Laser Spine Surgery

Hello Everyone,

WOW, "leave" for three days and I'm way behind. GREAT!!!!

Thanks Mare and Ratter for your thoughts.

Ratter, yep, keeping moving loosens things up for me too. "I have a new unrelated problem in that my left hand and fingers cramp up and start to hurt but when I free them up the minor pain goes away instantly and hand and fingers are free again." Now that sounds very familiar. Many years ago the joints in the fingers of my one hand "froze" up to the point I could only slightly move my fingers. ARTHRITIS was the problem!!! Voltaren has helped that problem greatly. (Except for this "bad weather" day when all my joints are hurting.) I suspect as your doc told you that you have that nasty arthritis.

"This getting old sucks" Amen to that!!!

Mare, "getting old is not for sissies" is a word for word quote from my wife's uncle when he was in his 90's. DAMM I wish it wasn't so!!!! AHHHHhh but to cherish the good days and what we CAN still do and enjoy as you have so well written.

Glad you got that nice $10K back. Have you spent it yet? lol

Take care.

RichT

Hello Algosdoc,

Nice to "see" you back on this thread!!

Had just about completed a post to you and then the whole thing went blank GRRRRRrrr.

Will try again later.

RichT

Sciatica Al.

Your mental approach to your spine problem is very objective and shows a clear thinking person. Your recognition of the spine problem and the realization that only you can decide which way to go....surgery or no surgery.. is great.

Your decision in regard to the neurosurgeon is good too.
I was wondering, "Is your neurosurgeon a spine specialist?"

Neurosurgery, like Orthosurgery are a specialities in itself, but they also have specialities within specialities. What I went looking for was a spine specialist who did not do other types of surgery other then on the spine. When you find the "spine specialist", look for the number of years, he/she has done this type of surgery. The longer the number of years, the greater the experience, the better for you as a patient. All that I have just said is logic to the logical mind.

Listen to the advice of your PCP but do not bind yourself to just what he tells you about the neruo doctor because I have found doctors can refer you to a surgeon, but they do not always have the time nor resources to really search for the best surgeon for you. Of course what can bind you to one doctor is the insurance that you have and their rule of "you can only choose a doctor on our panel." If you are lucky, you have "off panel" options.

If you believe you can live with the pain you are now experiencing then I would say, forget surgery. The only requirement for re evaluating if surgery is in your future is age. The older you are, the longer the recovery.

I am Mare's age. I am 6 months out of a lot of "stuff" done to my spine.
I am just beginning to be able to carry out the instructions of "walk,walk, walk." I do two miles a day, walking at a medium pace. Believe me when I say, this old spine, reacted with twinges, spasms and some jolts of pain to every additional 10 min. I added to my walk. So, if you can stay away from surgery, I would say "It's your decision."

Be careful of that computer chair. A lot of people foul up their spines sitting at the computer for too long periods of time. Maybe you can add heat, or ice kept in place by a binder when you are sitting in the chair. A pillow located either at the Lumbar or at the Thoracic region of the back should help too. For some weird reason, I need mine at the Thoracic region even though my surgery was in the Lumbar region.

And your comparison between spending money or buying a tombstone was really funny. I needed a little light laughter today. Thankyou.

I wish you continued good luck as you struggle through your pain and decisions.

Marie B.

Most of out posters have been those who have Lumbar problems. Its been ages since Dragonfly has posted results of cervical surgery.

If anyone has had cervical surgery, I wish they would consider letting us know about their problem and how it was handled surgically and their post op recovery.

I just sent a person to my doctor because the man heard and saw how well I had done under my spine specialist. His problem is in the cervical region, but no problem for my spine specialist because that is in his lineup of speciality surgical services.

This poor man must have surgery. He has 3 Cervical discs that have pressed so deeply on the spinal cord, it is half the size in circumference due to the pressure.
Many symptoms are present including leg pain. The cord must be relieved from this pressure because any accident which involves a jolt, knock, or jerk of the neck can result in putting him in a wheel chair for the rest of his life.

