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L4-L5 back surgery & hunting?
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Howdy Men,

I'm apparently in need of surgery to fix a large disk protrusion between my L5 and L4 vertebrae (lower back), which has been causing me much pain for some time now. I'm just wondering if any of you have had this type operation and how it has affected your hunting?

I see an orthopedic surgeon in a week who is a spinal specialist.

Thanks for any advice,


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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Did you give epidural steriods a try?

Depending on what kind of shape your in and your general overall health most people do fine and bounce back pretty quick. You should be good by fall.

Some people become better hunters as they are able to hold still longer for stalking and shoot better without that constant ache bugging them when they are in some crazy position.
 
Posts: 283 | Location: SW Oregon | Registered: 12 June 2004Reply With Quote
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I have a ruptured disk between L4 and L5. Here is what helped:

1. Loss of 35 pounds.

2. Lots of muscle strengthening exercises for the abdomen and back. Traditional situps like you did in high school don't cut it. It may seem weird, but pilates exercises really help core strength and stability.

3. Lots of relatively low impact cardio, such as an elliptical machine, swimming, and rapid walking.

4. Chiropractor, however if you end up in the care of a baboon he will tear your spine out.

I have heard that the epidural steroids work well for about 6 months.

As a general rule, we should all put off back surgery as long as we can.
 
Posts: 18352 | Location: Salt Lake City, Utah USA | Registered: 20 April 2002Reply With Quote
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Thanks for the responses. I'm only 39, but I've had on/off back problems since my Army Infantry days back in the late 80s. Apparently I also have a desiccated disk, and I'm not sure what can be done about that. I'd like to put off surgery, if at all possible, but I don't know what can be done about a dried out disk. I guess I'll see what the spine Doc says. The good news is that I work with a bunch of good MDs and they say I'm going to the best man I can, given my situation.

I'm at the point now where my back will just "go out" and I'm pretty much helpless, and I hate that (not to mention the pain). I thank God I have a great wife. Losing 35 lbs wouldn't hurt though, for sure.

I just can't imagine not being able to walk around in the woods with a ruck sack on.


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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I had a microdiscectomey at 4-5 wednesday how is that for timely experience. My herniation not bulged disk was 2 cm by 2 cm. It had been putting me out of hunting for a month every year for several years. I had the surgery because of the size of the rupture and the fact that it could flair up and make me miss a hunt. I had a similar rupture at the same place 20 years ago and had surgury then. I got 20 years of hard hunting out of the last one and expect the same or better this time. Hard hunting to me is defined as yearly back pack week long crosscountry elk and mule deer hunts. I will not be doing that this year to make sure I am fully healed. Since I live in Idaho I may give up that type of hunting anyway. (wolves) My advice is listen to your specialist not me. I have no experience with witch doctors.
 
Posts: 1952 | Registered: 16 January 2007Reply With Quote
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I had double lamenectomy surgery on my L-4 L-5 about 11 years ago.
My situation was quite bad, and surgery was the best choice for myself.
I recovered quickly but carefully. I would say within 6 months I was back to normal.
I can't remember the last time my back went out.
As for hunting my back is a non issue. I backpack hunt and horseback hunt without any problems. I hauled out a large bull elk on my back last season and was fine. Tired and sore, but fine. Wink I do work out which I feel is essential for a quick and whole recovery.
It doesn't slow me down and I am glad I had the surgery.
I would try physical therapy first though.
Personally I would be leery of a Orthopedic.
I would talk with a Neurosurgeon.
Good luck!
 
Posts: 295 | Location: Oregon | Registered: 24 June 2006Reply With Quote
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In 1991 I had a fusion done.
The Steriods that people are saying is acualy called a pain block. I have had that too .
I just learned what to do and what not to do.
I have been to Alaska to B.C. goat to Africa to Mexico Coues Deer. You will learn you limitations if any. I feel 10 thousand times better. No more Numbness or bad pain. I still have pain sometimes but not real bad.
 
Posts: 1456 | Location: maryland / Clayton Delaware | Registered: 16 December 2004Reply With Quote
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I had a double laminecotmy after going through the cycle of steroid shots (yes they work about 6 months), a "mini-disectomy: finally the big procedure at L1-2 and L5-S1

500Gs is right, exercise and fitness help, but in my case I should have done the surgery sooner.

