Lumbar Back Problems

Posted by grhaibach @grhaibach, Apr 27, 2023

I have been diagnosed (MRI) with spinal stenosis, osteoarthritis, and disc bulging - mostly in lumbar area - moderate to severe
Working with a physiotherapist, he has alleviated some of the pain, but has done nothing that would make things better. Am on pain medication, as well.
My question - what kind of medical expertise do you suggest I need to help me?
Thanks

Interested in more discussions like this? Go to the Spine Health Support Group.

@jenniferhunter

@suev I think the doctor might be talking about replacing a disc with a fusion in the lower back (lumbar spine). A bad disc is removed, and they have to put something in it's place and can refer to that as a "spacer". I had a cervical fusion, and my spacer is a milled piece of bone. Sometimes they put in a cage that can be metal or made of a plastic material. These spacers can have a place to add bone cells to seed bone growth for the fusion. Bone cells are removed during surgery such as bone spurs or bone overgrowth, or what they remove to prepare the surface of the vertebrae for the fusion.

Jump to this post

Thank you Jennifer for your wonderful explanation. I believe this is what my doctor wants to do with 3 of my vertebraes T11, T12 and L1 but others may be required as there is degeneration from L3 to L5. My surgeon is calling it a vertebrectomy, cage and fusion to lombar as you said. My vertebraes are eroding like they have an infection so he would need to replace them with donated femur bone. How did your surgical fusion go?

REPLY

Your description sounds very much like my issues. I would like to know what treatments and meds have been useful to you. Thanks in advance for your help.

REPLY
@suev

Thank you Jennifer for your wonderful explanation. I believe this is what my doctor wants to do with 3 of my vertebraes T11, T12 and L1 but others may be required as there is degeneration from L3 to L5. My surgeon is calling it a vertebrectomy, cage and fusion to lombar as you said. My vertebraes are eroding like they have an infection so he would need to replace them with donated femur bone. How did your surgical fusion go?

Jump to this post

@suev I'm sorry, I missed your question to me. If you wanted to alert me to a response, you can "at mention" me by typing @jenniferhunter in your post. That will flag me with a notification. My cervical fusion was very successful and it took care of all the pain I had which was due to spinal cord compression. It has been several years since then and I'm still doing well. It probably took about 6 months to recover since I needed to do rehab after being in a neck brace for 3 months. That was because I wanted a fusion without any spine hardware. Thank you for asking. This was the story that Mayo did about me. https://newsnetwork.mayoclinic.org/discussion/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Have you had surgery for your spine or are you in the process of waiting for a surgery? Did you get other opinions from different doctors? I sounds like your surgeon wants to remove and replace vertebrae which sounds very involved. Did they give you a reason for the erosion of bone and how to stop that from happening?

REPLY

I have spent 10-years suffering with Lumbar spinal stenosis. I've had numerous Epidural steroid injections, Radiofrequency ablation, PT, OT, Acupuncture, an Interspinous spacer inserted, a MILD procedure, and now finally I have just had the SPRINT PNS System device procedure done on my lower back. Finally, I have found relief from all the pain I have suffered for all these years. See a Physiatrist, don't waste your time with Pain Management physicians or Orthopedic physicians, they didn't help me, and they won't help you.

REPLY
@jenniferhunter

@suev I'm sorry, I missed your question to me. If you wanted to alert me to a response, you can "at mention" me by typing @jenniferhunter in your post. That will flag me with a notification. My cervical fusion was very successful and it took care of all the pain I had which was due to spinal cord compression. It has been several years since then and I'm still doing well. It probably took about 6 months to recover since I needed to do rehab after being in a neck brace for 3 months. That was because I wanted a fusion without any spine hardware. Thank you for asking. This was the story that Mayo did about me. https://newsnetwork.mayoclinic.org/discussion/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Have you had surgery for your spine or are you in the process of waiting for a surgery? Did you get other opinions from different doctors? I sounds like your surgeon wants to remove and replace vertebrae which sounds very involved. Did they give you a reason for the erosion of bone and how to stop that from happening?

