Joined: 09 Aug 2007 Posts: 107 Location: Tampa, FL
Posted: 01-24-08 10:48am
Algosdoc,
Thank you for taking the time to post here
on this thread. Your knowledge on this
topic is very much appreciated and I thank
you for sharing that with us.
I had 2 arthroscopic surgeries (with the
use of laser) in August 2007. I feel
better than before surgery but not where I
had hoped to be 5 months out. I had a dura
leak after my second surgery so when I
read your post, I immediately wondered if
they are more common in laser surgery than
they are in traditional. I also wonder if
the leak prolonged my recovery. Any
thoughts would be much appreciated!
Thanks again and welcome!
Best wishes and God bless,
Carrianne
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Marie B.
Experienced User , Rather EHEALTHy
Joined: 28 Aug 2007 Posts: 231 Location: Ohio
Greetings And Welcome Algosdoc Posted: 01-24-08 14:24pm
I'm not sure whether I should clap or do
cartwheels for your post.
I'm going to assume you are from England
or at least served there for a period of
time with the information you stated in
your earlier post.
I came to the same conclusions and decided
against laser because of the reasons you
gave when it came to the glib laser
surgical advertising on the web.
When the laser centers could not tell me
anything about further spine slippage if
no Fusion was performed when spine
slippage was present, I became
suspicious.
They seemed to have all of the dollars and
cents down in regarding to each
identifiable procedure they would perform
on a patient and that was another red
flag. No hospital care, no room and
board, no post op care, no nurses,not even
a post op visit at at future date, and a
host of other uncertainties was enough to
make me turn to a surgeon, a spine
specialist from the Spine Institue at the
Cleveland Clinic in Ohio, USA. After
almost two years of suffering and a great
deal of inquiry, research, and visits to
other surgeons, etc., I finally found my
man and stuck with him. Minimally
Invasive Surgery with Fusion Insitu was
the recommendation. And I went with it.
I have no regrets. I am doing well and
can't wait for my next appointment just to
give my surgeon a great big hug. I never
spoke to him directly about laser surgery.
I did speak to the Ortho surgeon who was
on fellowship at the Clinic and was doing
a serve with my surgeon learning about
spine surgery. When I asked him if he
knew anything about laser surgery, he just
gave me a great big smile and said "Not
anything really positive because I might
lead you astray but I do know a couple
really nice, snazzy websites that
advertise on the web for laser surgery if
you want to look into it." His smile,
body language, and my own doubts were
enough for me to decide I had made the
right decision for me to go with my
surgeon. He's my main man for the spine.
Thankyou. Thankyou. Sometimes it takes a
professional to say what neophytes are not
quite capable of putting into clear
language. You did the job for us.
Marie B.
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algosdoc
Experienced User , Rather EHEALTHy
Joined: 23 Mar 2004 Posts: 186
Posted: 01-24-08 21:17pm
Thanks very much....I actually practice in
the states, but have trained in endoscopic
spine surgery including laser surgery,
from Korea to France to Switzerland, and
know of many of the variations in
techniques.
Dural tears are problematic with
endoscopic or laser spine surgery since
there is no way to repair the dura through
an endoscope. Usually the dural tears are
in the anterior or lateral aspect of the
dura, and heal on their own. The anterior
dura is inaccessable to repair, even with
open surgical techniques. Sequelae of
dural tears include the development of
persistent CSF leak with development of a
CSF hygroma (fluid filled pouch under the
skin filled with spinal fluid), and the
issues with intracranial neurological
changes such as hearing and blurred vision
due to traction on the cranial nerves from
the brain being surrounded by too little
CSF (leaked out through the spine). More
insidious is the development of
arachnoiditis from a dural tear....this is
a permanent condition with clumping
together of inflammed spinal nerve roots
with the development of pain and
neurological changes. These changes may
occur months to years later, and often are
missed on MRI unless the radiologist is
specifically looking for them.
