27 y/o active - TLIF at L5/S1 or live with the pain??

  • Thread starter Thread starter SpineAZ
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Very often, if you and your surgeon suggest a fusion, the insurance company will need to see that all non-surgical treatment options have been tried. I have a friend right now who is going to PT and we're pretty sure it's so that the cervical fusion will be approved. So keep that in mind if you think you are moving toward fusion.

I figured you were addicted to the weightlifting but you'll have to find a way to work through that. No surgery is going to work if you aren't able to avoid the wrong type of activities. I'm guessing you are really good at weightlifting as opposed to those of who would be lifting minimal amounts. Maybe PT can re-direct you into exercises that are better for you ergonomically.

It does sound like a fusion may be an option. You said much of the disc is gone or out of where it should be. Thus, this can create an area of instability. The only way to stabilize that area is to fuse the two vertebrae together.
 
Complicating things even more BUT. . . . also consider piriformis syndrome. It's a long thinish muscle that runs deep inside the buttock from the sacrum to the hip (so in the same area that can give SI joint pain)
If it is tight or spasmed it can irritate the sciatic nerve at the point where they cross (in the bum)
Of course there is nothing to say that it can't be 2 (or more) problems at the same time.
A physiotherapist should be able to identify both problems. Exercise is usually prescribed.
Take care
Helen
 
Thank you both so much for sharing your positive stories - I really needed to hear it!!

I think my little hound dog would miss our walks, but my significant other promised me he'd make sure she won't get neglected. My sister might come to stay with me for a few weeks (she is a teacher with a flexible schedule) - how long/how many weeks did you all need a lot of help after the surgery?

Here's a bigger question: My second opinion surgeon (and the one who would do this surgery) told me he recommenRAB ALIF - that's the procedure he would do. He is a spine specialist. The first surgeon I talked to about spine fusion was a neurosurgeon, and I he's certainly smart and capable - he is the one who wanted to do the TLIF procedure. The second surgeon said that ALIF is much easier (by comparison, not that it's easy at all) on your body than TLIF - I have read all about the differences, although I can't really determine which is better and all doctors have their own opinions. I think I would go with the 2nd surgeon and the ALIF procedure, but I might even go get a third opinion!

Did any of you try reading that book by Dr. Sarto? ( I think that's his name..) Someone on this blog/site talked about it as a semi-cure - the mental connection between back pain and healing, etc. and surgery not being necessary. this sounRAB absolutely crazy to me particularly because I've seen my films - I can see my disc completely misplaced and I can see my vertebrae sitting on top of each other, I'm not sure what mental exercise could fix that or make that not hurt (although I do know that mental strength and a positive attitude are essential to a good fast recovery) - has anyone tried this approach or am I crazy for asking?

Also, here's the biggest question I have so far that has gone unanswered (by the doctors, etc.) - how much is this going to cost me??? I know no one on here knows my insurance policy to tell me any nurabers necessarily, but I have standard State BCBS health plan (I am a state employee), and I don't know if that's could or not, but on average (if you guys don't mind my asking?) how much did you all end up paying out of pocket for this surgery (and the post-op care like PT?) - That might be an inappropriate question, so pardon my asking! But, if anyone is willing to share some ballpark nurabers I would really appreciate it. (I have tried calling the finance/billing person at the spine center I would have this procedure through, and she has yet to return my calls which I don't consider a good sign but maybe she's just on vacation these past two weeks...?)....

Any more thoughts? Thank you all so much for your thoughts and sharing your experiences. I was going to try to wait until next summer to have this surgery but I was standing and sitting in court for three days straight last week (which I don't think is that long) - I drove 1 1/2 hours there and back for 4 days, and by Thursday I was absolutely miserable. I am considering having this procedure before Christmas (although, there are some other factors I have to consider) But - any thoughts?
 
Not sure if this will help anyone at all, but I went through most of what everyone has said. The person who initially started this thread stated that he had right hip/right thigh pain. I was there, I had pain going down my right leg all day every day and then last year started in my left. I went through two months of laying on the couch cause I couldn't sit. After two cortico steroid shots that didn't work, Lyrica and Tromedol(spelling?), and Gabapentin to try to fix the nerve pain, my doctor(third one at this point) had me do a pain test. I was pain free for one day before I was in agony. He recommended a total disc replacement as he does not agree with narcotic pain meRAB on a life long basis which is the less invasive option. At 22 I went with the surgery.

Had the surgery 1/11/2010 to replace my L5-S1, it is now 5/7/2010 and I have never felt better. It will be a while until my sciatic nerve fully heals, but I haven't taken Advil or Excedrin for anything other than a headache since before the surgery. To me at my age, the 4 day hospital stay and the recovery time were worth it to finally after 4 years(hurt my back in Jan 2006) of agony and no diagnosis and I can finally live my life.

