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View Full Version : Oh here goes- a personal vent of sorts, and a wishful "surgery date"



scooter950
04-15-2014, 09:41 PM
Hello my scoli friends, I've set a date: Oct 13. Now I must get my surgeon to agree. I wish this was behind me - but as much as I tell myself to plan, to prepare - the days creep past and I am no closer to being organized or "ready" for surgery. So I may as well schedule it.

here's my problem- pain. I know I must get "in shape" for surgery, I know I should exercise - but I can barely get enough energy to cook dinner after work, then i collapse with the laptop. I don't even walk my dogs anymore. organize the house? i can barely sweep th floor. no excuses, just facts. I've been a member of this forum for years, now- in retrospect- I wish I had the surgery years ago, before my L3-L4 gave out. but I want my life to be better, not worse, not a slow deterioration and depression; I am struggling with severe depression, too, I'm taking meds and it helps a little; I do manage to work but that's about the extent of any productivity.

so I was looking at the calendar and I selected Oct 13 as my surgery date. I am going to see my surgeon next week. hopefully, he will agree.
but I fear I will be fat and out of shape and have to struggle with rehab. but if that's the best I can hope for -- i pray it will stabilize the curves and maybe lessen the pain.

thanks for reading, I will let you know if the surgeon agrees with my "plan". blessings to all- Jamie in TX

susancook
04-16-2014, 02:01 AM
Who is your surgeon? Just want to wish you the best! Many of us have some extra pounds and not in such great shape. I suggest that you start small and increase a little bit every day. I suggest strengthening quads and an easy exercise to do is to hold on to the kitchen sink and bend your knees to 90 degrees, if you can and come up again. Do maybe 10 every day for a week, then try 12....whatever you want to do, but do it every day! Increase to twice a day. Get on some workout clothes and funky music.

Pain is a bummer, been there and not going back. Depression is also a bummer and being in pain is depressing.

Sending good vibes your way.....Susan

LindaRacine
04-16-2014, 08:31 PM
I wish I had the surgery years ago, before my L3-L4 gave out. but I want my life to be better, not worse, not a slow deterioration and depression; I am struggling with severe depression, too, I'm taking meds and it helps a little; I do manage to work but that's about the extent of any productivity.


Hi...

There's no way to know, but had you been fused years ago to L3, you would have a high likelihood of needing fusion to L4, L5, or the sacrum anyway. At UCSF, patients are really encouraged to do whatever core strengthening exercises they can, as it's the one proactive thing we can do to minimize the potential of needing surgery to the lower lumbar region.

I'd also encourage you to get the depression under control. Depression is a very strong predictor of poor outcome in spine surgery, and the surgery itself is highly likely to actually make the depression worse.

Best of luck, whatever your future holds.

Regards,
Linda

rohrer01
04-17-2014, 11:21 AM
Scooter,
I agree with everyone about doing exercise. If you can't do anything else, walking is great. Get in a habit of it if you can.
I'm thinking being on the plump side is better than being too skinny. At least you have weight to lose.
I doubt that any surgeon would touch me right now. I'm too thin and don't have any room to spare. If I lost the usual 15 pounds, I'd end up under 100 pounds on a tall frame. Ask your doctor. If he's concerned that your weight is an issue, then he'll tell you. I think the most important thing you can do is get as physical as your pain will allow you. It will not only make you physically more prepared, but exercise releases endorphins which combat depression.

I wish you all the best!

scooter950
04-18-2014, 09:56 PM
hi again, thank you Susan, Linda and Rorher for listening to my vent. the depression is here to stay, I've been on & off different antidepressants for about 11 yrs now, my Primary care doc said that with my history of relapses- he wants me to stay on the meds. The pain is fairly constant, it waxes & wanes throughout the day but I tried to walk on the bech last weekend, couldn't go very far. I had my niece go ahead without me, I turned back and sat in the car. and I love the shore. this work week, I ended up taking Lortab at bedtime just so I could sleep- the pain wakens me during the night, I get cramps and paresthesias and incredible hip pain ( another thread! I know...) with taking th narcotic at bedtime I feel like i get better quality of rest.