Hopefully there is one out there who will post his experience.

Marie B.

Hello Marie,

AHHHhh, so nice to see and read your posts.

SUPERB thoughts, wisdom and words of advice to Al. Right ON!!!!

Sure would be nice to see Dragonfly posting again.

Thanks for sharing the cervical back problems about the fellow. I hope Dragonfly and others will respond to your request for their experiences with cervical surgery, etc.

Marie, I'm amazed that you can walk two miles at a good pace. I know you would put me to shame. Would you give us an update on how your recovery is going and how the pain "issues" are doing.

Have a GREAT Day!!!

RichT

Hello Algosdoc,

Well, I'll try again. lol

I agree it would be great if the laser spine centers would share with the public the information you mention. AND so too for "traditional" spine surgeons. Algosdoc, I have gone to 6 spinal surgeons. Not a single doctor provided me with the information you mention should have been provided. NOT ONE!!!

The Oswestry and Roland Morris tests are new to me. I know of no one who has had spinal surgery whether at a laser spine center or at a traditional spine center who has had these tests.

And regarding the SF36 pain assessment, I know I have not had one from any of the spinal surgeons that I have gone to. When I have an appointment at the traditional spine institute I go to, each time I am to write down on a form the level of my pain, where it is located and any nerve issues. That is the only thing my spinal surgeon has ever "looked at". Never has he ever mentioned the SF36 pain assessment. Same for the modified MacNab outcome assessment.

Algosdoc, I will definitely mention these tests and assessments to my spinal surgeon the next time I have an appointment with him. Thanks for the very valuable info.

AND I WILL ALSO ask those two important questions you recommend that we ask of our doctors.

Regarding publications - Only one doctor has openly shared his publications with the public, and he is in the UK. I have checked as best I could if any of the 6 docs I have seen has published in the medical literature. Again, a big zero. SOOoo in fairness to the doctors at the laser spine centers, their publishing record is no worse than the vast majority of "traditonal" spine surgeons (if I may be permitted to extrapolate from my experiences).

Well, had better close before I lose this post.

RichT

Hello Mare,

I'm slowly working my way "backward" on this thread.

In your 5-16-08 4:38pm post you stated - "On any studies I have seen comparing laser spine surgery to open back surgery...the results were not even close." First, where did you find the studies that you refer to? I have tried to find such information on the web through the numerous medical journals. Almost without exception such published studies were not available to me because I am not a paying member of any of the medical journals. Heck, I can't even get to my past chemical publicatons. lol

Would you be so kind as to expand upon your statement "the results were not even close". What were the differences, which came out on top, and could you give us the name of the journal publication, name of journal, volume, etc.? Thanks

I agree, that generally the more invasive the spine surgery the higher the risks. And then there is the risk factor of the hospital, and the competency of the surgeon.

Now to continue backward.

RichT

Hello Mare and Algosdoc,

Thanks Mare for your question to Algosdoc on the Total Facet Arthroplasty System. What especially caught my eye was that it offers an alternative to rigid spinal fusion. Spinal fusion is the MAJOR reason I'm trying to keep the knife away.

Thanks Algosdoc for your excellent response on the TFAS. Do you have any idea when the study will be completed and the results published? Hope soon.

There is another technique called Total Posterior Spine system (TOPS) that Impliant developed. It is currently being studied for those people who ONLY need to have two adjacent vertebrae "stabilized". From my understanding it is placed between the two vertebrae and permits motion of the spine at that location, rather than no motion with the "screws and rods" technique. I did make application to be included in the study, however, I did not qualify because of my need to have two spinal fusions. I will look forward to you response on this technique.

RichT

Hello SciaticAl,

I read your post with a great deal of interest. Thanks for sharing the details of your spinal situation.

You have received SUPERB thoughts, advice and wisdom from Marie. She has provided you with excellent "food for thought".

So important that you have had an MRI.

"Quality of life" - Yes, that is a most important question that most of us have had to deal with. What compromises in our life style are we willing to accept that still gives us an acceptable quality of life? That is the basic question I dealt with about a year ago.

