I have spondylolisthesis - and need advice

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again, i appreciate the replies and feedback. i've kinda just been sitting back seeing where this goes the last month. that was my plan, with my two appointments coming up this week. i fully expected to meet the two surgeons again (second visit for each) and then decide who i'll let do it.

so, now i'm second guessing all this. i'm right on the cusp, i decided 'yup, i should do this'. now, im set back...not sure what to do.

between my chiropractor throwing out the 'oh, people wth spondy usually dont get surgery' comment...to, not being able to find anyone who's had the same problem to talk to directly....it's making it hard to decide. do surgeons give references? i wanna talk to someone wh's had it done (realizing they wont give me the name of someone they've botched).

the core excersizes helped take the tingle out of my foot. but that's where the improvement stopped. but, am i giving it enough time? no idea. the leg pain/nurabness has shifted positions, it seems. and good days it's good, on bad days its BAD. it does make me worry about permanent nerve damage. that alone is enough to scare me into getting the fusion.
 
For me all I can say is all my life my ligaments and tendons have been over flexible. This caused me to have my foot bunion surgery at a young age as the tendons and stuff around that joint just give out. Same with my knees and spine. Nothing specific they have diagnosed me with but has caused me more problem sin my 40's (currently 44)
 
Exact same issue here. Excellent health and ran marathons 3 years ago, can't run to my mailbox now without upsetting nerves. I'm still active but the condition is extremely symptomatic, I can even do modified strength training with minimal negative effects. Some days are good and others are not. Once the epidural steroid injections wear off life becomes difficult and most activity stops and my overal mood is in the gutter. When the pain is bad its difficult to focus on life when your taking Hydrocodone and Skelaxin ever 4 hours. Also, I'm VERY nervous about surgery...
 
i forgot to mention - it wasnt until talking with the chiropractor that i recalled falling flat on my back while ice skating with my family that might have set this off. that was two years ago, right about the same time when this all started.
 
Welcome to the boarRAB...sorry you are going through all this. I'm in a similar situation...I have spondylolisthesis, along with severe disk degeneration and a bad herniated disk.

What type of surgery did the doctor discuss with you? I'm wondering if a discectomy would be an option. It sounRAB like your nerve pain is what's bothering you the most, in which case if there is a way to remove what is irritating the nerve, that would probably buy you some time. A discectomy is a much easier surgery (i was in and out in the same morning, and back to my routine within a few days, with no lifting bending or twisting for a month). It sounded like from your report that you have disc material protruding out, which is probably part of the reason for your pain.

I did all the same things you tried, and nothing helped. I finally went for a discectomy/laminectomy back in 2005. It gave me relief from my pain for 4 years. Unfortunately I reherniated my disc at the end of my last pregnancy, and had a second discectomy in Feb 2010. That surgery helps tremendously the nerve pain. If there's a lot of back pain, that's a different story. At this point I am getting ready to schedule my fusion, because there's nothing else I can do and my quality of life went down the tubes. I'm also very inflexible due to the spondy, and my disc is a disaster (severely degenerated, desiccated, and narrowed, on top of being herniated for the umpteenth time).

Did the doctor go right to suggesting fusion, or did he give you other surgical options?
 
Spondylolisthesis is when one vertebrae moves forward over another below. No amount of injections can fix this though it can help the symptoms. No amount of chiropractic can fix this permanently as your vertebrae is no longer anchored and will continue to move based on daily normal movements and that will all cause repeat symptoms.

The important thing is to discuss with an Orthopedic Spine Surgeon or Neurosurgeon what Grade of Spondylolisthesis you have.

For people with Grade 1 often injections can help as they are less invasive and will help decrease symptoms if they work.

For people with Grade 2-3 often the best treatment is a fusion. The fusion anchors the moving vertebrae to the one below (or above it) so the moving vertebrae (spondylolisthesis) .

At Grade 4-5 surgery is virtually mandatory to avoid permanent nerve and spinal cord impairment.

