Another spine thread: spondylolisthesis surgery

[old goat]

From what I've heard the UK vets their surgeons pretty well compared to the US so your chances of winding up in the hands of someone who's less than stellar are probably pretty low. And in the UK surgeons are "Mister", not "Doctor", since they don't have academic doctorates (neither do most internists) but do have master's degrees in surgery. It's reverse snobbery--they don't want to be confused with mere internists. Admirable IMO. In the fine tradition of barber surgeons. Hey--I do cut my own hair so I qualify.

Good luck with the surgery. If it doesn't go well I don't want to hear about since I may be needing soon.

[orlowskij]

From what I've heard the UK vets their surgeons pretty well compared to the US so your chances of winding up in the hands of someone who's less than stellar are probably pretty low. And in the UK surgeons are "Mister", not "Doctor", since they don't have academic doctorates (neither do most internists) but do have master's degrees in surgery. It's reverse snobbery--they don't want to be confused with mere internists. Admirable IMO. In the fine tradition of barber surgeons. Hey--I do cut my own hair so I qualify.

Good luck with the surgery. If it doesn't go well I don't want to hear about since I may be needing soon.

Huh, I'd wondered about the Mister/Doctor distinction.

I found out I can get a physician to physician second opinion through my US health system (for $$$ of course)- need to decide if that's something to pursue. Looking like ~ June for surgery so a little time to work it out.

[detrusor]

Damn. Nothing to offer other than well wishes, good luck.

Need to fuse one above and one below the problem in order to get stability.


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[MagnificentUnicorn]

That's was auto correct on the cauda equine, I i didn't realize he was referring to spondylolithis as welll.

It's right there in the thread title.

OP, if you have surgery you will likely never be the same again and if you stay active you will likely require a fusion extension in the future. The alternative is the loss of full use of your legs and a lifetime of pain. You have a bad problem, it's kind of a Catch-22.

The advice about finding a fellowship trained spine surgeon is sound, but I've worked with some truly shitty fellowship trained spine docs too. Shop wisely.

[WMD]

Damn, good luck. I'm dealing with spondylolisthesis (and a synovial cyst) myself and am wondering what the future will bring, so I appreciate following this thread. I've been told surgery and spinal fusion is in my future. So far cortisone shots in the spinal column have taken me from flat on the ground to skiing again, but I know those are not a long term answer.

[old goat]

Huh, I'd wondered about the Mister/Doctor distinction.

Apparently docs can get an actual doctorate in the UK by doing research and a thesis, like any other doctorate. The great majority don't bother; the non surgeons call themselves doctor for their ego because they don't have the balls to cut people open and faint at the sight of blood. Sad. I wish we had the same system here.

[orlowskij]

OP, if you have surgery you will likely never be the same again and if you stay active you will likely require a fusion extension in the future. The alternative is the loss of full use of your legs and a lifetime of pain. You have a bad problem, it's kind of a Catch-22.

The advice about finding a fellowship trained spine surgeon is sound, but I've worked with some truly shitty fellowship trained spine docs too. Shop wisely.

At least I'm not overthinking it.....

I got a letter from the surgeon yesterday with more details. Scans are stable but show severe stenosis, and the change in symptoms sounds like an "L5 nerve root flareup". Proposal for surgery is "L4-S1 fusion and decompression with an L4/L5 TLIF and a postero-lateral fusion following the decompression". Forecasting 6 weeks off work and 3 months to recover, though in the discussion he did say that nerves could take longer to recover. Still on track to get a CT and updated xray then tweak the plan from there.

[orlowskij]

I decided to go through with the decompression and fusion on Wednesday. I'll be leaving the hospital today or tomorrow morning. Final hardware arrangement is 4 screws, 2 rods and a cage. The lower 2 screws are through the L5 and S1 (still close to horizontal due to the degree of slip), and the upper screws are in the L4. The cage was installed between L4/L5.

The last couple days have been managed with drugs but off the morphine today. While I'm sore and extremely weak, I can tell that the nerve pain that I've had in my legs for as long as I can remember is gone.

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[::: :::]

congrats, dude

that feeling of progress is unmatchable, even through the pain of recovery

[Hood26]

I have a little bit of that hardware in the same place.

I hope your recovery is going well!

[orlowskij]

Another one.

Thanks. Things are on track. Saw the surgeon a few weeks back- the focus now is on rebuilding my core while everything continues to fuse over the next 1-2 months. I've been on my road bike on the trainer a bit. I'm still getting pain daily but am pretty much off the meds. Going to be moving back to the states next week and need to get set up with a doctor pretty quickly to keep an eye on it.

