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Old 04-08-2011, 12:20 AM   #1
Jeff Haugland
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another back surgery question (have read current threads)

So I am a 28 yr old EOD tech in the Army, and I was involved in a car accident where a guy hit us from behind at about 40 mph while we were stopped. I have had severe back pain ever since. I was in great shape, trained bjj/mt and have fought amateur mma.
The MRI shows bulging disc L5/S1, which is severely degenerative, significant narrowing of the vertabrea. X ray shows spondololythesis, and sponololysis, and pars defect. All in L5/S1. All other discs are healthy. My neuro is telling my best option is fusion, but this would all but eliminate me from continuing in EOD and my outside hobbies, from what I've read.

Now to the question, is there anyone out there that has had a spinal fusion (preferably single level only) who has been able to resume to normal activity post surgery? Activities like lifting, bjj/mma/mt, if any military out there- wear a basic load or worse an 80lb bomb suit. These need to happen for me personally for my mental and emotional clarity, but I have run out of options and it seems fusion is my only option.

I have severe sciatica like pain down left side, have felt numbness in my heel while bending in random positions, and as embarrassing as this is, have wet the bed recently a couple of times. Cant currently perform job duties, and all I want is to get back to work and back overseas where I can be useful if healthy.

Any advice greatly appreciated.
Also, is it worth it to try a discectomy for temporary relief so I can participate in a once in a career mission, and then if pain is still present fusion after?
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Old 04-08-2011, 07:30 AM   #2
Brent Sallee
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Re: another back surgery question (have read current threads)

Eek, man. Spondylolysthesis (which kinda includes the others by default) is a pretty severe diagnosis. TBH, your neurologist is probably right. He's looking out for your longevity when it comes to avoiding chronic neurological pain, which is a BIG deal. With a fusion between L5-S1, you'll lose between 15-20 degrees of flexion/extension ability (quite a bit), almost no rotation, and a 3-5 degrees of sidebending. There are so many physical activities you can participate in with slightly decreased sagittal plane motion. You may be ok lifts, depending on how you feel, and perhaps Muay Thai just based on its mechanics. I think BJJ will be affected to some degree because you won't be ability to move your hips as well. Honestly though, waiting is a bad thing to do with spondylolysthesis. If it progresses further by default or due to your activity level, a fusion option may be taken off the table. In that case, you have to find other ways to deal with the pain and such, which is not a good idea. Does your doctor know about the wetting the bed? That's not something you need to embarassed about - it's likely from impingement on your cauda equina. That's a pretty serious symptom as well so you should definitely tell your neurologist. I dunno man, I'm not in your position, but with what your options are, it seems like a fusion may be the best bet to avoid chronic, debilitating back pain. New exercises and hobbies can always be discovered - back pain is forever (in this case).
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Old 04-08-2011, 02:10 PM   #3
Malisa Trimble
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Re: another back surgery question (have read current threads)

I ruptured my L4-L5 and fractured my tailbone while working as a police officer and swat medic. I tried to heal with everything conservative but nothing seemed to work. I opted for a discectomy six months later and it was by far the best thing I ever did. I was walking within hours of surgery, running in 3 weeks, and weight lifting, crossfitting, etc. with no complications. It's been 6 years. The important thing is to keep your core muscles strong post surgery and if you have no pain, don't limit yourself from activities out of fear. Good Luck to you and I hope it works out for the best.
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Old 04-09-2011, 11:48 PM   #4
Jeff Haugland
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Re: another back surgery question (have read current threads)

My neuro is fully aware of all symtpoms. That is why he is recommending the fusion. The problem is that this takes me out of a once in a lifetime mission, training is a huge priority in my life, and the fact that I will not be able to pick up my eight month old child for quite a while.
i am leaning towards a discectomy, against the neuro's advice only because
i can do my mission, and work like hell to get back into quality figthing shape quicker, while not sacrificing my relationship with my son. However, the disc is so degenerative, i am not sure would see alot of positive results. I am scared to death of fusions, only because I have read nothing but negative things post surgery from others who have had the procedure.

