[PeakOiler]

Looks like I get to have a "cage" installed around the L2 and L3 vertebrae in a couple weeks. (Bad disks and spinal stenosis). Perhaps this will finally relieve the constant pain I've had in the left thigh (and more recently in the hip) for almost three years now. Today I got the lower lumbar x-rays done. The neurosurgeon will get a look at them tomorrow.

[Subjectivist]

Best of luck on a skilled surgeon and a speedy healing process!!!

[Pops]

Good luck POer! I hope all turns out well.

[ritter]

Having seen my dad go through a spinal issue, the surgery is the easy part. It's the recovery that sucks! Best of luck and a speedy rehabilitation.

[davep]

Best of luck, PO.

By the way, there was a recent discovery http://www.guardian.co.uk/society/2013/may/07/antibiotics-cure-back-pain-patients that found Up to 40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery

Up to 40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery, in a medical breakthrough that one spinal surgeon says is worthy of a Nobel prize.

Surgeons in the UK and elsewhere are reviewing how they treat patients with chronic back pain after scientists discovered that many of the worst cases were due to bacterial infections.

The shock finding means that scores of patients with unrelenting lower back pain will no longer face major operations but can instead be cured with courses of antibiotics costing around £114.

One of the UK's most eminent spinal surgeons said the discovery was the greatest he had witnessed in his professional life, and that its impact on medicine was worthy of a Nobel prize.

"This is vast. We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics," said Peter Hamlyn, a consultant neurological and spinal surgeon at University College London hospital.

Hamlyn recently operated on rugby player Tom Croft, who was called up for the British and Irish Lions summer tour last month after missing most of the season with a broken neck.

Specialists who deal with back pain have long known that infections are sometimes to blame, but these cases were thought to be exceptional. That thinking has been overturned by scientists at the University of Southern Denmark who found that 20% to 40% of chronic lower back pain was caused by bacterial infections.

In Britain today, around 4 million people can expect to suffer from chronic lower back pain at some point in their lives. The latest work suggests that more than half a million of them would benefit from antibiotics.

"This will not help people with normal back pain, those with acute, or sub-acute pain – only those with chronic lower back pain," Dr Hanne Albert, of the Danish research team, told the Guardian. "These are people who live a life on the edge because they are so handicapped with pain. We are returning them to a form of normality they would never have expected."

Claus Manniche, a senior researcher in the group, said the discovery was the culmination of 10 years of hard work. "It's been tough. There have been ups and downs. This is one those questions that a lot of our colleagues did not understand at the beginning. To find bacteria really confronts all we have thought up to this date as back pain researchers," he said.

The Danish team describe their work in two papers published in the European Spine Journal. In the first report, they explain how bacterial infections inside slipped discs can cause painful inflammation and tiny fractures in the surrounding vertebrae.

Working with doctors in Birmingham, the Danish team examined tissue removed from patients for signs of infection. Nearly half tested positive, and of these, more than 80% carried bugs called Propionibacterium acnes.

The microbes are better known for causing acne. They lurk around hair roots and in the crevices in our teeth, but can get into the bloodstream during tooth brushing. Normally they cause no harm, but the situation may change when a person suffers a slipped disc. To heal the damage, the body grows small blood vessels into the disc. Rather than helping, though, they ferry bacteria inside, where they grow and cause serious inflammation and damage to neighbouring vertebrae that shows up on an MRI scan.

In the second paper, the scientists proved they could cure chronic back pain with a 100-day course of antibiotics. In a randomised trial, the drugs reduced pain in 80% of patients who had suffered for more than six months and had signs of damaged vertebra under MRI scans.

Albert stressed that antibiotics would not work for all back pain. Over-use of the drugs could lead to more antibiotic-resistant bacteria, which are already a major problem in hospitals. But she also warned that many patients will be having ineffective surgery instead of antibiotics that could alleviate their pain.

"We have to spread the word to the public, and to educate the clinicians, so the right people get the right treatment, and in five years' time are not having unnecessary surgery," she said.

Hamlyn said future research should aim to increase the number of patients that respond to antibiotics, and speed up the time it takes them to feel an improvement, perhaps by using more targeted drugs.

The NHS spends £480m on spinal surgery each year, the majority of which is for back pain. A minor operation can fix a slipped disc, which happens when one of the soft cushions of tissue between the bones in the spine pops out and presses on nearby nerves. The surgeons simply cut off the protruding part of the disc. But patients who suffer pain all day and night can be offered major operations to fuse damaged vertebrae or have artificial discs implanted.

"It may be that we can save £250m from the NHS budget by doing away with unnecessary operations. The price of the antibiotic treatment is only £114. It is spectacularly different to surgery. I genuinely believe they deserve a Nobel prize," said Hamlyn. Other spinal surgeons have met Albert and are reviewing the procedures they offer for patients.

[PeakOiler]

Thanks you guys.

Yeah, it's the recovery part that I dread. One of the deciding factors in having this done now is that I don't have a big peach harvest to deal with. I understand I'm not supposed to lift anything greater than 10 pounds for the first couple weeks, then nothing over 20 pounds for a couple weeks, etc. No carrying 5-gallon jugs of water for example.

No post hole digging, shoveling, moving potted citrus around, etc. for awhile. I should be able to harvest stuff from the garden but I would think I will still need to avoid bending over a lot.

I learned that one of my coworkers had similar surgery about a year ago, and he said he feels fine now.

I'll keep y'all posted.

