Spondylolisthesis and Surgery

[DarcyFL]

I have had back and leg pain for 8 years and a year ago, I was finally diagnosed with Class I Spondylolisthesis, Herniated discs of the L4-L5 and L5-S1 with possible pars defect by an Orthopedic Specialist.  I have been through a back brace, steriod shots, therapy and the procedure of deadening the facet joint nerves (lower back pain relief lasted less than 6 months).  Non of these approaches have been successful and now I am losing bladder control.  I am scheduled to return to the Orthopedic Surgeon at the end of January to discuss my options, etc.  I will request a second opinion if surgery is needed, just because this is my spine.  Here are my questions:  Should my second opinion come from a Orthopedic Surgeon or a Nuerological Surgeon?  Should I request both to perform the operation or is that being too paronoid?  And last,  has the artificial disc been approved in the US and if so would it do me any good?

Thanks, DarcyFL

[terriprr]

A related discussion, Decompression vs surgery was started.

[Wytchypoo]

I am 46 years old and have had 3 spinal surgeries for spondyl,C4,C5,L1. I have had the cages put in, bone grafts, decompression and unfortunalty none of these have worked. I am now refered to the Cleveland Clinic Failed Back Surgery Clinic. I have not been given much hope of anything else working. They are thinking of trying narcotic pain pump that is inserted in the back. I would like to know if there is anyone else out their that has had Total failed back surgery? I would also like to know if anyone else is having a real problem with weight gain due to being unable to excercise or do much walking ? I have been searching endlessly for any sites that help handicapped people deal with this problem.I would like to hear from anyone else with these problems or suggestions. Bright Blessings to all.

[kscs]

I have spondylolisthesis of L4-5.  Neurosurgeon wants to fuse but I am reluctant.  Heard about Bone Morphogenic Proteins, BMP, in the use of fusion.  Trying to wait for a less invasive surgery.  Both feet are becoming numb on the bottom.  Also, L4 Nerve root is inflammed.  Trying to locate new procedures for this problem.  If anyone has any information for this problem, please let me know your thoughts.

[ned407]

Hi, I know that I'm a bit late with this but I think that its a very good idea to get a second opinion. Your doctor should not mind in fact my wife's doctor insisted on us getting one. The more educated you are about your choices the better. We had a doctor that we trusted (and still do) I'm a nurse, my wife a pharmacist. We did our research on the best options and still we had problems. Cindy developed osteomyelitis two weeks post op and spent another two weeks in the hospital. Her back has not improved much at all and the doctor has referred her to pain management for now until her P/T kicks in. I still like the doctor and I think that Cindy still has some options but with all the pain she is going through Its been a tough year and a half.

[Marisela]

My younger sons best friend was just told he has spondylosis form his family physician but the orthepedic specialist can not see him until the 30th of this month. This yoooung man is ver sports inclined and is an awesome student, a sophmore in high school. My son asked me to find out something about this disease for his parents. Can you please tell me about this disease and what to do. Will sports hurt him, is this genetic, how to make the pain go away and if he could do some kind of exercise or therapy while he is waiting for the specialist. The young man doesn't want to waste anytime. They think he has had this for a few years now. Can you also refer me to a support group. This young man is 15 years old and has been in pain for someme but coped with it. Please help me.
Thank you very much,
Marisela

[ebgirl]

Thank you Darcy, I am copying this now. Good luck to you. Its been ten years since my surgery and I got a few good years in after the surgery. I was an athlete before that. I am now having some problems again from the disc above. It is a hard decision about surgery. I had one Doctor say I was too young to have the surgery and one say you are too young not to! ~smile So the third doctor was a neurosurgeon who was great also, and helped me make the final decision. Thank you so much for the info on the denerving procedure.

And thank you CCF-neuro-MD for the good info also. This is a great site. I will be back.

[DarcyFL]

I found the name of my procedure.  It is called Facet Rhizotomy and you can find a little information on it at www.spine_health.com.  If this is what she is looking at getting done, then an internet search for Facet Rhizotomy may be more productive.  Hope this helps.

[DarcyFL]

Yes I have had the facet joint nerves deadened.  I am not sure if it is the same thing as you speak of.  It was a simple procedure that was done on as an outpatient.  I had an option of being given a "calming drug" as Dr. Stein in Tallahassee Florida does not put you to sleep for this procedure.  They give you a local and then insert a needle to find the nerve.  You will know when they find it.  I had 3 nerves on each side done, but it took two procedures as he couldn't "find" one of the nerves. It worked and the spondy pain was gone, but it only lasted a little less than 6 months.  I'm not sure if I (or my insurance) want to go through the procedure every 6 months!  Not if surgery can take care of it permanently.  The Doc said that it would last anywhere from 6 months to the rest of my life.  Your friend may have better results and the relief is almost instant

This procedure only helped with the facet joint nerves and doesn't do anything for the herniated disc pain.  So I was still in some pain while it was in effect, but nothing like before or now.

Tell your friend good luck and it is worth a try!  My doctor here was great!  I really liked him and he does this kind of stuff all day long so is quite good at it.

[ebgirl]

Hello, I wish I could be of help for you, as I have had a disc removed and was somewhat successful. But I can say [this was 10 years ago] it was my neurosurgeon who had all the most detailed information for me. He was on top of the problem immediately, put me in the hospital in traction for 5 days, and basically the only Doctor that took me seriously. And after he got in there found it was much worse than the MRI showed.

I came here today looking for a friend, information about radiofrequency denerving, as she has been disabled for 6 years and is looking at a long trip in the winter to the best specialist in the world in Switzerland for this process. I see you had that done? She is really worried, and can not find much information on this subject. [she lives in Norway] Do you have any suggestions for her? Thank you so much, and good luck to you.

[CCF-Neuro-M.D.-JT]

The loss of bladder control is concerning. If it is truly due to your herniated discs (as determined by a physician), then it's time for surgery. You should definitely see a surgeon, but you should NOT need both an ortho and a neurosurgeon (NSG) for your operation.  We tend to refer all of our spine cases to our neurosurgeons, but I'm sure there are excellent orthopedists out there who do these surgeries all the time. Call your orthopedist's office and tell them that you are having bladder problems, which may warrant an earlier appointment.  As for the artificial disc, they have been used in the U.S., but there is not enough clinical evidence that it is superior or equal to traditional spine surgery. If you already have an orthopedist, consider getting your second opinion from  a neurosurgeon. If you are in the Cleveland area, Dr. Ed Benzel is one of the best spine surgeons in the country. Dr. Kalfas is also a good spine doc. (both are NSGY)

Good luck.