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red3 (@red3)

Spondylolisthesis and DDD

Spine Health | Last Active: Jan 21, 2020 | Replies (64)

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Jennifer, I have been thinking about your post and appreciate it, as well the links that you included. I am glad that surgery was a good solution for you and your pain is alleviated. I have a very solid diagnosis of spondylolisthesis (Grade 3) from quite a few doctors. I am an ex athlete, so it stands to reason. Like you, I have kept off the operating table thus far because I exercise daily. It's just that it's getting harder and harder to cope. I am definitely not a smoker. The surgeon whom I am considering is Andrew Metzger M.D. He operates on spines and brains. His bio seems highly qualified and he is in private practice. I did appeal to his office to ask to be put in touch with patients he has done the procedure on but I did not receive a reply. I think I will try again. I was also considering a neurosurgeon at Baylor University. However, after talking to someone who had the surgery I thought it would be less complicated if I had the surgery in the city I live (Albuquerque). But yes, finding someone who is most qualified is of upmost importance. As far as getting ahold of research papers..that is a good idea. Not sure how to do it other then googling his name and hope some links pop up? Thank you again for your input.

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Replies to "Jennifer, I have been thinking about your post and appreciate it, as well the links that..."

@red3 I searched in Google Scholar and came up with this about using an MRI in the operating room. https://www.ajronline.org/doi/full/10.2214/AJR.06.1247 Perhaps that is the surgeon you mentioned? Google Scholar keys in on research studies. https://scholar.google.com/

The institutions sometimes have links to their research papers from the bio of the surgeon. Mayo does that. You can look at Becker's Spine Review for information and search doctor's names and institutions. They have a list of 100 surgeons to know, and career updates. It might be a starting point for further searches. https://www.beckersspine.com/ You can also look at the manufacturers of spine hardware and sometimes find literature about procedures with the hardware or a list of doctors who use it, and you could search for research on particular implants to learn about any issues. Once you find one study, there are often related links to studies on the screen in sites like Pub Med. I even looked at the government trials website for spine implants. You can learn a lot by reading what excludes a patient from a government trial study and that can hint at what some of the drawbacks could be. Also ask the surgeon you see specifically what hardware they use, and look up any studies about that implant or adverse reactions. There is also US News rankings of doctors and institutions at https://health.usnews.com/doctors Also for your state, search on the medical review board to make sure there is no disciplinary action listed. There is information at https://www.spineuniverse.com/ with case studies by some surgeons on there if you look up a doctor.

The most important thing is to find the doctor you think has the best skills and area of interest match for your condition. If you can find that close to home and you know you can trust that surgeon, that would be great and you need to be comfortable with your decision. There are also hospitals around the country that are affiliated with Mayo and have remote access to Mayo specialists. Mayo Clinic has a Care network where they work with other hospitals and doctors have access to consult with Mayo Physicians. https://www.mayoclinic.org/about-mayo-clinic/care-network/members

I have watched a lot of online spine surgery conference video presentations, and sometimes you can find a surgeon you'd be interested in teaching there. Be prepared to see actual surgery photos/video, otherwise, just look at the names of the presenters and their information and title of their topic. The Seattle Science Foundation has videos from spine conferences on You Tube at https://www.youtube.com/channel/UChIIig54yF9aQYvpWGe1DPg/featured

If you scroll down that screen, there is a Spine Conference section, Neurosurgery Grand Rounds section, and Cranial Conference section with videos. I learned a lot by watching surgeons teach other surgeons.

You really have to do your homework to pick the best surgeon for you, and believe in a great outcome. Ask what you can do that could help make the surgeon's job easier. I was told to stretch my neck with my hand to keep it loose. I also had done a lot of myofascial release with my physical therapist before surgery, and that made my muscles looser and easier to retract during surgery, and after, it helped break the tightness of the surgical scar tissue when I was recovered enough to begin. Here is our Connect MFR discussion https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

I couldn't find any surgeons who would help me close to home, and I went to Mayo after 5 spine surgeons turned me down over a 2 year period. It was a 5 hour drive for me to Rochester and it was worth it. I knew a lot by that time, and it helped me ask good questions when I met the surgeon who did help me, and I had seen enough of my imaging to know that he was giving good answers and a good explanation of the problem at my evaluation. If you want to consider Arizona, there is a Mayo campus there, and also the Barrow Neurological Institute that I have seen in my online wanderings of looking at leaders in spine surgery. You should seek the very best, and I wish I had come to Mayo first instead of wasting 2 years chasing doctors. Initially I tried to find help in a major city near me, and every surgeon could read the MRI, but they didn't understand how to connect my unusual symptoms to the imaging, so I was the patient that these surgeons didn't want to take a risk on. They have success ratings by insurance companies and patients, and a possible poor outcome would lower their ratings. I had unexpected pain all over my body from spinal cord compression in my neck. I found a medical case study similar to mine, and sent that with a letter to the surgeon at Mayo, and that is how I became his patient. I have a biology degree and used to work in university research for a neuroanatomist, so looking for medical literature was somewhat familiar. My tissue preparations from the lab and my technical drawings were published years ago in the Journal of Neuroscience.

It sounds like you are doing all the right things. It's an important decision, and get enough opinions so you can make an educated choice and have the absolute best surgeon. It will be a long recovery and you'll need patience and a good support from your family. Hopefully something in my long list can help you on your journey. I had a lot to do to work through my anxiety over major surgery, and if you have that, seeing a counselor sure helped me along with all the creative things I did on my own to overcome my fears.

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