You can start at Grade 1 and gradually it can get worse to the latter grades. In my case I though I had hip pain one day during college and it was Grade 2. Since no amount of non-invasive treatment would permanently correct the problem I opted for surgery and had a quick recovery. I'm unique in that I have very loose ligaments and tendons so I get additional levels of problems and have neck, knee, foot and thurab problems as well.

Your MRI does indicate anterior listhesis. Spondylolisthesis shows in two forms. Anteriolisthesis when the vertebrae moves forward, which is the most common and posteriolisthesis when the vertebrae moves backward which is not often.seen. So perhaps the NS and OSS you saw didn't explain using the exact term spondylolisthesis but the MRI shows that as a finding.

Grade 1: 25% of vertebral body has slipped forward
Grade 2: 50%
Grade 3: 75%
Grade 4: 100%
Grade 5: vertebrae has fallen off level below.
 
You guys are awesome! Although it sounRAB insensitive, I am glad to see that I am not alone. People that haven't gone through this really can't sympathize.

My pain started in my legs and feet over 10 years ago. My first round of doctors said everything from 'Welcome to middle age' to 'I can't help you, but here is a Handicapped Parking permit'! More than one 'specialist' said that my pain was imaginary.

Over the years I have seen Neurologists, Chiropractors, Pain Management Specialists, Physical Therapists, etc, and nobody had any answers. After 9 years of absolute misery, my daughter recommended that I go to see the Ortho Surgeons at the medical school she is attending. What a blessing!

After a couple of Xrays and MRIs, they found I had major L5-S1 slippage and a nasty bone spur in my hip. I had the hip surgery in April and now I can walk without a cane for the first time in years! I am going in for the L5-S1 cage/screw surgery in Deceraber and that has me worried. I am concerned about how much time it will be until I am able to do simple things like drive my daughter to school or go to the grocery store. I know that everyone is different, but I am hoping that there is a common answer to this question.

I too have the current issue of going off at the mouth when I try to get out of bed in the morning. If I cough or sneeze, I see lightening and stars and other things that you might see in a cartoon. I know that the spine surgery is my only option at this point, but I am terrified that I will be an invalid for a long period of time during recovery. Any advice?
 
I don't know if you have read any of my threaRAB or messages but I am having my surgery in a week finally. It has been 10 years of agony and about 5 surgeons, 3 pain specialists and several GP's but finally I was happy to go with this surgeon. I know my disc at L5-S1 is almost non-existent and L4-5 has a tear and is black in the MRI meaning there is no soft centre any longer I am not sure of the condition of the facets but this neurosurgeon came up with the plan I envisioned when I was shown the mri by one of the surgeons.

The lower vertebrae will be separated then fused with an implant and the next disc will be removed and replaced with a flexable disc replacement. I know of other people having success with the replacements and if it will help give me some flexibility, hopefully that will stop any damage to the next level over coming years. But I also realise my back will never be like it was in my 30's and I plan to change my life completely. No more shovelling, jumping, lifting weight, etc. I will not damage my back any more especially for someone else's benefit.

I had to change my spiritual and emotional life completely when I gave up drinking and smoking at 40 years old and I am able to change my physical behaviour now at 50. Along with my exercise regime. I will have to spend lots of time on nice quiet walks and regular swimming. I will not be doing any of the physical exercise I grew up with in my outdoor field of work. Concreting is out along with building and motorcycle riding.

So I am expecting a big change so I will need emotional and spiritual support or I won't change anything. I believe it will take a lot of relaxation as well. So I don't expect to be working for a while until I am healed up properly and if it takes 12 months or 2 years well that is what it will take. I am planing on giving it my best shot. Lucky I like music Ha. I will need something to stay sane.

Allan
 
yeah, it's mostly nerve pain for me. at the 'pinch' (right buttock) it hurts (sometimes burns), on the right side of my calf it hurts - like it's being twisted, and the tingle in my foot scares me (aside from being super-annoying). oh, and deep in my hamstring it will hurt. really not much back pain. and i was having spasms, but i think the stretches, etc helped clear that up.

yes, he (and the other two docs i spoke to) all jumped right to fusion. no one mentioned this discectomy. but you've got my attention! is this done with laser? or am i thinking of something else?

thanks for the reply
 
After 10 years of suffering gradually worsening pain I finally had a spinal fusion on July 7th of this year. Even though the recovery is frustratingly slow I can already say it was the best decision I ever made.