Are there any Cfers out there with fusions that found there was little modification to the wat they trained pre surgery? The pain suck, but I am willing to function with a significant fraction of the pain I am feeling temporarily to participate in a once in a career mission.

Please post if you have anything to say positive or negative towards fusions and how long post discectomy you were pain free, and any mods that took place.

Note to add- I have had a l medial meniscectomy that was significant enough to warrant the doc recommending not running, until I have had a cadaver's allograft surgery on my knee. I was able to modify my cardio/ CF to be satisfied. No squats, but DL and cleans without any pain. I row, swim and perform BW metcons for cardio.
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Old 04-10-2011, 11:46 AM   #5
Brent Sallee
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Re: another back surgery question (have read current threads)

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Originally Posted by Jeff Haugland View Post
My neuro is fully aware of all symtpoms. That is why he is recommending the fusion. The problem is that this takes me out of a once in a lifetime mission, training is a huge priority in my life, and the fact that I will not be able to pick up my eight month old child for quite a while.
i am leaning towards a discectomy, against the neuro's advice only because
i can do my mission, and work like hell to get back into quality figthing shape quicker, while not sacrificing my relationship with my son. However, the disc is so degenerative, i am not sure would see alot of positive results. I am scared to death of fusions, only because I have read nothing but negative things post surgery from others who have had the procedure.

Are there any Cfers out there with fusions that found there was little modification to the wat they trained pre surgery? The pain suck, but I am willing to function with a significant fraction of the pain I am feeling temporarily to participate in a once in a career mission.

Please post if you have anything to say positive or negative towards fusions and how long post discectomy you were pain free, and any mods that took place.

Note to add- I have had a l medial meniscectomy that was significant enough to warrant the doc recommending not running, until I have had a cadaver's allograft surgery on my knee. I was able to modify my cardio/ CF to be satisfied. No squats, but DL and cleans without any pain. I row, swim and perform BW metcons for cardio.
I'm aware of your goals and such, but this is like an athlete wanting to compete in an event so bad that he is willing to risk the rest of his life's function. Do you think your neurologist is trying to dupe you? He's trying to do what's absolutely best for you. Getting a discectomy doesn't actually address the spondylolisthesis. It's likely your L5 vertebra is still sliding anterior off of your S1 vertebra. A fusion is the only thing that can address that issue. Look at the following series of pictures. I don't know what grade your neurologist classified you as, but here's a pretty typical grade II case:

General diagram - http://www.precisionspine.com.au/ima...age_spond1.jpg (WFS)

MRI pre-op (Refer to bottom right in particular: the blocks are vertebrae and the L4 is slipping significantly forward on L5 (in this case) leading to spinal cord impingement) - http://www.nature.com/sc/journal/v44.../3101852f3.jpg (WFS)

MRI post-op (Left is before, Right is after) http://londonspine.co.uk/news/wp-con...G1spondylo.JPG (WFS)

I can understand how important a mission can seem, but is it worth functioning for the rest of your life? Honestly, a discectomy won't do much and you may undergo major surgery for no alleviation of symptoms. It doesn't stop the anterior slippage of the superior vertebra. I do sympathize that you won't be able to pick up your baby, but it's better to be able to play with him/her for the rest of their life later rather than play with them for a short period now (and not at all later). You can find activities that you can do in resting positions. It won't be the same, but it will be sufficient in the meantime.

I don't mean to sound abrasive or pushy here, but I don't think you understand the degree of your pathology. You likely won't be able to continue lifting like you did. You won't be able to participate in combat sports. This is a lifechanging injury. It seems like you haven't quite accepted that, but it's important that you do. Honestly, you could impinge on the cauda equina so severely that you could lose lower muscle function in your legs entirely. Think about that.

