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Andy Ryan

Disc fusion. Anyone had one?

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So been having nerve pain down one side of my leg now for over 3 years due to a pars defect (slipping of a disc) of L5  that is pinching a nerve. Been told by sports doc that it is irreversible with rehab and after trying every pain numbing medication, cortisone injections, etc that a fusion of the disc is the only way to relieve the pain.  

Has anyone had this done before? What was your recovery/ success like? Are you able to do all activities like swim, run, bike, day to day life stuff? Also what was your out of pocket expenses for the op. As there is likely to be a long wait list to get it done, is it worth getting private health insurance?

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51 minutes ago, Andy Ryan said:

As there is likely to be a long wait list to get it done, is it worth getting private health insurance?

Just be sure you ask about waiting periods, and exclusion of pre-existing conditions on that one.

 

As for the rest, sorry to hear.  I have a lot of similar problems so can relate.

 

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3 hours ago, Andy Ryan said:

So been having nerve pain down one side of my leg now for over 3 years due to a pars defect (slipping of a disc) of L5  that is pinching a nerve. Been told by sports doc that it is irreversible with rehab and after trying every pain numbing medication, cortisone injections, etc that a fusion of the disc is the only way to relieve the pain.  

Has anyone had this done before? What was your recovery/ success like? Are you able to do all activities like swim, run, bike, day to day life stuff? Also what was your out of pocket expenses for the op. As there is likely to be a long wait list to get it done, is it worth getting private health insurance?

(Sports physio opinion):

 These are difficult as the research supporting lumbar fusion isn't great (e.g. there isn't a lot that shows good long term results). Often as you've mentioned you feel like you are left with no other choice. Have you given the rehab a good crack?

current recommendations for fusion are below in the pic

re: swim, bike, run, it's very individual so hard to answer. The advice you get often depends on the sporting background of the therapist, e.g. a surgeon who isn't sporty is less likely to recommend return to running.

Can't advise on costs, waiting lists. But I would be more comfortable choosing my own surgeon with this procedure, there is a strong relationship with number of procedures performed and success rates.

current recommendations for fusion are below in the pic

D0yGGInUYAAdWjv.png

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Hi Andy

What Aidan says.  However, you have to be careful with your choice of orthopaedic surgeon.  If you live in Brisbane or close I can highly recommend Dr Labrom http://www.qcosspine.com.au/  He will not operate for the sake of operating.

Re health funds, there will be a preexisting conditions clause which may push out the waiting period.  Best thing to do is to find an orthopod and get an opinion and quote, then run the numbers.

Good luck

 

 

Edited by Cat Lady
spelling

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1 hour ago, Aidan said:

Have you given the rehab a good crack?

Have tried core strengthening work with no improvement. The strange thing is I have no pain in my back at all, just the nerve pain in lower leg. MRI’s have shown no problems in leg just at L5 of spine. Is there any other rehab I should be trying?

1 hour ago, Aidan said:

re: swim, bike, run, it's very individual so hard to answer. The advice you get often depends on the sporting background of the therapist, e.g. a surgeon who isn't sporty is less likely to recommend return to running.

To be honest I’d be happy to give away all sport if the op fixed the pain. It’s becoming more of a quality of life issue as at the moment walking for 30min flares it up, lying a certain way in bed, sitting on couch, etc.

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I had an L4/5 fusion 14 years ago. It will take longer than I have right now to explain the reason (and the ups and downs) but I'll try to post some time tonight with more details.

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Sorry this is long, but it's about as complete as I can be. Clearly this is not medical advice, just my situation, but might be relatable.

OK, I was originally diagnosed with spinal canal stenosis. Had fairly obvious symptoms - nerve pain in the legs, tingling and associated back pain. After trying a bunch of things (acupuncture, massage, chiro, physio and cortisol injections) we finally decided on a laminectomy. 

The result wasn't great - probably had more pain after than before and it was a miserable time in my life. About a year later I had a major 'slip' of the vertebrae (which can sometimes be a consequence of a laminectomy) resulting in a severe spondylolisthesis. I had direct pressure on the spinal cord resulting in severe nerve pain and numbness from the waist down - frankly, it was terrifying.

I saw the surgeon on Monday at 3pm and had an L4/5 fusion at 9am Tuesday morning - he said it was an emergency and literally couldn't wait another day - serious risk of permanent paralysis.

The fusion was far easier than the laminectomy, although a significantly bigger procedure. Needed virtually no pain killers and was up that afternoon walking on a frame. In hospital about 5 days and recovered pretty well. I was swimming (Dr's recommendation) as soon as the wound healed. Ironically it was this that got me into triathlon.

The Dr discouraged running but said if I wanted to I should just be aware of hard surfaces and wear decent shoes. I went back to touch football after about 12 months. I played about 10 years of 1st Div touch and still play social every week. Sometimes I can pull up a bit sore but I think that's more general arthritis in the spine rather than something specific to the fusion.