Like you, standing in one location makes the pain level rise very quickly in a matter of 2-3 minutes. So for me that is a NO NO. Also, like you, sitting in a wood chair or just an uncomforatable chair will take care of my back in short order. I take my special cushion with me when we go out to eat, and even then I may need to get up and walk around during the dinner. I should add that I've been sitting in my computer chair for over three hours now and my back is only now saying I need to take a break. A break to walk around a bit, and then to my recliner.

YES, MOVING for me also is the best way to keep the pain at a minimum level. My "gardening exercises" are great for that.

I weighed the pros and cons of surgery just as you are doing. It took me several months to do the research into the pluses and the minuses. In the process I sought out the advice from six spinal surgeons in my area, and from a surgeon at the Bonati institute. Three surgeons recommended surgery, and four did not. It took a lot of "soul searching" to feel comfortable in making a decision.

Al, for me, at the time my pain level was a 2-4. The four docs voting against having surgery ALL said that surgery should be the LAST option because of the risks involved. When I asked one doctor (recommended to me by Fran's doctor) what guide I should use to know when I needed to have surgery, his answer was - "When you can't walk across your living room."

I also need to add that the epidural injections (with the corticosteroid Kenalog) given by my pain management doctor have made all the difference in the world for me. I can do many of the things I could not do last year. Top of the list is gardening. My pain level now is generally in the 0-2 range (unless I get one or two of those "bad weather" days like now).

SOOOooo Al, give yourself the time you need to make the right decision for yourself. Do your research and get the opinions from several of the best spinal surgeons you can find in your area. Determine which compromises to your life style you will accept and which ones you will not. AND also understand that surgery has no guarantee that you will be pain free after surgery.

For me, I'll stay away from the knife as long as I can.

I wish you the best.

RichT

Hi Everyone,
Talking about "quality of life" and how much pain I was willing to live with.

When I decided to have surgery, there was never a time I was at a 0 or 2, even when being given corticosteriod injections with Lidocaine. When I look back to that day and time, I know I could not do what Rich has done. I had a chiropractor, a neuro muscular therapist, pills and my recliner. The recliner became my life.

For the first year, I took 3 Advil and 1 ULtracet. This allowed me to live my life. But a time arrived when my legs began to buckle and the pain was unreal and scared me to death. The recliner was the only thing that gave me relief. I couldn't stand for very long let alone climb steps and lift heavy items and I hated every minute of the whole experience. The stenosis in my Lumbar region extended through 2 vertebrae.

I also have a moderate stenosis in my Thoracic region, but that doesn't seem to give me much trouble. I do get tired between the shoulders, but that's where massage, physical therapy, ice, warm moist heat etc. helps the tiredness. That tiredness does not happen often.

After surgery, the Recliner was a chair to look at longingly. With Fusion, I had instructions to forget about that chair forever....too much stress on the Lumbar region that was fused. I now use on an upright chair, pillow behind my back and one at my feet when I sit. I do this not because I have pain, but I have been told by the occupational therapist from the hospital where I had my surgery to "protect my Fusion." Since I have had Fusion Insitu at the L4 & L5 I will have to be watchful that I don't stress the location. I have learned, for some people, it may take an entire year before Fusion is complete. My last visit to my surgeon the X-Ray he took showed everything was still in place and doing O.K.
I am surprised that I do have as much flexibility as I do. I know this is a concern for many. But I will never bend down again and touch my toes. Couldn't do that before surgery either.

Giving up the recliner was not a bad thing for me. Between pills, warm moist heat, & blankie it would not be too long before I would fall asleep in front of the TV. I ended up with an aching neck. Now I do upper body exercises with 2 lb dumbells and walk a lot.
Rich, I used to walk a lot during my 30's and 40's but at this time of life it is like a new form of living. Every muscle in my body was out of shape because of the length of time I would stay in a recliner. There was no way I could keep in shape.
Now, I am having to re-educate those muscles in my legs, arms, and back as well as those tendons and muscles that were manipulated during surgery.