Most importantly, when I asked about a Feb ski trip, doc said he considered it mandatory. I'm not going to be dumb about it but am pretty pumped- I'd written this winter off.

[WMD]

So how's it going? I've got spondylolisthesis at l5 s1 which has caused a synovial Cyst at l4 l5. I'm getting the cyst removed this Friday but opted to not address the spondylolisthesis with fusion, as my spine appears stable. Just curious how recovery is going for you.

[4matic]

So how's it going? I've got spondylolisthesis at l5 s1 which has caused a synovial Cyst at l4 l5. I'm getting the cyst removed this Friday but opted to not address the spondylolisthesis with fusion, as my spine appears stable. Just curious how recovery is going for you.

Hey man. How are you? I’ve got Coflex device implant prescribed. Just waiting for approval. My spondy is not bad or they couldn’t do it. Been down for the season.

[WMD]

Yo 4matic! Sorry to hear you are having back troubles. That sucks. I got to ski for a while but between my back and my knees I've been shut down for over a month now.

I didn't have surgery on Friday after all as I failed the pre surgery physical because of a sinus infection! I'm now on antibiotics and surgery is scheduled for April 23. Hopefully it helps and I don't need a fusion. My new medical marijuana card helps for sure.

[4matic]

I had to shut it down in January. Didn’t really have to but it just wasn’t fun. Epic year too. No complaints. I’m lucky all said. Good luck and we’ll ride again with replacement parts. Keep us informed!


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[WMD]

Surgery yesterday went well. It took way longer than expected due to having to get through a bunch of scar tissue but the doctor was able to chop out all of the cyst. Anesthesia kicked my ass and I was dizzy and nauseous all evening and finally barfed. Pain is better than before surgery already, so I'm stoked about that. 2 weeks in bed with no bending, lifting, or twisting. Hopefully this will all be worth it.

[4matic]

Glad you got it done. Be aware that they use a numbing agent in the wound that will wear off in a couple days. I had some fever on days 3-5. Days 1-2 I felt like superman. For rest I had good luck laying on my side with pillow between my knees or dead flat on my back with knees elevated on a pillow. Take your pills and lay off the protein. Trust me on that. Fruit and fiber.

[WMD]

Thanks for the advice. I was wondering why I felt so good. Makes sense.

I hope you are doing well with yours.

[4matic]

I can walk! I cried. Still crying. Lol. Probably walked a mile including hills today. I haven’t been able to walk normally in months. My left leg is still weak but gets better with short rest. Before it only got better with time.


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[WMD]

I can walk! I cried. Still crying. Lol. Probably walked a mile including hills today. I haven’t been able to walk normally in months. My left leg is still weak but gets better with short rest. Before it only got better with time.


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Awesome!

[4matic]

Hey WMD. How you doin? Today, I had probably the best (3 mile) walk in 3+ years. Still some weakness in my calf but mostly on flat surfaces. Virtually no back pain. Yesterday I went to the gym and did an almost a complete weight circuit for upper and lower, arms and legs. It really helped!! It seems to have stabilized some of the weak muscles from surgery. I have to be very careful with amount of weight and range but I'm really optimistic.

[WMD]

Good to hear! I have not needed any pain meds today and have not needed many since surgery Tuesday, so doing better than expected. Surgery site is more stiff than painful, but I definitely feel something major happened there.

I still have some nerve pain in my right butt and leg, but it's better than before surgery. I am really tired and even dizzy, which I didn't expect. I just walked 2 blocks and felt some pain in surgery site and was weak so think I'll take it easy and mostly stay in bed. The doc did tell me walking was good If it didn't cause pain.

[4matic]

Roger that on getting tired/fatigued. I suspect trauma to the muscles and nerves takes a lot out of you when they are trying to recover. On day three after surgery I had nerve and leg pain so intense I almost passed out, dizziness, etc. After my first one mile walk I basically slept for 24 hours. I feel good today after long walk yesterday. Gym and stationary bike today. Be patient. Stay optimistic.

[old goat]

Roger that on getting tired/fatigued. I suspect trauma to the muscles and nerves takes a lot out of you when they are trying to recover. On day three after surgery I had nerve and leg pain so intense I almost passed out, dizziness, etc. After my first one mile walk I basically slept for 24 hours. I feel good today after long walk yesterday. Gym and stationary bike today. Be patient. Stay optimistic.

When you're healing your body has a different metabolism than otherwise--energy stores are diverted to the healing sites rather than to exercising muscles. After major surgery figure 6-12 weeks roughly.

[4matic]

Thanks OG. I wish more basic information was provided when we're sent home. I got a one page handout with the wrong phone number stamped on it. Good basic recovery info but that's it.