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  #1  
Old 12-07-2017, 10:15 PM
Paul C Paul C is offline
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Join Date: Dec 2017
Posts: 15
Default Paul C Intro

Hello all,
I am 37 and have had some form of lower back pain my entire adult life. I have been active duty military for 19 years and first had a debilitating back episode in 2001, likely as a result of my own doing. Over the years I have learned many different back stretches and poses that have helped to improve my condition, and I have owned an inversion table since 2004, which used to bring me much relief.

As of recent, I have been unable to keep my back pain at a reasonable level, and have had to seek outside help. Months ago, I began the routine of physical therapy including dry needling, as well as chiropractic care. It is feasible that I have allowed my condition to deteriorate beyond significant help by these methods, though they do provide some short lived relief.

I had an MRI last month indicating herniation at L4-L5 and L5-S1, most significantly a the L5-S1 level, with nerve root contact. Also indicated severe foraminal narrowing at the L5-S1 level.

I am presently awaiting a consultation with an ortho spine surgeon and am at the point that I am willing to consider surgery, if I can continue to do my job.

My pain tends to be worst in the lower back, and can radiate to the upper back and neck as I am always compensating with posture. Though I have it a times, pain in the legs is not my predominant symptom, which seems to be the trigger for doctors to elevate beyond conservative care. Unfortunately, my LBP has progressed to a point that I must plan my daily routine around my pain, and it has significantly affected my quality of life.

I began researching ADR a few months ago and really appreciate the info and users who share their experiences on this site. I am aware of the costs most Americans incur when seeking ADR, and I think it would be worth every dime to experience relief. I am a ways out from making this decision, but will continue to research and gain lessons learned from others who have been there and done that so I can make a more informed decision when the time comes.

Cheers,
Paul
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37 y/o with 17 years of lower back pain. DDD L5-S1 and L4-L5
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  #2  
Old 12-08-2017, 07:49 AM
pichaku pichaku is offline
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Join Date: Apr 2017
Posts: 29
Default Hello :)

Hello Paul,
Post some photo of your sagittal and axial Mri ??
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L4L5 DDD...protrusions on c5c6 and c6c7 just discovered with mri and confirmed by EMG...going trough Pt....
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  #3  
Old 12-09-2017, 08:21 PM
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Harrison Harrison is offline
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Join Date: Oct 2004
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Question

Hi Paul.

Hey, is your ortho consult with an experienced spine doc who has done ADRs? Just curious...
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #4  
Old 12-10-2017, 03:43 PM
Paul C Paul C is offline
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Join Date: Dec 2017
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Default

Quote:
Originally Posted by pichaku View Post
Hello Paul,
Post some photo of your sagittal and axial Mri ??
Pichaku,
I have no idea what I am looking at with regard to the axial images. The sagittal attached seems to look a lot like others I've seen in this situation.
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File Type: png ccc.jpg.png (58.3 KB, 24 views)
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37 y/o with 17 years of lower back pain. DDD L5-S1 and L4-L5
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  #5  
Old 12-10-2017, 03:46 PM
Paul C Paul C is offline
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Harrison,
Unfortunately, it is not with an ADR experienced Doctor, as far as I know. ADR is not regularly performed or approved in my profession. It's my expectation that if I eventually need ADR I will need to pursue it on my own, likely overseas.

Cheers,
PC
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37 y/o with 17 years of lower back pain. DDD L5-S1 and L4-L5
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  #6  
Old 02-01-2018, 12:13 PM
Paul C Paul C is offline
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I wanted to update this post with a copy of the text from my MRI report. I think the radiologist was thorough.

If I had no other concerns besides addressing my back condition, I would be aggressively pursuing ADR overseas (likely 2 levels, but I'm not the surgeon).

Unfortunately, my present employment does not support the notion of ADR. Even if I were to pay for it out of pocket, it would medically disqualify me from my job which is, well, problematic.

My back pain can be hard to isolate, which makes it hard to describe and address. I have localized pain in the L4-S1 region for sure, and nearly always have pain in my quadratus lumborum, more severe on the right. My pain is sometimes localized to this region and, when it is, its manageable (though I have very little strength or stability with bending forward, which I have avoided for years).

Other times, I experience what I describe as tailbone pain, which is probably related to the sacroiliac joints. This is probably least common, and less worrisome than my other symptoms.

In the last six months, I have begun to experience pain that radiates throughout the entire mid-upper back, neck and shoulders, sometimes causing headaches as well. I had an x-ray of the c-spine which showed normal disc height. It is possible I am inducing these symptoms myself with my constantly-compensating posture.

Finally, I have recently begun to experience numbness and tingling in my legs and feet while sitting (driving). Often, I can push up with my hands and reduce weight on my spine and temporarily relieve this symptom. This is more pronounced on my right side, which I think corresponds with the diagnosis of severe foraminal narrowing on that side.

I would really like to hang on to my job for at least the next few years, so I have a couple questions for those who are more experienced.