In any event, 5 months after, I was hunting, Doesn;t slow me down at all, but I avoid lifting the animals, repetitive stooping, bending etc.

Odd thing, I sleep much better when hunting, because my only lingering complaint 2 years post surgery is continued spasms and pain at the surgery site when sleeping. I have not had a full nights sleep since my injury.....even after the surgery.


______________________________

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Posts: 1489 | Location: North Carolina | Registered: 19 July 2005Reply With Quote
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Teat Hound, I have some advice that may or may not be helpful.

First, I recommend a neurosurgeon over an orthopaedic spine doctor. That will probably piss some folks off but that is my recommendation.

Second, if you get a few opinions from the surgeons, you will find that there is a "window of opportunity" in which a spine surgery will be of greatest benefit. Unfortunately, the longer you wait (which is what most everyone wants to do), the less your odds are of having the greatest outcome. It is like a double edge sword. Surgery on the spine should always be the last resort, but that is only if you plan on taking the right steps to make your spine healthy, with core strength exercises, range of motion exercises, and a good stretch regimen. This is all in addition to increasing your daily water intake.

Disc dessication is what many refer to as "hardening of the disc" and "water loss in the disc."

Be very careful about making the step to do a surgery with a disc that is protruded.

The basic definition of a protruded disc is where the stalk is broader than the distance the disc has protruded towards the spine. An extrusion is where the stalk is smaller than the the portion that has "extruded" towards the spine. Both are "herniation" language.

Do you know whether or not your protrusion is subligamentous?

My advice is you find some doctors in your area that do "spine decompression." Bottom line is it works, you get to avoid surgery in most all cases, you get a very good list of core exercises to do.

You need to investigate the technique used by the surgeon as well. This is also why I much prefer neurosurgery to orthopaedic.

1. ALIF: anterior lumbar interbody fusion. A very successful approach, but an ugly anterior scar on the belly. Excellent outcomes compared to most long term results when a PLIF is performed.

2. PLIF: Posterior Lumbar interbody fusion, long midline scar from posterior approach. Surgeon must pull muscles away from spine, although patients have varied recoveries, this can be a painful recovery, and you can have permanent adhesions due to scar tissue.

3. TLIF: Very good approach. Transforaminal Lumbar interbody fusion. Scars much smaller, not midline.

There's much more to tell. Have 2 patients waiting for me now. I'll send you PM.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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I agree 100% with 500! If you can alleviate your pain with weight loss and excercise that would be the best thing for you. I blew my back up and had surgery on the L5 when I was 24 years old. I did not have any options, I had to have the surgery. I felt better the night after the surgery, no more spasms in my left leg. I was guiding the next fall with no problems(surgery was in May). It took me a while to get back in "playing" shape but I am so glad I had the operation. I am now 33 and am not having any lingering problems with my back, it hurts every now and again but thats to be expected. Hell, I am even back to dunking on a few guys in my city league basketball games. Not too shabby for a 33 yr old, 6'4" 250 lb. white guy with a surgically repaired
back.

Best of luck to you...

Drum
 
Posts: 2092 | Location: Windsor, CO | Registered: 06 December 2005Reply With Quote
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I had a micro-laminectomy on L5-S1 in 1994 at age 38 and have never regretted it.

I would 2nd Doc's recommendation on seeking out a neurosurgeon for your procedure. My incision is/ was only slightly > than 1 inch long and I was back to work in 30 days due to the requirements of my insurance short term disability... I could have resumed normal duties sooner. I was hunting 6 months later.

I've also had steroidal epidurals and consider them little more than medical grease and did not receive much benefit from them.

500 grains' advice regarding weight loss and strengthening your trunk muscles should not be ignored. That's the single best thing you can do for the best post surgery outcome.

I wouldn't put it off any longer.


Regards,
Brian


Meet "Beauty" - 66 cal., 417 grn patched roundball over 170 grns FFg = ~1950 fps of pure fun!

"Scotch Whisky is made from barley and the morning dew on angel's nipples." - Warren Ellis

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Posts: 479 | Location: Western Washington State | Registered: 10 March 2005Reply With Quote
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quote:
Originally posted by drummondlindsey:
I agree 100% with 500! If you can alleviate your pain with weight loss and excercise that would be the best thing for you. I blew my back up and had surgery on the L5 when I was 24 years old. I did not have any options, I had to have the surgery. I felt better the night after the surgery, no more spasms in my left leg. I was guiding the next fall with no problems(surgery was in May). It took me a while to get back in "playing" shape but I am so glad I had the operation. I am now 33 and am not having any lingering problems with my back, it hurts every now and again but thats to be expected. Hell, I am even back to dunking on a few guys in my city league basketball games. Not too shabby for a 33 yr old, 6'4" 250 lb. white guy with a surgically repaired
back.

