2 back surgeries in 3 years, now Fusion? :( MRI pics

[lovbyts]

OK here are the details first, Ill make is short and sweet.
I suffered for yeas with L3 & L4 herniation from 1985 until I could not walk or stand more than 15 minutes and had quite a bit of sciatic nerve pain. I had surgery in 2006 and it was GREAT, almost 100% pain free by 2007 and then ruptured L5 November 2007 worst pain I had ever been in. Basically paralyzed, couldn't walk, sit or stand for more than 1 minute. MRI showed disk was ruptured and pressing on sciatic nerves. Surgery relieved 80% but it still feels weak and even with a LOT of light work I have a pain but nothing crippling anymore and nothing unbearable most of the time but it does make it hard to get out of bed in the mornings and I fell like I'm 80 most of the time so it slows me down a lot.

Went and had an MRI last week due to ongoing pain and numbness. My butt is numb like I got kicked in the ass a week ago by a horse. My feet are numb from my little toes around the outside of my feet to my heel. This has not gotten better in about 5 months.

My MRI shows I still/again have a couple budging disks. My doc is suggesting fusion of at least one of them due to most of the disk is gone (L5-S1) and it looks like it is pressing on the nerves again/still. He said I probably have some scaring in there causing problems also.

We talked about other options like replacement but he is not a fan of that, he says after 2-3 years most people feel the same as fusion, no gain in mobility and there are more cases of failures, rejection or other complications and I am to young since they dont last a lifetime.

OK I have a couple MRI pictures I can put up and will find the cut views soon to put up also.

I put up one picture of my pre surgery MRI 2007 and the other 3 are from last week.

[yannick35]

How did you injure yourself Lovbyts? I check the link you posted and they look very good that OP-1 protein.

[Kratos]

How did you injure yourself Lovbyts? I check the link you posted and they look very good that OP-1 protein.

OP-1 aka bmp-7 is some sweet stuff, but insurance doesn't pay and almost no doc will put it in the spine unless it's a revision at this time. There is a competing protien from medtronic...BMP-2. The main difference being the carrier. OP-1 is a putty where BMP-2 is a liquid reconstituted on a collegen sponge.

They both work, BMP-2 only has clearence by the FDA for Anterior lumbar fusion in treaded fusion cages. Docs are throwing the stuff everywhere they feel like, even at 4 thousand bucks. The only place it's caused problems is in the cervical spine, causes trouble swallowing (dysphasia). Cool stuff, only been out a few years, keeps docs from taking bone from the crest. Clinical evidence is not there the way it's being used...it seems to work though.

[Kratos]

yeah, tough to call with no axial cuts from the mri, but looks like you need a 2 level fusion. You've got almost no disc height at 5-1, 4-5 looks dark and not good. You need a 360 degree fusion and depending on the doc they'll do a PLIF, TLIF, or ALIF. Basicially they need to jack your disc space back up and stuff a cage in there to restore height. If the surgeon wants to do a ALIF which may be a good option ask him about the possibility of using percutanious screws in the posterior rather than doing an open posterior lateral fusion.

The theoretical advantage to disc replacement is to spare additional levels from added stress and future breakdown. Even though the disc replacement doesn't last forever it lasts a very long time. The Charite' disc has been going in for 10 years in Europe and people are still doing very well and wear is usually dependant on placement of the disc ie the only ones showing any wear were put in off the midline so the forces are all messed up to begin with. The first one was put in like 18 years ago and still going strong. Revision is usually to leave it in and put screws in from behind anyway. With possible 2 level problem you might want to talk to your doc about the possiblity of doing a hybrid construct with an ALIF at 5-1 and a disc and 4-5 to spare stress on 3-4. Just a thought...let me know if you have any questions.

[yannick35]

There is a company here called genacol that produces a collagen supplement containing 4 matrix complexe.

Many studies have been done and i have spoken to many people who use that supplement, they all say its a miracle supplement, some of them got ride of there back pain, others arthritis pain and its even good for fibromylagia.

I have been taking it for 3 months now but they say to start feeling something you have to take it at least 6 months.

Apparently its good for rebuilding and strenghtening the interverbebral disk, also the study i posted on glucosamine and the 56 year old men taking the supplement for 2 years who has DDD.

http://www.pubmedcentral.nih.gov/art...i?artid=165439

Here is the complex i am taking right now

http://www.bodybuilding.com/store/univ/flex.html

Along with EFA

http://www.bodybuilding.com/store/univ/animal*****.html

[lovbyts]

yeah, tough to call with no axial cuts from the mri, but looks like you need a 2 level fusion. You've got almost no disc height at 5-1, 4-5 looks dark and not good. You need a 360 degree fusion and depending on the doc they'll do a PLIF, TLIF, or ALIF. Basicially they need to jack your disc space back up and stuff a cage in there to restore height. If the surgeon wants to do a ALIF which may be a good option ask him about the possibility of using percutanious screws in the posterior rather than doing an open posterior lateral fusion.

