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Spondylolisthesis L5/S1
Hi All,
I have just been diagnosed with grade 2 Spondylolisthesis at L5/S1 with bilateral pars defect at L5, which has resulted in posterior uncovering of the disk and impingement of bilateral L5 existing nerves (worst on left side). I was an active runner over the last six years running a few marathons and ultra runs. However, there has been no recent incident that I can recall that would have caused this injury.
It has been quite a journey to get here, but 4 months ago I encountered right hip pain and tightness when waking up in the morning. It would take a good 10-15 mins to walk off the pain / stiffness. Pain was generally a 2 but one stage hit a 7 on a scale of 10. After physio treatment over two months the hip pain went away and hasn’t come back. However, my right calf and hamstring would feel pretty tight minor tingling on the right lower and outside of the calf and top off foot. This can be triggered by running up to 7-10km or standing and sitting for too long.
I decided to see another physio who treated the issue as piriformis strain. Things seem like they were getting better in Dec. However in January the tightness and slight numbness came back so I decide to get an X-Ray and MRI done.
Unfortunately the result came back with grade 2 Spondylolisthesis with some impingement of the nerve. One good news is that the Spondylolisthesis seems stable based in flexion / extension X-rays
The medical expert has suggested I undertake surgery which would involve a fusion (ALIF and PLIF), which was a major shock gut wrenching. I am seeing the surgeon this week to see what his recommendation is.
In the meantime, I went to get a second opinion (expert spine physio), who did not agree with the advice and suggested I try passive treatment which would involve no more running and slow build up to core training with stretches. He didn’t think the current nerve issue was serious as I was only feeling limited pain or numbness. He said to monitor this over the next 2 months to see how it progresses.
I kind of agree with the second opinion but I don’t want to risk nerve or back damage.
I am not getting any share shooting pains done my body (leg), I am walking fine, have no back pain, etc. I am just more consciously aware of the issue, which has probably affected me more mentally than anything else.
My preference would be to prevent or delay surgery for as long as possible whilst limiting any future damage to my back and nerves.
Questions:
1. Has anyone encountered something similar and what path did you take?
2. When you should implement a solution to prevent nerve damage?
3. How do you know when your nerve is getting damaged?
4. Any other advice?
Thanks in advance for the feedback.
Sorry for the long post… it has just been a bit of a mental challenge over the last few days trying to digest the news, rejig goals and plan ahead.
Cheers ,
J
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Yes - surgery should be last resort!
I was actually supposed to do a 100 mile run/walk/hike race this year in the Blue Mountains and Snow Moutains in Oz. I was also targeting Mount Fuji and San Juan in a couple of years… oh wells. There goes those dreams.
At least I can walk - that’s the main thing!
Biggest fight is mental - you are old enough and cut from the strong cloth. I’m sure you have a 50 mile left in you!!!
Keep me posted! 🤘🏽👍
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1 ReactionYes I agree with above response too
I have had three 1st failure bad infection a lot scar tissue.
2 send one big hospital in Atlanta head of orthopedic
Still failed but alit scar tissue , nerve problems.
Tennesse finally at least got me where I can be up a few hours then rest you have pace yourself
So much can go wrong
I am nurse that’s why I did Chiro 10 years out it off another 5 , I know some come out not walking at all.
Do PT really good walks help even 30 min a day keep you going try theses need Lido patches really work wind we s talk irtho Doc try some, these Lidocaine patch that RX help a bunch. Try everything until you have to do it
I wished I never did 1st I feel I only got worse despite my pain
Good Luck
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1 ReactionJ... I can tell you are adjusting your lifestyle and finding ways to live with your L5-S1 problem. I think you are probably right that there won't be any more long distance "races" for you. But don't give up on something a bit less stressful. The 5-day, 50 mile walks I mentioned a few days ago are really something you should check out. There are wonderful experiences in New Zealand, Tasmania, and Australia that might suit you. As you may already know, many of these treks are suited for all ages... you go at your own pace, arrive at a hut or lodge in the late afternoon, enjoy a beer and a meal they cook for you, provide you with a bed, and then cook you breakfast before you head out the door to your next destination. These are really worth considering. And that's what I am doing again at age 76 with my L5-S1 issues.
