spondylolisthesis of the L5
 

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Hello,
I'm new to this site.
I'm looking for any helpful info on spondylolisthesis of the L5/s1 grade 2 50% slip with nerve damage.
I was told by a ER doctor i have spondylolisthesis in 2008.
And that i was born with it.
started to show in 2003.
peaked in 2008.
Almost 3 months ago i got into the pain clinic.
I'm on pain meds and a prohibitor.
It helps but needs to be bumped up.
Had all the xrays done and had the MRI done two days ago.
I will see the pain doctor in july.
And the surgyen in august.
I want the surgery done.
I have been unemployed for over a year now.
And can't get back to work the way i am now.
I'm looking for any info on this.
Anyone that has this.
Anyone that had the surgury.
What problems i will face till i get this fixed.
Any ideas of finacial help as in to help pay for the surgery.
I'm 39 going on 40 and i have to get my life back.
I have two girls that need me and i can't pay support like this.
welfare is a no go.
As well as disability.
The only help i have right now is charity care from the hospital.
I live in PA.
Any help i will be very greatful.
thank you.

Are you unemployed due to the pain, or due to the economy?

You might also want to read or post on our other forums -
Social Security Disability-
http://neurotalk.psychcentral.com/forum28.html

Layoffs, Unemployment and Worker's Compensation-
http://neurotalk.psychcentral.com/forum30.html

I suppose you have already done web searches about Spondylolisthesis - but just in case you haven't here is a link for it -
http://www.google.com/search?q=spond...ient=firefox-a

Hi ~ I'm sorry you're having such problems. I know how awful the pain can be.

Surgery isn't always the answer. Surgery does not always relieve the pain -- many times you're left with the same pain or worse after surgery. Surgery ONLY corrects mechanical problems. it's no guarantee that your pain will be relieved.

Once you have spinal surgery, often you're never the same. You will have SOME limitations after surgery -- you have to protect the back from further injury. Also, there is the danger of the "domino" effect. many times the levels above/below the surgery site will fail -- causing you more pain & the need for further surgery. This is because those levels have to take on more of the "load." So make SURE you research the kind of surgery you expect to have, so you know all the dangers & risks. Plus make sure your surgeon has done alot of these surgeries -- and do a background check on him. You can check online if he's had any lawsuits against him, i.e. malpractice, etc.

I wish you the very best -- if you do have surgery, I pray that it works for you. Please keep us posted and let us know how you are doing. God bless & take care. Hugs, Lee :)

About Spondy
 

Hi Steve,
So here's the deal... I have a 2 year old little boy, who basically saved my life, forcing me to get up everyday, and out of bed to play with him or to feed him, or to change him, etc... while I was recovering. I went to HSS- Hospital for Special Surgery in NY. Since you live in PA- you are close enough to go and I HIGHLY reccomend you do,as it is the #1 hospital in the entire US for Orthapedic spine proceedures, and they have financial assistance as well, based on need. I had a double level fusion- L4/L5/S1 and the difference from my pain pre surgery to post surgery is like night and day. I am a world better than I was. I am functioning and I am beginning to get my life back. I still have nerve pain, but I am going for additional testing to determine the cause. I am off the opiates finally and now on high doses of Neurontin for the nerve pain.
What Leesa said is true about the "domino effect" as high usage of the vertabre above and/or below, depending on where your issues are. So you will have to be careful with what you do and how you move, each and every day. Its all about adapting. I hate to say it but, spondylolisthesis is a condition that in my opinion will require surgery. I exhausted all of the means of PT, Epidurals and pain meds before resorting to this. Bottom line- my vetabre were falling off of my spine, and non-surgical measures were simply not going to resolve it. I had no choice, and even through the pain and recovery SUCKED, (it does and it will for you...sorry) it was worth it.
Feel free to email me for any further questions you may have...Be well and good luck!!!!:-)

Hi Steve,

The pathogenises of a spondy is repleat in the literature so I won't bore you with it. Yes, you have most assuredly had this your whole life short of a (very) traumatic injury.

