and have seen some pretty fantastic recoveries from other back injuries. What I can say is that, when you do come back, work on that core strength as best as you can! In my 4 years of being a pre-pt/med. student, I have figured out that weak and imbalanced muscles are usually the cause of many of these sorts of problems.

 

Sorry if this sounds too simplistic. I'm sure you can find some studies published online that might help you find more of what you are looking for.

 

Best wishes to your healing pal. Hang in there, and stay sane! I agree, injuries suck.

 

R

[iluka]

I'd be wary of back surgery for the purpose of relieving pain. If there are neurological deficits that result from a back problem (eg. compressed nerve leading to dysfunction in the muscle served by that nerve) it can be useful. For the purposes of pain relief, it is not nearly as successful and some people continue with pain. Perhaps a second opinion from another surgeon is in order?

[DPS]

I had an L5-S1 lumbar fusion. I was back to all normal activities within a few months and all pain is gone. Good luck.

Edited April 6, 2007 by danielpatricksmith

[gearup5000]

Surgery helped me. Remember, everything is a case by case basis.

You have to look at the pro's and con's, and that post surgery you will probably continue to lose muscle (self-explanatory).

If it's your last hope, don't put it off.

 

One thing that might help in general is improving your flexibility and smaller connective tissues/stabilizers. This will help in alignment, posture and thereby decrease the odds of re-injury and

painful moments in general.

 

I suggest doing Bikram yoga. It's yoga for flexibility done in a very hot steam room. This gets the blood going, so your muslcles are ALL super warm (your whole self), and allows for good overall stretching, not just muscle groups.

 

If everything is working together better, should be better off in the long run.

Lemme know what ya think/if this helped.

 

 

 

 

 

 

Edited April 6, 2007 by gearup5000

[artesonraju]

I had a L5-S1 laminectomy back in 1991 for a ruptured/bulging disk and sciatica. I had no pain or problems associated with the surgery, and I was up doing yard work within days and back climbing within 2 months. BUT - I was in grad school at Stanford at the time and the surgery was performed by one of the world's best neurosurgeons. While waiting in the office for post-op follow-ups, I heard many horror stories from patients that had used other surgeons - for these patients, surgery made their pain worse, and they were hoping that a great neurosurgeon could repair the damage done by previous botched surgeries.

 

So, for me, the laminectomy worked great. But, choose your doctor wisely!

 

Cheers, and I hope everything works out.

[PLC]

Surgery is no longer generally prescribed for lower back pain; it hasn't been shown to have any statistically valid efficecy.

 

The unfortunate reality is that most people will experience lower back pain at some point in their lives, and the root cause will most often be unclear. Even if you have a bulging disc which is clear as day on the MRI (like me) that may not actually be the source of your pain - the percentage of people with and without disc problems who experience pain are nearly identical.

 

Personally, I've had recurring sever lower back pain and sciatica for about 20 years. I've been to tons of doctors and chiropractors and physical therapists. I've read all the books and articles and I look for magical cures in medical journals all the time. There is no cure. All you can do is manage the pain through disciplined daily stretching, phystical therapy sessions, ice and heat applications.

[smithisheaven]

By fusing the vertabrate the next one in line up and down recieve additional stresses to compensate. I have heard wildly varing stories about the level of success. Exhaust all options prior to the cut. It sounds like you have tried alot. I compression fractured my back in 1990 in an off road motorcycle accident. T3,T4, and T5. Had tons of down time and pain. But I never got cut on. I rested and when ready, afterlike 3 months, I slowly started doing rehab. It was a bitch and the most painfull thing I have gone through in my life. Not the injury but the rehab after. It worked and I am in better shape now than before the accident. The rehab can be hell but worth it. I kow every situation is diff and I hope you have great luck with whatever you decide 2 do.

[kweb]

Gearup5000

Every positive comment right now helps. Like I said, I think I've tried it all thus far. I know there are pro's and con's and that everyone's outcome is different. Truth be told I just want to hear that everything will be okay.

I've already had an IME (exam by another doctor paid for by the insurance co.) with two other doctor's. If thier findings are "on the fence" I will get my own second optinion. Both of them did agree that I've definatly got 2 bum disk's and both said I have done everything I could short of surgery. But then tried to steer me away from surgery?????

I will definatly focus on better flexibility and core work post surgery.

 

There is even a "hot yoga" joint just 10 minutes from home.

[BirdDog]

kweb;

 

I suffered years of intermittant back pain and stiffness; sometimes so bad I was out of commision/work for 10 days. I tried therapy, excercice, drugs, electro-treatment, etc... no improvement. A times I would be so stiff/locked up I could not move in any direction. I had a L4-L5 micro-disectomy in 1991. I have been fine ever since. I keep my weight right, excercise, and mvoe/lift correctly.

