Degenerative Disc 5 Years Post-op

[Pooka1]

Thanks for the responses.
I understand it is just an educated estimate but that probability rate of 50-70% is just astounding, especially since there is no 20+ year follow up, the need for an extension of fusion is just within 2 decades and shorter after the original operation was done.
Keep us posted updated Linda with the report/study you are doing on fusion levels and quality of life, Im curious to know that
the most of the other 50% you are referring to that didn't need an extension later on in life, were patients who were only originally fused above L1. I for one would never agree to have surgery
if I was going to need an extension in the future and end up with a fusion to the sacrum, i'd probably rather live with my pain if that were the case.

Apologies if I asked you this... do you have one structural curve or three?

If just the one middle one, you might be able to level L1 or L2. Maybe if you can avoid further progression you can have a fusion stop at L1 now and hopefully only need one surgery (if your lumbar straightens enough).

Have you asked a surgeon if you are in a time window about staying above L1 if you move fast enough? Would you want to know if you still have the option? You are non-progressive now and hopefully it will stay that way and this is a mute point.

Also you might want to ask if your disks are expected to fare better within a straightened spine or within your present spine even if it doesn't progress much more. Dr. Hey harps on this disk loading issue in curved versus straighter spines. It is possible they might know if your disks will or will not hold out over a lifetime in that configuration since you are relatively young. Only a surgeon will know.

[Jinseeker]

Thanks for asking.
I have 3 curves, but the middle big thoracic one is the main one. I'm really not sure if the top and bottom curve is structural or not, correct me if I am wrong but I always had the understanding if the secondary and 3rd curve counteracting the main one are small they automatically count as compensatory?

From the side bending tests it looks as if both top and bottom curves don't really straighten, they still have a slight curve in the opposite direction, but that could be because you are also using your lumbar to side bend so it makes sense if it is not straight so it is really hard to tell. Also the lumbar hump and higher shoulder is always there no matter my posture is and how I bend.

I did ask that to my surgeon how a straight spine that is fused will fair with the current loading of my lumbar disks. His answer was, probably just the same and he admits he doesn't know at all and can't tell. The other surgeon though told me I may eventually blow multiple lumbar disks along the way, but he sounded more like a salesman. Also if my fusion ended at L1, I'm afraid I might not have as good of a correction at all, most curve patterns like mine seem to end at L2 or L3. so I'm afraid my correction may be so minimal that it probably is not worth getting it done if It ended at T12 or L1. This is added to the fact that In my side bending to the right x-ray, my curve goes down from only 47 to 34 degrees. Side bending to the left increases it the other way around. I also can't touch my toes when I bend forward, the farthest I can go without bending my knees is my tip of the fingers reach about my calves mid length. My chiropractors tell me I have a very stiff spine, maybe that's the reason why my curves haven't progressed despite already being over 45.

I also don't know if I really believe what you say about one stop shopping if the fusion ends L1 or above, since I have scouted this forum and multiple patients have still had degenerative disks 5 +10 years after even If they were fused at L1 or L2 like the person who started this thread did.

Cheers.

[Pooka1]

Thanks for asking.
I have 3 curves, but the middle big thoracic one is the main one. I'm really not sure if the top and bottom curve is structural or not, correct me if I am wrong but I always had the understanding if the secondary and 3rd curve counteracting the main one are small they automatically count as compensatory?

I don't know about that but I bet you are correct. What have the surgeons told you in terms of how many curves you have. Both my daughters had three curves because if you have a structural thoracic, it has to curve the other way above and below unless you have a total "C" curve involving your entire spine. It doesn't mean they are structural.

From the side bending tests it looks as if both top and bottom curves don't really straighten, they still have a slight curve in the opposite direction, but that could be because you are also using your lumbar to side bend so it makes sense if it is not straight so it is really hard to tell. Also the lumbar hump and higher shoulder is always there no matter my posture is and how I bend.

Neither of my daughters could straighten their compensatory lumbar curves on side bending. Yet both lumbars came to match the straightened thoracic on their own. Because one kid was hyper-corrected to <10* in the thorax, she now has no curve in her lumbar. It is straight and loading evenly presumably. This is why I think Boachie says a fusion to T12 or L1 can stabilize the lumbar for as long as we know. Also the other kid still has a residual ~25* curve because you can't hyper-correct that without leaving a high left shoulder and I found a paper showing that residual curve in that type of thoracic curve is stable to at least 20 years out with no fusion extension necessary. Small sample size, though.

