Any input greatly appreciated. (Possible 3-level Fusion)

[Toolturnr]

Hello all, Thank you for letting me join the forum,Not sure where to begin but here goes. I started my back injuries as a Heavy duty diesel mechanic and have had minor strains before but in 2001 I was going to get into a semi truck and the driver had indoor-outdoor carpet ziptied to the top step to wipe his boots but it was covered with snow so i did not know it was there. I stepped on it and had ahold of the grab handle, my foot went out as the zip ties were not pulled tight and it whiplashed me against the side of the truck. After this my life hasnt been the same. I kept working and went through numerous physical therapies and medications to try and help with the pain.

Whenever I would get close to feeling I could manage the pain another injury would happen from the most simplest of tasks that would put me back to the beginning with the pain getting worse on all occurances. I had esi's at MAPS clinic and CDI , physical therapy twice at Physicians neck and back clinic which was work hardening therapy and made it much worse. Have had at least 6 other physical therapies and also went to Fairview pain and pallative care to try and deal with the pain. As the injuries and therapies over the years continued to make my back worse my company moved me into a less strenuous job. By this time I was having severe pain in my legs especially outer calves while walking sometimes only a few steps.

They finally gave me another MRI in late 2008 and decision was to do a bi-lateral decompression to relieve the herniation pressure on my nerves. 1-2009 had my first surgery and within two weeks was able to walk for over an hour a day on the treadmill with no leg pain at all and less back pain. Approx, 4 weeks after surgery getting up from bed i felt a pressure in my back that set off my nervous system, drenched in sweat, nauseus, dizzy I laid back down untill it subsided. When I got back up I could just tell it had herniated again. Walking went back to a few minutes and could not go on,pain in legs and back right back up. Notified surgeon who tried medrol pack and then esi. No help so mri was done that showed it in same condition as pre surgery. They put me back to work and I worked until I couldnt function at all. Went back in and was referred by my surgeon to one of his partners. Another Mri and it showed I needed surgery again on the herniations. 2-2010 had lumbar laminectomy at 2 levels. I was back to being able to walk on treadmill for over an hour a day so they put me back to work. Within 3 days of going back to work new symptoms started showing up and all the old ones came back as well.

Back to surgeon and another MRI 5-2010 showing another herniation so recommended having a caudal block/esi. Had that 2 weeks ago and had some relief where 2 days i was able to walk on treadmill for over 30 minutes now back to legs cramping up just going from bedroom to kitchen. The new symptoms are nausea just from being in a upright position and legs upon sitting or laying down have spasms/twitching that is random up and down both legs non-stop. The Dr doing the injection this time said the medication did not spread out right when he inserted it it went so far and stopped because of scar tissue. The surgeon says that if the injection does not help he wants to do a 3 level fusion. Now I am freaking out!!! Im 45 yrs young and until the back injuries in good physical shape. I have gained over 60 lbs and am worried not only about the damage already done to my body but what a 3level fusion would do to me.

I have done some looking into ADR but not sure I would be able to get this approved through workmans comp or if I would even be able to see a Dr. in another state regarding any recommendations or further surgery. Just my opinion but I would feel ADR is a better option than loosing the mobility/motion but I am at a point where if fusion would get the pain under control then that might be a route I have to take. If anyone has any insights about working with workmans comp on seeing a surgeon in another state and about ADR v/s fusion any input would be greatly appreciated. I am in MN in the twin cities area and not sure if it does end up going into a fusion if my surgeon is right for me for that procedure. Sorry About the long intro but I can only sit for a very short time and wanted to get most of my info in here. Thank you everyone for any input that you can give as I see this coming to a decision soon.
Thanks Bob

[KBear]

Welcome to the forum! I'm sorry you have been struggling with back issues and failed surgeries. I am not at all familiar with workman's comp.; but I do know there are others on here who have it. There are also a couple of people in the Twin Cities area, that may be able to recommend some good surgeons.
I would definitely get 3 or more surgical opinions before having surgery. Also, research each one, ask the doctors why the recommend a certain procedure (is it because they don't do ADR? Or because you are not a good ADR candidate?) There are people who have had ADR and were not good candidates and then had to have it removed and a fusion (which is a very risky surgery and results are not as good as if they had just had a fusion in the first place). So, I would make sure that you are indeed a good candidate. I would ask about hybrids (where they fuse one or two levels and do an ADR on the other levels). It would concern me to have a 3 level ADR, while some do have it and do fine, I have heard of others where it allowed too much movement and caused problems. Become your own advocate and do your homework, that way you can make the best decision you can with the information you have.
Ask any questions you may have, there is no such thing as a dumb question when it comes to your spine.
Kathy

[scduggan]

Dear Bob,
Welcome! Gosh, just when I thought I had it pretty crappy! I am SO SORRY about your spine problems. I would also be really afraid of a three level fusion. On the other hand, sometimes it has to be done to have any quality of like. I know of a couple of people with three level ADRs. I think they are well but cannot say for sure.