 

I also have slight spinal stenosis, and three other degenerative disks. X-rays make me look like a cripple; yet I have virtually no problems - and I'm 49 years old and work in the construction industry (although not with my tools everyday).

 

Some of the other posts here make valid points. I've heard horror stories of people having 4 surgieries and still have problems. Before my surgery my Doc told me about a study @ UW where they found 80% of cadavors studied had back abnormalities, yet only 25% had a history of back problems/symtoms.

 

I feel very fortunate to be healthy now, much of this I credit to back surgery (If you're backs screwed up, you can't even excercise). I defintely know how you are feeling. My advise is to really check out your Doc, ask for references etc... I would also reccommend going to the University of Washington Medical Center. They have some absolutely top Doc's there with a ton of research info behind them. I recently had sinus surgery there and was very happy with the results and level of care.

 

Well that's my input. I wish you the very best; and hope you can write a succes story like this in a few years.

 

 

[ken4ord]

I had an L5-S1 lumbar fusion. I was back to all normal activities within a few months and all pain is gone. Good luck.

 

An ex had problem with back pain for as long as I knew her and tried everything to eliveate the pain. Finally her doctor said as a last resort she could have L5-S1 lumbar fusion. Everything worked out for her she was able to return to her activities cycling and backpacking.

[DPS]

I think the fellow who mentioned that it is important to choose a good surgeon is spot on. I know a fellow who had a very minor version of the same surgery I had who can barely walk following his surgery.

 

In my case the disk had ruptured, became infected and the adjoining vertebrae also became infected. The surgeon said the L5 and S1 vertebrae were the consistency of cottage cheese when he operated on me. He had to remove half each of the two vertebrae, bridge the gap with a piece of femur from a cadaver and screw it together with two steel plates and 8 large screws. Today I run ultra marathons, climb, ski, swim, and bike. The surgery has not held me back at all.

 

If you decide on surgery, or just want a really good second opinion, I would highly recommend Dr. Reginald Knight at Orthopedics International in Kirkland. He is certainly one of the best spine surgeon in the PNW.

 

Good luck!

[layton]

Damn, wish I got on this thread earlier!

 

Iluka's post about the neurological deficits vs. pain relief is right on, as is PLC's about herniations not always corresponding to the low back pain. Same goes with spondy's. Stenosis and osteophytes usually do correspond to the pain, however. But if it's so bad you think you need surgery, I'd concider it too. Get a 2nd opinion with another surgeon no matter what you do!!!

 

Low back pain still remains a mystery for the most part. No one is really sure what causes it. My back is killing me, and I expect to be on the floor in pain for the next 3 days.

 

The best thing found to help with chronic low back pain is lumar stability core strengthening exercises, not surgery. Sometimes massage does the trick, sometimes a chiropractic adjustment does the job, sometimes ultrasound/hotpacks/EMS...etc does it, but in all honestly acute recurring low back pain is a bitch to treat, kinda like the common cold.

 

Do you have progressive or severe neurological deficits?

[kweb]

Im not quite sure what progressive or severe neurological deficits would consist of? I do have slight weakening in my right quad, anterior tib, and toes. Also feel a slightly different sensation in the right leg when the "pin wheel" is ran down my leg.

 

My MRI report from 2001 says: "at L4-5, there is degenerative signal withen the disk...... There is also some increased signal in the inferior and the annulus...."

 

"at L5-S1 there appears to be a defect in the annulas.... the disk impinges on the thecal sac and posteriorly displaces the S1 roots bilaterally. There is signifiant foraminal narrowing. The disk also demonstrates some loss of height and loss of signal characteristics........

 

Conclusion: "Small central protrusion at L2-3.

Larger central protrusion, slightly greater to the right, at L4-5, with annual fissure or tear.

Central disk protrusion at L5-S1, effecting both S1 nerve roots."

 

My 2007 MRI Reads: "Findings: The L5-S1 level is assigned to the lowest fully formed disk level....... There is increased signal intensity in the S1, S2, and S3 levels and adjacent soft tissue on all sequences indicating this is probably related to coil position and signal intensity modulation....."

 

"L4-5 There is a moderate broad degenerative disk buldge and a small right posterolatal disk protrussion extendind partially intraforaminal. The right foramina shows mild narrowing, and the left shows minor narrowing. There is a moderate narrowing of the right lateral recess and mild flattening of the thecal sac. There is mild facet arthropathy."

 

L5-S1: "There is a mild broad degenerative disk buldge with mild bilateral foraminal narrowing. The is a small central disk protrusion. Both distal nerve roots are contacted with slight flattening of the right S1 nerve root. There is minimal impingement of the thecal sac. There is mild facted arthropathy."

 

Conclusion: Degenerative disk bulges of L4-5 and L5-S1 levels. There is a right posterolateral disk protrusion at the L4-5 level and a small central disk protrussion at the L5-S1 level."