Edit: The good part about this is I will probably take a month sick leave from work. That also means no commute for a month! (I hate driving in Round Rock/Austin. It really sucks. Austin has the 4th worst traffic in the US.)

See http://www.spinemd.com/operative-treatments/anterior-lumbar-interbody-fusion-reston-va.php

Check out the x-ray images at the bottom of the article.

[evilgenius]

A long time ago I used to work at an MRI scanner. I can tell you that if you can avoid surgery, by all means do avoid it. If you are going to have surgery, ask about what has the best prognosis for success over the long run.

I witnessed so many people come back five to ten years post op with the same or worse pain and problems. Many of them just had bad luck, so no real bearing upon whether surgery was a good choice, but some suffered because they chose the wrong track to deal with their problem in the first place. Bed rest and anti-inflammatories might have been a better choice for them, or a less radical surgery.

I don't know how many people who I talked to about where they were who said something to the effect of, "if only I had known this would be where I would have wound up I would have made a different choice." This didn't always mean bed rest. Sometimes it meant not choosing the surgery that, when time worked upon their bodies, would wind up leaving them only with the choice now of even more radical surgery.

[PeakOiler]

Well, let's see. I've tried physical therapy, acupuncture (about 10 sessions), and steroid injections in the spine. None did any good.

My doctors and I have explored the more conservative approaches with surgery was the last resort. That's where I am now.

My options are either to keep taking pain killers the rest of my life and continue to be partially mobility impaired, (I still walk with a constant limp), and since the pain has become more pronounced in the hip area, I'm taking the chance that surgery will help.

[PeakOiler]

The L2 and L3 lower vertebrae are nearly bone-to-bone when I bend that part of my back and that puts pressure on the spinal cord. I saw the x-rays. The surgery is now scheduled for August 1st. Yikes and hurray! I may finally be out of constant pain after three years!

[Quinny]

I had c3 and C4 fused in 1998 following an accident. They said it would be at least 6 months before I could walk, if ever. I was walking in about 6 weeks and recovered,though not fully in 6 months. In a planned operation you shouldn't have much to worry about. Good luck and get well soon!

The L2 and L3 lower vertebrae are nearly bone-to-bone when I bend that part of my back and that puts pressure on the spinal cord. I saw the x-rays. The surgery is now scheduled for August 1st. Yikes and hurray! I may finally be out of constant pain after three years!

[PeakOiler]

Thanks (again) to all, for the best wishes and warnings!

Thursday, August 1st, I go under the knife.

Six weeks is the expected recovery time for a spinal fusion. Even after that, the neurosurgeon said I still probably shouldn't lift anything over 35 pounds, such as 5-gallon water bottles for awhile even after that period of time.

I sure hope and pray that this procedure corrects the constant pain I've had to endure over the last three years.

Then perhaps I can get back to more serious gardening and other home projects next year. E.g.: I still have some cedar trees I need to cut down.

[basil_hayden]

Good Luck POer and get well quick!

[SeaGypsy]

Thanks for sticking around PO'er. You know what I mean. See you around again soon and may all be well with you!

[davep]

Best of luck Peakoiler.

[Timo]

Dude! PO! I can most definitely sympathize. I can also offer a bit of (2nd-hand) testimonial that everything in the lumbar spine should heal up rather nicely. Misery loves company, eh? I've recently been put in the unfortunate position of researching that same fusion (NOT LENR!!!!) procedure, but in an entirely different area of my spine. My fusion was suggested (and thankfully rejected!) between my skull and C1 and C2. The Alar ligament attaches the skull to the cervical spine, and coincident with a fall 4 years ago, right on the back of my head from a distance of some 20-feet, right on concrete, that Alar ligament was stretched. That ligament, unfortunately, runs through the interior of the spine, and is not accessible from the exterior. The only "fix" is to fuse the connecting vertebrae together, but that ends up prohibiting nearly all flexibility in the neck. No thanks. I'm too young to be old. In your case, however, the lumbar is low enough, and the fusion shouldn't be so restricting to your ability to move. It's also MUCH more accessible, without any of the dangers of going right where the brain stem happens to be. Good luck! I mean that!

[PeakOiler]

My surgery was postponed.

My cardiologist informed the neurosurgeon that my heart may not have been up to the surgery. A recent nuclear stress test indicated poor blood flow to the heart and also indicated that I had a "silent" heart attack sometime in the past. A silent heart attack has no noticeable symptoms. I certainly haven't noticed!!!

Apparently the general anesthetic puts greater stress on the heart. So guess what? I get an angiogram on Monday instead, with a possible stent implant!!! Jeeze! Then I'll have to reschedule the back surgery.

Timo: Wow! Are you in constant pain? What other options do you have? Just pain killers? Hope you can successfully deal with that trouble.

I don't like getting old...and these kind of ailments I never thought I would have until much later in life. I'm only 55 and am beginning to wonder if I'll make it to 65. But that's what I was dealt...

Damn! And I wanted to collect at least some of the money I've paid into Social Security all these years!

[PeakOiler]

G.W. Bush had a stent implant recently. I wish that's all I needed.

After the angiogram on Monday, my cardiologist told me a stent (or two) wouldn't have done me any good.

I'm now scheduled for a triple bypass operation on the 16th.

The doctor said it was likely I would have had a heart attack on the table during the back surgery.

Things are going from bad to worse!

Now I think I may wait to have the spinal surgery this winter instead...

[Pops]

Sorry to hear it PO'er, probably not as sorry as you tho.

Hang in there.