Need some advice regarding spinal surgery please
 

Although my own back is relatively OK, barring a fractured coccynx and a fractured sacrum (twice) recently, it's actually my husband who has the major back problems in our house.

Every disc he has in his lumbar spine is protruding, and some of them are actually dangerously squashed (on his last CT & MRI).

He's in so much agony that he screams out in his sleep every night!

Our GP said just last week that he was in danger of becoming paralized if he didn't have an operation soon. I have to assume she meant spinal fusion although she didn't say, but that scares me!

My husband has been actively refusing surgery for several years now because he's scared of what may happen........we've heard of far too many failure stories with spinal surgery.

He did see a neurosurgeon a while back and that Dr wasn't happen to operate on him, because of the extent of DH's spinal damage....now I think my worries are starting to compound.

We've moved to a brand new state so know non of the surgeons.

His pain is sometimes unbearable......how does one decide?:confused:

Sounds as if he may have stenosis - if the cord is being compressed.

The way I'd determine is by obtaining the names of more than one surgeon, doing a consult with each, checking the docs' standing with the AMA or with governing agencies or boards for each doc's profession/area of specialization, keying the names via, i.e., Google, and asking around once the potentials have been narrowed.

:hug:

P.S.: I'd lean more toward a surgeon who also details potential risks, along with benefits, and who does not come across as "put off" by questions and follow-ups. After-care is as important as the pre-op; if a surgeon hasn't the time prior to surgery or acts as if patients are an imposition, that type of demeanor just doesn't sit well with me.

just do it
 

I have surgery of my own coming up (2 level fusion L4-S1) for injuries sustained in a car accident. One of the deciding factors for the Docs was 1) my age and state of current health ( I am a 39 yo Police Officer), and 2) I dont smoke. The Docs said that they would not opperate on me if I was overweight or smoked; apparently smoking causes restrictions in blood flow and puts a big damper on healing. Although my pain is bearable from most days to most days; the impact on my life is not. I have 2 toddlers who want more and more attention, I cannot enjoy the outdoor activities I once did (I am a Ski Instructor, and have not been on the slopes in 3 years). After much conversation with my family and Docs, it was decided that narcotics and Gin was a bad way to deal with pain, and why sacrifice the next 10 years of my life to wait for surgery. Convince your husband that we never know what tomorrow will bring, and does he really want to go on knowing that things could have been better. And remember, the internet is a great place for advise, but you are going to get the extremes. Rather than use the internet 'nightmare stories' as fodder for not having surgery, talk to family, friends, and coworkers who have actually had surgery. To a person, all of the people I know that have had surgery said the same thing, "I cant believe I waited so long, I wish I had the last 10 years back." Keep you rhead up, and best of luck,
Mike

The first post in the following thread may be of some use:

http://neurotalk.psychcentral.com/thread171.html


Links to material that you might want to look over:

Neurosurgeon or Orthopedic Surgeon? Does it Matter?
http://www.spineuniverse.com/display...ticle2471.html

How to Select a Spine Surgeon
http://www.spineuniverse.com/display...ticle2462.html

Guidelines for evaluating a spine surgeon
http://www.spine-health.com/Treatmen...e-Surgeon.html

Red Flags from a spine surgeon
http://www.spine-health.com/Treatmen...e-Surgeon.html

An update on hubby's back.
 

Please forgive me Bobbi for not thanking you properly for giving me those fabulous links, but it was about then that things in our house started to go downhill. We had illness and two deaths (my brother's and a close friend's) to preoccupy us, and I always meant to get back to you, and hadn't.

My husband's back pain seems to have gone from bad to worse over these past few weeks and our local doctor finally referred him to a neurologist. Somehow he got an urgent appointment, and only had to wait a week to see the neuro, and yesterday was the day.

He did nerve conduction studies, including an Electro-myelogram one where DH was wanting to call him every name under the sun for sticking him with those nasty needles.......and it seems that he wants DH to have a spinal fusion post haste!