 

I'm not sure if that answers your question but I hope it kept your interest for the last 45 seconds.

 

How does one research to make sure he's found a good surgeon?

[ericb]

kweb

 

Did you get short term relief when you had traction (assuming with a PT)?

[layton]

Actually your post was really helpful. It does sound like the disc is impinging on your nerve roots and that if nothings worked after ~6months of trail and error, you should opt for surgery.

 

Talk to PTs and Chiropractors about who's the best surgeon. They're the ones cleaning up the mess and should be in the know.

 

[kweb]

ericb

The traction was done on a cox table by my chiropractor in Kent. Since I now live in Tacoma I no longer see that chiropractor. I was having traction done anywhere between 3x week to 1x month depending on where I was at in my numerous injuries. The relief would end as soon as I stood up from the table. I do think it helped prolong some flare ups but eventualy they would catch up to me.

 

Layton

Thanks for the advise on where to look. I've spoke with my old chiro in Kent but he just kept telling me not to get surgery. I will inquire at the Tacoma chiro I was seeing before my last injury. Also at the PT office down the street from me.

Can you reccommed someone?

 

[billcoe]

I only personally know 3 people who underwent similar surgeries and none were considered sucessful buy the people who got operated on.

 

None. They all had pain as bad (in one case substantially worse) as previously.

[mbcracken]

FWIW, I only know of one individual that had this surgery. He is back to climbing and XC skiing but does it with a completely numb left foot.

 

[Kat_Roslyn]

I am sorry you are in pain. Have you asked them what the recovery time is like with surgery? Sounds like you are exploring your options, good for you. Just thinking about surgery is scary, I have one tomorrow. I saw my surgeon the other day, he fixed my lower spine/ sacrum and pelvis and he couldn't stress enough about core strengthening excercises to relieve pain. I am feeling better everyday, the body is a neat machine. Good luck.

[layton]

Here's the trick about the surgery:

 

After the initial pain from having surgery wears off, lots of people have relief....for a while. Then the back pain comes back and they are back to square one. Finally, the pain gradually goes away. Research has found that in the long run (2-8 years) that adjunct therapy with exercise provides the same long term results as surgery.

 

Of course there are those who are "fixed" by one trip to the chiro, and those that are "fixed" by getting their surgery.

 

Even things like if you have a job or not (no matter how happy you are), if you smoke, and how much education you have seem to effect the outcome of low back pain.

 

Back pain is f'd up!

 

So after I wrote my 1st post I was in screamin' pain. I hooked myself up to a IFC machine and CRANKED it way above what I would a patient, and hung out for about 20 minutes! Of course I'd never do that to a patient, I was just experimenting on myself. After I turned off the machine, all I could feel was the phantom tingle from the electrodes (I didn't burn myself if you were wondering). I knew that my back was finally loose as could be so I grabbed someone in the hallway and had them crack the crap out of my back and pelvis. By the end of my self-treatment, I went from a 8/10 pain to 1/10 pain and 7 hours later still feel pretty darn good (1/10).

[kweb]

Kat Roslyn

The recovery time is:

6 months 50%

9 months 75%

1-2 years 100%

 

Most patients can return to light duty in about 6 weeks.

[iluka]

Im not quite sure what progressive or severe neurological deficits would consist of? I do have slight weakening in my right quad, anterior tib, and toes. Also feel a slightly different sensation in the right leg when the "pin wheel" is ran down my leg.

 

Neurologic deficits would consist of weak muscle groups... specifically the muscles served by the nerve that is being impinged on by a bulging disc for example. Another example would be areas of loss of sensation... patches of skin where you don't feel anything. Other concerning neurologic deficits include loss of control over your bladder or bowels. These are several of the things the surgeon should be evaluating.

 

I would not get too hung up on the details of the MRI report yourself. The radiologist will call a lot of things that they see on the MRI. The key thing is always to correlate the MRI findings with what problems the patient actually has. For example, you could do MRIs on various people and in some you might actually find bulging discs. Many of them would have no symptoms at all. The key is do the findings correlate with your complaints and what the physician finds when they examine you.

 

As to how to find the "best" surgeon, that's a great question. I wish I had good advice in that regard.

[Dechristo]

I hooked myself up to a IFC machine and CRANKED it...

 

What's an IFC machine and how much dey cost?

[layton]

interferrential (sp?) current. It acts as a nerve block via opiate and gate control mechanisms. It also fatigues the muscles in spasm. A few hundred bucks for a cheap one. There are many different types of electrotherapy, from TENS to mircocurrent, IFC, high volt, low volt-galvanic, russian current, biphasic, etc. You really need to have background in these things to own and operate it. You can really hurt yourself and others with it. Plus there are many settings for each type of electric current. Plenty of contraindications. I highly recommend not buying one yourself.