trying to avoid ADR and lumbar fusion!
 

Hi
I am a new member here and am desperately hoping for some feedback. I am a little suspicious and anxious that after managing back pain for nearly 7 yrs reasonably ok, nerve compression (foraminal stenosis l5/S1) is getting the better of me. My MRI reads like this:

loss of disc space L5/S1
disc dessication (minor) T12/L1
schmorls's node T12 (inferior endplate)
schmorl's nodes L1/L2 superior endplate
L4/L5 broad based annular disc bulge
left paracentral protusion midly deforms thecal sac
mild degenerative changes right side facet joint L4/L5
L5/S1 broad based osteophyte (more left sided)
mild facet joint degeneration
thickening of ligamentum flavum/left foraminal narrowing
L5 nerve contacted posteriorly and disc osteophyte anter inferiorly
mild narrowing right side foraminal zone, effacement of fat surrounding exiting right side nerve but not compressed

it seems a lot is going on, but I am guessing I could rule more than half of it out as normal wear and tear and easily manageable, would I be correct in guessing this?

My neuro wants to do ADR and fusion and says upper discs may also need adr in 5-7yrs

I would love to know if I can get away with just a laminectomy or (options?) to relieve the nerve so I can get back on my feet and just 'deal' with the rest through non invasive methods like P/T, posture, etc

I am going for a second opinion with a ortho surgeon but I am afraid that as these guys are all surgery based, surgery is what they will suggest. My P/T will not touch me anymore, 5 mths of osteo treatments did not work and i have had 2 yrs of pilates, yoga walking swimming etc which put me into worse pain and needing constant (weekly) treatment sessions! interestingly the pilates was the worst to induce pain and inflammation. I suspect the T12/L1 is the 'root'cause of my back pain and no one has suggested this? can anyone explain the normal from the abnormal and the what needs to be addressed and how (surgery/non surgery type treatments needed) I would dearly love to have someone who can read these results from a lay persons point of view!!
PLEASE HELP, I am a 38yr old mum of 4 young children who need me and I cannot stay on my feet to meet their needs, back surgery seems to promote more back pain and does not always seem to be the right answer.

Thankyou

Michelle

Welcome to Neurotalk--
 

--though sorry for the situation that brought you here.

Just casually looking through what you wrote, you do seem to have a pretty good grasp of the situation to me. I don't see anything in your report that screams "fusion now", and getting a second, or even third, opinion is a good idea. Much of what your reported is fairly common with aging and normal wear and tear, especially if you have an active or athletic history. On the other hand, only you know how much pain/discomfort you are in, and it is true that imaging studies, MRI or otherwise, do not always correlate exactly with symptoms--what looks mild and "normal for aging" there may be producing symptoms that seem out of proportion.

A laminectomy, or even a foraminotomy at that L5 level, may be a more appropriate procedure, but you do really need another opinion and maybe another high-tesla/high resolution MRI to gauge what's going on there at this moment.

I also would like to recommend you post in our Spinal forum to tap the expertise of that batch of people:

http://neurotalk.psychcentral.com/forum22.html

Welcome to NeuroTalk, SS.

Back pain stinks! Being Mom to 4 children, you need to be able to move and lift.

Sorry I can't offer any helpful advice. But I do hope you'll figure out what is the best option for you.

Let us know what you decide, k? :hug:

[QUOTE=glenntaj;658949]--though sorry for the situation that brought you here.

Just casually looking through what you wrote, you do seem to have a pretty good grasp of the situation to me. I don't see anything in your report that screams "fusion now", and getting a second, or even third, opinion is a good idea. Much of what your reported is fairly common with aging and normal wear and tear, especially if you have an active or athletic history. On the other hand, only you know how much pain/discomfort you are in, and it is true that imaging studies, MRI or otherwise, do not always correlate exactly with symptoms--what looks mild and "normal for aging" there may be producing symptoms that seem out of proportion.

A laminectomy, or even a foraminotomy at that L5 level, may be a more appropriate procedure, but you do really need another opinion and maybe another high-tesla/high resolution MRI to gauge what's going on there at this moment.

I also would like to recommend you post in our Spinal forum to tap the expertise of that batch of people:



Hi Glenntaj,

Thanks so much for your response! Last night I was looking into the procedures you mentioned because I feel if I can lose the constant sciatica and be on my feet P/T excercise and caution will do the rest! but from what I can see the laminectomy/foaminotomy involve a procedure where the bone has to be removed to get to the foramin resulting in the need for a fusion at that point becuase the bone has had to be removed to get to it ??? I want to look into that further to see if it can be done without fusion! would you mind explaining a bit about the difference between an MRI and high-telsa MRI? though I doubt there is much happening at all there because I pretty much sit on my *** all day now, a small grocery shop can cripple me, isn't online shoping and delivery a great invention! other than driving the children around I barely have to leave my home! not really something to be proud of but a relief that it is available!

I copied and pasted my above post in the spinal forum when I found it, so thank you! chat to you soon

Michelle :D

Hi Twinkletoes,

your name is the same name we gave to our daughters toothfairy (had to come up with a separate name for their 4 fairies !!:wink:) I will definitely keep you posted, I am trying to find as much as I can on this stuff becuase sometimes I feel doctors just give you their options not all options! and as they keep recommending surgeons for these opinions it stands to reason surgery is the option you get! and they really don't like to be questioned do they!
will keep you posted on the choices, but at the moment it is looking like a foraminotomy (which I think almost always leads to fusion at the same time becuase of the bone they have to cut away!) but I am prob going to refuse ADR, lets face it, discs wear away anyway and once they dry up, provided they are not 'slipped' at that point they generally don't cause probs!!

thanks for the welcome! talk to you soon

Michelle

Welcome to NT !
 

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I am so sorry for your back troubles. I have also had some over the years. It is really hard to take care of young children when you are in such pain. I have had two surgeries over the years. The last was a fusion. Both surgeries were successful for me, but I waited until I just couldn't take the pain anymore. I am thankful that both worked.

I hope you can get another opinion and come up with the best plan for you. In the meantime, I'm glad your have come to NT. There are many folks here who are caring and helpful. I wish you the best. Let us know how you are doing what your plans will be for your poor back.:hug: