Alternative to Spinal Fusion?

[fa fas]

Hi all
its been a whilst since I posted but wanted to start this new thread about alternatives to spinal fusion.

For those who dont know my history....
Jan 08 - emergency discectomy L4/L5 - left with foot drop
May 09 - revision discectomy L4/L5
Dec 09 - further herniation L4/L5 plus post op scarring and L3/L4 disc bulge.

The last time I spoke to the consultant he was making noises about fusion or pain management!

Is there anyone out there who has had a different procedure? I am interested in disc replacement or the laster treatment which the spinal foundation do.

Bonnie10

 

[buy levitra on-line]

Fusion is the last resort!! Avoid it like the plague!!

I did have some information about prosthetic discs Bonnie, these are still regaded as quite experimental though, I'll try to find them and give you details when you send your next PM.

Best wishes

SPINELF

 

[AJ Rawr Chomp Grr]

Hi

I had a discectomy at L5/S1 seven years ago after suffering a prolapsed disc and whilst the operation was a success, I now have 'bone on bone in that location, causing constant pain.

Mid 2008 I developed a prolapsed disc at L4/L5 and the consultant I was seeing at that time did not diagnose it (only having done an xray) and he offered me a spinal fusion, and/or pain management. My pain management doctor diagnosed the prolapsed disc after he sent me for an MRI scan, and he prescribed more medication and carried out a nerve root block procedure (which didn't work). I was off work for 6 months before it settled down enough for me to return. I have private health care and used it for the first discectomy, and also for the consultations/treatment during 08/09.

I was only back at work for 8 months before it prolapsed again in October 2009 and have been off work since then. I have gone down the NHS route this time as my first consultant no longer takes private patients, and I have no desire to see the specialist that I saw last time. I was referred for pain management and have been give more medication and was offered an epidural. However, my consultant has decided to do another discectomy because I am still in as much pain ow as I was in October.
The NHS route has amazed me because the appointments have been VERY quick, and I feel that I have been dealt with much more efficiently. I had expected to be on waiting lists for a very long time!

I talked to my consultant about spinal fusion and he advised that the outcome is poor and I also mentioned about disc replacement surgery (as I was prepared to pay myself if necessary), and he absolutely refused to refer me, as not enough is known about the long term results.

I am now waiting for my discectomy and have been told that the waiting time is approx 6 weeks, and hopefully as more treatments become available I may be eligible (eg disc replacement).

I believe that once you have spinal fusion you would be unable to have any of the newer procedures.

Good luck, and please keep us posted on what you decide to do x

 

[Goorgelelagox]

'I believe that once you have spinal fusion you would be unable to have any of the newer procedures'.

This is correct!!

 

[Lost &&. Confused]

Still waiting to hear back from nhs - its been 6 weeks since my scan and yet there has been a wall of silence from the consultant who I am now chasing daily as is my gp (this is not a service).
Anyway whilst waiting I have been doing my homework and even had a telephone chat with Mr Knight, describing my history and current symptons he thinks he may be able to help me.
have had a great message from spinelf (thanks mate) and would welcome any other personal experiences from anyone else who may have been treated by Martin Knight

bonnie10

 

[stormer_xxi]

Don't forget Bonnie, if you want more detailed experiences to answer any of your niggling questions as you go along, you know where I am.

Best wishes


SPINELF

 

[Jason Bernasconi]

There are several less invasive, or better say minimally-invasive therapeutic and diagnostic methods that can help in:
-clarifying exact pain source
-stopping pain transmission

In my opinion Spinal Foundation is definitely best place for such a procedures. Aware pain centric surgery performed by Dr. Knight will most probably help you.

There is also possibility of laser spine surgery, depends on source of your pain.

Don't be afraid of Dr. Knight, and you should not worry about other people's experiences. The fact is that Dr. Knight is pioneer minimally-invasive spine surgeon, he attends every MISS congress, not only as attendee, he is usually a faculty member that organizes such a congresses.

In my opinion where it considers spine issues there are 3 people in world who's name means much in every county of the world: Dr. Knight (UK), Dr. Hoogland (Germany) and Dr. Yeung (USA).

 

[Messenger007]

Keano is right, Mr. Knight is 'highly regarded' in the world of minimally invasive, aware state, endoscopic & laser spine surgery (MISS), particularly in the USA.

On a personal level, I found him to be the same as most surgeons in regards to the 'god like' mannerisms they display, but in the crucial regard of understanding complex spinal, muscle and nerve based symptoms of chronic back pain sufferers, in my opinion, he has no equal in the UK!!

He displays a very caring, understanding, honest and focused bed side manner and would be the first to emphasise the need to manage a patients realistic post op expectations with regards to the best possible clinical outcome.
He is brilliant, but as he himself would say, he is not a God!

Even so, he completely cured my right sided L 4/5 sciatic nerve inpingement without causing collateral damage, and I will always be grateful to him for that. If he wants to call himself a God, thats fine by me !!

For clinics with similar types of minimally destructive surgery in the US:
www.bonati.com
www.laserspineinstitute.com
www.microspine.com
As you read these sites, you will see that this procedure is neither new nor experimental, the reason it is not readily available in the UK, is that NHS Spine Surgeons are resisting it introduction.

Happy researching.


SPINELF

 

[qmrfrfcl]

As a aid to assuring you of these treatments efficacies Bonnie, take a look at these sites I found recently as well!!
www.zerospinepain.com
www.spinecenter.com
And
YOU TUBE - MDTV

Best wishes


SPINELF

 

[ZoomN]

That should have read, You Tube - MDTV - MISS


SPINELF

 

[Ebo]

Hi Bonnie,

I have had pretty similar problems to you. Albeit L4/L5 and L5/S1 rather than L3/4. Please contact Mr Knight as suggested in these previous threads - http://www.spinal-foundation.org/Contact-Us
Mr Knight operated (using the minimally invasive technique, which was excellent) on my spine in March this year - I have had 22 years of back problems, previous failed surgery, constant pain and discs that are so degenerative I don't know where to start.

3 months post Mr Knight's Op I am a different woman - the technique he uses finds the pain point and uses lasers under guidance of camera to remove scar tissue and free anything that is impinging a nerve, such as bony spurs from osteoarthritis (as in my case). The procedure is done at the BMI Hospital at Huddersfield. Mr Knight has an awesome reputation. He has done over 4000 of these procedures with less than 1% failure rate - compare that to a multi-level spinal fusion which only has a reported 40% success rate.

I hope I haven't seen your post too late for this to help you.

K.

 

[R-Jay]

Very glad to hear this

 

[Pryldamrin]

Kathy E

Could you please PM me as I would like to find out more about your op with Mr Knight. I also underwent the procedure 7 weeks ago and haven't had the results I had hoped for yet. I would just like to swap notes if you don't mind?
I cannot see how to PM you (perhaps because you are new).
Thanks
Maz

 

[Let it be]

PRAISE BE, PRAISE BE, ANOTHER CONVERT!!

Keep it up everyone, safer and more effective Endoscopic & Laser, Minimally Invasive Spine Surgery (MISS) is growing rapidly in the US,
it's only a matter of time before it excelarates in the UK too!!
Not before time!!


SPINELF

 

[vyxrnhwo]