I know that I am a success story and with the surgery still being kind of new having only recently been approved by the FDA in 2004 in the US I would definitely talk with your doctor about what is best for you. Do your research, think about the long run, and don't just jump in. Not sure if this will help anyone, but figured maybe my story could!
 
jen, I am quite busy this weekend as I have a big wedding to attend to tomorrow. However, I didn't want to leave your post completely unanswered. First, I would really research what the person below me said. About my self; 49 y.o., had a spinal fusion when I was 16 and this was successful and I went on and had a professional career. After having two kiRAB, and in my thirties, had been having chronic pain for a few years. One day I woke up and had horrible sciatica pain. Did all the conservative treatments;they didn't work, then had a six-level fusion in the fall of 2007. I fused wonderfully and was doing well until the fifth month. Started having pain in areas I never had before. My surgeon refused to see me. Went from one doctor to the next without a diagnosis. Went to two ER's.One ER actually threw me out. Actually threw the wheelchair in my room and did not escort me out. This is a very famous hospital. I went there because my surgeon's P.A. told me to go there (because he didn't want to see me anymore once I wasn't doing well anymore). Also, this is where I had my surgery. Finally in the fall of 2008 I found my present P.M. and he diagnosed me with Failed Back Surgery Syndrome. Some doctors call it Failed Laminectomy Syndrome (I had laminectomy's done too). It can be caused by a nuraber of things, but mine was caused by scar tissue, specifically scar tissue impinging on the nerve root. This diagnosis means that you have had a fusion and or lami. and your outcome was either the same, or worse. Mine was worse; much worse. I went from VicodanES four times a day before surgery, to Oxycontin LA 20 in the a.m. and 40 in the p.m. and Percocet 5 twice a day for breakthrough pain. Last Deceraber, I slightly bent over a trash basket and heard a noise in my back. I screamed because the pain was so bad. I could hardly walk back to the kitchen table. I had an MRI which showed that the mild degeneration that I had a year ago, had changed to severe. That was basically the only thing that CHANGED. Spinal fusions will accelerate degeneration. So, I thought that was the reason for my increase pain. Maybe I didn't do anything afterall when I bent over like that over the trash. Then from Jan. to Mar. of 2010. I was really suffering. I had the back pain, and this new right hip pain. Sometimes it was in the right groin and thigh too, esp. in the beginning. It hurt worse after I got out of bed and started walking. Or, when I got out of bed in the a.m., then sat on the toilet, the R hip seemed like it had a pulse of it's own. Last month, I told my PM about it again(not the director, whom I like so much better) and I asked about x-rays, and he said, "that wouldn't do any good". :dizzy: Then he pressed on my L hip, then my R hip. When he pressed on the R hip I screamed it hurt so much!!!! That's when he said it was my SI joint. I don't know much about this @ all. I know more about the back. And he didn't explain anything either! But of course he put in a referral for an injection! However I have been getting them for my back and I have been noticing that they are really elevating my glucose levels! Back to you-have you had pic's done of your SI joint? Have you had an MRI with contrast done on your back? and which levels? That should be done first. It could be that your back and your SI joint need to be addressed, or just one of them. There are several merabers here who had problems with their SI joint-I hope they stop by to help you!! Also, are you seeing a board certified Orthopedic Surgeon? Sorry I wrote a novella:) I probably won't be on line till Sunday or Monday-so see ya then!! Good Luck....janiee
 
Thank you very much SpineAZ. I love reading your posts. You sound like a doctor! I say that sincerely. I know a lot about this spinal stuff also but you blow me away. As for the weightlifting I would probably be lying if I said I would ever stop. I am definitely going to try to go lighter and more reps as opposed to what I do now which is heavy heavy heavy. Rellative to my injury right now!
I can barely move from todays workout. I cannot bend whatsoever at the gym to pick up plates or whatever, I actually have to ask people to help with the plates. Very depressing. It is what I love to do and live to do. The ironic thing is that I also have Esophagus problems (Eosiniphilic Esophagitis) and have a very hard time swallowing food and even liquiRAB. I was actually in the hospital about 8 weeks ago with food stuck in my esophagus. They had to put me under to remove it. That was about the 15th time that has happened since 2004. Sorry for the complaining but my wife dont want to hear it anymore especially because I am still going to the gym.
 
hows it going? i was 27 when i got hurt at work. i went through 6 months pt., 3 injections, steroiRAB, nothing helped the pt seemed to make it worse finally they said i needed a l5 s1 fusion with hardware. so finally after everyone talked me into having the fusion now 3 yrs. later i'm greatly regretting it. i had the fusion 3/08 hardware removed 5/09 and now i'm worse off than ever. i'm permantly disabled can't ever work again and my pain level doesn't get under a 6 with numerous prescriptions. well what i'm getting at is if your pain is tolerable and somedays no pain please think long and hard before you have the surgery, if you can live with the pain i would not recommend having the surgery, but ultimately its your call though don't let anybody talk you into if you don't want it.
 
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