L2-4 stenosis/facet degeneration - l4-s1 ddd help

[Katie]

Hey Kathleen, a girl after my own heart...asking a million questions

The steroid injections first...I had a series of one a week for three weeks, (I think), and they were only a tiny bit successful. Then I tried one every few weeks for several months...it was between eight and ten in number...foggy brain syndrome ;-) They would get worse at first for a day or two, then better for the same, then nothing....

There was only one injection each time

A medical friend told me nasty stories about too much steroids in the body over time, so I decided it wasn't worth the effort. They really didn't hurt much while she was doing the injections, except for the strong needle ***** at the beginning, and the really weird feeling of pressure and coolness with the fluid going in. My legs would turn to rubber for hours, so my husband had a great laugh at my expense...along the lines of not having any sea legs...him being a sailor and all ;-)

The discogram was another story. When we came back from the hospital, I was still in agony. We had been in the hospital all day, and several patients with the same procedure came and went from recovery for quite a while before me. I was in a great deal of pain for most of the night, but finally got some sleep in early morning. By noon the next day though, I was feeling a lot better and was able to be a coherent passenger when we left at lunch time...a five hour drive home. I was really surprised that I recovered that fast, considering how bad it was earlier.

[ajj1001]

Where did you have the ADR surgery done? How was your recovery? What device was used?

- NHS Hospital - Salford Royal Hospital. 2 charite adr. I immediately had a reduction in my pain and was able to walk well after 10 days. The recovery was a very long one as the anterior approach did not agree with me. I started rehab at 5 months and was pretty much normal at 18 months apart from some numbness and lack of control in my right leg. I was able to improve the muscles and manage the gait in this leg.

As I understand it, a revision surgery is done if the ADR is unsuccessful. Am I correct that ADR didn't work out for you and that they removed the artificial discs and performed a fusion? If so, how long before you knew that ADR wasn't working out? Did the fusion help? How do you feel about ADR now?

- My adrs were very successful until I started to have problems moving my left leg in 2007, I also had some back ache which I never had before. I reported this and changes became more and more obvious over the next year. My lowest adr had deteriorating facets and cysts behind it, bone spurs on the left hand side narrowing even further the nerve exit. All in all misbehaving alot. I was offered a fusion over the ADR, my surgeon had done this revision before and was confident that it wouldn't make me any worse. I did not pursue a removal as I did not want a life threatening operation and was not offered on the NHS.

-The disc was left in and an instrumented fusion with bmp was done from a posterior approach. This has not fused as yet, there is some bone forming on the right hand side. My left leg movement has improved and my pain is at 7/10 rather than 8-9/10 before the fusion.

-I would still advise myself back in 2002 to go ahead with the adr and enjoy life as much as possible. My surgeon at the time that he expected a period of 10 years good function out of it. I took care to remember this and was able to do alot painfree.

Have you ever had a discogram? If so, what was your experience with it?

-My adr op was done as an emergency operation as I experienced cauda equina syndrome so I dodged the discogram, I am scheduled for one on L2/L3 and L3/L4 soon (NHS waiting times are long). I am not looking forward to this as the caudal epidural I had in 2008 caused alot of extra symptoms and did not assist in anyway. I needed 2 weeks resting to control the pain. Yuk

[WPKat]

Where did you have the ADR surgery done? How was your recovery? What device was used?

- NHS Hospital - Salford Royal Hospital. 2 charite adr. I immediately had a reduction in my pain and was able to walk well after 10 days. The recovery was a very long one as the anterior approach did not agree with me. I started rehab at 5 months and was pretty much normal at 18 months apart from some numbness and lack of control in my right leg. I was able to improve the muscles and manage the gait in this leg.

• Major surgery doesn't agree with me either (or so I've been told by people who haven't had one). I have wondered myself how well I would do with the anterior approach. Although I was told they don't cut across the muscle, it still seems like a pretty long incision to me. However, reading the words "pretty much normal after 18 months" is very encouraging.

As I understand it, a revision surgery is done if the ADR is unsuccessful. Am I correct that ADR didn't work out for you and that they removed the artificial discs and performed a fusion? If so, how long before you knew that ADR wasn't working out? Did the fusion help? How do you feel about ADR now?

- My adrs were very successful until I started to have problems moving my left leg in 2007, I also had some back ache which I never had before. I reported this and changes became more and more obvious over the next year. My lowest adr had deteriorating facets and cysts behind it, bone spurs on the left hand side narrowing even further the nerve exit. All in all misbehaving alot. I was offered a fusion over the ADR, my surgeon had done this revision before and was confident that it wouldn't make me any worse. I did not pursue a removal as I did not want a life threatening operation and was not offered on the NHS.

-The disc was left in and an instrumented fusion with bmp was done from a posterior approach. This has not fused as yet, there is some bone forming on the right hand side. My left leg movement has improved and my pain is at 7/10 rather than 8-9/10 before the fusion.

• I'm sorry to hear that you your pain level is still at 7/10 after all that you've been through.
• Interesting, I didn't know they could do the fusion over the ADR. I would think that as long as there are no defects with the device itself that it would be the smarter approach. I could easily have misunderstood what they said about revision surgery though.
• I'm glad you brought this up as I have bone spurs as well. I need to ask whether or not they would address them while they are in there. They have already said they would deal with the severe foraminal stenosis and any other issue before they put in the ADRs, but I would feel better knowing I asked beforehand.

-I would still advise myself back in 2002 to go ahead with the adr and enjoy life as much as possible. My surgeon at the time that he expected a period of 10 years good function out of it. I took care to remember this and was able to do alot painfree.

• It's good to hear that you don't regret having it done.
• I didn't think to ask how many years of good function I could expect - excellent question to ask.

Have you ever had a discogram? If so, what was your experience with it?

• I realized after I asked the question that we had already talked about the discogram (oops). I am suppose to have one too, and like you, my pain escalates for a while whenever they stick needles into it. I am not looking forward to it at all. The one up side is afterwards I will have no doubts about whether or not ADR would help me.
• Interestingly enough, Stenum doesn't require a discogram unless it's a borderline case. If so, then they do one level at a time - one day in between each test. They said otherwise it is difficult to tell about subsequent levels after a patient's pain spiked at the first one tested. Makes sense to me. Unfortunately for me, that's not how it's done here.
• Since you are having it done, are you now considering ADR at these levels as well?

-My adr op was done as an emergency operation as I experienced cauda equina syndrome so I dodged the discogram, I am scheduled for one on L2/L3 and L3/L4 soon (NHS waiting times are long). I am not looking forward to this as the caudal epidural I had in 2008 caused alot of extra symptoms and did not assist in anyway. I needed 2 weeks resting to control the pain. Yuk

• I had symptoms of cauda equina syndrome prior to surgery as well. My surgeon was unaware of them because no history was done and I didn't realize the significance. The look on his face when I told him the problem had resolved after surgery was priceless. He swiftly left the room for a while adding to my confusion. At the time, I had no ideal what the big deal was because I had not connected the dots between the two problems. I researched it later to find out why he reacted that way.
• The surgery was done within a week of seeing him anyway because my pain level had been at a relatively constant 8/10 for an entire month prior. I am NOT a fan of surgery, but this was the one and only time I wasn't anxious beforehand. My pain level over shadowed any fears I normally would have had. I'm sure you understand the feeling.