Jump to this post

Hi Jennifer
What a lovely article and portrait of your surgeon. I am so happy the surgery enabled you to continue your passion ❤. My surgeon is recommending surgery. Its would be very intensive as it would entail the removal and replacement of vertebraes from T10 to L3 so I wouldn't be able to twist ny body but I would be able to bend and walk which at the moment causes me alot of pain given the bone erosion is prevalent at T10-T12 and it is causing pressure on my spine which is curving outward. My surgeon feels confident he will be able to successfully replace all vertebraes. My spine doctor has never seen anything like it before.
My rheumatologist and a score of others who have reviewe my file believe it to be SAPHO. I take Cosentyx injections from Novartis which is helping to keep the inflammation down which they believe is eroding my back vertebraes. Fortunately my neck vertebraes are fine so far. I have to have an updated CT scan and scoliosis xray so my surgeon sees what has transpired. I too am very afraid of surgery and chose to take 6 months to get to a place of peace and acceptance as my pain has subsided immensely due largely to a 4 motor chair that helps relieve stress on my bertevraes given the lumbar vertebraes are pretty well bone on bone. I have lost at min 3-4 inches in height. Thankfully I was 5 ft 10 so not sure if the surgery will increase my height again. I haven't yet discussed it with my surgeon. Why did you elect to not have spinal hardware? I don't think its possible for me given I have so many vertebraes to replace.

REPLY
@suev

Hi Jennifer
What a lovely article and portrait of your surgeon. I am so happy the surgery enabled you to continue your passion ❤. My surgeon is recommending surgery. Its would be very intensive as it would entail the removal and replacement of vertebraes from T10 to L3 so I wouldn't be able to twist ny body but I would be able to bend and walk which at the moment causes me alot of pain given the bone erosion is prevalent at T10-T12 and it is causing pressure on my spine which is curving outward. My surgeon feels confident he will be able to successfully replace all vertebraes. My spine doctor has never seen anything like it before.
My rheumatologist and a score of others who have reviewe my file believe it to be SAPHO. I take Cosentyx injections from Novartis which is helping to keep the inflammation down which they believe is eroding my back vertebraes. Fortunately my neck vertebraes are fine so far. I have to have an updated CT scan and scoliosis xray so my surgeon sees what has transpired. I too am very afraid of surgery and chose to take 6 months to get to a place of peace and acceptance as my pain has subsided immensely due largely to a 4 motor chair that helps relieve stress on my bertevraes given the lumbar vertebraes are pretty well bone on bone. I have lost at min 3-4 inches in height. Thankfully I was 5 ft 10 so not sure if the surgery will increase my height again. I haven't yet discussed it with my surgeon. Why did you elect to not have spinal hardware? I don't think its possible for me given I have so many vertebraes to replace.

Jump to this post

@suev Thank you so much for your kind words. My surgeon loved his portrait and the news of it even made it into a publication for his college alumni. It meant a lot to me to do that since he made it possible for me to paint again with accuracy.

I looked up SAPHO and found this website. https://rarediseases.info.nih.gov/diseases/7606/sapho-syndrome

Your condition sounds like a very complex problem and it will likely be discussed at spine conferences and perhaps in literature. What will they replace the vertebrae with? Is it donor bone or a manufactured prosthetic? This sounds like much more than just fusing existing vertebrae. I am glad you have a motorized chair to help you function.