I did ask that to my surgeon how a straight spine that is fused will fair with the current loading of my lumbar disks. His answer was, probably just the same and he admits he doesn't know at all and can't tell. The other surgeon though told me I may eventually blow multiple lumbar disks along the way, but he sounded more like a salesman. Also if my fusion ended at L1, I'm afraid I might not have as good of a correction at all, most curve patterns like mine seem to end at L2 or L3. so I'm afraid my correction may be so minimal that it probably is not worth getting it done if It ended at T12 or L1. This is added to the fact that In my side bending to the right x-ray, my curve goes down from only 47 to 34 degrees. Side bending to the left increases it the other way around. I also can't touch my toes when I bend forward, the farthest I can go without bending my knees is my tip of the fingers reach about my calves mid length. My chiropractors tell me I have a very stiff spine, maybe that's the reason why my curves haven't progressed despite already being over 45.

You might be right about that being the reason you are non-progressive. Sounds reasonable! Does that give you pause about doing PT which might loosen it up? It might be a double-edged sword. I think you may have mentioned this in the past?

You have to ask each of these guys where the fusion would start and end in order to make a rational decision about surgery. It's a huge part of the picture given Boachie's statement on the matter of one-stop shopping or not with thoracic curves. People don't know to ask and surgeons don't talk about this or how it might create a time window for progressive curves and I don't know why they don't. Maybe they don't agree with Boachie but I can tell you our surgeon told my kid with the now perfectly straight lumbar and me that this was one-stop shopping.

I also don't know if I really believe what you say about one stop shopping if the fusion ends L1 or above, since I have scouted this forum and multiple patients have still had degenerative disks 5 +10 years after even If they were fused at L1 or L2 like the person who started this thread did.

Cheers.

The Boachie quote is about ending above T12 or L1, not L2. Our surgeon said every vertebra into the lumbar you go, the risk of needing an extension goes up although he seemed to indication L2 was okay in his opinion in terms of likely not needing an extension. All this is predicated on the lumbar straightening enough on its own. That said, the OP looks to have a pretty straight lumbar after surgery so I am wondering if straightness doesn't matter if you go to L2 or below per se. Who knows. Maybe they will all need extensions after 50 years. What is apparently known is even the Harrington rod thoracic fusions seem stable years out. The people having flatback and issues are the ones with lumbar curves also it seems. Clearly lumbar and thoracolumbar curves have not been solved to the extent that thoracic curves have been solved. That's why people with only thoracic curves should avoiding snatching defeat from the jaws of potential victory. I feel like my daughters may not be victorious in the long run but they are avoiding defeat for most of their life because of their fusions. They leading completely normal lives with no pain. Scoliosis is off their radar.

Good luck, Jinseeker.

[briarrose]

Hi everyone,

I haven't been on the forum in quite some time so it was nice to see an old thread revived.

I'm 7 years post-op now and deal with daily pain, mainly in my low back and left leg. The disc problem seems to be under control at the moment. I injured myself pretty badly when my husband and I moved back in November of 2013. I could barely walk due to low back pain. It was a bad time since I couldn't help empty boxes. I definitely still have low back pain and have to be careful not to reinjure myself. I do very little bending at the waist. Getting out of bed in the morning is always painful as is standing up and walking after sitting, though the low back pain generally subsides in a few minutes.

I still get the "lightning bolt pain" that takes my breath away. It used to be only up and down my spine but now it seems to occur anywhere in my back.

My latest issue is left leg pain that generates from my lower back (near iliac crest). I had been assuming this was sciatica, but my surgeon thinks it's a sacroiliac joint issue. He recommended pain management with injections, but I have not gone yet. This pain gets really bad sitting in certain chairs and even when walking. At times I have not been able to put weight on my left leg due to the pain. I've been having problems with my left foot as well. I saw a foot orthopedist a few weeks ago because my foot was swollen and I was having nerve pain in my middle toe (also couldn't bend my toes or spread them apart). He looked at my history and decided that my problem was due to my back. I'm not completely convinced of this as I think it may be a Morton's neuroma.

My quality of life has definitely decreased since my surgery. My feet and legs always hurt even though I where expensive Dankso shoes. I am generally in some sort of pain. I work 8-9 hours a day as a chemist and find I have to rest in the evenings and weekends to prepare for my next work shift. I don't regret my surgery, but it may have been better to wait a few more years. I do not have children yet and at 33 I'm running out of time, though I fear what a pregnancy will do to me.

Shell