Should I have an L4-L5 Fusion

[Rick]

About 6 to 7 years ago I injured my lower back by leaning forward and lifting a large weight improperly. Since that time it has been prone to re-injury, and I seem to have a relapse about every 6 to 12 months but occasionally shorter. The pain is primarily limited to the lower back, although sometimes I will have very mild numbness or very mild pain in my legs, but not always and it is never severe or really much of an issue. The lower back muscles lock up during these episodes and I cannot stand erect, sometimes for as long as several weeks. The longest period I have gone without re-injury is about 18 months. Recovery/rehab is varied and takes between 2 weeks to 6 months. After recovery I can do pretty much anything I want with reasonable care. During these times I lift weights and do Judo, but I am careful to protect my back, for example I do not do dead lifts or squats or do very much stand up work in Judo where I might be thrown in an uncontrolled manner. The re-occurrences seem almost random, for example several have occurred when I simply leaned over to pet my dog or pick up a sock.

MRI indicates that the L4-L5 disk is degenerative(It is black and shows a slightly less inter vertebral space). There is also a slight bulge posteriorly at this level. All other levels look completely normal. X ray during back extension (leaning over backwards) shows reduced space between the vertebrae posteriorly as opposed to anteriorly. Forward and side flexion

[Regina M. Koeppel RNBS, CEN, CCRN]

Rick, I have recently injured my back and after months of misdiagnosis I found great Orthopedic who finally read MRI with
Bulging at L4 and 5.
     My initial c/o was after downloading a 200 lb isolete off of the helicopter i work on, was searing shooting pain isoated to my left quad.  Within 15 minutes of this lifting I was also unable t bear wt.   Initially it was diagnosed as a QUAD TEAR.
I saw 4 ortopediacs all missed the critial indicator of the developement of left buutock pain, which would have indiacted the injur abouve the left leg.
   Within 3 months I was writhing in pain, unable to tke care of my 4 kids and unable to work, even tho thier Doc. said i could rt to light duty.
    I was shoked that the MRI were negative and if wished they were positive so I could have surgery and get better.
     But I am glad I didnt need it and I want to share finally what helped me (and initially it was not traditional medicine)
     After MRI were neg. I contacted a Chiropractor...Helped immensely and researched about back PT and found  a physical theripist who is trained in the Mac Kenzie technique. She is affliated with Kessler the reknowned rehab place where Christopher Reeves went with his spine injury.
     While doing the therapy my sympoms initially were status qua, but after 3 weeks I regreessed terrribly.  I asked the PT if the new anyone who had the EPIDURAL for relief of symptoms and she refeered me to the Spinal Specialist.
...Six months later and 4 ortho and 1 radiologist calling the MRI negative, Dr. Kopacz told me THAT IT IS NOT NECESSARILY NEGATIVE ...and Dx me with the Bulging at L4-5.  So even me, a health care professional, with years of trauma/er experience in the largest teaching hospital in the state, has been literally jerked around.
    I did obt for this procedure by the pain specialist and anestiologist at Morristown Memorial here in Jersey.
   You can have up to 3.  60 % have relief totally by the first epideral.. IT is the injection of steroids around the affected area t promaote healing and decrease of the inflammation.
Now  don't know if you wouldbe a candidate, but I think you would be.
     I am going to give you the # to call for the MacKenzie therapy book,.  Dr. Kopacz, the only one to Dx me correctly is a proponent of this back therapy.
     The last resort should be surgery and even tho I have great respect for DR. Kopacz, I would have the surgery as a last resort and have a neurosurgeon present.
I think this book will help you and look into Epidural at A more progreesive hospital and their pain managemnyt center.
Good luck

TREAT YOUR OWN BACK

BY: Robin McKenzie # [phone]

[ED uk]

I would suggest you listen to the people who have undergone the "knife", i to have had spinal fusion to L4/L5 with titanium plate fixation of the same. It is hard to decide what is the best thing to do when you are in so much pain. I had my back problem since 1995 and in late 98 decided enough was enough and gave in to the DOC's, since the op it hasn't improved my back pain, but it has made leg pain 100% worse the only benefit i have is i am now vertical, before due to the amount of muscle spasms i was vertually at 40 degrees. on reading a lot of the replies i can sympothise with them.
My advice is that if you can build up your stomach muscles and back muscles as large as you can possibly get them then this is your answer, your physiotherapist will tell you the correct excercises. The other bit of advice is to take it easy and rest often.


Good luck

[Dena]

I would suggest to anyone who has been told to have back surgery - DON'T DO IT!!! If there is any possibility that you can live with the pain and undergo therapy. My husband has had five back surgeries at L4/L5, one in which they also did L5/S1. He is disabled with nerve damage and in pain every minute of the day and night. There has been so much scar tissue built up after each surgery that has to be removed each time, now the last neurosurgeon that saw him will not touch him. Again, DON'T HAVE SURGERY if you can avoid it in any way!!!!

[Helen Lilly]

Rick glad to hear you did not have surgery, I had great pain and numbnes in legs and hands and had a lumbar spine block or that is what was tried, which resulted in a spinal leak and many
blood patches. this is 3and half years ago and I have terrible
head pain and still have bad back even after the surgery I had for L5-sl disk. Thank God you did not do it!!! good luck  Helen

[lanua]

Rick,

i'm glad we helped.  God bless you.

Maggie..thank you too..the doctor has been talking to me about
the herniation he just found on L5 s1   and surgery..he can
FORGETABOUTIT...enough already i'll live with it and offer it up.
blessings to you.

[Rick]

Thanks Terry Maggie and Lanua. I greatly appreciate you taking the time to comment on this. Based on your comments and my progress, I have definitely decided against surgery for now. My rehab is going very well, and I am in a true rehab program with a physical therapist for the first time. Before this I always did it on my own with a single appointment with the therapist. I have already learned a lot, and I think I will be back to normal in a month or so.

I am very sorry that you guys have had so many problems. As advanced as medical science is, it does not seem to have very good solutions for back problems. Good luck to you all, and thanks again.
Rick