Here comes MY problem! DH has decided now that the neuro is a quack (he's the same one I see for MS and I don't think that), and that there's no way he'll have spinal surgery. I'm half convinced that if the Neuro hadn't stuck those needles into him without any warning or explanation at all, he may have been more open to listening to the pros and cons of this surgery.

The neuro said that surgery is indicated and that it should be soon. Now I'll be worrying myself sick incase the nerve involvement increases and he's left with permanent spinal nerve damage.

He could seek another opinion; I would. He's not comfortable with what the neuro. stated, so, what's the harm in attaining another specialist's take on everything?

If he does go for another consult, he might want to ask, when the appointment is being scheduled, whether there will be any tests (done or results from earlier testing needed.

I'm sorry about the losses you've recently felt. :hug:

Thanks Bobbi. There's a Spinal Specialist in town, and he's agreed to go see him. I'll wait now and see what that one has to say, and how DH feels about the possibility of surgery if it comes from that doc as well.

If it was/were me? I'd go to the appointment with an open mind. Possibly, your hubby might discover some things/info. he hadn't known previously :cool:.

I hope that his appt. is a productive one - for him.

Hi Koala, sorry for your losses. Before surgery your husband should get a discogram. That will tell the doctors for sure which disks are truly causing the most pain.

I had a fusion of L5 S1 last year and it took care of the problem. I did not have them go through the back. They went through the front. Not an easy recovery, but less chance of them cutting nerves to my legs.

Good luck.

Thank you Starfish.

He saw the neurologist 3 weeks ago but we don't have a neurosurgeon here where we live, so DH has been referred onto a spinal surgeon. Unfortunately the first appointment he can get is not until October, so he has to bide his time in terrible pain until then.

He's been started on a new patch for his pain which is doing zilch, and Sodium Valproate (eplipsy drug) and that one has helped a little.

I'll post again when we know more.

You don't need a neurosurgeon to do the discogram. An orhtopedic surgeon can order it. My orhto had a physiatrist ( MD) do the discogram at the hospital. It does not take long at all.

I had an orthopedic surgeon and a neurosurgeon for my surgery, plus a vascular surgeon. I never even met the neurosurgeon. He just did surgery in concert with my orthopedic sureon who specializes in spine surgery.

Call the office once in a while in the mornings. Once in a blue moon they have a cancellation. It took 6 weeks after my appt. with the spinal surgeon to have surgery.

For pain try a pain mgmt doctor, perhaps someone the neurosurgeon's office suggests. I had 3 epidurals to help ct the pain.

I was on percocets at first. They make you sleepy. 2 at a time was not covering the pain the last 2 weeks b/f surgery, but I refused to take more. After surgery you are on a morphine pump. Shots for pain are way more painful. After surgery I was put on dilaudin which is less sedating.

Now once in a blue moon I take a 1/4 of a pain pill if I forget and bend a little more than I should. Such an improvement!! No shooting nerve pain, no limping!! Yahoo!

(I did get in a month earlier to see my surgeon because someone cancelled.)

Thank you Starfish for replying.

It is the Ortho consult that DH is waiting on, but so far there are no appointments before October. He said he'd do what you said about ringing for cancellations though, because even he agrees that October is far too long to wait when he's in so much pain.

Thank you again, it's so kind of you to take an interest.

I had a 3 level fusion recommended and I actually improved enough from conservative care that I did not have the fusion.

I can give you some thought about my situation, maybe it will help, I don't know since I don't know the details of your husband's case and obviously I am not a doctor.

I had quite large herniations. The surgeons seemed in general to think you could wait on a decision to have surgery if the main symptoms was pain. If there is significant nerve compression to your spinal cord or the nerves to your limbs, then waiting a long time to have surgery is not a good idea. If the nerves are compressed more than a year or so, then they tend not to recover as well if at all after surgery. If you are waiting on a surgery decision, it can be good to get epidural steroid injections as that removes some of the irritating chemicals that can damage the vascular supply to the nerves and the injection can help his pain levels.

If he has a big enough herniation, the herniation can sometimes reach an area where it get to substances in the body that can dissolve it. You still have pain because the disk is still damaged but it can be much less because the nerve compression gets better. Sometimes the disk itself still hurts as much as the nerve compression, sometimes it hurts less. A diskogram can help tell if it's the disk itself causing pain. In my case the disk herniation pressure on the spinal cord was much more painful than the disk pain itself. They can not tell in advance if the disk herniation will dissolve.

The herniations did dissolve in my case and I had compression both to the spinal cord and in the nerves to my leg. I still have pain and cannot do as much as I did before but most of the time the pain is manageable if I do not overdo it.

I worked very hard on strengthening the muscles supporting my spine and I still get steroid injections every few months into my spine. Both make quite a difference in my pain. The strengthening took me a couple years before I really notice a big improvement in my pain but I was unusually weak since it took them years to diagnosis the problem.

One rule of thumb I got for a spine surgeon was that if you are improving 10% per month, then continuing to try conservative care is a good idea (as long as there no compression likely to cause nerve damage.)

Neither conservative care or surgery will get you back to where you were before the spinal problem if the spine problem is bad enough but in my case I did get about as much pain relief from conservative care as the surgeon said I could expect from the surgery.

Hi Kola, it must be noted that if a spinal problem is progessivily getting worse it is caused by doing or not doing something. Herneated disks heal if treated properly in spite of what the mainstream medical community will tell you.

I wish you and your family the best of luck
,Mike

Thank you so much Mike. My hubby is finally getting some pain relief now, and although inadequate, he's at least in less pain than he was before.

His appointment with the Spinal Specialist isn't until October, but as this year is speeding by, the day will be here before we know it.

Thank you again for taking the time to reply. I appreciate your thoughtfulness.

quick update on me...
 

I had my fusion surgery about 5 weeks ago. The first 48 hours were a bear; but I was walking the next day, home in two; off ALL meds in two weeks. I walk with no braces or crutches and go to physical therapy (pool) 3 times a week. The pain I had before surgery is gone; completely!! I do have 'recuperative" pain which is managable with Tylenol. My Docs. have said that I am ahead of schedule, but that this is marathon and not a sprint. I still wont be back at work anytime soon and my range of motion is somewhat limited (I am not suposed to bend at the waist) I am honestly amazed at how good I feel knowing how invasive this surgery was (it took 7 hours).. Anyone with fears of surgery, find a good Doctor, trust them, and get on with youyr life; I cant believe I waited 3 years!!!

my dad has DDD, stenosis & arthritis no herniation's though- he was gradually beginning to hurt more and more after being fairly stable for awhile - goes to the PT place 2-3x a week and can use the equipment to continue with self care therapy per the PT plan that was made for him.
Has TENS for use at home too.

surgery was being considered - dad wasn't ready to do that yet... then the dr suggested a re evaluation by the PT and that seems to be really making a difference for him.

I was wondering if the drs have rx'd any PT {for pain relief at the very least} or even a TENS - these are simple things but may help to make him a more comfortable until the appt in Oct.

Thank you Mike for that update, and I'm so pleased that you finally got relief. I do hope my DH doesn't end up having to have surgery, but at least it's good to know that if it is necessary, there are success stories out there.

Thank you also Jo55. DH has done the physio thing over and over, but each time it only made his pain worse. He even tried hydrotherapy but the chlorine level in the pool was so high that he know has a rather nasty allergic dermatitis to deal with as well. He just can't seem to take a trick!

He has tried the TENS machine and he did get some limited pain relief, but even that was short lived. He would try anything ever thought of, not to have surgery of any type but he's running ut of options.

Because of the severe chlorine induced dermatitis from the heated pool, he can't have any heat therapy to his back, as that only breaks down his skin all over again.

He's tried ice, but that didn't work, and at present he's trying magnets. He does say that the pain has eased quite a lot since he started wearing a belt that has been studded with magnets, across the most painful areas of his back. Seeing the magnets are actually helping I thought I'd buy an underlay for our bed and see how he goes with that.

He also has started a new analgesic patch (Toredol) and that combined with Epilum (for the nerve pain) he is at least getting some pain relief, where he had none before.