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Carrianne
Experienced User , Rather EHEALTHy
Joined: 09 Aug 2007 Posts: 107 Location: Tampa, FL
Posted: 01-25-08 10:21am
Ok, that officially has frightened me, but
I do thank you for your honest answer.
It's great to have your professional
knowledge on this forum. Thank you!
Best wishes and God bless,
Carrianne
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Marie B.
Experienced User , Rather EHEALTHy
Joined: 28 Aug 2007 Posts: 231 Location: Ohio
Ahaa! Education Posted: 01-25-08 10:45am
It looks like we now have a
physician/surgeon who is also an
educator. A very rare find today.
I would like to advise my spiney friends
not to lean on him for your particular
spinal problem as in "getting a
diagnosis." If you do you will loose him
because no competent doctor will make a
diagnosis over the internet or on the
phone without knowing you and having a
great deal of familiarity with your spine
problem and any other health problems,
procedures etc. that may refer to your
particular case. Learn and ask questions
about what you are experiencing and he can
give you information just as he just
posted. He is telling you of his
experience and his observations as a
doctor.
Let me also say what captured my attention
when I went to the spinal surgeon who did
my operation....let me repeat "did my
operation" not supervised it, was his
willingness to explain everything to me
BEFORE I had even committed to doing the
surgery. He used charts, pictures, and
other tools to be able to answer all of my
questions.
My husband asked him. "Do you think she
needs surgery considering the MRI you have
looked at and her symptoms. My surgeon
was hesitant to say "Yes" or "No." He
explained to me that this is always the
patient's decision when there is no total
incapacitation of the body because of the
spinal problem. In other words, "No
Emergency!" at the time the symptoms
presented to h8im.
It was then I revealed the reasons for my
doubts about surgery.
One of them being, "My PM Dr. saying he
did not think my symptoms required
surgery."
I expressed my concern by saying "I'm not
getting any younger", and I have read that
stenoses with its various causes present
can only worsen with time. And I needed
my surgeon to help me with this decision
and I asked "With your experience and
knowledge of multiple spine patients
suffering with this kind of problem what
would you do if you suffered from this.?
He spoke with assurrance to me and said,
"You would not be making an incorrect or
poor decision to choose surgery at this
point in time. With all of your concerns
about foreign metal or plastic parts in
your body, there is no reason for me to
expect that Laminectomies on 4 & 5
with Fusion Insitu will not relieve you of
the severe pain you have been having these
last two years."
At my first post op visit, he was pleased
with my recovery and I asked him for a
copy of his surgical report to give to my
PCP for the purposes of his reading it and
then keeping it as a permanent record in
my file located at my PCP's office. I,
being an "old nurse" and and "old scrub
nurse" at that, read the report he gave
me. I could write everyting down, but the
procedure was two pages long and I would
need a very long post to tell you. He
even identified each instrument used for
each procedure on the spine.
Today, the surgical rooms and people
involved are far more hi-tech then they
were when I was a "youngie". Since my
spine betrayed me at this point in my
life, if I had to have surgery, I am glad
it was now and not in the past. They can
see and do so much more now for the
patient then before. Grateful, I am.
Grateful.
Now, was a great doctor placed in my path
while I walked a calvary of pain? You can
bet on that and I am forever greatful for
the Power Above and a very caring doctor
who got me through the most God awful pain
I will ever experience in life. Even
having babies was no comparison.
Marie B.
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scottchambers60
New User, Becoming EHEALTHy
Joined: 24 Jan 2008 Posts: 8
Posted: 01-26-08 17:37pm
Browsing through this thread I've noticed
there is a lot of skepticism concerning
the effectiveness of spinal laser surgery.
To be honest if I had medical insurance I
probably would have gone with a more
traditional back surgeon myself. My
decision to use MicroSpine was motivated
purely financial reasons. My first call,
actually, was to the Laser Spine Institute
where I was told I would have to pay
$30,000 up front. MicroSpine quoted me
16,900. This seemed a bit odd that LSI
costs nearly twice as much because it
seems that they do the exact same
procedures.