Best of luck to you...

Drum


You lost all credibility when you admitted to playing basektball banana


"Science only goes so far then God takes over."
 
Posts: 3504 | Location: Tennessee | Registered: 07 July 2005Reply With Quote
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I'd forego the injections all together. Epidurals, facet injections, nerve blocks, the whole lot.

I've referred many patients for injections only to hear the same results time and time again:

Injection/epid. #1 works for as little as a day to 2-3 months.

#2 works for a day to maybe a week, if that. OR no change to worse.

#3 nothing, or worse.

Remember, corticosteroid injections will ease some of the inflammatory changes that are ongoing but they do nothing whatsoever to the portion of the disc that is effacing your descending nerve roots, pressing on your dorsal nerve root ganglion, or the ventral sac.

Dr. Pomeranz, a well known orthopaedic radiologist here in Cincinnati recommends lumbar disc surgery ONLY when the patient has foot drop, bowel/bladder dysfunction related to the nerve root, or pain 24/7.

The problem with invasive lumbar disc surgery fusion is what your future holds. The likelihood of a future disc rupture at the level above or below is greater than 50%. When you fuse 2 segments (vertebrae), all normal mechanical motion is lost as they become 1. The adjacent discs above and below will become overworked (that's the catch), from doing all of those exercises that are vital anyway. In that regard it is a lose/lose.

However, the remaining discs stand the best chance with core strength. Your own worst enemy will be you. Do not allow your back to become deconditioned.....ever.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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quote:
Originally posted by 500grains:

As a general rule, we should all put off back surgery as long as we can.


This is absolutely 100% true. Once you cut the soft tissues and do this type of invasive procedure, there's no going back.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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What are your symptoms? Are you having leg pain or sciatica? Or is there any neurological deficit in any areas of your leg or foot? Or is it just (although that's not to minimize it) back pain? My back is a mess, I have several herniated disks from a long life of abuse as well as moderate stenosis. I had a chimopapayne (sp) injection in 1983 and it worked ok, but problems persisted. Since then, I've had a few bad episodes, but after discussing with my neurosurgeon and orhthopedist each time the downsides of what would be a very serious surgery, I've opted to go the physical therapy/yoga/exercise route. So far it's worked. I'm going on another sheep hunt in August, have no problem packing 50-60 pounds when I need to and I've drastically improved my posture and core strength. The longer you can put off surgery (I've also put off shoulder surgery) the better off you are. I know it sounds a bit like voodoo, but you might also read John Sarno's book, mind over back pain. Believe it or not, it works too. Good luck. Bad backs are no fun. Take care, EB
 
Posts: 318 | Location: No. California | Registered: 19 April 2006Reply With Quote
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I forgot to mention, one of the cheapest, effective self treatments you can do is to buy yourself an inversion table and use it daily. A few hundred bucks and it's worth every penny.

This website can get you started.

Anyone going on a rigorous hunt might entertain using one of these. Especially beginning a few months before the trip.

Actual disc surgery using a tubular retractor.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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Lumbar microdiskectomy fifteen years ago. I have problems with my back but not THAT problem anymore. I went the neurosurgeon route and have been very satisfied.
 
Posts: 167 | Registered: 26 November 2006Reply With Quote
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I had L5-S1 fused May 1st last year and went to Australia the last week of June on a Buffalo hunt. I had to have surgery because my disk was completely destroyed. I'm just now to the point where I do not have any pain. The doctor said it would be 12 to 18 months before I would not have any pain so I guess I'm on track.

I was able to hunt last season but not as hard as normal because of the surgery. I'm looking forward to this season.
 
Posts: 125 | Location: Coalgate, Oklahoma | Registered: 21 April 2002Reply With Quote
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Everyone, thanks for the advice. I owe you all a nice, cold dark beer (Doc!).

BTW, I'm about 6'2", about 235 lbs, and I could use a lot more exercise than I've been getting the last few years. I can barely drive to work right now, and my wife has to help me put my socks on. For an ex-Infantry guy who went to airborne school, this is not the way I pictured myself at 39 years of age.