My back cramps up at the lumbar area- like a charly horse in my back that I cannot get rid of.

i'm going to Austin to see my surgeon; we were supposed to schedule the scoli surgery in 2011 but I asked him to please check my neck because the neck and shoulder pain was worsse than the back pain- so he did the C spine fusion. Now, I'm going back for T2- ?? I feel as Linda stated: if I only fuse to L4 I am probably facing a second surgery to fuse to sacrum. BUt the surgeon wanted to limit me to L4 if possible.

I will stay positive and yes, i will try to walk. thanks for "listening" to my concerns ~~ Jamie in TX

scooter950
04-18-2014, 10:00 PM
the surgeon said my L3- L4 was "bone on bone", back in 2011. I swear, sometime I think I can feel it moving/ grinding especially when I have poor posture....

titaniumed
04-19-2014, 12:03 PM
I'd also encourage you to get the depression under control. Depression is a very strong predictor of poor outcome in spine surgery, and the surgery itself is highly likely to actually make the depression worse.


Jamie, this can be a battle for sure......I donít think that its worth it. (Depression, stress, worry, and anxiety....) These are deadly words for us. Every single time I let these take a hold, it just caused me problems. Every single time....

I really had to do an about face in my mind, and did whatever it took to keep from being depressed about all of this. My surgeon and I bumped heads on this matter, and I was the one that was wrong and I was rejected because of this. He wasnít going to continue with my surgeries if I couldnít get a grip on things....he was right and I was wrong. I had a lot of things that were boiling in the pot....and all sorts of changes were about to happen. If we are uncertain in our minds, its hard, but all we can do is walk that path and trust that things will be ok.

Accept the change thatís about to happen no matter what happens. Setting your date is the beginning of the process. Congratulations.....

Linda is right about this.....its probably the most important thing we need to do. Its all about attitude. This is at the very top of the list of things to bring to the hospital.

Rejecting negatives...and I know you can do this. Itís a mission with rewards. Pain takes a back seat, and your mental set becomes your primary goal.

Eyes on the prize....look forward, never back. Donít ever think ďI set my date, Iím going to stress over thisĒ because thatís looking back.

Donít ask, ďCan I do this?Ē Think ďI CAN do thisĒ. Ask the right questions.....think the right answers.

I found that short daily outdoor walks alone, are optimal thinking times....you donít have to walk much....

Ed

Pooka1
04-19-2014, 12:30 PM
Great advice, Ti Ed.

There is no way my daughters or my husband or I could have gone through this episode if we didn't view it as cutting losses. Normal is off the table. Say good bye. All that was left was to throw ourselves completely into the fight to stem further loss and hope to get back to a life. My daughters would not have any life absent their surgery. In that sense it is a huge win for them that they are carrying on in a normal life.

Another thing that helped me was just to acknowledge early and often that life is unfair and things could be a lot worse. What can you do other than to cut your losses?

Good luck.

titaniumed
04-19-2014, 02:06 PM
Sharon

I don’t know if I would call it cutting losses.....maybe so, but it seems that change is inevitable in our lives. I never thought of it as a loss, but that’s my forced positive mental programming. Its different as a single patient vs being a parent.

If one moves because of war in a country, would that be considered cutting losses? It’s a careful balance....a change for the good? Why, of course! Communists forced my relatives to move, I have first hand experience in this....Its not negative, its positive. Leaving your home suddenly becomes a positive thing. You laugh when your home catches on fire and you move on. This loss becomes a positive thing.
Scoliosis surgery is similar.....its just a change. How you handle it is important.

Back to the stress subject, I wanted to add that when my mom passed away last year, 2 days later my cervical herniation’s suddenly took a dump. Yes, they were documented in my massive hospital reports in 2008, and you just don’t fuse everything, ha ha (my little scoliosis surgeon joke) and no they don’t laugh at that one, but this stress solidified my beliefs in the destructive nature of stress. It’s a killer. Why this happens, I wonder......scoliosis isn’t that black and white, its complicated and we have a long long way to go figuring all this out.

There is a lot of value in breathing deep and slowing down.....

I had an event at work the other day where I had a 10 level hip stabbing that hurt like heck. Everyone gets all concerned because I yell out in agony....

No biggie, and no I’m not running to a doctor....I laugh at them and ask “Are you crazy, why would I do that?”

