L5-S1 ADR Revision...subsidence; Germany

[dshobbies]

Jamie,

We do care. And though I had a successful surgery with Dr. B and think very highly of him, I too have read his follow-ups with unsuccessful surgeries are wanting.

You mentioned Dr. Regan, some good and not so good. Though I think his people skills could improve, from what I've heard, his hands are quite skilled and he has more revision experience than most others. If nothing else, it would be worth a consultation for his opinion.

Also, though not medically savvy like others on the forums, I have to wonder, did I read correctly that Dr. Blumenthal at TBI suggests fusing a perfectly healthy disc on top of your 3 level? This does not sound right. If it ain't broke, don't fix it - but instead concentrate of the disc(s) that are causing your pain.

And if you have no pain in walking, I'd keep it up. Just for the telling, after 4 years I still have problems with sitting for longer periods of time. If a chair fits, I'm usually OK, if not, like a movie theater, I have trouble after just a few minutes. What makes it fit or not, damned if I know. Just letting you know that even if some revision is successful, your 100% may very well have a different meaning. Having said that, living a pain free life should be SOP, not a luxury. Do what you feel is best but get a lot of opinions before deciding.

Dale

[jamie5136]

See comments below:

Originally Posted by dshobbies

jamie,

we do care. And though i had a successful surgery with dr. B and think very highly of him, i too have read his follow-ups with unsuccessful surgeries are wanting. I get emails daily from unsuccessful patients of dr. B. He overlooked my subsidence and then wants to charge me quite a bit of money for the dss. I fell through the cracks and my x-rays were ignored until mark mintzer said, "jamie, you have subsidence!" otherwise, i was just told over and over, "you are fine and all is in alignment." well, it was not.

You mentioned dr. Regan, some good and not so good. Though i think his people skills could improve, from what i've heard, his hands are quite skilled and he has more revision experience than most others. If nothing else, it would be worth a consultation for his opinion. I am going to do that this week. Waiting on an x-ray from tbi. Takes seven days to just make a copy.

Also, though not medically savvy like others on the forums, i have to wonder, did i read correctly that dr. Blumenthal at tbi suggests fusing a perfectly healthy disc on top of your 3 level? Yes, he does. This does not sound right. Well, l34 had some subsidence, but was caught with cement, but still subsided, so this is why he wants to do all three. If it ain't broke, don't fix it - but instead concentrate of the disc(s) that are causing your pain. I agree and he will do just l5s1, but the group at tbi all said fuse all three. I guess they don't want a fusion, an adr and then another fusion.. Odd combo i guess. They also don't do dss at tbi, but pettine does, but i hear mixed reviews on him and dr. Spivak said dss is okay, but bulky and no so necessary. He said for what i need, a regular fusion is fine. I am just afraid that once it is fused, i can never get it out if needed.


And if you have no pain in walking, i'd keep it up. I am afraid i will hurt my back and now my legs feel heavy and i have sciatica, which i never had post surgery. This tells me the disc is subsiding more.


Just for the telling, after 4 years i still have problems with sitting for longer periods of time. If a chair fits, i'm usually ok, if not, like a movie theater, i have trouble after just a few minutes. What makes it fit or not, damned if i know. Just letting you know that even if some revision is successful, your 100% may very well have a different meaning. Having said that, living a pain free life should be sop, not a luxury. Do what you feel is best but get a lot of opinions before deciding. I am trying. It is costly and time consuming and the doctors are all so busy. It is sad, but when dr. B wanted my money, i got all types of attention; now that i am a failed case, much less attention.

Dale

[Maria]

Since I have no hardware but I do have a disrupted L3, previous discectomy on L4 and L5S1. L4 is still bulging and when L5S1 was as well I had a great deal of pain with sitting.. really horrible in fact.

Then about '05ish to '06 I noticed a change with regard to being able to walk much more and much less pain albeit using low dose pain medication, gabapentin and ESIs tho all same treatment for about 5 years ~ just less pain and more mobility.

Still sitting always flared everything up and made me miserable until about a year ago. L5S1 supposedly has autofused as I probably mentioned (original injury 20 plus years ago).

If this autofusion has created a lack of motion at this segment it has definately helped alleviate pain w/sitting. I still cannot sit long long periods however at least I can sit again w/o having to go thru all kinds of extremes to try and sit and have a cup of tea, coffee or a meal out with people (or even by myself).

So I still have problems at the other 2 levels tho the one that seems to have been the most problematic was dealt with even if on it's own and the relief has actually been significant.

I keep wishing that L4 might autofuse anyday now by itself...

I'm really interested to hear what the consultations will yield in terms of opinions/recommendations and what you'll be thinking with regard to these consultations.