Now when I look back at my post op time, I felt fine the first three days, but it was almost 2 weeks post op before pain diminished completely.

Now 6 months later I feel the tugs and pulls of muscles and tendons of the back that are being re-educated through my exercises. I'm moving muscles that I had neglected for a long time. They must have liked to just hang there and now they protest as I insist they become more mobile. The pain, which is not the best word, I feel now is more like soreness and stiffness. that doesn't last very long after my workouts.
I will feel this for awhile as I continue to increase the time and distance and speed with which I walk. Because of the Fusion, I will never jog nor run. No jarring of the spine! The two laminectomies still do not permit me to wear anything tight around my waist. That's O.K. I don't have that girlish figure anymore and I don't need to flaunt anything.

Luckily for me, I didn't have to give up that glass of wine. That's the best thing for muscle relaxation and warmth. My muscles begin to feel like melted butter. That's almost as good as a massage.

Hope I have given you an update on things at this post op. point, Rich.

Marie B.

Hello Marie,

Thank you for your excellent "update".

I am in awe of your determination and dedication to follow your doctor's recommendations during your recovery. BRAVO!!!!!

Oh yes, what would I do without my recliner and my heating pad. I would really be hurting without them.

"I had instructions to forget about that chair forever....too much stress on the Lumbar region that was fused." - Thanks Marie for including that very important piece of information.

I'm glad that all is in place and doing well for you. AND that you have more flexibility than you expected.

WOW your walking and the exercising with those 2 lb dumpbells should get your muscles back in shape.

I had a bit of a chuckle when I read about "flaunting". AHHHhhh my good lady I'll bet you certainly did so in your younger days. Your husband noticed! lol

GREAT!!! that you have not had to give up that precious glass of wine. I couldn't agree more that it is a great muscle and mind relaxer.

Thanks again for your very informative update. I wish you the very VERY best as you continue on your recovery. You are a SUPERB model for all of us spinys on following ones doctor's recommendations.

Have a most enjoyable day!!!

RichT

RichT
All the info I compiled on independent studies comparing different types of spine surgeries was sent to the Min. of Health last summer when I was attempting to get out-of-prov. health ins. coverage. My data required by the Ministry was considerable, including specialist lists, hospital data, health centers etc. in order to prove that the surgery wasn't done in Canada. It was after this that I lost my HD and all my info so I am unable to tell you what sites I went to for the info. Some we're listed in the other spine forum we talked on...others we're quite excellent including side by side graphics. The statistics on success rates for laser spine surgeries were somewhere in the area of 70-90% where open-back it was listed as in the 10-15% rate. Of course there is no way of proving if these statistics are accurate or not. However it is unfortune I have lost these links.
The different studies basically showed how laser surgery resulted in less scar tissue, less time to recover, no muscles being cut, less bleeding, usually smaller incision....lots of pluses, but generally stating the obvious that the less invasive a surgery is, the better chance of positive outcomes.

And no I haven't spent the $10K...actually I returned most of it to my sister who paid the lion's share of the surgery, bless her. She feels so bad that my outcome wasn't like hers, and she is still doing great...out walking nearly every day (I am so glad for her, but jealous too! ha ha!)

Mare, you mentioned in your last post about your sister walking almost every day.

Are you able to get out and walk at all or maybe just even a little bit?

Rich, I just went to my PCP and he took a fit when I told him that I was walking an hour every day. He backed me down to no more then 20 min. every other day. My surgeon had told me to do what was "tolerated."
When the sun is out, which it is rarely in this area of Ohio, I love to get out and walk, smell the grass, feel the warmth of the sun, hear the birds singing. I'm really a sunflower. I can almost forget that I have back problems when I am walking.

Mare, when I read what you had to do to get surgery in regard to your Canadian health care, my hair grows even greyer when I think that here in the states, Hillary and Obama would like us to have that kind of care.
Lord save us all from what you had to go through.

Marie B.

Rich, Fran hasn't posted for awhile.