I wish I had something new and exciting to tell you. I just wanted to check in and tell you I will be praying for you and wishing you the best. I believe there are better days ahead for you.
CD

[Toolturnr]

Thank you Kathy and Cd for welcoming me and giving me some great advice!! In my opinion my current surgeon does not feel ADR is a good option for anyone That the results havnt been good for them. He also said it is only available on one level so it really makes me wonder how up to date he is, although Work comp tells me he is a very good surgeon. That maybe good or bad depending on whether your the insurer or insuree...lol Thats why I try and spend as much time as I can researching all available treatments and am trying to get as much input from all you inspirational people who have already gone through this. I try but can only do a little at a time right now as just being in an upright position really brings on the pain and I get very nauseous.
Kathy I am very interested in success rates on the hybrids as I feel it might be one of the best options for me medically and especially with work comp involved possibly a greater chance of having that approved. The 3 level fusion and 3 level ADR both make me very nervous not that any surgery doesnt just seems like both are extremes and the results I have been able to find so far have me leaning toward a hybrid if I am a good candidate.
CD I see you have a freedom disc done by DR. Zigler. Is this the one from Texas spine? How are you doing with your new hardware and how did you like Dr. Zigler. I am in the process of getting my MRI's and other info sent to him so I can get an opinion from him long distance. Just found out they would do that today!! Thank you for the prayers they are definitely needed during this ordeal and I will be praying for you all also. This is a terrible thing to go through but having some others that have come through the battle and came out with a life to live v/s bedridden is definitely an inspiration I need right now. Thank you again for your time and opinions they all will help me in my journey on what to do next.
Bob

[Cindylou]

Welcome Bob. I am another twin cities spine person on this site, with 3 lumbar adr's and 2 fusions. Do you mind me asking who your surgeon is? Where he works out of? I have had a pretty long road to recovery that I won't bore you with all the details, just suffice it to say after 10 years of hell with unrelenting back pain I am finally turning a corner....with much caution and reserve, but more thanks than you can shake a stick at. You have come to an excellent community here, where folks are long on compassion, intelligence, and support, and short on NOT MUCH. We are here to help you in any way we can, to bring you closer to your goal of pain-free living again. Hang tough.....not easy, we know. And ask away!

[KBear]

Bob,
I live in the Dallas area and have seen Dr. Zigler. He is who I wanted to do my surgery; but insurance would not approve it, and they had finished their portion of the clinical trial, so I went to Florida. Dr. Zigler was great, he took all the time I needed to talk with me, explain things with me and was compassionate and caring. I had to take my young daughter to a few of the visits and sometimes both of my kids, he would talk with my kids, play with them and did not have the I'm better than you attitude. I completely trust him and would have let him operate on me in a heartbeat. I now see Dr. Blumenthal (same office) for my follow up care and he is great too. That entire office is awesome. There is never a wait, maybe 10 minutes at most. In the x-ray room, the people always entertain my kids so I can be x-rayed, even getting them candy! They are all so sweet and understanding, I can't say enough good things about them. A lot of places, you may get a good doctor, but the staff is less than appealing. This was my experience in Miami, the front desk people were mean and inconsiderate. The people in the back were great, but I had to deal with the front desk every time I called or came in. Not that that is a huge deal or a deal breaker, but when you are in pain, the last thing you want is to mess with an a-hole!

[Gilbert P]

Hi Bob
I have been meaning to reply earlier but been busy, Yes we are in the same boat.
I am on W.C. for the past three years and they have paid for everything so far. But foe ADR ??

I will be back have to go and get some Maple Syrup for Pancakes.

Gil

[Toolturnr]

Cindylou the surgeon that I am currently seeing is Dr. Garvey from Twin cities spine. He is the second surgeon from twin cities spine as I had Dr. Schwender for my first surgery. Dr. schwender basically abandoned me after surgery and after it herniated again just told me I have a right to have a second opinion if I wanted but he didnt see anything causing my pain!!!. Dr. Garvey is who my second opinion was with and he has been much more involved in trying to help/find a solution than Schwender was but seems against any ADR.

Kbear, thank you for the information on DR. Zigler. I am currently getting my information together to send to him to get a opinion from somebody very knowledgeable in the ADR field and hope I have a shot of getting treatment through him. Mpls isnt that far from Texas right!!!

Gil, Thanks for the reply and hope your pancakes were good!!!

Thank you everyone again, I will keep updating as my appointments and second opinions come in. Bob

[Gilbert P]

Hi Bob

I am back and they were great.

I was going to see Dr Garvey in Sept but had a major herniation and had surgery instead All my wife family lives in the Twin Cities so It would be easier for me to go their. Also sent my MRI to the TBI no luck. Now waiting for many replies. Fusion at Two levels possibly Four ???
If you like to Talk give me a P.M. and I will give you my number.
Workers Comp will not pay if I go out of country and BCBS will not pay because its a W.C. case

TAKE CARE

Gil

[MaddySpondy]

Hi Bob,
I'm also in the Twin Cities. My fusion was done by Dr. Mullaney, after a suggestion from a radiologist that did my epidural injections. My surgery was only 3 weeks ago, and aside from some major swelling in my foot which is now being treated, I've been pleased with how much better my back feels. Though, it's too early to tell. I heard Dr. Schwender was the best! You just never know, I suppose. It so much depends on the unique individual, recovery and surgeon's strengths/weaknesses. I have been really pleased with Dr. Mullaney's nurse and secretary. They are very responsive, as is Dr. Mullaney. My surgery was 6 hours, so I suppose he's also thorough.

BTW, I also had a very negative experience with Physicians Neck and Back. They "graduated" me because I had a really strong back, yet I told them I was still in pain. They didn't really seem to care much about that minor detail.
Madeline