I too had spondylolisthesis along with a few other issues and over the years I have tried everything in order to avoid surgery. I was treated by an orthopeadic surgeon who was excellent. She advised fusion as opposed to other surgeries as she believed anything less would have resulted in further surgery in a few years time.

I have been unable to do any form of excercise for the last two years and at my worst had to call an arabulance as I was unable to get out of bed! I have permanent nerve damage in my right leg which is irreversible.

People are right when they say you notice the difference as soon as you wake up - I couldn't believe it and kept waiting for the pain to start - it never did! That said fusion is MAJOR surgery and you should think long and hard before you make any decisions. Mine was a one level fusion of L5-S1 which sounRAB like the same area you are having problems.

Again I am otherwise healthy so the prognosis is good (35 at the time of surgery). I start hydrotherapy next week as my hamstrings have contracted and I am not looking forward to it - I get the feeling that the surgery was the easy part and the rehab is going to be hard work after being inactive for so long.

If you do have the surgery good luck and remeraber that it will take a long time to recover which can be very frustrating. There is a wealth of information and advice on this forum and I found it invaluable when making my decision. Let us know how you get on
 
Hi. I'm sorry you are having such a hard time of it. It sounRAB to me like you are at the end of your rope; you can no longer do the things you love, you have lots of pain, you've tried lots of conservative methoRAB to "fix" yourself and it looks like things have only gotten worse with some mild relief in-between.

If you weren't crazy about the lst doctor you saw, I would urge you to find either an Orthopedic Spine Specialist (my preference) or a Neurosurgeon. It's possible that surgery is all that is left. I don't know why the chiro was so sure you have spondylolithesis but for sure you have a bad disc which is putting pressure on a nerve at the L5-S1 and that is causing many of the symptoms you describe. The annular tear (outer lining of the disc) is allowing disc material to drip onto the nerves....that material is caustic.

I hope you don't delay any longer. Nerve damage can become permanent if you wait too long to remove the impingement and thats no fun at all.

Good luck to you. And please let us know how you are doing.
 
I had a spinal fusion in 2009 when I was 22 and it was the best decision I have ever made. I was in constant pain with no relief. I also sought the help of a chiro with no help. Finally they x-rayed me and found a pars defect that had lead to grade 3/4 spondy. I had 4 screws and 2 roRAB put in. I have some range of motion limitation but nothing that really effects my everyday life. I have normal back pain when I overdue it but by the next day its gone. You need to find a surgeon you trust. I am a surgical technician by trade so I know how important it is for a patient to trust their surgeon. It will make everything go much better if you do.
 
isnt this horrible. when my alarm goes off, i lay there a minute with anticipation wondering what kind of day it'll be. when i swing my feet out of bed - i'll know. i've had to apologize to my wife a few times about my demeanor. 'sorry, this isn't me - you know that, right?'



can you tell me more about this? because i've had issues with my shoulder, ankle and thurab joint - all on the same side (right) as my spondy symptoms.

...i'd hate to think i'm unique too. ;)



sounRAB like your on the up side of this. that's awesome. i wish you a great recovery.

i know it'll take time. lots of time. but, after suffereng for two years...i'm willing to wait out recovery.

i still havent decided. when i met the two surgeons a couple weeks ago. the first said i've tried everything i could, i've taken the right steps - now it's up to me to decide and that i should call him when i'm ready. the second practically threw me out of his office (in a nice way) and said 'you arent ready for surgery'. the problem was i wasnt crawling on my hanRAB and knees begging to be fixed. i was having a good day that day.

those were both orthos. i'm meeting a neuro in a couple weeks for a 4th or 5th opinion. she's was highly recommended from a friend of my dad.

still.....can't .....decide.......
 
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