Anyways I made the appointment with
MicroSpine and the doctor I spoke with was
very up-front about what I should and
shouldn't expect. In my case my problem
was so clear cut that I didn't need the
diagnostic testing bringing my total costs
down to 13,600. I believe that my case
represents the very best a person can
expect from laser surgery due to a couple
of reasons:
1. At 33 I am relatively young and in
good health.
2. My problem (disc herniation at L4-L5)
was the only problem I faced.
3. My out-of-pocket costs were far less
than I had originally anticipated.
4. My recovery time took just 7 days for
my pain level to reach zero.
Would I have gotten the same results with
regular back surgery. Maybe, Maybe not.
I can't comment on regular surgery because
I have never had one nor am I a doctor
that has preformed one. All I can say is
that I am extremely happy that my laser
surgery has given me my life back. I
posed a synopsis of my experiences in the
Back Pain forum (Looking back I probably
should have posted it here).
You told us everything, Scott but what was
done to your herniated disc?
There are many people who have herniated
and still have herniated discs that caused
pain when they herniated but in a period
of time the pain disappeared. Some
doctors do not believe in touching a
herniated disc unless it is pressing
against the spinal core, a major nerve
with additional degeneration of the disc
itself.
If you wish to share with us about what
was done in your procedure, it would be
nice to know.
Thanks for posting on this Thread.
Marie B.
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scottchambers60
New User, Becoming EHEALTHy
Joined: 24 Jan 2008 Posts: 8
Posted: 01-26-08 21:48pm
Ah forgive me for not being more specific.
I had a bulging disc that was compressing
the nerve at the L4-L5. The doctor also
said the hole in the bone where the nerve
exits was abnormally small which added to
the problem. He was able to shrink the
herniated disc with the laser and chip
away some of the bone to expand the hole
and help relieve the pressure. In the
short term it appears to be a total
success.
Scott
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RichT
Active User, Really EHEALTHy
Joined: 22 Jul 2007 Posts: 910
Thanks: 21
Thanked:0
Posted: 01-27-08 00:18am
Hello Scott,
Welcome to this thread and the wonderful
spineys who post here.
Amazing how many of us have spine problems
at L4/L5. I know I do.
Wonderful news that your receovery is
going ro well.
Thanks so very much for posting your
experience at MicroSpine. In the past we
had received input from patients who had
surgery at LSI and at Bonati, but not from
MicroSpine.
We really appreciate your sharing. We
look forward to an update now and then.
RichT
|
Marie B.
Experienced User , Rather EHEALTHy
Joined: 28 Aug 2007 Posts: 231 Location: Ohio
Foraminotomy Posted: 01-27-08 11:21am
that little hole you were talking about
where the nerve exits from the cord to you
lateral hip and thigh etc. When they
widen that, that is what is referred to as
a Foraminotomy.
Did you have a buldging disc and a
herniated disc in the L4 L5 area? Or are
you speaking of the same disc. I ask
because a buldging disc is different then
a herniated disc.
It may seem that I am pressing for details
but I'm not familiar with "shrinking a
disc." with laser.
What is important is that you now have no
pain. But it might help you in the future
if you have a surgical report in writing
from the surgeon. Sometimes discs and
even the same disc can cause you pain
again. If you have that report, you can
have it as documentation as to exactly
what was done in this last surgery.
Marie B.