I (under)trained for an ironman - never ran more than 20km. Cycling was not an issue. I could do 5  hour bike rides with little discomfort and I could swim as much as I wanted. Walking was not a problem. I had to give up Judo as I felt the risk of violent twisting, jerking and falling was too high. I recently started indoor rock climbing and it's been fine. I do yoga to maintain flexibility and movement.

On the downside, about twice a year I'll do something which feels like badly pulled muscles in the lower back. It can be very debilitating and very painful. It normally takes a few weeks to pass and then returns to normal. Often it is brought on by something quite inconsequential (picking up my briefcase at work) which is ironic given how much I test my body at touch football and climbing. It always passes but it's not fun when it happens.

Lifting is a no-no. Forget throwing around bags of cement or anything over about 5-10kg. Lifting in one thing which does give me trouble as it compresses the spine. It's not a huge problem but may be a consideration if you have young kids.

I do have a tendency to be very stiff after sitting for any length of time. Needs a few seconds to get straight and then walk it off. Keep in mind I am 60 so it might just be age catching up as well. Once I'm in motion I'm fine.  

Sometimes sleep can be a challenge if I'm feeling sore. Hotel beds aren't my favourite thing.

Here's a summary.

Do everything you can to NOT have surgery. If you haven't tried yoga, do it for at least 4 weeks and see if it helps. My body is noticeably better when I'm doing yoga (and swimming) regularly. In some respects I regret the first surgery but hindsight is 20/20 - at the time the nerve pain was pretty bad and I wanted it fixed.

Whilst I didn't have an option for the fusion, it resolved pretty much all of my problems - nerve pain gone, back pain gone - it was great. Having said that, my body isn't what it used to be - but it could also be age. I know a lot of people younger than me who can't do half what I do physically.

Long term I'll probably need an L5/S1 or L3/4 fusion as fusing a level puts additional workload on the adjacent levels, accelerating their degeneration. I was told about 10 years - it's been 14 now and I'd like to hold out until I retire then hopefully get another 15 years.

Can't think of anything else right now. If you have any questions feel free to ask.

FYI, this is what my spine looks like - you can feel the screws sticking out of my back :)
 
spine.thumb.jpg.d5a07359214f19d98a84b924c8789877.jpg
Edited by trinube

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I have no experience in this but 2 of the guys in my Pilates class have had back issues and both have said that after Pilates for a few weeks there is a significant improvement.

Good luck with it

NSF

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1 hour ago, trinube said:

Sorry this is long, but it's about as complete as I can be. Clearly this is not medical advice, just my situation, but might be relatable.

OK, I was originally diagnosed with spinal canal stenosis. Had fairly obvious symptoms - nerve pain in the legs, tingling and associated back pain. After trying a bunch of things (acupuncture, massage, chiro, physio and cortisol injections) we finally decided on a laminectomy. 

The result wasn't great - probably had more pain after than before and it was a miserable time in my life. About a year later I had a major 'slip' of the vertebrae (which can sometimes be a consequence of a laminectomy) resulting in a severe spondylolisthesis. I had direct pressure on the spinal cord resulting in severe nerve pain and numbness from the waist down - frankly, it was terrifying.

I saw the surgeon on Monday at 3pm and had an L4/5 fusion at 9am Tuesday morning - he said it was an emergency and literally couldn't wait another day - serious risk of permanent paralysis.

The fusion was far easier than the laminectomy, although a significantly bigger procedure. Needed virtually no pain killers and was up that afternoon walking on a frame. In hospital about 5 days and recovered pretty well. I was swimming (Dr's recommendation) as soon as the wound healed. Ironically it was this that got me into triathlon.

The Dr discouraged running but said if I wanted to I should just be aware of hard surfaces and wear decent shoes. I went back to touch football after about 12 months. I played about 10 years of 1st Div touch and still play social every week. Sometimes I can pull up a bit sore but I think that's more general arthritis in the spine rather than something specific to the fusion.

I (under)trained for an ironman - never ran more than 20km. Cycling was not an issue. I could do 5  hour bike rides with little discomfort and I could swim as much as I wanted. Walking was not a problem. I had to give up Judo as I felt the risk of violent twisting, jerking and falling was too high. I recently started indoor rock climbing and it's been fine. I do yoga to maintain flexibility and movement.

On the downside, about twice a year I'll do something which feels like badly pulled muscles in the lower back. It can be very debilitating and very painful. It normally takes a few weeks to pass and then returns to normal. Often it is brought on by something quite inconsequential (picking up my briefcase at work) which is ironic given how much I test my body at touch football and climbing. It always passes but it's not fun when it happens.

Lifting is a no-no. Forget throwing around bags of cement or anything over about 5-10kg. Lifting in one thing which does give me trouble as it compresses the spine. It's not a huge problem but may be a consideration if you have young kids.

I do have a tendency to be very stiff after sitting for any length of time. Needs a few seconds to get straight and then walk it off. Keep in mind I am 60 so it might just be age catching up as well. Once I'm in motion I'm fine.  

Sometimes sleep can be a challenge if I'm feeling sore. Hotel beds aren't my favourite thing.

Here's a summary.