Doc, PM sent.


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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T-H

As an old retired Army chopper pilot, I know just what you mean about not seeing yourself this way. I'm 60, and getting out of bed in the AM is no fun, nor is the trip to the bathroom. I'm thankful I can usually go overnight without a bathroom trip.

Have not decided whether or not I'm going to let 'em cut -- but I'm leaning to the let 'em side of that fence as I'm tired of the pain.

Good luck, whatever the route you take.


An old pilot, not a bold pilot, aka "the pig murdering fool"
 
Posts: 2865 | Registered: 14 October 2004Reply With Quote
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quote:
Originally posted by Teat Hound:
I owe you all a nice, cold dark beer (Doc!).



DARN right you do! cheers beer


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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Originally posted by dustoffer:
T-H

As an old retired Army chopper pilot, I know just what you mean about not seeing yourself this way. I'm 60, and getting out of bed in the AM is no fun, nor is the trip to the bathroom. I'm thankful I can usually go overnight without a bathroom trip.

Have not decided whether or not I'm going to let 'em cut -- but I'm leaning to the let 'em side of that fence as I'm tired of the pain.

Good luck, whatever the route you take.


Guys, let me help you understand some things. There is no question that surgery has been the absolute answer to many spine problems. HOWEVER, please please please at least attempt to make every conservative, less invasive treatment option first.

Many times over, those who have "bad backs" believe, or want to believe that the surgery will be a success 100% of the time and will always be the relief to the chronic problem they've dealt with for years.

The fact is, if you've gone for years with a ligamentous problem (including a disc), you have developed scar adhesions, fibrotic tissue that even a surgery will not change.

Most of the symptoms from these permanent/chronic conditions can be greatly reduced by a daily regimen of spine conditioning exercises, despite body mass. Deconditioning is the devil. A strong low back is the key. Yoga style stretches keep the soft tissues more pliable. Pilates is an excellent choice. McKenzie exercises work very well.

A home inversion table done daily will in many instances, reduce global symptoms by as much as 90% depending on chronicity.

Good luck.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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Teat Hound,

I am the same age as you and had that surgery in Sep 2005. I had a neurosurgeon do my surgery. I had a piece of my disk between L4 and L5 come off and lay in my spinal cannal. It damaged some nerves that go to my left foot. I still can't walk on the heel of my left foot. Starting under my big toe and going up to the top of my foot is still numb and probably will be forever. I also get a lot of cramps in my left leg. About 2 a nite. I also have to be mindful of where I walk. Because of the nerve damage my foot doesn't send the signal to my brain that I have stepped on a rock and I will roll my ankle. As far as hunting goes, it has not affected me much. My wife says I still suck. I am glad I had the surgery. I would srongly recommend that you have a neurosurgeon do your surgery. There are many nerves in that area that you do not want clipped by mistake.

Best of luck,

Bret
 
Posts: 64 | Location: Utah | Registered: 02 January 2004Reply With Quote
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I will be going in for surgery in 3 weeks. I'm 59 years old and have herniations at L4,L5 and S1. Presently, my neurosurgeon will be performing a microdiskectomy on the L5 bulge since it is impinging on my nerve. I am in constant pain in the right hip and thigh, lower calf , ankle and foot. I have already tried the 3 epidural injections, physical therapy, weight loss (25 so far) and all other "moderate" treatments. Due to a liver problem, I am unable to continue sustained use of pain and anti inflammatory meds indefinitely. For me, there is no other option, I simply can't live the way I have been with this problem. I haven't had a good night's sleep since before August, when this really flared up. They are doing my surgery as day surgery, he says about an hours worth through a 1" incision. The doctor predicts a possible 75% possibility of success, mainly due to my weight, currently 255 (5'8"). I feel that I have no other option. I will continue my weight loss program, but it is difficult if I can't exercise at all. The epidurals gave a small amount of relief, probably 20-30%, but didn't last. The first one worked the best, second-no change, and the third, little to no change. The ultrasound at physical therapy was great for a day, but certainly not worth the cost when considered as part of the overall picture. Whatever you do, see at least two different neurosurgeons, it's a decision you will have to live with for a long time !!! Wish me luck, as I wish you luck.


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Posts: 931 | Location: Somewhere....... | Registered: 07 October 2002Reply With Quote
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Originally posted by BretNAdams:
Teat Hound,

I had a piece of my disk between L4 and L5 come off and lay in my spinal cannal.