--retired professor
At 29, I collapsed in a Target. I was just standing there and my lower half buckled. I was taken out on a stretcher because I could not move from the pain. That's the day I was dx with L5-S1 spondylolisthesis grade 2 with pars defect, bulging disc, no disc, deteriorated disc. etc. I was told that I was born with it, it happened when I had my first child (after which I started experiencing a lot of lower back pain), or hurt myself at some point. When I was 5, I woke up and couldn't move. So who knows. I'm 59 now. No surgery. I was in great shape at 29. Dr. told me he could put a rod in me, flip me over and put in a few silicone discs and there would be a 50/50 chance it would help. That was a no for me. I was not careful of how I worked out. I continued to do what I'd always done until I was in my 40's. I gave up kick boxing and tai Kwon do and eventually skating and skiing; golfing. I walk now. I ride a bike, and I swim. But I'm no longer in great shape. Thu the pain and the years, I've put on a lot of weight. I hurt so I don't move, I don't move so I gain weight. etc. I take Methadone now. I've been on it since 2008. I could barely walk anymore when I started taking it. I'm on 7 mg a day. I started skating again this year because my back has not changed a whole lot in the last 30 years. The spondy is stable. I have more nerve pain but it's not the worst part for sure. I just have to not be on my feet too long and not sit in the same position too long. I continue to work, but I'm fortunate that I work for me so I work around my back.
There's a group on facebook with people who've had surgery. I joined some years ago and hearing their stories talked me out of surgery. I may need it soon. I'm putting it off as long as I can. I'd hoped that by the time I was "older" the surgery would be better, but it seems to be the same! Anywho, I think you can go years without surgery. And it doesn't look like you'll be carrying babies, so maybe you'll never need it!
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2 ReactionsWow
That is an amazing journey! I can’t believe how many years you have gone through!
My back has flared up again recently and unsure what has caused it. It could be my recent weight training or might be my over exuberance on my BMX which brings nostalgia. It also could be due to work - I’ve had 18 works shops, 3 hours per session, then multiple meetings, over a six week period. Then having to deal with generation ‘Z’ mentality, ethic and tenacity - oh such is life!
The good thing is, I have lost 3kgs with my trainer partly training and more so diet. I will probably have to give weight training a miss and slow down on the bike - shorter duration and slower speed. Also cut back on the red wine and beer.
I am trying to avoid surgery and also joined FB Groups, which have turned me off surgery even more! I am hesitant in taking another MRI, but I should to check if the spondy is stable.
We have a 2.5 yr old that still wants to be carried and we are also planning another. Hence, I’m trying to get fitter and stronger than before!
I too have been researching advancement health technology - here’s hoping some sort of solution like ‘stem cell’ would help!
Try the ZT lido patches they work great if insurance will not cover Get some lidocaine cream it works good too Ice is another that works,
We have to try to use all the tools in our tool box to avoid surgery as long as you can
Backs are no guarantee
Good Luck Hope you feel better soon
It’s a battle but we have to move Walking helps me greatly, east in joints and great fir back start slow
Move up as soon as you handle the 1st distance you set that does not cause too much pain
Use cream for soreness
Vanessa
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1 ReactionGentle reminder about the Community Guidelines (https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/), in particular guideline number 1:
1. Be careful about giving out medical advice
- Sharing your own experience is fine, but don't tell other members what they should do.
- Experiences and information shared by members on the Mayo Clinic Connect are not a substitute for professional medical advice, diagnosis or treatment.
- Never disregard professional medical advice or delay in seeking it because of something you have read on the community.
*****
I see that many people are concerned about surgery as an option and recommend it as a last option. Surgery requires careful consideration and finding a qualified, experienced surgeon who is focused on you. Keep in mind that people on forums or Facebook groups often overly represent people who are looking for answers and/or had poor results with treatment. Surgery may be right for some people when other options no longer work.
Q: How do you know when it's the right time for surgery for you? What's your criteria?
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3 ReactionsVanessa, do you have a personal experience using ZTLido (Lidocaine)? How did the patches and the cream work for you? When do you use one over the other or in combination?
Thanks Colleen.
Agree with the reminder and that different folks have different strokes!
I’ve received a different medical advice, which pushed me down the path of further research and testing different approaches.
Also comfortable that one very reputable surgeon advised against fusion at this stage. Advice taken with arms wide open!
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1 ReactionHello Collen, yes I have been using ZT Lido patches and they work so well They are amazing I can usually skip meds and put one I usually takes care of my back or nerve pain I love them, you can only put up to 3 on and only wear them for 12 at a time , the cream I use the patches every night yet they are working on getting me approved so I wear one every other night, Doc gives me samples to keep me covered until RX comes thru , I use cream in night or days I don’t wear a patch
Please check with your Doc ok
I have never had anything work and stop this nerve pain from surgeries but these sure do work and I have tried every procedure there is to reduce pain. Nothing seem to help if it did it was for such a short period of time it was nit worth doing, getting put to sleep ect if it only lasts few weeks
I am doing much better now with these patches
Hope you find some relief and feel better soon
Blessings your way
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