I'd try to keep up the walking just to keep the rest of your body going strong.

[beka]

Hi there

I'm new to this particular board, but certainly not so to back pain and associated surgeries/procedures.

My worst pain is also upon sitting and it is just so frustrating and depressing. I don't know that mine has the intensity of yours, but when you struggle to ride in a car etc it limits your life so much. I do not work, and certainly could not manage out of home work. My sitting limit is about 20 - 30 mins, then I struggle to bear it.

What I really wanted to say though, is, has the suggestion been made that it is the vertebrae themselves hurting so much by having the ADR press in so hard when you sit?

The reason I suggest this is because, before my first fusion, I had complete degeneration of the disc at one level, and due to the vertebrae rubbing back and forth across one another, I had developed swelling in the vertabrae, known as Modic changes. This was extremely painful.

Additionally, when a bone is fractured, it is painful. Anyone who's had bone grafted from their hip for use in spinal fusion knows at times it can hurt worse than the fusion itself.

Bone hurts. Just my opinion but I'd be getting that thing out and going for a fusion if it ends up being deemed necessary.

Wishing you the best.

[jamie5136]

I had sitting pain before and now the three level ADR has made it worse, so something is pressing on something.... I just had another opinion on what to do. I will type it below. I want to see what people have to say. I have had so many opinons varying from posterior fusion at all three lower levels to DSS to this... all so confusing.

Okay, I have one more opinion, but still no focus on my sitting/laying pain. Dr. Scott Leary from California said to do an extraction of the sunken L5S1 level and then fuse. He must do this by going through my stomach and my back. He said a complete fusion cannot happen with just a posterior fusion. This does make sense, I suppose with the way the disc has subsided, plus why did it subside in the first place. Maybe I have some type of early bone condition that cannot be detected during surgery or on a bone density. Dr. Leary is young and has done a couple dozen extractions, but not of a Pro-Disc...this is scary!

I have been told that if a doctor does not know how to remove or is scared, then they will say, "keep it in." If they are removal guys, then they will want to remove it. Much like if you take your car to a muffler place when you are having a problem, magically, it is the muffler.


I have heard such horror stories with extraction and I could be left in a worse place than I am now. Now I can dance around, shop, hike, etc. I have leg pain now, 10 months after the 3-level ADR, but my MAIN issue is that I can't sit down... or lay down w/out having pain in the lowest part of the back that "feels" like tailbone pain... I have buttocks pain and NOW leg pain, which I did not have before, so something is changing in my back.

So, extraction and a fusion could make me worse with the dangers of not fusing or with some ventral issues.

So, I am now thouroughly confused! I could have a posterior fusion at L5S1 and "see" what happens and then do an anterior approach, but I heard this is much harder trying to do it after the fact. Although, this is what Dr. Bertagnoli suggested... he said try posterior first and then anterior. He did not say anterior and remove.



GOD, I WOULD RATHER BE HIKING, SHOPPING,.... ANYTHING NOW BUT FOCUS ON THIS!!!!



Any ideas?

Originally Posted by beka

Hi there

I'm new to this particular board, but certainly not so to back pain and associated surgeries/procedures.

My worst pain is also upon sitting and it is just so frustrating and depressing. I don't know that mine has the intensity of yours, but when you struggle to ride in a car etc it limits your life so much. I do not work, and certainly could not manage out of home work. My sitting limit is about 20 - 30 mins, then I struggle to bear it.

What I really wanted to say though, is, has the suggestion been made that it is the vertebrae themselves hurting so much by having the ADR press in so hard when you sit?

The reason I suggest this is because, before my first fusion, I had complete degeneration of the disc at one level, and due to the vertebrae rubbing back and forth across one another, I had developed swelling in the vertabrae, known as Modic changes. This was extremely painful.

Additionally, when a bone is fractured, it is painful. Anyone who's had bone grafted from their hip for use in spinal fusion knows at times it can hurt worse than the fusion itself.

Bone hurts. Just my opinion but I'd be getting that thing out and going for a fusion if it ends up being deemed necessary.

Wishing you the best.

[james]

I haven't been able to sit since 2006. I gave up my PhD after 4 years because of that. I was able to stand up and work, but now I have burning sensation on my sole feet and cannot stand up more tan 5-6 minutes. I hurt my knees in physical therapy, which makes standing even more difficult.

I lay down on my bed or coach most of the day. I have started mild exercise since few months ago.

When I sit, the back of me legs start burning like hell.

[dshobbies]

Hi James and welcome to the forum,

We know nothing about your circumstances. Why don't you start a new thread and tell us about what's going on. Five years of no sitting sounds like too long to do nothing.

Dale