That is called a sequestered disc. In many cases this requires surgery.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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Well Men,

I switched to a group of neurosurgeons today, should be in to see them soon.

I'll let you know how it goes.

BTW, Doc recommended that I use a cold pack on my back rather than a heating pad, and other than freezing my cojones off for a short time, it did have a positive effect. Thanks Doc!


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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yerwelcome. Big Grin


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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Where is your pain? Back surgery usually will relieve leg pain (your butt is part of your leg), but will NOT relieve back pain. But, you should first try a McKenzie approach (which is physical therapy lingo). Get to a therapist and ask them to show you a McKenzie extension protocol. It involves just 4 exercises initially, all having to do with positioning and influencing the position of the disc. Lie on your stomach with your shoulders propped up....20-30-45 minutes. One of the exercises looks like a girl's pushup, but leave your pelvis on the floor. You are trying to increase the lordosis (curvature) of your lumbar spine. In standing, put your fingertips towards your spine and bend backwards. YOU, the patient, determines if the treatment is successful. If your pain moves towards your back, up and out of your leg, keep doing these exercises/rest postures. If your leg pain becomes worse, or moves towards your foot, STOP. You are pushing the disc further out. A caveat: often as leg pain is relieved, your back will actually hurt worse. This is temporary and you should continue with the exercises. The initial treatment for a disc lesion is entirely positional and has nothing to do with strengthening. When you are out of leg pain for at least a couple of weeks, THEN you can start your core strengthening program, slowly.

Not all disc lesions are treatable conservatively, but probably 80-90% are. One of the therapists I work with ruptured a disc 2 years ago, put off surgery until he lost function of his calf muscle, had microsurgery as an outpatient on a Friday, and came back to work the following Wednesday. If you end up in surgery, and IF YOU ONLY HAVE A RUPTURED DISC, do NOT allow them to do a fusion. That is very old school thinking and WILL result in future disc problems for the reasons Doc mentioned above. There are back conditions that require fusion, but a simple ruptured disc is not one of them.

There is NO REASON why you should not be able to return to all normal activities following a microdiscectomy and proper post-op rehab. For YEARS we in the medical profession have scared the living s__t out of our patients by telling them don't do this or that after back surgery. After your rehab (soft tissue healing is 8 weeks, BTW), I think you should hunt more often. Your back will probably be stronger and more flexible than it is TODAY!

Just my opinion.....but I've been a Physical Therapist since 1978.

MKane160


You can always make more money, you can never make more time...........LLYWD. Have you signed your donor card yet?
 
Posts: 488 | Location: TN | Registered: 03 January 2004Reply With Quote
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Transforaminal epidural steroid injections work for some people. We get good results from most of our patients. Try less invasive things first before you move on to surgery.
 
Posts: 323 | Location: Jackson, Miss | Registered: 12 October 2004Reply With Quote
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quote:
Originally posted by Teat Hound:
Well Men,

I switched to a group of neurosurgeons today, should be in to see them soon.

I'll let you know how it goes.

BTW, Doc recommended that I use a cold pack on my back rather than a heating pad, and other than freezing my cojones off for a short time, it did have a positive effect. Thanks Doc!


I am in a similar boat. I broke my neck at the C3/C4 when I was 12. All have been fine until 35. Now I am having issues, but the Docs say a fusion would help. I think I will wait.
 
Posts: 3284 | Location: Mountains of Northern California | Registered: 22 November 2005Reply With Quote
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333_OKH:

I obviously know nothing about your situation, but the mechanics in the cervical spine are totally different than the lumbar spine. Fusions there are common and successful, especially the anterior interbody fusions. You might want to get a couple of surgical opinions....

Again, my opinion and $1.50 will get you a large coffee at McDonalds.... ;-)

MKane160


You can always make more money, you can never make more time...........LLYWD. Have you signed your donor card yet?
 
Posts: 488 | Location: TN | Registered: 03 January 2004Reply With Quote
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Thanks for the help MKane160.
 