Do everything you can to NOT have surgery. If you haven't tried yoga, do it for at least 4 weeks and see if it helps. My body is noticeably better when I'm doing yoga (and swimming) regularly. In some respects I regret the first surgery but hindsight is 20/20 - at the time the nerve pain was pretty bad and I wanted it fixed.

Whilst I didn't have an option for the fusion, it resolved pretty much all of my problems - nerve pain gone, back pain gone - it was great. Having said that, my body isn't what it used to be - but it could also be age. I know a lot of people younger than me who can't do half what I do physically.

Long term I'll probably need an L5/S1 or L3/4 fusion as fusing a level puts additional workload on the adjacent levels, accelerating their degeneration. I was told about 10 years - it's been 14 now and I'd like to hold out until I retire then hopefully get another 15 years.

Can't think of anything else right now. If you have any questions feel free to ask.

FYI, this is what my spine looks like - you can feel the screws sticking out of my back :)
 
spine.thumb.jpg.d5a07359214f19d98a84b924c8789877.jpg

Thanks for the great summary. I can relate to a lot of what you have been through. It’s interesting that you were swimming so soon as that is the one activity that really flares the pain. It must be the way I rotate in the water puts pressure on that joint compressing the nerve. Running, riding, walking, sitting and lying have only really started to cause a lot of pain In the last six months.

Who was your surgeon if you don’t mind me asking and where about did you have it done? I’m Victoria based so would be looking at having it in Melbourne.

Thanks again

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6 minutes ago, Andy Ryan said:

Thanks for the great summary. I can relate to a lot of what you have been through. It’s interesting that you were swimming so soon as that is the one activity that really flares the pain. It must be the way I rotate in the water puts pressure on that joint compressing the nerve. Running, riding, walking, sitting and lying have only really started to cause a lot of pain In the last six months.

Who was your surgeon if you don’t mind me asking and where about did you have it done? I’m Victoria based so would be looking at having it in Melbourne.

I saw Dr Andrew Cree in Sydney - operated in Westmead Private.  He specialises in paediatric spinal surgery so I figured if he could handle very delicate little things he'd be good with me. Very gentle and competent, and clear in his discussions - no BS sort of guy. I'd gladly see him again if needed.

https://www.stadiumclinic.com.au/dr-andrew-cree-spine-surgeon-sydney.html

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5 hours ago, trinube said:

 

Here's a summary.

Do everything you can to NOT have surgery. 

spine.thumb.jpg.d5a07359214f19d98a84b924c8789877.jpg

Now you tell me :lol:

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4 hours ago, Andy Ryan said:

...It’s interesting that you were swimming so soon as that is the one activity that really flares the pain. It must be the way I rotate in the water puts pressure on that joint compressing the nerve. Running, riding, walking, sitting and lying have only really started to cause a lot of pain In the last six months.

Swimming is bad for me (amongst loads of other things) because I have a completely crap core and bend like a banana in the water. Any position that has me in a prolonged anterior pelvic tilt causing me significant amounts of grief. Repetitive lumbar extension/flexion is the other worst thing. 

As others have said, I am at my best when I do regular core and pelvic stability work. I have an awesome power yoga routine, only 20 minutes long, if I do that daily, I am in the best shape I can expect to be given the condition of my lumbar spine. I've been neglecting it and paying the price. 

I've always said I never want surgery if I can avoid it and I had gotten to the point of giving up and deciding I needed it and there was no other option. Thank you Trannies for reminding me I've actually been managing this for a decade without surgery, I need to get back to doing what I need to do.

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1 minute ago, Katz said:

Swimming is bad for me (amongst loads of other things) because I have a completely crap core and bend like a banana in the water. Any position that has me in a prolonged anterior pelvic tilt causing me significant amounts of grief. Repetitive lumbar extension/flexion is the other worst thing. 

Yep, ditto. And why i gave up IM. 4K swim was too much. 

Need to get back into the Pilates tho. 

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On 07/03/2019 at 8:44 AM, Andy Ryan said:

Also what was your out of pocket expenses for the op. As there is likely to be a long wait list to get it done, is it worth getting private health insurance?

I missed his first time around. Remember, mine was a long time ago so the pricing will have increased.

From memory, private health insurance covered all hospital costs (rooms, theatre etc). I paid a percentage of the anaesthetist and the surgeon. I seem to recall being out of pocket a few thousand.

As for waiting time, I only waited 18 hours :)  If you have private health you'll probably get in within a few weeks. Going public I have no idea. Dr Cree is usually booked pretty solid - normally about 3-4 months to see him in rooms.

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1 minute ago, Turts said:

Yep, ditto. And why i gave up IM. 4K swim was too much. 

Need to get back into the Pilates tho. 

I'm fine with a wetsuit on. It keeps me straight. It's the training in the pool where I struggle. 

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18 minutes ago, Katz said:

I'm fine with a wetsuit on. It keeps me straight. It's the training in the pool where I struggle. 

Interesting. I'm the exact opposite. The additional flotation in the legs does me in. Especially with a full sleeve wetsuit. 

Maybe I'm a reverse banana? 

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