Do you or anyone know if the last injection that she had was a success or did she have to go back in for another tune-upon the back from that accident?

Marie B.

Marie
I do go out and walk about 2 lots over and back again, enjoying the wild flowers growing in the marsh, and the beautiful sunny sky and fresh wind blowing in my face. I return to my chaise lounge chair for a while...then later I walk down to the dock to sit and watch the sunset on the lake. While doing odd jobs around the house I walk up and down stairs and for the most part can get the meals etc but often have to sit down every 15 min or so. For some reason something clicked in my back yesterday and my back kept going in to spasm. I woke up at 5am with cramping and knotting in my legs and feet which wouldn't let up. I couldn't bend the feet to get them flat on the floor to walk for at least a couple of hours. The knots were so painful I got sick to my stomach. i got the heat on my back, then around my legs, then tried icing them, then tried massage all to no avail. It continued on till the afternoon while I rolled around in agony. I finally tried an ativan, then we headed to the hospital. They gave me another ativan, which relieved me quite a lot. They did blood work and found I had low potassium so the Dr. wants me to try potassium pills to see if that stops the cramping in the legs. I usually have some cramping and lots of nerves jumping around but NEVER like this before. Has anyone out there had any problem like this happen to them?

In the days when my back was just beginning to cause me aches and pains and spasms, I went to a chiropractor and neuro muscular therapist.

During discussions I learned that the two occupations had a difference of opinion in regard to which needed care first...the bones or the muscles.
The muscule therapist believed that if you kept the tendones/muscles warm, exercised, and relaxed with the blood flowing freely through them a person would not experience as much pain from pulling on the bones. She would demonstrate that using rubber bands on bone models.

Now the chiropractor believed that if the bones were readjusted or "subluxated" that would relieve the tendons and muscle causing pain, stiffness etc to go away.

Now to get to your potassium question, Mare.
Lack of K can create havoc in the body. Blood clotting factors change, muscles/tendons contract and sometimes very painfully. That can occur anywhere from head to toe. If no other serious factor can be found for the muscle pain and the blood test shows low potassium that can point to the cause of the muscle spasms.
I don't know how many children you have had, but leg cramps are very common in pregnant women and doctors usually up their intake of foods that have potassium. The same things occur in those who are extremely active and sweat alot while on the athletic field. In fact, just working hard in the sun and sweating can cause loss of water and with the loss of water goes the potassium. That's why you see Gatorade and such products on athletic fields. The eloctrolyte balance in the body becomes disturbed and you can have dizziness and other such difficulties.

I take a blood pressure pill with a diuretic and my doctor watches my blood tests regularly to make sure my blood chemistry is O.K.
With that combination, he added a potassium pill.

I use to look at the previous generation when I was young and found it hard to believe how often they visited the doctor. They did have various health problems like blood pressure, but then they also lived to the ripe old age of 92 through 98. So if the doc thinks you need potassium, take it and see if those muscle spasms go away. If they continue, then you must make the doctor to look elsewhere.

Marie B.

Hi Fran, I love all of the things you say and have said, and how many times I have told you that you and I agree and think so much alike on these surgeons and spines that we have.

I was hoping you would not have to face another surgery, but when I read your message, and your satisfaction with you doctor, a song popped into my head. The one from South Pacific. "Some Enchanted Evening". It ends with the words, "once you have found him, never let him go. Once you have found him, never let him gooooooo!"

Stay in touch and let me know if you go on to that "jackson table" again.

Marie B.

Marie B.
I think you might be right on re the potassium problem. I take the water pill and Norvasc so probably getting potassium-depleted. ...I took a pill yesterday and had very little cramping in my legs this morning. My legs hurt from top to bottom due to the knots I had yesterday...as if I did a lot of jogging with no stretching and they were full of lactic acid or something. I will be taking potassium pills for a while, along with drinking OJ and more water. My back still feels like it is "out" so I am stepping VERY carefully. Hard to imagine that a little area of 2-3 inches can control your whole body...control your whole life-style. Gotta talk to myself about this whining.