Posts: 3284 | Location: Mountains of Northern California | Registered: 22 November 2005Reply With Quote
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quote:
Originally posted by MKane160:
Where is your pain? Back surgery usually will relieve leg pain (your butt is part of your leg), but will NOT relieve back pain. But, you should first try a McKenzie approach (which is physical therapy lingo). Get to a therapist and ask them to show you a McKenzie extension protocol. It involves just 4 exercises initially, all having to do with positioning and influencing the position of the disc. Lie on your stomach with your shoulders propped up....20-30-45 minutes. One of the exercises looks like a girl's pushup, but leave your pelvis on the floor. You are trying to increase the lordosis (curvature) of your lumbar spine. In standing, put your fingertips towards your spine and bend backwards. YOU, the patient, determines if the treatment is successful. If your pain moves towards your back, up and out of your leg, keep doing these exercises/rest postures. If your leg pain becomes worse, or moves towards your foot, STOP. You are pushing the disc further out. A caveat: often as leg pain is relieved, your back will actually hurt worse. This is temporary and you should continue with the exercises. The initial treatment for a disc lesion is entirely positional and has nothing to do with strengthening. When you are out of leg pain for at least a couple of weeks, THEN you can start your core strengthening program, slowly.

Not all disc lesions are treatable conservatively, but probably 80-90% are. One of the therapists I work with ruptured a disc 2 years ago, put off surgery until he lost function of his calf muscle, had microsurgery as an outpatient on a Friday, and came back to work the following Wednesday. If you end up in surgery, and IF YOU ONLY HAVE A RUPTURED DISC, do NOT allow them to do a fusion. That is very old school thinking and WILL result in future disc problems for the reasons Doc mentioned above. There are back conditions that require fusion, but a simple ruptured disc is not one of them.

There is NO REASON why you should not be able to return to all normal activities following a microdiscectomy and proper post-op rehab. For YEARS we in the medical profession have scared the living s__t out of our patients by telling them don't do this or that after back surgery. After your rehab (soft tissue healing is 8 weeks, BTW), I think you should hunt more often. Your back will probably be stronger and more flexible than it is TODAY!

Just my opinion.....but I've been a Physical Therapist since 1978.

MKane160


Thanks for the response. Last week I saw a neuro doc, and he recommended a disckectomy and nerve decompression. He said a fusion does not appear to be needed and he won't do one unless it is truly warranted. This guy has done a few other men I know, and all have reported good results.

I hope for the best. I'm waiting on my HMO now . . .


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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Hello Eric...sorry I am so late to your question.

I am a neurosurgeon in Nashville, and I do quite a few of these surgeries.

A few questions: Are you having leg pain with this? (Significant pain that is) If so, your chances of surgery helping are quite good.

Is back pain the biggest part of your complaint, with very little leg pain?
If so, then by all means try non-surgical therapies first.
I would seek out a Pain Management program that focused on some injection therapies (especially epidural steroids or perhaps facet injections...depending on what your MRI scan shows).

Are you much overweight? If so, losing weight (easy to say, hard to do) might help considerably. (If you're only a few pounds overweight it's not likely to be a major factor in your pain)

Finally, if you have some lumbar stenosis (narrowing of the spinal canal) PLUS some disc extrusion/herniation on top of that, surgery has a high chance of helping you.

Sorry I couldn't be more specific, but there are alot of variables to back surgery. It's still very much a art, superimposed on the background of science.

A second opinion is NEVER a bad idea when it comes to back surgery.

Regards,
Garrett
 
Posts: 987 | Location: Orlando, FL | Registered: 23 June 2003Reply With Quote
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Originally posted by N. Garrett:
Hello Eric...sorry I am so late to your question.

I am a neurosurgeon in Nashville, and I do quite a few of these surgeries.

A few questions: Are you having leg pain with this? (Significant pain that is) If so, your chances of surgery helping are quite good.

Is back pain the biggest part of your complaint, with very little leg pain?
If so, then by all means try non-surgical therapies first.
I would seek out a Pain Management program that focused on some injection therapies (especially epidural steroids or perhaps facet injections...depending on what your MRI scan shows).

Are you much overweight? If so, losing weight (easy to say, hard to do) might help considerably. (If you're only a few pounds overweight it's not likely to be a major factor in your pain)

Finally, if you have some lumbar stenosis (narrowing of the spinal canal) PLUS some disc extrusion/herniation on top of that, surgery has a high chance of helping you.

Sorry I couldn't be more specific, but there are alot of variables to back surgery. It's still very much a art, superimposed on the background of science.

A second opinion is NEVER a bad idea when it comes to back surgery.

