spineally challenged Charite III, L5/S1 , L4/3 November 2003

[Tim]

2 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):Not a great year! Of the preceding 12 months 6 have been spent pretty much housebound. In the other 6 months I've been able to walk but not much else. I'm still considering further surgery either fusion or additional ADR at the 4/5 but am currently pursuing less invasive avenues to determine what if any role the facets are playing in all this. Trying to stay positive..

3 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):Again not a great year. In the main I’ve managed to keep walking throughout the year but still have great problems standing, sitting or doing anything even remotely physical. I have had periods when things have been easier but these are so easily ended and often short lived. I had facet injections at all 3 levels almost a year ago and these made no difference to my condition either positive or negative. The remaining L4/5 remains the likely culprit. I remain cautious of further surgery but haven’t ruled it out. Cost and the risks of repeat surgery remain as huge real deterrents from moving forward.
I am unfortunately still worse off following surgery.

4 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]):

5 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): Pretty much the same as at 3 years. Again I’ve managed to keep walking throughout the year – usually only one walk a day at a slow pace. On better days I sometimes manage a short second walk. The rest of most days is spent lying down with short breaks to potter around the garden or house. I still have great problems standing, sitting or doing anything even remotely physical. Driving is limited to 20 minutes (30 minutes on a good day) so travel is limited. I still have periods when things are easier but these are too easily ended and often short lived – Catch 22 really; you feel a bit easier do a bit more and end up feeling bad again. This cycle repeats over and over…
I’ve now had several offers of surgery at the remaining L4/5 but remain hesitant. I had a repeat discography at L4/5 in the Autumn but sadly the results were inconclusive – the disc is so shot that it couldn’t hold any pressure. The doctor who did it still feels that such a badly degenerate disc is the most likely suspect but only offered me odds of a 50% chance of making me 60% better! He wanted to use a minimally invasive MAST TLIF approach with BMP which I must admit is more attractive than the open alternative. I’ve also researched the XLIF approach but this is pretty new in the UK and I don’t really want to be part of a surgeons learning curve.
One of my major worries is the lack of a definitive diagnosis. I worry that some or all of my problem might be coming from the ADR L5/S1 level – certainly the bilateral leg pain I suffer from follows a typical L5/S1 dermatome. As yet no surgeon has suggested revising the L5/S1 ADR level but I wonder if they’re blinded by the obviously degenerate L4/5. Perhaps I need to ask more questions about the L5/S1 – maybe there are more tests that could help to rule this level out..?
Basically I still can’t rule out further surgery but would love to have a more definitive diagnosis before committing..