1) Based on the report, does anyone think it is advisable to pursue foraminotomy, laminotomy or possibly microdiscectomy to alleviate the leg symptoms and possibly prevent permanent nerve damage? I recently spoke with an orthopedic spine surgeon who said these would only serve to reduce leg pain. Leg pain is not my prevailing symptom, but the tingling sensation is an increasing concern of mine. I would consider one of these surgeries only as a method of buying time to appropriately address the issue in a few years - and only if it would not preclude me being a candidate for ADR in the future.

2) I am aware that there is an argument that the L5-S1 level should always be fused when addressing DDD. I am not adverse to the notion of a hybrid surgery, and have heard many success stories about them. I may be able to arrange an ALIF for the L-5/S-1 and continue in my current job for now, and pursue ADR on the L-4/5 level in a few years, or possibly even many years if the fusion at L-5/S-1 addresses the majority of the symptoms. I think common sense dictates that one surgery is preferable to many, but does anyone see anything inherently problematic about this method of essentially "piecemeal-ing" a hybrid surgery?

My apologies for the extensive post, and to anyone who has read this far, I thank you. I honestly had no idea how many layers of complexity I would find when I finally got around to addressing my back issues, and I am incredibly grateful for the knowledge and advice shared on this site.

Best,
Paul
Attached Files
File Type: pdf MRI Report.pdf (467.1 KB, 15 views)
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37 y/o with 17 years of lower back pain. DDD L5-S1 and L4-L5
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  #7  
Old 02-02-2018, 05:53 AM
dorian dorian is offline
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Join Date: Jun 2017
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Sorry to hear your situation and I am in the same boat as you pretty much. I got three levels and by the looks of your MRI you are doing better than me but that does not mean a thing really as everyone reacts to DDD differently. Some people barely have any discs at all and don't have back pain while others have just a little disc gone and are in agony.

My advice to you is to not limit yourself to the Western doctors. They can't even do an ADR more than one level, perhaps 2 in certain cases. They are locked in the notion of Fusion and doing multiple little surgeries to ease your pain. I am not saying that Western Doctors are bad but if you are really serious you should explore your other options.

I went to 4 or 5 doctors in the Western world and 3 in Asia all experts in the field. They all told me I got a terrible back but am lucky I am not screaming in pain daily, at least not yet. There were two sides one side says you need fusion, some said now, some said in a few years.. others would say don't do anything , exercise stay in shape blah blah

Well that is when I started looking into ADR. I would suggest you touch base with some of the doctors that are recommended on this site. I am dealing with both Doctor Clavel and Dr Desai but there are others here. You can send your MRI, set up a question and answer period, on phone, on skype etc, I know Dr Clavel does it we have an one hour session on skype but it costs like 300 Euros but that price will be deducted on my surgery if I decide on him.

Dr Desai is answering my questions via email and soon we plan to have a phone call. I am sure other doctors have similar methods. I would take all your questions to these doctors and then compare the overseas procedures with the Western ones and determine which one is best for you.

I am leaning towards ADR because I want to keep that movement, I want to keep the stress off my upper discs which are still good. Dr Desai and Clavel think I am a good canidiate because I havent had any surgeries yet, so it seems they would prefer someone with a clean slate when it comes to the operating room.

I have a feeling you are much like me, will what I do make things worse, that is always in my head but it is getting to that point where I will soon have no choice. hope my ramblings help a bit
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44 Year old Canadian
Disc Degeneration (13 years)
L3-L4
L4-L5
L5-S1
Considering ADR Procedure This Year
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  #8  
Old 02-02-2018, 10:42 PM
Paul C Paul C is offline
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Join Date: Dec 2017
Posts: 15
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Dorian,
Really appreciate you reading my ramblings. If nothing else, its therapudic to be able to share with others who share the condition. If I were an outsider looking on on my personal situation, I would probably make the observation that the best choice is to drop everything and go for the modern, two-level ADR in Europe. The unfortunate downside is that ADR now would require a career change for me, which will affect my earning potential for many years. Again, from the outside, the choice is a clear one, but still difficult to make.

I think it is feasible that foraminotomy may help me kick the can a few years down the road, but I need to make certain it would not make me a poor ADR candidate in the process.

You are several steps ahead of me in the process and I wish you the very best of luck in pursuing a pain free life.

Cheers,
Paul
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37 y/o with 17 years of lower back pain. DDD L5-S1 and L4-L5
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  #9  
Old 02-03-2018, 08:09 AM
perepere8 perepere8 is offline
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Join Date: Dec 2016
Posts: 16
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I am 2 months post op with dr. Clavel
L3-4, L4-5, so far im good and thanks God for that :-)
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Back pain since 16 year old, im 31 now.
DDD L3 L4, positive discogram at that level. Concordant pain.
28.02.2012 Selective endoscopic discectomy with thermal annuloplasty. No relief at all.
Considering ADR at that level
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