I have too much fun all the time. The stares are just golden.....

Ed

scooter950
04-20-2014, 11:07 AM
thank you, Sharon & TiEd, there are other reasons for the depression, it's been a battle, scoli isn't the only scourge I carry. be that as it may: I try to move forward, that's why I "set the date" - I realize that the years are going to pass and I continue to be paralyzed - mentally paralyzed- by fear, by apathy, or depression- but I NEED this surgery. The rational mind recognizes it- the depression just forces me into a bare minimum survival mode. I am thankful for my job; I fully intend to continue working post-op. I need to work to fight the depression.

I trust this surgeon, he is a scoli expert, Dr Geck in Austin; I am 55 almost 56, I have to accept the fact that I have limitations. My house ? I need a maid, I can afford to pay one but I feel guilty if I sit while she cleans, yet there's only so much I can do. Correction: I say- I can do ANYTHING, but only for 5 mins then i must lie down. but I cannot keep waiting for the house to be perfect, I am not quite a hoarder BUT I have clutter! I am a clutter-er ! almost as bad...

but I am trying to be positive: and I read everyone's post-op posts and I wish this was behind me already. well, today I am taking my puppies to the beach and I will walk. and then I will lay on the warm sand and my dogs will lie beside me/ or on top of me ( the small one) and I will enjoy this glorious day, thank y for sharing your experiences... I look forward to this "short" work week, and then Friday we shall see if the surgeon agrees to my surgery date!! yaaa! blessings and Happy Easter - xxx Jamie in TX

scooter950
04-20-2014, 11:21 AM
PS - Sharon, i think i understand what you mean by cutting losses: it will be a new "normal" for me, I will deal with the post-op limited mobilty, I am trying to do that now- avoid bending, etc. but tiEd, i am also seeing this as a positive: I want to be better, I want to WALK! I want to travel- my husband wants to take me to europe, to disneyworld, he wants to go to the resort in the Bahamas - but I keep saying no, not now- I recognize my limitations, and I don't want a vacation where I must take narcotics in order to do anything. I feel my husband got a bum deal when he married me, the back pain has worsened with age. he deserves better. so I will get stronger, I will try to walk - yes, I am fghting depression but I will stay on the meds, I try to laugh ( reruns of Everyone Loves Raymonds always make me laugh!!) and I try to get out of the house, when possible. so depression may affect recovery- but I was depressed with my C spine surgery too- and I wasn't on antidepressents then yet I healed-- I am fused! the pain was tolerable, and now- I will work to prepare for the big surgery.

bottome line: I just recognized th years are flying past, and I am no closer to getting this done. and I need to stabilize my scoli- so - <deep breath> let's do it! I hope & pray the depression will not be a factor; I'm taking meds and I'm trying to fight it. thanks for listening,

PeggyS
04-20-2014, 01:57 PM
Hi Scooter,
I can identify with the dilemma of 'getting ready' for the BIG surgery! I'm looking at October 2014 for my surgery, too. I've put it off multiple times - mostly by choice, but the last 2 date changes were due to needing to heal from an accident and last time was that my husband needed neck & lumbar surgery first.
If I stop doing whatever is causing the pain, it does go away quickly. I think I could live the rest of my life with my current condition because the pain is controllable. The problem is, my curve has progressed another 10*, up to 75*, in the last 2 years and now I'm 60.
We hired house cleaners because I was responsible for everything during my husband's recoveries. It's SO worth it! Now I can spend my energy on other things - like de-cluttering & organizing my house - just like you're trying to do! You might want to reconsider! Also, I need to lose at least 15 pounds & strengthen my core.
Looks like we could be October buddies!
I pray your pain lessens so you can do the things you need to do in preparation. Let us know what your dr says about your date!

Pooka1
04-20-2014, 04:13 PM
It really comes across in threads like this about how hard a decision this is in adults. It seems like it is rarely clear cut until it gets so bad. That is a such a hard position to occupy.

For me as a parent, it was so important to focus on the choice between surgery and no surgery as opposed to surgery versus normal. There was no point in spending any time comparing surgery to normal because that was off the table. The only thing on the table was surgery versus no surgery. And then it became obvious my husband and I had no choice.