Conservative treatment is strongly recommended and for good reason. The surgery is huge and wickedly brutal with about a 1 year recovery and frankly, the patients that I polled felt no better or worse after the surgery, thought it was a failed waste and wouldn't do it again. Activity modification and avoiding known precipitating events are essential with a mix of various pain management procedures like interlaminer epidurals, selective nerve root blocks, facet blocks, medial-branch blocks and pelvic traction/exercises in PT. You can try accupuncture or chiropractic as everyone has different success stories and may have something to offer. There is no good answer but I think you have some things to work with. You can also get a special lumbar elastic support that has a sleeve for which a plastic thermaform plate is contoured to your body and inserted into the sleeve. That gives some a lot of relief.

As a surgeon told me, you only do a fusion on a spondy when the patient is in prolonged intractable pain, crawling on thier hands and knees for awhile, all conservative efforts have failed and they are ready to shoot someone!

Good luck!

You have received excellent advice. Although I have had eight spinal surgeries that were basicly for stablization, I was at the "on the hands and knees" stage before I had the surgeries. The less invassive treatment was very helpful for a while. You are young enough that you are considered a good investment. When talking with the doctors or anyone else relative to financial assistance, keep emphasizing your need to obtain restored function. That's what they want to hear. Best wishes.

Lumbar fusion
 

7 weeks ago I had a lumbar fusion with Cage done. I woke up without pain for the first time in years. I am still in aw that i feel so good.

I was in such pain for years before i finally went for this. I had a neurosurgeon do it. I was in the disability process for 5 years before i was approved and could get this surgery with insurance. I am so thankful i was able to have it done.

I am 47 will be 48 christmas and feel as tho i have a second chance at life.

Never give up, keep going until you find what you need and get it.

Was your surgery to reduce a spondylolisthesis?

yes i also had spinal stenosis and bulging disc. Alot of pressure was on my nerves. I couldnt walk a block without losing all feeling in my legs and feet. I fell often. It was really getting bad.

For me it was worth it. I have too much life to live to be in pain 24/7

11 years was too much anyway.

Sure hope you can get some relief.

Hello Steverenoe
 

I just came across your post. Sorry you are having so much pain. I had spond. in my cervial spine. I do agree with Leesa. Please make sure that you need the surgery, and get second and maybe even third opinion. My first neruo surgeon fused C6-7/ Six years later, my neck acted like dominos, and above and below the origional site failed. I had also reversed the curve of my spine. Was fused a year ago C3-7. I really didn't do my homework for the first fusion, I was too busy being in pain I guess. I had trouble right after the first surgery and didn't know that other areas of my spine were left with damage. I didn't read my records until I was embarking on my second fusion. I did get great results with my last fusion. I hope you do not have to go the surgial route unless it is absolutely necessary. I had no choice in eithor of mine. Please do get your MRI and do the research on what is said, and research your neurosurgeon as much as you can. I had a different second neurosurgeon because I had not been told all the truth about my condition. I do wish you all the best. I hope you find the right resolution so that you can again have good quality of life. I know you want to take care of your family. In any case, my surgery did turn out OK in the end, it can for you too. Just do all the homework. ginnie

I guess I'm confused. A spondylolisthesis is decompressive for the central canal as it actually creates more space that would significantly lessen potential effects of spinal stenosis and bulging disc. Due to the regional anatomy (Hoffman's ligaments, up/down phenomena of the IVF's, etc) the exiting nerve roots are actually at higher risk of involvment in a spondy so I guess I am confused that as to whether or not you surgically had a pedicle screw reduction of a pars defect (for the spondy) or simply a discectomy/fusion for the disc and stenosis?

Make sure you get a second and even a third opinion. If the nerve is being impinged on it will cause more damage. It needs to be free. If the doctors opinions are the same and your in alot of pain I would try to get surgery and get it stable. I say this because I've had 4 l5 s1 discectomies and another for lg chunks of disc imbeded in the nerve encassed in scare tissue. The last surgery I had there was no more disc left so I had a l5 s1 disc replacment. this made a world of difference. The nerves were being crushed and pain like that no medication could touch those levels, so this is why I say the nerve needs to be free whether it's bone fragments, disc material,spurs, alignment issues it needs to be off those nerves. I went to HSS in NYC great hospital very knowledgable surgeons and the staff is professional. They also have a great financial program. Just double check everything and bring a list of questions. I also took my father there due to a local hospital major mess up and the did a limb salvage surgery on him he is great like a miracle. Good luck and hang in there.