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tjh299
New User, Becoming EHEALTHy
Joined: 04 Nov 2007 Posts: 17
algosdoc Posted: 01-28-08 20:10pm
i have read your thread on this site and
notice that you became a member march 22
2004, wasn't aware that this site had be
on going for that long. anyway , my
question would be so these places
advertise to do surgery with laser, but in
all reality they really don't, because of
damage that the laser could do. correct?
so are they charging for something they
aren't doing? i know i took my spouse to
one in florida and had to come up with
large amount of money that we are trying
to find a way to pay for now. for 7 weeks
he was pain free, but the pain came back.
they said that maybe he needed a second
surgery. but they neglected to tell us
that they put 2 epidural patches in before
they stitched him up. which would account
for the pain free time, right or wrong. i
am not real familiar with medical
procedures. i am not trying to put you on
the spot, but would really like to know if
these places really help people or do they
give them false hope. my spouse has had
chronic lower back pain for 6 1/2 years
with no help from therapy, chiropractors,
decompression, water aquatics,
accupuncture,accupressure, massage
therapy, pain meds, and a spinal
stimulator that the pain doc talked my
spouse into. my husband was on the verge
of having to quit work for he wasn't able
to stand, walk, or sit for any length of
time. he was very depressed that he didn't
know how his life became like this for it
just came on one day and just got
progressively worse over the years. when i
found this place i talked to many people
that i didn't even know. i got their phone
numbers from information. all the way from
michigan to oklahoma. everyone that i
spoke to told me that they had wonderful
results. so at my wits end on what to do
for my spouse, i took him to florida. he's
back to work and has had a bi- lateral
nerve block to help with some of the pain
that came back. had it on friday , early
and today is monday, but no relief yet.
boy i sure don't know what to do for him.
i hate to see him in pain. could you give
any suggestions? he had a laminotomy/
forminotomy and partial discectomy @ L-5
S-1. i sure would appreciate your input.
thank you for reading and listening. it
helps sometimes for someone to listen.
god bless mary
|
littleonefb
Experienced User , Rather EHEALTHy
Joined: 11 Aug 2007 Posts: 228 Location: ,
Thanks: 6
Thanked:0
thj299, Mary Posted: 01-28-08 23:13pm
Mary,
I am so sorry to hear that your husband is
still having pain and that the laser
surgery didn't help him in the long run.
First let me tell you that I have some
experience with a nerve block. I had one
a few months ago and it can take anywhere
from a few days up to 2 weeks for it to
become effective, and it is also possible
that in that time your husband will not
got any relief at all.
So there is still time and hope for it to
work. I didn't begin to feel any real
pain relief for a little over a week.
As for whether the laser facilities really
do help people, I can't really say. I
would assume that they do help some
people, but I personally doubt that there
success rate is as high as they lead
people to believe.
As I've stated before, one of my big
concerns is the number of steroid
injections that they use that lead people
to believe that they are "cured" and the
consistent statements that if the first
surgery didn't work that the patient needs
more surgery.
At this point in time, it sounds like to
me, your husband needs to be searching for
a spine specialist in your area, either a
sports medicine orthopedic surgeon that
specializes in spines or an neurosurgeon
that specializes in spines.
Your husband needs further evaluation of a
reputable spine surgeon to see what is
going on and what the laser facility did
for you husband.
Do you have detailed records from the
laser facility? If not, I would do
everything possible to get all the
detailed information, including all the
tests that they did and all the surgery,
including surgical notes and post op care
as well.
This will be important for you to have to
give to a new spine specialist.
Don't let the laser facility give you any
problems about getting those records. It
is your husband's legal right to have them
and since you are far from their facility,
you should have them on hand no matter
what.
The one thing I wouldn't do, is return to
them for further surgery.
I would think that a new spine doctor will
want to do, at the very least, a new MRI
and possibly other tests to determine what
is going on.
Please, Mary, have your husband get those
records and proceed to find a new doctor
that, hopefully, will be able to help your
husband.
Fran
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littleonefb
Experienced User , Rather EHEALTHy
Joined: 11 Aug 2007 Posts: 228 Location: ,
Thanks: 6
Thanked:0
So much has happened since I've checked in. Posted: 01-28-08 23:26pm
Marie,
Please, please, slow down. No cartwheels
please. We both my have had surgery to
correct some of our spine problems, but we
are still living proof that our spines are
fragile and need good, safe care.