I understand that it's very, very hard to deal with. Your life is going to change a bit, but that doesn't mean it's over. You can have longevity and function with a fusion. If you don't have the fusion, you may permanently lose strength, sensation, and other functions in your lower extremity (including bowel and bladder control). It's not really something that you mess with for one occasion. I'm quite sorry that this has happened to you and I could never imagine how I'd cope with this whole thing, but with significant understanding of what this can lead to, fusion is really the only option for continuing any sort of function in the long term.

Last edited by Brent Sallee; 04-10-2011 at 12:12 PM..
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Old 04-10-2011, 12:43 PM   #6
Megan Zetter
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Re: another back surgery question (have read current threads)

I just want to clarify for anyone else reading this regarding spodylolysthesis. The diagnosis is not always BAD, in fact, a lot of perfectly healthy, asymptomatic people have a spondy, or DJD or bulging discs for that matter. It really depends on the symptoms and impact on the persons health and life. Anyway, back to spondys.

There are 5 (6 depending on how inclusive you are) types:

1) congenital -- you are born with it
2) isthmic -- the most common type and often seen in younger population due to stress, especially associated with extension activities, such as with gymnasts.
3) degenerative -- older aged
4) traumatic
5) pathological -- older woman are particularly prone due to bone loss
6) surgical

These various types are then graded on how much they have "slipped". This is known as Meyerding grading. Keep in mind that nearly 100% slipped vertebra can be asymptomatic. Therefore, you must take the whole person in to context when deciding the best approach for treatment. The OP sounds as though he is experiencing significant problems due to the multitude of injuries he sustained. He did not say whether his spondy was due to his accident or not. This would be apparent on imaging. Yet, as I already of said, not all spondys are a cause for concern.

Because the OP is experiencing incontinence and severe inability to perform daily activity it might be in his best interest to have surgery. Yet, it's hard to say on a forum what his best options are. I tend to lean towards not going straight to surgery until all other avenues have been pursued, but quality of life and health definitely need to be considered. And as Brent said, it does sound as though the OP is having nerve irritation, which explains the incontinence, so in this case a quickly expedited decision should be made. If I were the OP I would not hem and haw on this for long.
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Old 04-10-2011, 04:59 PM   #7
Brent Sallee
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Re: another back surgery question (have read current threads)

Quote:
Originally Posted by Megan Zetter View Post
I just want to clarify for anyone else reading this regarding spodylolysthesis. The diagnosis is not always BAD, in fact, a lot of perfectly healthy, asymptomatic people have a spondy, or DJD or bulging discs for that matter. It really depends on the symptoms and impact on the persons health and life. Anyway, back to spondys.

There are 5 (6 depending on how inclusive you are) types:

1) congenital -- you are born with it
2) isthmic -- the most common type and often seen in younger population due to stress, especially associated with extension activities, such as with gymnasts.
3) degenerative -- older aged
4) traumatic
5) pathological -- older woman are particularly prone due to bone loss
6) surgical

These various types are then graded on how much they have "slipped". This is known as Meyerding grading. Keep in mind that nearly 100% slipped vertebra can be asymptomatic. Therefore, you must take the whole person in to context when deciding the best approach for treatment. The OP sounds as though he is experiencing significant problems due to the multitude of injuries he sustained. He did not say whether his spondy was due to his accident or not. This would be apparent on imaging. Yet, as I already of said, not all spondys are a cause for concern.

Because the OP is experiencing incontinence and severe inability to perform daily activity it might be in his best interest to have surgery. Yet, it's hard to say on a forum what his best options are. I tend to lean towards not going straight to surgery until all other avenues have been pursued, but quality of life and health definitely need to be considered. And as Brent said, it does sound as though the OP is having nerve irritation, which explains the incontinence, so in this case a quickly expedited decision should be made. If I were the OP I would not hem and haw on this for long.
I agree wholeheartedly. The symptoms are the primary guide here and they definitely seem significant. Bowel and bladder issues are a huge red flag in this situation, showing to me that there should be a high priority on alleviating the temporary lesion ASAP. I just picture Jeff going to do something without a tight enough core and just going limp. That would break my heart.
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Old 04-11-2011, 12:03 AM   #8
Jeff Haugland
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Re: another back surgery question (have read current threads)

I appreciate all the posts and would like to thank you for the advice given. I fully respect the posters on this forum, simply for the knowledge given. I hve another neuro appt in two days and will likely decide fusion is my option.

