23 year old active duty male, facing spinal fusion

[kingtut7290]

Hello,
I’m new to this how online forum thing. I am a 23 year old with lumbar disc degeneration at L4-L5, lumbosacral radiopathy, and a recent microdisectomy on 22SEP2011. I originally started feeling pain in DEC of 2010, and sense then have done physical therapy, every medication under the sun, as well as epidural injections. My Dr has tried everything there is and has now said we might have to do a Spinal fusion at L4-L5. I am an Active Duty sailor working in the medical field but this surgery will get me medically discharged. I don’t want to leave the military, but my body can no longer support the demand the NAVY requests of it, I now walk with a limp and have constant tingling and weakness in my left leg. This problem has caused a slew of other medical problems going form insomnia all the way up to hypertension. I truly do not know what to do anymore and I guess I just wanted to talk to people who know what I’m going through. The military treats me like I’m exaggerating and need to “Man Up” while my Dr tells me I need to relax and not push myself. Any words of wisdom, tips to help, or any incite would be most gratefully appreciated.

[trkdoc714]

First of all, Thank you for your service to our country.

Welcome to the forum but I'm sorry this has to be your first experience with it.

I had similar experiences with my employer when the lumbar issues first happened. One manager went so far as to tell counterparts I was milking the disability system.

I guess the best advice I could give based on my experiences would be to make healing your back your first priority. You're too young to risk damaging your back further just to prove a point to detractors.

Good luck. I hope this forum leads you toward your solution.

Bob

[Justin]

Hi Kingtut,

Welcome to the Spine Patient Society.

As Bob said, thank you for your service. I am sorry that you are dealing with spine issues at such a young age. I have literally been in your shoes regarding spine issues in your 20's (even my teens). Anyway, have you had any recent imaging of your spine?

In regard to moving forward: will a formal medical examination by a military physician / surgeon help "build your case" or help establish that you really have legitimate spine pathology that is interfering with your duties as an Active Duty sailor? It would possibly help extinguish their claims of exaggeration and the need for you to "man up?" Bear with me, as I'm not familiar with the military protocol for being medically discharged: will evidence of your spine pathology (imaging, physical exam, etc.) through a formal medical examination by a military physician / surgeon place you at risk for being discharged or is only when you pursue spinal surgery? Can both situations possible place you in the "unfit to serve" category?

Honestly, it sounds like you have covered a lot of the "conservative" bases when it comes to spine. You've done physical therapy, tried medications and injections, etc. Has your doctor considered a spinal cord stimulator? Also, has he/she established that your L4-L5 is your only pain generator and there are not any other pain generators? Before pursuing an invasive procedure like spinal fusion, you might inquire about a discogram. It is a way to help determine which discs are truly your pain generators (it's not the end all - be all diagnostic examination, but it can help establish a better picture of what is, indeed, causing your pain). Since you have had spine issues for a while, it would behoove you to have your facet joints evaluated as pain generators as well (diagnostic injections are frequently done to determine if they are pain generators, as facet joints can hypertrophy and degenerate along with other elements of your spine).

First and foremost, think about your health and your spine. You only get one spine in this life and you want to be able to enjoy your life from here on out, as you've got many years ahead of you. Good luck and feel free to send me a private message if you want to talk or have any questions...I'm all ears.

[laid up doc]

i have heard that there are active duty soldiers with artificial discs... anyone know if this is true?

why do you say you'd be discharged? plenty of folks return to quite active lives after ADR and fusion... and a friend of mine in the Navy just had microfracture surgery and is still a corpsman...

i would get at least 4-5 surgical opinions, with 1/2 of those being surgeons who you know do artificial discs. the fact is that adjacent level disease from fusion is real, and at 23 well... that's very sobering unless you have contraindications to an artificial disc.

best of luck, i thought i was young at the time of my surgery - 33...

[kingtut7290]

good afternoon,

Thank you all for your support for your service members . Unfortunately the military doesn’t make it very easy to obtain help from outside sources especially when it comes to a nuro surgeon, because they must except our particular type of insurance and a boat load of paper work must be complete just to see a Dr outside the military hospitals. my surgeon has never mentioned artificial Disc replacement for me, but we have talked about Fusion on numerous occasions, but he does want to avoid fusion at all cost. I’ve had 13 MRIs done within the past year most was before the first surgery. The most recent MRIs show that the microdisection was a failure and my disc is beginning to re bulge, it was herniated before with significant compression of the nerve. The disc itself shows up almost completely black on MRI showing it has significant degeneration, the disc has also decreased in size and the vertebral spacing has begun to close in on each other. When it comes to the NAVY my current Chain of Command is not the most supportive group of people I’ve met. As far as the being discharged part, if I go through with the fusion surgery my surgeon said he would have to implant screws and brackets into my spine, due to my young age 23, height 6’2” and weight 195, to insure that I would have the best support on the fussed area. The Military as a whole is “slimming down” and discharging any one that isn’t fit to deploy at a moment’s notice. I’ve only been in for almost 3 years now, so there is no reason to keep a “damaged” person with a current medical problem that could become worse in the future if deployed. I try to take it easy, but that can be hard when you work every day 0600-1600 and wearing a uniform that weighs around 10lbs and having to carry all my crap around for my job. I work in two different locations every day which has me doing a lot of moving, as well as seeing around 20 patients a day so my body is always being pushed. Honestly a part of me wants to have the surgery because it has the possibility to help me and release me from this prison I’ve been trapped in for the past year, but at the same time it scares the life out of me to think of the bad things that could come from a surgery like that.

[lurch]

Hi,

Also want to thank you for your service. I am sad that you are having this type of issue sooooo young. I just want to tell you that I firmly believe that adjacent level degeneration is a real problem. I know that most surgeons will tell you that it is not conclusively proven yet, but the fact remains that it makes common sense and many, many people including myself have experienced it. Less than 3 years from my L3/4 fusion, I have herniated L4/5 which was perfectly normal before. Also, have facet joints in the area deteriorating at "an alarming rate" along with other discs that have gone from minimal problem to moderate/severe in the same time frame. Please, given you age, exhaust all options that would preserve your motion (ADR or whatever) before resorting to fusion.

Best of luck,
Larry

[lurch]

PS: Durning that 3 years I was not working and had no injury...... nothing to explain the new / accelerated problems except adjacent segement stress / degeneration.

[laid up doc]

lurch makes some very good points. you are VERY young for a fusion in a case where it sounds like fusion isn't the only option.

i seem to remember that a military spouse got an ADR at Balboa Hospital - are you able to get an opinion there?

[kingtut7290]

i am currently stationed in Chicago IL and am seeing the only Nero surgeon clinic within an hour from my base. i now have an appointment on the 23rd and will talk with him about ADR and see if its an option for me.

[ajj1001]

Hi, I had my two level disc replacement op in my mid thirties and one of the main reasons I had ADR because fusion was regarded as unsuitable for someone so young. Hope that you get your options looked at properly so there is a possibility you can stay active and in your job.