Not sure where to start a post so Being that your statement is very thorough, I thought I would post under yours. I have a good friend that has just turned 80! she has kyphosis bent over but not at upper back.. she is bent from well, like in the pike position, but not so much a 90* as more 130*. She was hit by a pick up while crossing the road some @20 yrs ago. She got up and walked away and took herself to the local ER, they said since she walked in on her own she was fine and sent her home!!! BAD MEDICINE THAT! oh well. anyhow shes dealt for years using water arobics to keep moving. SUDDENLY shes got severe sciatic pain down her right side, having incontinence issues and is at the point she is in tears in the AM and barely makes it out of bed. I saw a 7 yr old MRI and her L4 is slipped over L5.( i cant imagine what it is now) She was one that said NEVER to back surgery but now is so desperate for pain relief shes even got her bags packed at her door!! I have taken her to ONE neurosurgeon and hes sent her for Standing MRI only because she cant get up once she lays down for it. He did take an Xray in the office. She is 5'5" , aprox. 220lbs. has some kidney issues but not on dialysis. Doc , was not interested in surgery , offered steroid but shes scared of them due to side effects of swelling. I told her what is a bit of swelling over the pain ? so shes now telling me 2 wks later shes more than ready for the Steroid as shes in such pain. We already have a second doctor appt with another to get a second opinion and have seen online a Bonati spinal place that will give you a review of MRI as well. She had been moving around and all fine, so mechanically she wasnt having issues, im assuming <cough cough> that the vertebrae arepressing on nerves now. I read that this wont help pain? just mechanical function? So would this be a useless avenue to persue? I wish she wouldnt do anything due to her age but shes in so much pain shes telling me if a doctor gave her a 50/50 chance shed take it. shes done no blocks/ no stimulators/shes told me when i mentioned block that "oh no they could paralzye you". UH? surgery????? wondering what other options are there?

Back issues
 

Just a thought about surgery. if L4- is slipped over L-5, that may constitute a need for surgery. I never think surgery is good, unless the pain has become so severe, that quality of life is compromised. I had the same thing happen, C5- was slipped over C-6. The ones above that reversed the curve. I did have surgery, and it did turn out OK. My pain specialist said there comes a come when shots, blocks and intervention conservatively doesn't work anymore, and that is the time to investigate a surgical approach. An elder friend of mine had back surgery, and she was in her 80's also. Her surgery did OK for her and greatly reduced her pain. I hope everything turns out OK. ginnie

Thanks Ginnie, She has since changed her mind. She is taking the oral prednisone dose pack, although shes terrified with her kidneys being stage 2 impairment. Im thinking which outweighs which ? pain or risk of damage? She is awaiting a call to go in for a epidural in hopes of calming the nerve down. I really think shes looking at surgery. The doc is saying that since she lived with the slip for so long, that the ruptured disk is creating the problem. I hope she can get some decent time with reduced pain from the epidural. The pain is getting worse rapidly as she went from NO EPIDURAL to waiting by the phone for the call to do one!

Hi flahair
 

Hello, and I am sorry about that painful condition. I hope she is going to an actual pain specialist for the epidural. These injections sometimes really help, and at other times they do not. Each person is different. In my case I didn't get the relief and went for Katemine infusions. these did work for me for a period of about three weeks each of them. In my case however, the pain specialist was the person who told me, they just could not control my pain and he sent me to the best Neuro surgeon around, since old hardware and the curve of my spine had to be addressed as well. If her pain specialist ever comes to the point they cannot help. that certainly is a time to consider a surgical solution. I was on morphine on a high does, and the Katemine infusions stopped working. Also under the guide machine, he could see what was happening in my spine. I do wish her all the best. I hope you can find the solution, to lead to a better quality of life. Keep in touch, and let me know how it goes. ginnie