Regards,
Garrett


Hi N.G.,

Appreciate the response, and your opinion matters much to me.

I didn't have much leg pain until very recently. I'm 6'2", 235 lbs (losing a few pounds would not hurt me, for sure). I've had this back pain for several years, starting occasionally around the time that I left the ARMY (1991), but for the last few years, I've had it worsening and persistently. Since 01/01/2006, I've had two bad incidents where I was laid out for two or more weeks. I've seen a chiropractor, been to physical therapy, and have been given soma and vicodin, plus oral steroids. The last incident was scary, because all I did was step out of my truck, and WHAM! - out for two weeks. From my MRI, my disk looks like a piece of shoe leather to me ("black disk disease" according to the neuro-surgeon). I'd love to know what you think, as the L4-L5 problem seems to be common here on AR. Thanks again,

I’ve said this before, I think, but I just hope I can hike around and hunt after this is done . . .

Here's the report (I've got nothing to hide, but feel free to PM me if you want):


Not spell checked -
FINDINGS:
There is anatomical alignment of the vertebral bodies with maintenance of the vertebral body heights. There is a prominent disc space narrowing seen at L4-L5 level where there is extensive disk desiccation and posterior disk protrusion. There is mild endplate marrow signal consistent with degenerative change. No additional abnormal marrow signal is seen within lumbar spine. The conus medullaris terminates at the T12-L1 level.

L4-L5 There is a large central disc protrusion that appears to extend 7 to 8 mm beyond the disk margin. It causes marked inversion of the ventral portion of the thecal sac which now has a slightly U-shape to it. It does causes compression and crowding of the lower cauda equina fibers. No prominent foraminal stenosis is identified.

L5-S1 Mild facet joint hypertropic change and ligamentum flavum thickening is seen. There is slightly asymmetry along the L5 lamina which may be congenital variation. Slight squaring of the thecal sac is seen but no clumping of the nerve roots or other abnormalities are identified. The neural foramina are widely patent.

IMPRESSION:
1) There is a large disk protrusion at L4-L5 that extends posteriorly 7 to 8 mm. It causes marked compression of the thecal sac, which is inverted ventrally. There is clumping of the cuada equina fibers with loss of the normal surrounding CSF signal. No neural foraminal narrowing is seen.

2) The remainder of the lumbar spine shows no prominent degenerative change, central canal or neural foraminal stenosis.


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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I had back problems for many years. I abused my body and especally my back when I was young, riding rouge horses, driving jeeps too fast, lifting too much weight without using my legs, a little football until my knees gave out, that sort of stuff.
I put of surgery as long as I could and finally could not stand it anylonge and went to the neuro doctor. I wish I had done it years earler. I was off from work seven days and have not had a problem since (with my back). I had mine in late Feb. and was able to hunt, fish, and preform sll of my manly duties (if you know what I mean) by spring. I say go for it.
Remember, the quicker you are up and around the faster you will heal.
Good luck-
by the way 235 ain't in no was bad for a 6'2'' man. just tighten up some when you are able.
Judge Sharpe
And when It is time to have the old ticker worked on ask me about that too. been there and done that.
JS


Is it safe to let for a 58 year old man run around in the woods unsupervised with a high powered rifle?
 
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Hey Teat Hound, you could always request a CD with your MRI images from the imaging center and mail it to Dr. Garrett for an opinion.

Maybe then he can make recommendation on your surgical options and what technique he feels is most appropriate for your exact condition.

One thing about a large protrusion is that in many cases, the body will resorb the space occupying lesion on its own, given proper conservative treatment, like decompression/traction. It is always worth a try.

Good luck.


Ted Kennedy's car has killed more people than my guns
 
Posts: 7906 | Registered: 05 July 2004Reply With Quote
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Teat Hound