I think some parents inadvertently slip into the comparison of surgery versus normal which can only cloud good judgement as that isn't really the choice they are faced with.

I wish all the adults here good luck and positive, productive thoughts. I do think attitude is important. My second kid had an easier time than the first because she saw the first one go through recovery and knew what to expect. It really seemed to matter.

titaniumed
04-20-2014, 11:36 PM
It really comes across in threads like this about how hard a decision this is in adults. It seems like it is rarely clear cut until it gets so bad. That is a such a hard position to occupy.

For me, it was so important to focus on the choice between surgery and no surgery as opposed to surgery versus normal. There was no point in spending any time comparing surgery to normal because that was off the table. The only thing on the table was surgery versus no surgery. And then it because obvious my husband and I had no choice.

I think some parents inadvertently slip into the comparison of surgery versus normal which can only cloud good judgement as that isn't really the choice they are faced with.

I wish all the adults here good luck and positive, productive thoughts. I do think attitude is important. My second kid had an easier time than the first because she saw the first one go through recovery and knew what to expect. It really seemed to matter.

Adults with adult degenerative scoliosis that really need surgery wait and hope they can maintain their pain somehow, and all along the clock is ticking and time passes quickly.....Pain makes our decision, for some of us, this pain can be hard to fathom. When all my methods of pain control failed to work, I knew it was time. It was a non-linear pain curve in which failure accelerated rapidly. You know when you are out of time. Its failure mode analysis done the hard way.

Setting the date is the start. When your surgeon asks ďHow about next week, I have an open slotĒ thatís a bit much because we need some time to absorb the impact of actually making the decision. I was thinking ďDoc, Iím 99% on this.....I need another 3 months for the final 1%. Thatís when we become zombies, thinking and making sure, we are sure, we are ready.

By the time the date rolls around, you need to be 100% ready.....and as hard as commitment can be with anything, the option of backing out isnít there. Its sink or swim, and swimming can be a little hard for fused scolis, but like Susan mentioned, simply use the mask. A great example of adaptability.....its all about our mental prep and positive attitude.

Recovery takes a lot out of us. I know I couldnít handle any other distractions or worries, the trivial things like cleaning up something just has to wait. The little things all have to be deferred, its not something that recovering scoli patients need to have on their minds. Recovery and recovery thoughts should be just that. I couldnít imagine having to have to worry about going back to work in a few weeks, this stress is not worth it. Loved ones and the inner circle need to know this. Please donít expect anything from us right now, thatís not fair.

Having a choice is something we have, and that makes it hard. If I have a heart attack and need heart surgery, there is no choice. It actually makes it easy. All that decision making stress isnít there.....

Parents have it hard because they reinforce their kids and have to answer if something goes wrong. Kids rely on parents and surgeons 100% but if something hasnít been covered, which is impossible, then answers have to be understood which can be difficult sometimes. I think it was best that I made my decisions all on my own and rejected surgery back in the 70ís. With limited medical knowledge, my question was ďScoliosis surgeryĒ Yes or no. I knew it was like launching a rocket and landing it back down on the pad.

But we do that now.....(watch till the end, itís the best part)
http://www.youtube.com/watch?v=2t15vP1PyoA

Huge smiley face, and yes things in the medical arena are better which makes the decision easier.....
Ed

susancook
04-21-2014, 03:45 AM
Adults with adult degenerative scoliosis that really need surgery wait and hope they can maintain their pain somehow, and all along the clock is ticking and time passes quickly.....Pain makes our decision, for some of us, this pain can be hard to fathom. When all my methods of pain control failed to work, I knew it was time. It was a non-linear pain curve in which failure accelerated rapidly. You know when you are out of time. Its failure mode analysis done the hard way.

Setting the date is the start. When your surgeon asks ďHow about next week, I have an open slotĒ thatís a bit much because we need some time to absorb the impact of actually making the decision. I was thinking ďDoc, Iím 99% on this.....I need another 3 months for the final 1%. Thatís when we become zombies, thinking and making sure, we are sure, we are ready.

By the time the date rolls around, you need to be 100% ready.....and as hard as commitment can be with anything, the option of backing out isnít there. Its sink or swim, and swimming can be a little hard for fused scolis, but like Susan mentioned, simply use the mask. A great example of adaptability.....its all about our mental prep and positive attitude.