Thank for all the information Kratos, this is what my doctor has planned if I understand him right, we will talk more. BTW his name is Mark Remington http://www.valleyorthopedicassociate...t/view/79/138/
PLEASE if you have any more suggestions feel free to suggest away.

I will try to add some of the other pictures but I'm having trouble figuring out what one is what. LOL

[lovbyts]

How I got hurt, Originaly was due to carrying drywall, 240 lbs by myself when I was 22 or 23 I wall maybe 160 lbs, 5' 8" carry 2 4x12 sheets of 5/8 through mud and on a windy day. Wind caught it, twisted and POP OUCH!!! Never the same after that. I'm sure the rest is from years of 4 wheeling/crashing, skiing/crashing, jet skiing/wave jumping and other spine crushing activities.

Yes my last one was not due to the inversion table, it was ready to go and had been hurting for about 2 weeks due to a LOT of activities in Thailand that where quite back stressful but worth it.

[yannick35]

How I got hurt, Originaly was due to carrying drywall, 240 lbs by myself when I was 22 or 23 I wall maybe 160 lbs, 5' 8" carry 2 4x12 sheets of 5/8 through mud and on a windy day. Wind caught it, twisted and POP OUCH!!! Never the same after that. I'm sure the rest is from years of 4 wheeling/crashing, skiing/crashing, jet skiing/wave jumping and other spine crushing activities.

Yes my last one was not due to the inversion table, it was ready to go and had been hurting for about 2 weeks due to a LOT of activities in Thailand that where quite back stressful but worth it.

A friend of mine got a lot of DDD in is spine and arthritis has well doing the same thing has you lifting tones of heavy stuff on is job.

He showed me is X rays scary stuff, almost no more disk between the vertebrae, he doesnt work anymore because of the pain and gets cortisol shots a few times a year.

[lovbyts]

I have been reading a LOT on disk Fusion. It seems there are a lot of success stories luckily and sounds like most of the complications are due to inactivity.
I'm not sure yet what I am going to do. The pain is manageable but I am getting tired of taking Vicodine or some type of pain killer almost daily for many years. I have gone a week or maybe 2 without any pain meds but that is about it.

I also added a few more MRI photos if they are helpful to anyone.

[Ronnie Rowland]

I have been reading a LOT on disk Fusion. It seems there are a lot of success stories luckily and sounds like most of the complications are due to inactivity.
I'm not sure yet what I am going to do. The pain is manageable but I am getting tired of taking Vicodine or some type of pain killer almost daily for many years. I have gone a week or maybe 2 without any pain meds but that is about it.

I also added a few more MRI photos if they are helpful to anyone.

I hate this for you. I've been there and it sucks!

Theres a good chance you will still have to use vicodin post fusion. The bad thing about fusions is the high rate of non-unions. Have them take bone from your hip not the bone bank. Theres always a possibility your body will reject someone elses bone.

It will take about a year for the fusion to fully mend and the disk above and below the fusion will be weaker. I would try artificial disks before doing a fusion. Use fusion as a last resort. Also, you will be limited on exercises you can perform.

[lovbyts]

Well I'm going to hold off a long as possible, keep working the core and see how long I can tolerate the pain. It's not disabling or anything now, just very annoying and also limits what I can do or at least how fast I can do it, I move like I'm 90 sometimes.
Also I have been on and off vicoden (taken as needed) for YEARS. Yes it's hard on the system but I manage to go a couple weeks without sometimes and then always split it up to 1/2 at a time and not more than 1 a day unless things get BAD.

Yeah I know about rejection, I have a donor lens in my right eye I have to take drops for so it will not reject. 6 years so far so good

[Ronnie Rowland]

Well I'm going to hold off a long as possible, keep working the core and see how long I can tolerate the pain. It's not disabling or anything now, just very annoying and also limits what I can do or at least how fast I can do it, I move like I'm 90 sometimes.
Also I have been on and off vicoden (taken as needed) for YEARS. Yes it's hard on the system but I manage to go a couple weeks without sometimes and then always split it up to 1/2 at a time and not more than 1 a day unless things get BAD.

Yeah I know about rejection, I have a donor lens in my right eye I have to take drops for so it will not reject. 6 years so far so good

Hang in there. They are working on new surgical techniques all the time. They just approved a new implant devise for spinal stenosis. Advil works well with vicodin when the pain runs down the leg.

[DSM4Life]

Is that 3rd pic your junk ?

[lovbyts]

For me Advil does NOTHING but I will try it with the Vicodin. Most of the time if I have any leg pain/numbness it is due tot he sciatic nerve and the ONLY thing that helps is Prednisone.

3rd pic my junk? NO I dont think so. LOL, that is just the exploded top view of my disk.

[DSM4Life]

[tcw]

what kind of surgery did you have?

[lovbyts]

My surgery was just a simple herniation repair where they go in and remove all the little pieces that are floating around due to rupture like the ones that where putting pressure on both sciatic nerves and clean up the herniation by cutting out the bulge but obviously it is bulging again/more.