In my case, I was suspecting that I may have an immune reaction to foreign materials or possibly titanium because I had so many reactions to all the metals I tried when I had pierced earrings. For many years I could wear the earrings, but then it changed. Nothing worked, and it always turned into some kind of infection no matter what I did. I also have asthma that can cause a lot of breathing issues, and I didn't want a plate on the front of my spine talking up space pressing into my esophagus and trachea from behind. I tried to get a test for reactions to metals prior to surgery, but the surgeon (not at Mayo) I saw at that time would not test me even though there was a lab that did that. I had my GP do the test and amazingly, it did not show reactions, but you can always develop a reaction later, and spine hardware would be difficult to remove if there was a problem. Since it was one level, it was easier to ask for no hardware and by then, I was seen by a surgeon at Mayo and he agreed to do it with just a bone spacer disc if I stayed in a neck brace for 3 months. Deal. It was worth it. I also had metals in dental work for many years with crowns that when removed suddenly improved my breathing. That was a couple years after spine surgery when I was getting ceramic dental implants and the teeth were removed. Then I broke my ankle a few years later, and got titanium plates installed. 6 months later, I had chronic hives and had to stay on antihistamine all the time, my ankle throbbed with pain all the time, and there was pigment forming over the plates on the skin. After a year and a half of healing, I had the surgical plates removed and it resolved the pain and hives, so I figure that I was right about my body reacting to foreign materials. The metals are alloys anyway, and not pure, so it's hard to know exactly what caused it. I am glad I chose to do spine surgery without hardware. This is how they did fusions before plates were invented. The plate isn't always needed, but it does aid in stability increasing fusion rates and peace of mind for the surgeon.

My environmental allergy medicine doctor told me about a practice in Texas that treats patients for reactions to implants in case there were no options to avoid hardware and there was an issue. It is the Environmental Health Center Dallas. I ave recommended this to others on Connect and some patients are treating there.

Have you sought second opinions for your surgery? If you feel very confident in your surgeon, that's great, but you have one chance to do this major step. I had 6 opinions, but that was because the first 5 local surgeons missed the correct diagnosis, and that is why I came to Mayo. FYI, I lost a half an inch of height with my collapsed C5/C6 and the fusion gave my height back to me, so I think you will regain height too.

Jennifer

REPLY
@nanny23

How long was your recovery from a laminectomy? My surgeon says o need that and spinal fusion on L4-L5. I afraid of fusion. But considering laminectomy. I have very painful sciatica. Been going to physical therapy a while. Between a hip replacement torn rotator cuff surgery knee surgery from r torn meniscus I’m tired of surgery. I don’t know what to do.

Jump to this post

I had a laminectomy/decompression procedure five years ago and it was completely successful. I am 85 now and am experiencing lower back pain,not associated with the sciatica, I am at a loss as to weather or not to try surgery or epidural injections.

REPLY
@denman55

I have spent 10-years suffering with Lumbar spinal stenosis. I've had numerous Epidural steroid injections, Radiofrequency ablation, PT, OT, Acupuncture, an Interspinous spacer inserted, a MILD procedure, and now finally I have just had the SPRINT PNS System device procedure done on my lower back. Finally, I have found relief from all the pain I have suffered for all these years. See a Physiatrist, don't waste your time with Pain Management physicians or Orthopedic physicians, they didn't help me, and they won't help you.

Jump to this post

Interesting comment about the SPRINT PNS system. Who did this procedure and was it a painful procedure to have done and are you still happy with the results. I had a failed spinal cord stimulator and have suffered from that for a few years. I would be interested in learning more about this one and see who performs the procedure. Thank you

REPLY
@mdfriel

Interesting comment about the SPRINT PNS system. Who did this procedure and was it a painful procedure to have done and are you still happy with the results. I had a failed spinal cord stimulator and have suffered from that for a few years. I would be interested in learning more about this one and see who performs the procedure. Thank you

Jump to this post

The SPRINT PNS SYSTEM is working wonderfully for me - I chose this system over the Spinal cord stimulator which I really was just not comfortable with having done after reading the reviews and the number of complaints regarding it. My SPRINT PNS SYSTEM was performed by my spine doctor, an MD Physiatrist. It was definitely not a painful procedure and Yes, I am still very happy with the results.

REPLY
@denman55

I have spent 10-years suffering with Lumbar spinal stenosis. I've had numerous Epidural steroid injections, Radiofrequency ablation, PT, OT, Acupuncture, an Interspinous spacer inserted, a MILD procedure, and now finally I have just had the SPRINT PNS System device procedure done on my lower back. Finally, I have found relief from all the pain I have suffered for all these years. See a Physiatrist, don't waste your time with Pain Management physicians or Orthopedic physicians, they didn't help me, and they won't help you.

Jump to this post

What is a sprint PSN system? How can i find out about it. Sounds great.

REPLY
Please sign in or register to post a reply.