Recovery takes a lot out of us. I know I couldnít handle any other distractions or worries, the trivial things like cleaning up something just has to wait. The little things all have to be deferred, its not something that recovering scoli patients need to have on their minds. Recovery and recovery thoughts should be just that. I couldnít imagine having to have to worry about going back to work in a few weeks, this stress is not worth it. Loved ones and the inner circle need to know this. Please donít expect anything from us right now, thatís not fair.

Having a choice is something we have, and that makes it hard. If I have a heart attack and need heart surgery, there is no choice. It actually makes it easy. All that decision making stress isnít there.....

Parents have it hard because they reinforce their kids and have to answer if something goes wrong. Kids rely on parents and surgeons 100% but if something hasnít been covered, which is impossible, then answers have to be understood which can be difficult sometimes. I think it was best that I made my decisions all on my own and rejected surgery back in the 70ís. With limited medical knowledge, my question was ďScoliosis surgeryĒ Yes or no. I knew it was like launching a rocket and landing it back down on the pad.

But we do that now.....(watch till the end, itís the best part)
http://www.youtube.com/watch?v=2t15vP1PyoA

Huge smiley face, and yes things in the medical arena are better which makes the decision easier.....
Ed

Ed and all, I believe that the degenerative group are different from the folks that knew that they had scoliosis since heir teens or twenties because us older degenerative folks, like me, don't think about having scoliosis or surgery....or worry about it for as long as many of you have said who had scoliosis and knew that surgery was inevitable, but thought that you could wait it out. Many folks have gone to the surgeon over many years playing the "what's my number" game, waiting until they reach some magic number when surgery and or pain make the decision inevitable.

Many of the "degenerative folks" have spent their life periodically in pain, but have some minor treatments and go on. Then, they get tired of going to a chiropractor or PT and finally have a full back X-ray and get the surprising news of "scoliosis" at which point they are very, very surprised! Then, learn about the treatment and say things like, "why can't I just have my L4 stenosis and my thoracic kyphosis done"? And are told, "you need a big surgery Tsomething to Pelvis". Ha, not on your life....or mine! Pain becomes the factor that tips the scale as well as the pain management MD saying, "there is nothing mor that I can do for you".

For many of us degenerative folks, decisions are different as we are older, kids left home, retired or close to it and have somewhat slowed down in life. I used to backpack but now mostly hike.

When I decided that I was going to actually have surgery, the hunt for THE surgeon did not take long. The first surgeon was ready to schedule me in 6 weeks and the second in 2 months. Having the luxury of 2 great surgeons to choose from was great. The day after I saw the second surgeon and met with her RN right after I had the initial meeting, my head was on overload with way too much detail! A day later, the surgeon's scheduler called me to set a date.....no, I told her, not ready to do that. I waited 2 days more and called back and set the date. About 1 month before surgery, I suddenly had a sinking spell of doubt and wanted to cancel. That passed in a few hours and there was no turning back. About 2 weeks before surgery, a sudden calm came over me, and I did not have any doubt or fear. My whole attitude was, "Bring it on!" The morning of my surgery, I asked if I could walk into the OR. After they laughed, they decided that their insurance would not cover it, so I had to ride.

The journey for each of us is different, yet in many ways has similarities. In many ways, we face the surgery like we have faced many other challenges in life. I remember repelling off a tower in the Army. I knew that the sergeant that was controlling the lines would not let me fall, so I just lowered myself onto the wall and tried to repel down. I had no fear. For me, it is a do it or don't do it....there is no try! Like Yoda said. For my spine surgery, I had total faith that my surgeon would fix me. But as a caveat, that if I had a postop problem, we would just figure it out when it happened, and it did happen and I figured it out! For me, it was have the surgery 100% in it, or be less than that and not schedule.

Recovery was not on any schedule for me as I did not have to go back to work. That made it easier on me. Like I said on my thread, the drugs that hey used were potent on this little old lady and I do not remember much of the 18 days at UCSF. My son said that it was the Ketamine.

Enough! Susan, nicely tucked lower abdomen with healing 2nd degree burns......