But I sure do understand how you feel.
algosdoc, thank you so much for posting
your professional thoughts on the laser
spine surgery facilities.
You have summed up many of my major
concerns that I have had with them for a
long time and you've done it with a very
professional view.
As Marie stated, I too, have had open back
surgery, not nearly as extensive as
Marie's,but traditional open back and
never regretted it for a minute.
My surgery was a laminotomy on the
L4/L5/S1 and am grateful to the wonderful
spinal surgeon that I have and his honesty
and integrity as well.
One of the most important things to me in
deciding who, when where and how I would
have surgery, was to have continuity of
care between my spine surgeon and my
primary care physician.
So many things can develop during and post
surgery that affect our health and to have
both my primary and spinal surgeon close
by was very important to me.
When one travels thousands of miles for
surgery, this type of care is not
available. complications do occur
following surgery and may not happen for a
few weeks afterwards.
To not have the surgeon available to see
you immediately and follow your care for
quite some time, is not in my opinion,
good quality medical care.
The fact that none of the laser surgery
facilities are associated with a hospital
scares me. In this day and age of
infections that are resistant to
antibiotics, that risk is something we
must undertake at times, but the lack of
the laser sites to deal with this within a
full hospital setting is not good.
We each have to make our own choices in
how we deal with our spinal problems and
how we treat them.
It's just so very important to make those
choices with full knowledge of what we
decide to do. It is important to have
full disclosure and I really don't believe
that the laser facilities actually give
full disclosure to their patients.
Mary and her husband are a perfect example
of that.
Fran
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Marie B.
Experienced User , Rather EHEALTHy
Joined: 28 Aug 2007 Posts: 231 Location: Ohio
Last Nerve Bloc Posted: 01-29-08 08:50am
Fran in you last nerve Block. What area
did they go after. If they end of doing
more then a nerve block, on you keep us
(me) informed.
Where are you having discomfort and is it
from the car accident where the fool
could't drive the car?
Marie B.
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RichT
Active User, Really EHEALTHy
Joined: 22 Jul 2007 Posts: 910
Thanks: 21
Thanked:0
Mare Posted: 01-29-08 13:41pm
Hello Everyone,
Has anyone had any communication with Mare
since her last post on January 17th. I'm
concerned, especially being we shared some
of our concerns regarding how things
were/weren't going at LSI.
Hello Mare,
I hope all is going well for you. Do give
us an update when you can.
Take care.
RichT
|
Marie B.
Experienced User , Rather EHEALTHy
Joined: 28 Aug 2007 Posts: 231 Location: Ohio
I have anot heard. Posted: 01-29-08 14:05pm
Rich, The last thing I've heard from Mare
was that her surgery was postponed due to
her getting ill. But that was posted.
Heard nothing since then not even by PM.
Carrianne may have heard something.
My hubby and I were planning to go to
someplace where the sun was shining, but
due to "work" he has had to postpone for a
few weeks. If you don't see a post from
me, know it is because I'm away from the
computer for a little trip.
Marie B.
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littleonefb
Experienced User , Rather EHEALTHy
Joined: 11 Aug 2007 Posts: 228 Location: ,
Thanks: 6
Thanked:0
Re: Mare Posted: 01-29-08 16:29pm
RichT
wrote:
Hello Everyone,
Has anyone had any communication with Mare
since her last post on January 17th. I'm
concerned, especially being we shared some
of our concerns regarding how things
were/weren't going at LSI.
Hello Mare,
I hope all is going well for you. Do give
us an update when you can.
Take care.
RichT
Hi Rich,
Mare posted on "the other forum" on
1/23/07, that today was the first day that
she felt like she was going to live from
whatever illness she had and was hoping to
reschedule her surgery for the next week.
There have been no other posts from her
since.
I do hope all is well with her.
