Looking for people who had a disc totally worn away, GOKHALE method

@annie1
I had severe stenosis at L4-L5. My MRI showed I had no space whatsoever at that level for my spinal cord/nerve roots to function properly or send signals or allow proper blood flow/circulation.

I ended up having a disc spacer put in where they removed degenerated discs and decompression of my spinal cord/nerve roots with fusion to stabilize L3-L5. My L4 vertebrae was slipping over my L5 vertebrae (spondylolisthesis).

Before surgery, I had pain, weakness and numbness in my lower back, hips, buttocks, thighs and down to my feet. I couldn’t stand, standup, walk, use stairs for long at all. I was afraid of walking because my legs/feet would go weak/numb. All of my symptoms fell under the neurogenic claudication umbrella. After surgery, many symptoms improved.

@annie1
The Gokhale Method would not necessarily help me because I have a congenitally narrow spinal canal to begin with and any degeneration of my spine, discs, bone spurs, etc. would cause compression of my spinal cord/nerve roots. Posture is definitely important and having a strong core helps but some degeneration makes the need for decompression of spinal cord/nerve roots necessary. If fusion can be avoided, that is probably ideal but some don’t have spinal stability. Fusion helps for a period of time prevent the need for more surgery. The problem is that with fusion, you can get segment issues above and below the level of fusion and require more surgery.

I had decompression and fusion of c5-c6 and need c6-c7 done next week. I most likely with need more surgery in the future on my lumbar and cervical spine (currently in my mid 50s).

Thank you for your response. Did they have to do fusion to keep the spacer in place and if you don't mind me asking where did you have the surgery done? Your case sounds very similar to mine so that's very encouraging but so far the doctors I've spoken to have only offered fusion and my own surgeon said he was reticent to do that because there are often problems above and below the fused area requiring more surgery. Again I'd love to know where you did this surgery so I could contact them.

I just reread your whole message and saw that you did have fusion so excuse my asking again about that. At any rate I'd like to know where you had the spacer put in so I can follow up with that place.

@annie1
I live in New England and went to Ortho RI (Dr. Ian Madom).

Dr. Madom put cages in between my L3-L4 and L4-L5 vertebrae and used some of my own bone to create the “cement” to fill the cages for fusion. Using your own bone helps your body accept the fusion material. They needed to cut away so much to give space to my spinal cord/nerve roots so they had plenty of my own bone for this “cement.” When they did the ACDF fusion on my C5-C6, they used my bone spurs that were removed due to causing compression on my spinal cord/nerve roots.

Okay thank you. I have osteoporosis so I am being treated for that before I can have any fusion since my bones would be strong enough to hold anything. That's why they're being very cautious with me. I don't have a surgeon picked out I've been interviewing surgeons literally all over the country. I have to wait till my bones get strong enough I'm on the bone building medication for osteoporosis.

@annie1
Good luck strengthening your bones. Do you know why you have osteoporosis (is it caused from diet low in calcium or something else)?

Are you doing weight bearing exercises to help build bone along with taking medications/supplements?

Are you working with a dietitian/nutritionist to help you review your diet and supplements to strengthen and build your bones?

This is the response I received when checking AI:

Spinal fusion surgery is a procedure used to join two or more vertebrae in the spine, which can help stabilize the spine and alleviate pain caused by conditions such as degenerative disc disease, spinal stenosis, or spondylolisthesis. When osteoporosis is present, it can complicate the surgery and recovery process due to the weakened state of the bones.
Considerations for Spinal Fusion Surgery with Osteoporosis
Bone Quality: Osteoporosis leads to decreased bone density, making the vertebrae more fragile. This can affect the ability of the bones to fuse properly after surgery.
Surgical Techniques: Surgeons may use specific techniques to enhance stability and promote fusion. This might include the use of bone grafts, screws, and rods that are designed to provide additional support.
Preoperative Assessment: A thorough evaluation, including imaging studies like X-rays or CT scans, is essential to assess the extent of osteoporosis and plan the surgery accordingly.
Postoperative Care: After surgery, patients with osteoporosis may require additional monitoring and rehabilitation. Physical therapy can help strengthen surrounding muscles and improve overall stability.
Medications: Patients may be prescribed medications to improve bone density before and after surgery. Bisphosphonates or other osteoporosis treatments can be considered to enhance bone health.
Risks: The risks of spinal fusion surgery in patients with osteoporosis include nonunion (failure of the bones to fuse), increased risk of fractures, and complications related to hardware used in the surgery.
Consultation with Specialists: It is often beneficial for patients with osteoporosis to consult both an orthopedic surgeon and a specialist in osteoporosis or endocrinology to optimize treatment plans.
Conclusion
Spinal fusion surgery can be performed in patients with osteoporosis, but it requires careful planning and consideration of the unique challenges posed by the condition. A multidisciplinary approach involving surgeons, physical therapists, and osteoporosis specialists can help improve outcomes and ensure a safer recovery. If you or someone you know is considering this surgery, it's important to discuss all concerns and treatment options with a healthcare provider.