I expected fusion to be my only option in this situation, however, I do not like the limits it may put on me.

I do know that I am in fairly good shape, not fighting shape these days, but better than most, and that limts are only made to be broken.

Thanks all for your posts and I will check regularly to see any more advice/ experience anyone might have.
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Old 09-22-2011, 04:47 PM   #9
Douglas Scarborough
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Re: another back surgery question (have read current threads)

So Jeff, what was the final outcome? I have had a spondy. at two levels, crossfit has been ok, except I am really trying to avoid max efforts.. Not a good idea for me.. Let us know how you are!
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Old 10-13-2011, 07:54 PM   #10
Jeff Haugland
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Re: another back surgery question (have read current threads)

Sorry for the delay... I have not been on the site due to the fact that I cannot participate in CF right now being 5 months post op. I did end up having a L5/S1 spinal fusion, mainly due to the fact that the neurosurgeon said it was my best option. He said the discectomy would only delay the inevitable.

So, being 5 months post op- I have lost 38 lbs, mainly muscle mass. The only exercise I can do is swimming, which I do 3-5 times a week depending on my recovery that week. I am on a ridiculous amount of pain medication which I continually ask to be weened off of, but I have been experiencing more and more pain as time goes by. These include MS contin, percocet and valium. The trifecta of the most addictive prescription pain killers. This is the exact opposite of what the doc told me. Originally, the doc said he has never seen such a fast recovery. I was walking and going up and down stairs with no pain and no problems 24 hours after surgery. However, at about 4 months- about a month after I returned to work, I began experiencing intense pain around 1-3 PM everyday. To the point, that I had to lay down or my legs would give out. My mobility is extremely limited, I can't pick up my kid, and my back still gives out in the afternoon. I have an evaluation in a little over a month by a military surgeon who will determine my future as an EOD tech in the military. Most likely, if nothing improves in 30-45 days, I will be medically retired from the Army. I regret my decision to get the operation. I wish I was given other options or looked for second opinions. The doc had a great reputation and success rate so I did not feel the need, given that I had one of the best surgeons in the area. I take Fish oil, krill oil, glucosamine, chondroitin, MSM, and drink a ton of whole milk for the vitamin D and calcium. the whole milk is mainly because I cannot keep any weight on. I am going to get a CT scan to see how the fusion is progressing tomorrow, but I am pretty much fed up with my surgeon who has referred me to pain management and I feel that he is passing me off to another doctor to be some other docs problem. I received another spinal epidural 2 weeks ago from my pain management doc and that didnt help. He talked to me about implanting an internal TENS unit directly into my spinal chord, which will definately make me ineligable to do my job.

Overall, life sucks! I am in more pain now than I was pre op. I feel like a 75 year old man trapped in a 29 year old body. I am hoping for the best case scenario where the opportunity to accomplish all my goals isn't taken from me prematurely, but preparing for the worst. And currently, I am trying to look at the positive side of things. I haven't been blown up, I have all my limbs, my wife has been incredibly supportive, despite what a pain in the butt I have been, and my son is happy, healthy and the best thing I have ever done! He makes me so proud everyday, and I am continually amazed by him.

I am not really a religous person. I tend to practice a buddhist way of life but not for religous purpose. I just tend to agree with the principles that founded buddhism. I try to meditate to help with pain relief and peace of mind. But for those that have commented or read this thread, I would appreciate any prayers or positive thought sent my way.

Thank you for all the posts and I appreciate the inquiry about my recovery. For those that are able keep kicking ***, and hopefully, someday soon I will be back on track making gains!
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