SPINELF, and anyone else who has had a positive experience with Martin Knight... please can you message me directly re. your experiences! I'm at the end of the rope. Since 1996 my back has 'gone' every three years or so – but this always settled down with bed rest and Ibuprofen and Paracetamol. Each episode would be triggered by bending down too sharply or twisting a certain way. However, in November 2010 I was walking, seized up and things got worse from there. Ended up in hospital on 09/11/10, but after three days on an orthopaedic mattress and medication I was discharged and I was getting back to normal. Degenerative Disc Disease was diagnosed, the disc at L5/S1. The disc is dehydrated. On 22/11/10 I decided to have a private physiotherapy session to keep on top of the situation, but the next day woke in agony (I'm concerned that this physio session made things worse, not better). Since November I've had constant lower back pain - nothing like the minor episodes I used to experience. I had to grimace through Christmas Day, and ended up back in hospital on Boxing Day because I couldn't tolerate the pain any longer. I was on Morphine in the hospital, but they discharged me three days later and told me to get back in touch if things hadn't settled in six weeks. The pain never went, and is still here. I'm on Diclofenic, Codeine and Diazepam. Can't take Tramadol or Dihydracodeine as I'm severely allergic to these. I can't sleep in a normal bed – I've had to buy an orthopaedic bed (one which bends), and sleep on my back. I can't stand up, sit or walk far without the pain kicking in. Sometimes the pain is confined to my lower back, sometimes I get an ache between my shoulder blades, pains in buttocks, thighs, down to knees, sometimes down to feet. The area at L5/S1 feels highly unstable. It takes me a long time to get into bed, for fear of disc slipping and getting that indescribable pain which happens when disc slips. I've been to see three consultants. One told me to go away and do yoga and swimming (Yeah, I can't even get on the floor to do any exercises or drive to the swimming pool, and if I did get in the pool I'd probably seize up and drown); another told me to see a pain management specialist (but I've since been told that having Cortisone injections can fail and can even damage the surrounding tissues); another consultant looked at my MRI scan and said that an MRI can't show specifically what is going on with the nerves, and told me to get back in touch when I was 'at the end of the road' (great help). I'm on the waiting list for a spinal fusion, but this scares me greatly (I've read about the complications, risks and the fact that it may not address any trapped nerve problems). I've just turned 40, but I'm living like an invalid. I used to be very active (gym, socialising, travelling, etc), but can't do any of this any more. I have had to give up work (desk-bound) because I can't sit in a chair for long periods, I used to go to a lot of business meetings but can't stay anywhere overnight as I need to sleep in an orthopaedic bed, and no hotels have them. I had to hold my 40th birthday party in the house, and spend a lot of that time in my orthopaedic bed. I have three children, and am reliant on family and friends to run around after me and them. If my disc is empty of fluid, what can be done? I'm very scared about the future, and scared of never being able to do the things I used to do. I am seeing Martin Knight for an initial appointment, and I'm hoping he will be able to do something for me. Is it too much to hope to be pain-free and back to how I was before? What are the chances of getting back to normal life? I'm scared of any kind or surgery, but the Endoscopic Lumbar Decompression surgery has been suggested to me. How can this procedure deal with a dehydrated disc and/or trapped nerve(s)? How can I be sure that I will recover from this debilitating condition? Any advice/suggestions would be gratefully received.

 

[ozokyqbd]

Hiya kimkitsch. Sorry for the delay!

Your story is typical of most of us, so you are in good company.

I will help you in any why I can. Just let me know what information would help with your decison. As far as Mr. Knight is concerned, I would go back for a second operation, LIKE A SHOT! He has already cured me of my L4/5 lumber spine nerve compression, and more importently, he has not created any 'colateral damage' to any other area.

It is this colateral damage that is synonimus with NHS procedures and usually results in the patient's poor clinical outcomes. Because MISS does not open up large areas of your body or cut through nerves tissue, muscle, ligments or bone, your chances of a 'fuller' recovery will be maximised. no spine surgery is easy, but MISS offers the best and least destructive of all spinal procedures available, anywhere in world, and Mr. Martin Knight is one of the worlds best practioners!!

Have you seen Mr. Knight yet?

In the past, I have sent other back pain posters, the descrition of my experience at the hands of Mr. Knight, and they were comforted enough to go on to have procedures under him. I can send you the same if you wish? No presure, just let me know!

Do read his web site KIM www.spinal-foundation.org it does what it says on the tin!

All the best


SPINELF

 

[Pompal 09.]

I would disagree that collateral damage is the cause of complications or poor outcomes from NHS work, although in some cases this may indeed be a factor. There may be an element of truth here but it is not the whole story.