PeggyS
04-22-2014, 07:03 AM
Very well said, Susan & Ed!! It helps so much to read about your experiences & thought processes. Thank you for taking the time to share.
Friends & family frequently ask when I'll be having my surgery. My husband needs to be fully recovered & I'm not 100% sure on who my surgeon will be. I do have the month picked out: October! Other key components of being ready are: having a garage sale, organizing our house, moving my mom & a vacation! Goodness, I'd better sign off & get busy!

susancook
04-24-2014, 01:09 AM
PS - Sharon, i think i understand what you mean by cutting losses: it will be a new "normal" for me, I will deal with the post-op limited mobilty, I am trying to do that now- avoid bending, etc. but tiEd, i am also seeing this as a positive: I want to be better, I want to WALK! I want to travel- my husband wants to take me to europe, to disneyworld, he wants to go to the resort in the Bahamas - but I keep saying no, not now- I recognize my limitations, and I don't want a vacation where I must take narcotics in order to do anything. I feel my husband got a bum deal when he married me, the back pain has worsened with age. he deserves better. so I will get stronger, I will try to walk - yes, I am fghting depression but I will stay on the meds, I try to laugh ( reruns of Everyone Loves Raymonds always make me laugh!!) and I try to get out of the house, when possible. so depression may affect recovery- but I was depressed with my C spine surgery too- and I wasn't on antidepressents then yet I healed-- I am fused! the pain was tolerable, and now- I will work to prepare for the big surgery.

bottome line: I just recognized th years are flying past, and I am no closer to getting this done. and I need to stabilize my scoli- so - <deep breath> let's do it! I hope & pray the depression will not be a factor; I'm taking meds and I'm trying to fight it. thanks for listening,

When we marry, it is unconditional. We do not say that we will stay married as long as our partners stay, fit, or thin, or youthful, or without pain, or without medical problems, whatever. If you marry for love, then the love is unconditional. There are no guarantees once you are at the alter. Some day, your husband may have severe physical or mental problems. You will stick by him and "make it work". Your husband did not get a bum deal marrying you. That is negative thinking.

Susan

scooter950
04-25-2014, 11:32 PM
@Susan - oh, thank you, but I am acutely aware of my limitations .... I appreciate your encouraging words. My husband's a really great guy - which is why I wish I could do more for him.

BUT .... I saw my surgeon today, I feel so relaxed and ready to move forward. He wants to do a discogram- UGH! Has anyone had a discogram? I believe they try to elicit the pain, so that the surgeon will be more knowledgable about what levels are causing pain. I told him: I really do NOT want any test that will deliberately cause me pain. but I also told him- if he needs this- OK. I want to have the best outcome... he wants another MRI, more Xrays, bone density, and PT for cardio and hamstring exercises/ leg strengthening. he may not be able to do Oct 13 but we will schedule it for Oct. once all the preliminary tests are completed.

My curves have not progressed. so in reality- my curves have not worsened in 30 years. But the pain has worsened, my activity level has dropped significantly, slowly over the years, but I am sedentary. He would like to stop at L4 if possible, but he feels the discogram will give him better insight into my pain.

sounds like the 70's ... disco! disco duck... on that note- good night! Jamie outside of Austin! 4 hr drive home zzzzzzz

leahdragonfly
04-26-2014, 09:35 AM
Hi Jamie,

I got a second opinion from a surgeon who wanted to do a discogram on me. He tried to sugar-coat it, but the more I learned about it the less I liked the sound of it. Apparently it can be and frequently is excruciating, especially if your discs are bad. I posted about it at the time (several years ago) and Linda said it is rarely used at all anymore especially by scoli surgeons. I ended up not going with that surgeon and I am glad for several reasons.

I also wonder about your comment that the surgeon is trying to stop at L4-----It seems that leaving one disc unfused below a long fusion is almost never a good idea. Some folks here have tried it recently and as I recall two have had to go back for fusion extensions due to unrelenting pain. I would be very concerned about that, and would want to know what odds your surgeon gives you that you will not need a second surgery for extension to the sacrum/pelvis. I am not sure how much mobility saving one level would give you, especially if there is already degeneration at that lowest level.