Fran
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littleonefb
Experienced User , Rather EHEALTHy
Joined: 11 Aug 2007 Posts: 228 Location: ,
Thanks: 6
Thanked:0
Re: Last Nerve Bloc Posted: 01-29-08 16:46pm
Marie B.
wrote:
Fran in you last nerve
Block. What area did they go after. If
they end of doing more then a nerve block,
on you keep us (me) informed.
Where are you having discomfort and is it
from the car accident where the fool
could't drive the car?
Marie B.
Hi Marie.
The nerve block was done to the L3 disc
nerves on the left side. I had it the
week before thanksgiving and it was done
as an emergency because I couldn't stand
on my leg due to the horrible pain and
loss of feeling in my leg from the thigh
to the knee.
Yes, it was courtesy of the wonderful old
lady that can't drive and caused the
accident.
The reason the nerve block was done was
because the ins. wouldn't pay for another
MRI at the time because I had just had one
done several weeks earlier as a follow up
to surgery. Even with the accident, the
ins said I had to wait till after the 1st
of the year.
The prior MRI of course showed no problem,
because there wasn't a problem there. He
attempted to arrange to have the MRI
facility post date the MRI to the first of
the year, but they couldn't do that as the
state was doing their routine auditing of
MRI facilities and they would see the
illegal post date on the MRI, otherwise,
they would have been more than happy to do
it for me.
Then the doc realized that if the MRI was
done like that, and it showed a need for
surgery, he would have trouble getting the
surgery paid for because it would be based
on a MRI that wasn't supposed to be done.
So the next best thing to do was a
diagnostic and pain relief selective nerve
block to the suspected area of a problem,
i.e. the L3 disc and nerves. They used a
lidocaine type injection and 2cc of
kenalog.
The lidocaine worked immediately and I
went home totally pain free. that lasted
till the following evening, when about 50%
of the pain returned.
I was expecting that to happen as it can
take up to 2 weeks for the kenalog to kick
in and work fully, if it is going to.
By the weekend after Thanksgiving, the
pain was completely gone and has only just
begun to slowly return with some off and
on surface numbing and a bit of stinging
to the thigh.
Now the problem is that to get an accurate
MRI that would show if there are nerves
being compressed or a problem with the
disc itself, I have to wait until the pain
returns and has me all but doubled over in
pain again.
That's because the kenalog has reduced the
inflammation in the area, including the
inflammation of the nerves. that means
the swelling is reduced and if an MRI is
done with it like this, it would no doubt
show that there is no nerve compression
going on and the results wouldn't be
accurate.
Such is the life with a spiney and we deal
with what we have to deal with. No point
in getting and MRI that isn't going to
show what is needed to show.
I also did another round of full core
strengthening as the muscles had really
weakened again, cause I was barely able to
move. Shows that if you miss just a few
days of spine exercises, you will do your
back in real quick.
So I'm going about my life as best as I
can, till I have the need to get that MRI,
which will be done within 24 hours of
calling the doctor that the pain is where
it is supposed to be, and then we go from
there.
I have already told the doc, that surgery,
if needed, will have to wait until around
the same time as the last time, June 13,
as I plan on getting my gardens done and
planted before I am stuck with needing
someone else to do the watering for me.
Since he's also an avid gardener himself,
and wants his seedlings from me again this
year, especially his tomato seedlings, and
knows I will have at least 800 seedlings
that I've started from seed to plant, he
has no problem with waiting, as long as I
can tolerate the pain.
Will let all know what happens as soon as
I do.
Fran
|
RichT
Active User, Really EHEALTHy
Joined: 22 Jul 2007 Posts: 910
Thanks: 21
Thanked:0
Posted: 01-29-08 16:46pm
Hello Marie and Fran,
Marie - Yes, hopefully Carrianne has
communicated with Mare. Enjoy your trip
south.
Fran - Thanks for the info that Mare
shared on the other forum. She and her
husband have had a most difficult time.
especially being "home" is Canada.
