Spinal pain management

I had a spinal fusion ten years ago at UCSF, as I lived in Northern California. it didn't give the relief I was looking for. Spondyliothesis, DDD, stenosis, and levoscoliosis, which the latter plagues me today. After the epidurals, PT sessions at various locations, neurosurgeon at Mayo, twice (two different surgeons) I decided after the disc slippage again while playing tennis, to consider a spinal cord stimulator. The pain management doctor recommended an Abbott, and the latest device. After the trial to see if it was successful for five days, of which it was, I interviewed three surgeons. I chose the surgeon the rep recommended, and I have and been pleased with him. The device was switched out for a more compatible device, as the non-chargeable unit was too large on my body frame. I walk away with three pieces of advice: have more than one neurosurgeon's referral; use the paddles and not the lead wires for more pain management effectiveness; and work with your rep after the implantation: it is not a one size fits all. I have called and worked with the rep six times to find a program that works for me. I believe for some people, they give up too early. The recovery is longer with the paddles, and not an easy recovery. I took off seven weeks from sports, but I don't suffer from morning pain when rising, or pain after a long tennis match. I am 69 years old, extremely active, and hope to engage in sports well into my 80's.

best of luck to you. Please continue to keep the viewers updated on your results. I like how you mentioned " I am old enough that I can remember going to the Dr. and they would tell you what is wrong, now days you have to be the Dr. and tell them what you have and what they need to do for you. "

I am to see a scoliosis neurosurgeon this month, upon recommendation from the neurosurgeon who implanted the SCS last year. This neuro ordered the X-rays, and CT scan along with the doctor's referral. He is Keeper!

The trial is important. It will give you an idea as to how well you will do with the permanentimplant. My trial gave me about 80% relief. The permanent implant was only about 50%, but, along with the meds, I got decent pain relief. The next decision is which one to use. There are many different ones out there... Medtronics, NEVRO HFX, Boston Scientific, and others. I have seen people say to get the paddle electrode which is sutured in place. Less chance of moving away from the sweet spot.
Mine worked for about three and a half years. Then it just suddenly stopped. There was some thought that some of the electrodes on the paddle had burned out. Who knows? Good luck with whatever you decide.

Hi all
I just joined this group as I am waiting for an appointment schedule for a second opinion at May Phoenix. I have herniated disc l5-l1, spinal stenosis, ddd and as a result have had serious lower back pain over the last 6 years, with excrutiating sciatic pain down both legs starting about a year ago.
I see a great pain doc in Chandler AZ and he tried everything, steroid injections, blocks, nerve ablation. Nothing helped. I saw a surgeon at Barrow, and he said that while he can do a laminectomy on three of the discs, he is worried about the impact on spine stability. Now waiting for a second opinion from Mayo.
I am a 53 active female and I feel my life has been taken away from me. I am on gabapentin and duloxetine, tylenol, aleve, THC, CBD ... do reformer pilates 5 times a week ... and I still cannot walk more than 100 ft without pain.
Anyone who has looked at a three disc laminectomy vs fusion in the L5-L1 section? I have not looked into stimulators at all.
Any advice is appreciated.

My problem is in my cervical spine. According to one surgeon I will become paralyzed without laminectomy and fusion. I have dealt with this off and on for 30 years. Do not want spine surgery. Going for second opinion with chief of neurosurgery at Univ of Penn Friday. Best thing you can do is second opinion and don’t go to orthopedic surgeon. Go to a neurosurgeon. I worked in orthopedics for 20 years They are trained differently. Good luck

Ugh, I have cervical stenosis and thoracic outlet syndrome in addition to the lumbar issues. But I’ve been lucky that I’ve been able to manage it with medications, injections, and massage therapy. No luck with any of that for the lumbar issues.
So scary to think it could lead to paralysis! Hoping for a good outcome for you.

Thanks. They can’t do an epidural because there is no space to put the needle in. I tried that first. Good luck with your lumbar. That is a harder recovery

Hi germangirlvt- I'm assuming you are talking about a potential fusion of L5-S1. If not, please explain where the fusion will be taking place.
I am fused from L2 to L5. I have considerable back pain coming from L5-S1 and from the two SI joints. The neurosurgeon I saw said that a fusion at L5-S1 was guaranteed to fail because that is the only level of the spine that currently has any movement. If that level were to be fused, my lower spine would be totally w/o any ability to move. He said he could guarantee that a fusion at L5-S1 would be a failed fusion. Perhaps you are talking about a different level?

@germangirlvt - Good morning and welcome to Mayo Connect. This is a great place to get new ideas, share common experiences, and converse with those who are going through or have gone through medical situations similar to yours. You already have gathered some good input!

I had a four-level lumbar laminectomy/fusion (L2-5) in May 2023. My situation was somewhat different then yours - which is nearly always the case with every spine patient. It's a great idea to get a 2nd opinion from Mayo.

I'm not sure I follow your discectomy vs fusion question? In my case, the two procedures, though separated in the OR by 48 hours, were connected. The discectomies dealt with the spondy and stenosis while the fusion helped with the spondy while creating a point of stability in my lumbar region. In other words - one begat the other.

Are you attempting to avoid a fusion? In my case, I don't think having one vs both would have made any difference in my recovery while doing both improved my overall spinal stability.

Which doc are you seeing at Penn? I have gone there for my spine issues and there are good and not good neurosurgeons there, in my opinion. I f you want to message me I am happy to share my experience.