Tomorrow will be 2 weeks since my micro surgery. I thought I would fill you in in case you decide to take the plunge and want some idea of recovery. My wife drove me home and I took up residence in my pre-planned sick room. First a little about the room. My wife with a little help from me put our spare queen bed in my reloading/library room. I put a spare tv on a 4 drawer file cabinet so I can watch it from the bed without kinking my neck to do it. I moved a computer next to the bed so I cam do what I am doing right now without flopping around at all. I also wired in my dvd player right next to me so I can watch hunting programs or movies without getting up. Anyway, the day of the surgery I was out of it. The second was better, and by the third day I did not need meds at all. Every day since just gets better. The first 3 days felt like someone cross checked me good accross the lower back which is surprisimg considering how small the incision is. I spent up to today taking it real easy; I wear a device that reminds me off an old corrset that keeps me from forgetting to not bend forward at the waste. I only took it off to shower up until today. After day 3 I started walking about a 1/2 mile a day but mostly I laid on my back and caoght up on my reading or read AR threads etc. Today I went in for my 2 week review and can now start exercising more, for me a recumbant stationary bike. I still need to avoid bending at the waist, lifting much more than 1 beer at a time, and avoid sitting unless it is short term and sway backed, no slouching. He said 6 weeks total of taking it easy to let it heal up so it doesnt squeeze out any more disk juice (not the technical term). The only pain that was worth mentioning is controlling my desire to get back to my normal life because I feel good or at least good enough. The trick is not to do anything stupid. Harder than it sounds beleive me. Also I lost 7 pounds so far. I am going to head back to work monday and slowly work back into full time. I'm a desk jockey so I am getting a stand up desk just like ol Tom Jefferson used. Good Luck.
 
Posts: 1952 | Registered: 16 January 2007Reply With Quote
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quote:
Originally posted by Doc:
Hey Teat Hound, you could always request a CD with your MRI images from the imaging center and mail it to Dr. Garrett for an opinion.

Maybe then he can make recommendation on your surgical options and what technique he feels is most appropriate for your exact condition.

One thing about a large protrusion is that in many cases, the body will resorb the space occupying lesion on its own, given proper conservative treatment, like decompression/traction. It is always worth a try.

Good luck.


Thanks Doc, noted. I'll think I will try to get a CD - good idea! I know that the place I went to for the MRI is completely digital.


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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Originally posted by SG Olds:
Teat Hound

Tomorrow will be 2 weeks since my micro surgery. I thought I would fill you in in case you decide to take the plunge and want some idea of recovery. My wife drove me home and I took up residence in my pre-planned sick room. First a little about the room. My wife with a little help from me put our spare queen bed in my reloading/library room. I put a spare tv on a 4 drawer file cabinet so I can watch it from the bed without kinking my neck to do it. I moved a computer next to the bed so I cam do what I am doing right now without flopping around at all. I also wired in my dvd player right next to me so I can watch hunting programs or movies without getting up. Anyway, the day of the surgery I was out of it. The second was better, and by the third day I did not need meds at all. Every day since just gets better. The first 3 days felt like someone cross checked me good accross the lower back which is surprisimg considering how small the incision is. I spent up to today taking it real easy; I wear a device that reminds me off an old corrset that keeps me from forgetting to not bend forward at the waste. I only took it off to shower up until today. After day 3 I started walking about a 1/2 mile a day but mostly I laid on my back and caoght up on my reading or read AR threads etc. Today I went in for my 2 week review and can now start exercising more, for me a recumbant stationary bike. I still need to avoid bending at the waist, lifting much more than 1 beer at a time, and avoid sitting unless it is short term and sway backed, no slouching. He said 6 weeks total of taking it easy to let it heal up so it doesnt squeeze out any more disk juice (not the technical term). The only pain that was worth mentioning is controlling my desire to get back to my normal life because I feel good or at least good enough. The trick is not to do anything stupid. Harder than it sounds beleive me. Also I lost 7 pounds so far. I am going to head back to work monday and slowly work back into full time. I'm a desk jockey so I am getting a stand up desk just like ol Tom Jefferson used. Good Luck.


Thanks SG, I'm kind of planning a "hold-up" room like you described above. Also, I'm figuring that I might finally finish my History Channel PhD. I've been a microscope jockey as of late, so I don't have to worry about doing much lifting once I go back to work. Maybe OLN (ie "VS" channel now) might pull their head out and put some of the Dangerous Game shows back on.

I'm going to "offer" to my wife that she sleeps in the spare room, and let me have our King size bed (which usually has a kid or two, and/or the dog hopping around on it). Maybe she'll let me keep my .270 next to me to facilitate the healing process. Big Grin

On the honest side though, I’m going to focus on losing 20 lbs whist I’m off; should be easy as long as the wife keeps the New Castle hidden.

Thanks again,


-eric

" . . . a gun is better worn and with bloom off---So is a saddle---People too by God." -EH
 
Posts: 952 | Location: Bakersfield, California | Registered: 03 June 2005Reply With Quote
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