The main reason why many patients get stuck and fail to improve whether or not they have surgery, is that the issue of cause is not addressed. This is, of course, far too big a subject for a single post or even thread. Ten years in the business including five years of training and I reckon I'm beginning to get a handle on it.

We do not see many lazy people with disc injuries, and often getting our patient to take sufficent recovery time is vital, however they go about approaching their problem. This may sound cynical, but it is much easier to justify to the boss, family etc, a month of rest just after having surgery. Nevertheless, surgery or not, a period of rest may be crucial to turning this around - or at least time spent focussing only on recovery, and exactly what that requires, and not on the other pressures of life. Which means that one does need to ask for understanding and support from others, and that too can be strange to those used to always being the rock.

Of course, brilliant treatment is often the more desireable, however, the body has its basic needs too. In the bright light of rocket science we can be blinded to the importance of simple stuff.

One other factor with many standard approaches to disease is that they do tend to give the impression that the problem is a fact of life and the answer is in the right treatment. My belief and experience is that however great the treatment, the vast majority of the recovery is down to the healing ability of the patient, and how they go about helping themselves. The right simple guidance can make a huge difference, in fact this area is generally left to chance.

 

[Dhan Raj]

Let me say from the outset, that my admiration for professional and caring medical staff (NHS or Private) knows no bounds. I understand the pressures of the front line jobs, as I have family working in the NHS.

I totally agree with your points, good quality post operative exercise and recovery stratagies are critical in ensuring the best possible clinical outcomes for spinal patients after surgery. You are also right, that without the 'total commitment' of the patient to utilise these stratagies in order to increase cardio-vascular capacity, muscle power, core stability, mobility & stamina, full or even significant recovery will be fatally compromised! I would go further, and say the without the patients total commitment to pushing his/her capacity to the limit, in order to find their true fitnes levels, they are still selling themselves short.

One more area we agree on, is that without a full, graded and accurate diagnosis, the 'true cause' may never be properly and effectively treated.
I personelly know this to be true, because I was mis-diagnosed for 3 years and underwent the treatments applicable to this mis-diagnosis for 3 years.
The result was, I became less able and reacted adversly to every rehabilitation session. On one occation it took me 1 hour to get to the car park after a particularly physical session. The physiotherapists walked past me (without stopping) as I was clinging on to the walls and never asked me WHY?

Where we will have agree to disagree, is all to often 'physcological refuge' and 'failed back syndrome' excusses are applied to cover up poorly directed therapies, wrong diagnosis, inappropriate procedures and really poor quallity post operative care. Mine was limited to 6 weeks!
It is also used to cover up Colateral damage, the effects of which, I believe, have been grossly understated

 

[Grumple]

I certainly don't disagree, I don't have a lot of time for these kinds of diagnosis either, partly because they are not very helpful. To my mind they reflect on the limitations of the treatment modality or the diagnostic paradigm. It can look far too much like shifting the blame onto the patient when we don't understand the cause of their problem or when our treatment isn't as effective as we would wish.

Certainly collateral damgage does exist, most medical procedures are capable of doing harm as well as good. While very aware of this, I don't like to focus too much on it, because what has gone is gone, lamenting that doesn't help us to proceed. Our interest is where to go from here to make the situation better if we can. And that means considering the factors that are continuing to stress the body and dealing with the ones that are still amenable to change. They may have caused the whole problem in the first place and never been addressed, eg arch mechanics of the spine, exhaustion, poor nutrition, dehydration, stress, bad habits etc etc. And if better surgery is required to get them out of immediate danger I wouldn't necessarily argue against that either.

 

[james s]

Your points about the lack of accurate 'causational' diagnosis, as well as the lack of accurate 'medical' diagnosis, are well taken, and I agree, that more and better therapies should be far easier to find, and fund. I believe that the NHS should fund far more 'so called' alternative therapies, you know, the ones that have been around years and years and have never killed anyone, and earlier in a patients treatment the better!

By the by, do you have any figures on how common 'spinal misalignment' is caused by such things as 'wallets in rear pockets' or poor ergonomics on 'posterior areas' of seats ?

Many thanks!

SPINELF