Have you considered a second opinion from another top scoliosis surgeon? I know you are ready to get this over with, but you can never be too careful picking the right surgeon and the right surgery for your situation.

leahdragonfly
04-26-2014, 09:39 AM
Hi Jamie,

Here is a prior post from Linda about disco grams:


There's some very new research that casts a negative light on discography:

http://www.orthosupersite.com/view.asp?rID=40067

Discography may quicken disc degeneration

By Robert Trace
1st on the web (May 20, 2009)
MIAMI ó Results of a 10-year, prospective study suggest that discography can result in accelerated disc degeneration and herniation.

In the multicenter study, 75 patients without serious low back pain received an MRI and discography examinations in 1997. A matched group was enrolled at the same time and underwent the same MRI examination.

Discs that had been exposed to discography demonstrated signs of greater degeneration at 10-year follow-up than discs that were not exposed to the procedure, Eugene J. Carragee, MD, of Stanford University, said at the 36th Annual Meeting of the International Society for the Study of the Lumbar Spine (ISSLS), here.

ďWe also saw a greater loss of disc height and signal intensity in the group of patients who had discography compared to the control group,Ē he said.

In qualitative MRI findings, Carragee and his colleagues documented new cases of disc herniation, new endplate changes and progression of disc degeneration more frequently in the patients who were exposed to disc injection.

ďDisc puncture, even with modern discographic techniques, causes definitive structural injury to IV discs,Ē he said.

The findings confirm the results of earlier animal and organ culture studies, Carragee noted. As such, orthopedic spine surgeons need to carefully consider the risk and benefit of disc puncture for diagnostic or therapeutic interventions.

The investigation did have a few limitations, according to Carragee, including the fact that study subjects were predisposed to disc degeneration, and the effect may not be the same in everyone. Also, ďThe rate of degenerative changes is unclear, since we only used two time points in the study. Finally, the results were not homogeneous among the groups. Some discs showed no progression at all,Ē he said.

Carragee and his colleagues earned the Best Clinical Paper Award for their presentation at the ISSLS meeting.

Reference:

Carragee E, Don A, Hurwitz E, et al. Does discography cause accelerated progression of degeneration changes in the lumbar disc: A ten-year cohort-controlled study. Paper # 57. Presented at the 36th Annual Meeting of the International Society of the Study of the Lumbar Spine. May 4-8, 2009. Miami.

titaniumed
04-26-2014, 09:44 AM
Hi Jamie,

I got a second opinion from a surgeon who wanted to do a discogram on me. He tried to sugar-coat it, but the more I learned about it the less I liked the sound of it. Apparently it can be and frequently is excruciating, especially if your discs are bad. I posted about it at the time (several years ago) and Linda said it is rarely used at all anymore especially by scoli surgeons. I ended up not going with that surgeon and I am glad for several reasons.

I also wonder about your comment that the surgeon is trying to stop at L4-----It seems that leaving one disc unfused below a long fusion is almost never a good idea. Some folks here have tried it recently and as I recall two have had to go back for fusion extensions due to unrelenting pain. I would be very concerned about that, and would want to know what odds your surgeon gives you that you will not need a second surgery for extension to the sacrum/pelvis. I am not sure how much mobility saving one level would give you, especially if there is already degeneration at that lowest level.

Have you considered a second opinion from another top scoliosis surgeon? I know you are ready to get this over with, but you can never be too careful picking the right surgeon and the right surgery for your situation.

I agree with Gail....now I donít have to type my post.(smiley face)
Ed

Susie*Bee
04-26-2014, 01:20 PM
I have nothing to say about discograms... but did want to say that I am fused T2-L4 and have not had any problems with that. At my last appt. a year ago (?) all looked well with the lower vertebrae. My surgeon had given me the odds of 80% not needing further surgery, no promises made, entirely my decision. He did think the added flexibility was a plus, but I do need to be careful not to do repetitive type movements that would cause stress there. I will hit my 7th post-op anniversary May 4th.

