2 discs bad and Osteoporosis

[oldtimegrrl]

Hi.
I've been lurking for a little while, this is my first post.

I'm a computer programmer & professional dancer & dance teacher. Or at least I was. March 2008: Ruptured L4-L5 disc while dancing & moving sound equipment. Severe sciatica, muscle atrophy in left calf. Microdiscectomy performed May 2008 relieved sciatic pain, but lower back pain remained. Many months of physical therapy, walking, etc. and I still can't walk or stand for longer than about a half hour without pain. An hour on my feet and it gets pretty severe.

Discograms, MRIs, CT scans confirm ruptures at L5-S1 (bone-on-bone), L4-L5, and possibly L3-L4. Insurance approved me for fusion at L5-S1 and ADR at L4-L5. But DEXA scan just came back at -2.5, which is borderline osteoporosis.

I go to see my surgeon tomorrow. He's one of the top people in the country for ADR. I suspect he will say no ADR due to the bone density issue, and will recommend 2 level fusion.

I'm reluctant to get the fusion just because I'm pretty certain it will mean no more dancing and/or certain problems at L3-L4 in the near future. I will probably go with whatever he recommends, I'm just wondering if anyone has any other bright ideas for suitable treatment?

thanks, and best wishes to all out there living with pain, and a big thank you to the care-givers.

[dshobbies]

Hi OTG and welcome to the forum,

Been there, done that - we all understand your problems and pain. Your insurance company approved as ADR, a miracle unto itself but your bones are a no go.

If you're completely against a double fusion, I see two possibilities. You can try an osteoporosis drug for a year or so to build up bone density. You can also have surgery in Germany or other country where bone 'glue' is legal. I do doubt that your insurance company would pay for an out of country elective surgery but is worth investigating.

I realize these aren't the best solutions and you must decide for yourself which way to go, it's food for thought.

I wish you the best, Dale

BTW, what insurance do you have?

[fuzzy]

I was T -2 dexa when I had 2 level lumbar surgery. The surgeon was stunned that a 40yo male could have lousy bone like that. From what I was told the cut off in Germany is about -2. After that they suggest fusion. My surgeons comment was that my bone was "pretty soft". I ended up with 1 of 2 levels fused and the other was a close call but got a ADR. It worked out good and I am more flexible then I was for years before. I used to dance in ballroom competitions but had to give that up long ago due to these problems. Today I sometimes feel I could do it again but I think I am getting to old

[oldtimegrrl]

Well, we're going ahead with surgery next month. My surgeon said that he'll see how bad/soft my bone is when he opens me up. If it's hard enough, he'll go ahead with the ADR, but it's greater than a 50% chance that it'll be 2 level fusion. I'm happy with that - at least he didn't totally reject the possibility of ADR. I have 100% confidence in this doctor - he's very good, and very honest, and very experienced. I realize no one's perfect, but I know he'll use his best judgment.

He did say that he'd phone his "colleague in Germany" and discuss options with him, so that made me even more confident.

The big lesson that I've learned is how fast Osteoporosis can set in. He said it's surprising how fast we lose bone density with inactivity. Catch 22- my back hurts too much to exercise, but without exercise, my back's going to get even worse. So if there's anyone out there wondering if they should bother to get up & walk, since it doesn't seem to be doing any good, my message is: do it. Your bones need the exercise, even if it isn't helping your joints/discs.

Oh, and my insurance is Aetna. They apparently accept ADR as fairly standard treatment.

[fuzzy]

Good news about Aetna. I wish you the best for surgery. I hope it works out to your best. The comment about calling the german colleague is interesting.

Exercise for me has been oh so important to keep my bones from hurting even worse. It is true that exercise can reduce pain unless things are mechanically trully wrong. I would exercise pain away and than "bang" back to square one. After my lumbar surgery 2 years ago no more "bang" and my low back has been continuesly improving. I hope it stays that way.

Worst thing for me is bad posture in front of the computer...

[Maria]

Good luck with the surgery.. I had a fusion at L5S1 and ADR at L4 authorized by WC back in '06 but started feeling better even tho on same pain med regime for nearly 5 years at that point.

Thought I'd wait a bit because I wanted to see if we'd ever get an FDA approval re use of something to shore up the bone like Dr.Bertagnoli does as my BMD was -2.2 at that time.

Ok a year ago my BMD (lumbar) was -2.6 so I was started on injectable Forteo to build my BMD back up and then was told that I should be maintained on IV Reclast one time a year after the 24 mo. use of Forteo.

I've been on the Forteo 9 months now. My most recent lumbar xray showed that L5S1 had autofused (perhaps why I have less pain) and that I have facet degeneration at L4 as well as L5S1 (why the ADR wasn't going to be done at L5S1 and fusion was going to be).

I'm rooting for you and please let us know how things turn out!