Doodles
04-27-2014, 07:27 PM
Glad I happened on here today so I can respond to the discogram. I originally was going to have surgery at Baylor Univ. in TX. I was so taken with the doctor and just ready to go. He wanted myleogram and discogram over the next couple days and surgery was about 3 months out. (I chickened out got a different doctor--Dr. Lenke in St. Louis and had it about 8 months later.) At any rate I went ahead with the tests. Myleogram was OK. I have a pretty high pain tolerance (I think most of us scolis do) but the discogram wasn't much fun. But mainly I felt it caused me an increase of pain and a quicker progression of curves over the next several months. Dr. Lenke said they do NOT do them anymore. I totally agree with the study Linda had cited. Good luck with your decisions. Be sure your surgeon is one who is a specialist in adult scoliosis. Janet

JenniferG
04-27-2014, 08:45 PM
Couldn't agree more. Choice of surgeon, in my opinion, is the #1 predictor of the outcome of your surgery. Sounds like a couple of unticked boxes here, and you have the time to get another opinion before surgery date. Wishing you the very best of luck.

mabeckoff
04-27-2014, 09:13 PM
Talking from personal experience, your choice of surgeon is the most important decision you can make. My first surgeon in NC messed me up big time. I thank God every day for Dr Bederman who fixed the most that he could fix

scooter950
04-29-2014, 11:34 AM
hello to all, and thank you for sharing your concerns.

I wanted to write in more detail and explain the doctor's conversation- when I last posted, it was late at night and Iw as very tired, so I just shared "my" highlights. here is what the doctor told me:

first- of course, I told him I was ready to plan my surgery/ he took Xrays, then he asked where my pain was located. Most pain is at the apex of the lumbar curve, but I also have lumbar-sacral pain when I sit too long ( or slouch). So this gave him pause- next, we looked at the Xrays and my curve has not progressed. Still 65 degrees thoracis and approx 40 +/- degrees lumbar ( he did not measure it out right then, we were talking). But he brought up the 2011 Xray and the two spines appeared very close to identical. So then I asked- I was concerned because although it's great that my curve has not worsened- wouldn't that make it more difficult for him to straighten it? I asked if my nerves are already used to this curvature- I have had the same degree more or less since 1985. So I am thinking this is a pretty stiff curve, not easily corrected.

IN response to my questioning, he discussed a recent surgical case of an older patient with a 90 degree curve, and he said it was a stiff spine- so then he discussed getting the myelogram and discogram- because he wanted ot understand why my pain is both at the apex and the midline L-S areas. He said the myelogram will be his roadmap for the surgery- and the discogram may explain my pain; he explained he reasoning to me- he said he also wants MRI's and that the tests will determine whether or not he is able to stop at the L4 level. He would like to preserve the L4-L5 and so would I, but he did tell me it may not be possible, this was only our first pre-op meeting.

The plan: I must have another bone density test, another MRI, the myelogram, the discogram, and possibly another cardiac stress test- and then we would meet again to review and decide what would really be fused.

so I wrote my Reader's Digest condensed version due to fatigue. I was really worn out from driving 4 hrs. it took a toll on me, I cannot imagine going anywhere else for surgery. Of course, hearing so many great things about Dr Lenke- I considered St Louis, BUT... I cannot tolerate the travel. I have other issues besides scoli, and this causes me significant pain, I was worn out from the Fri/ Sat travelling I cannot imagine trying to coordinate surgery out of state. Look how long it has taken me to get to this point!

As for getting a second opinion: I did go to two other scoli surgeons before choosing Dr Geck- but from the first moment i started talking with Dr Geck, back in 2011- i was calm and at peace. I remember it - I just trusted this surgeon. Heck, I let him cut my throat! ( sounds weird- but in reality- that's what he did! and the C spine is more risky than the rest of the spine!) When I asked him about my neck pain, and he reviewed the MRI and he did the C spine surgery first- he said it's better to correct the C spine so that when he manipulates the spine during scoli surgery, there's more room in the cervical area. (not exact wording - my memory).

Dr Geck IS a scoli specialist. He is travelling this Oct to do mission medical work, he will be out of the country so the date of my surgery will be after his return. I am at peace with my choice of surgeons. and the distance is stretching my physical reserves to the Nth degree! But I will ask him / his nurse about the long term effects of discogram on disc degeneration, and ask if I may refuse the discogram. I hope this detailed post explains the meeting and surgical plans a little better. Thanks to all- very much and sincerely- for reading and sharign advice from your personal experiences! I value your insights! Jamie back home now !