Spinal Surgeries VS. Pharacological Management

Sunny,
I do hope everything went your dad's way today. It's about time.

I have had many experiences with all kinds of chiropracters, physicians and surgeons as I have a degenerative disease of my spinal discs. It is most pronounced in the lumbar area and that is what gives me severe pain that impacts upon my ADLs (activities of daily living. I have bulging, withering, thin and herniated discs from L1 through L5 including S1 (sacral). There is also "facet degeneration with hypertrophy, foraminal stenosis, slight scoliosis of the lower spine, spinal stenosis and spondylolisthesis. The pain started about 6 years ago. The rest of my spine is also affected but not to an extreme point yet.

After going through every possible non surgical therapy and getting no relief of my severe pain, I finally decided on going in for surgery. Last year I had two surgeries as I got no relief after the first surgery and, after the second surgery, I still did not get any relief.

I must say that the pain shifted a bit but the intensity remaind the same. Each surgery took about two hours and included the use of a laser at times. Both times they performed laminoforaminotomys, partial mediofacetectomys and forminotomies. Ligaments were removed from around the nerve roots and thecal sac. After a brief stay in the recovery room, I was driven home on the same day, by my best friend. That was for both surgeries. In and out the same day.

After each surgery I requested and received a written Physician Operative Report. That covered every single little thing that was done and what medications were used for irrigation, bleeding control, anti-inflammatory steroids, antibiotics, etc. In reading the report after both surgeries, it was very clear that they used a flourascope x-ray machine to guide the placement of instruments so as not to nick or cut the Dura. They were quite patient and careful to repeatedly use the flourascope which is like a motion picture x-ray to be certain that the Dura would not be damaged during the procedure.

Now after seeing a top notch Neurosurgeon, and Orthopedic surgeon from two of the best medical schools in Philadelphia I was referred to a pain management physician and it is working out very well. Both surgeons agreed that they would never have operated on my spine and that no operation would be appropriate in my case.
You might want to request a copy of the "Physician Operative Report" and check out all of the details of your dad's operation. It's just a thought and it is your right to obtain a copy of that report.

My brother, who is a Neurosurgeon, was always dead set against me getting any kind of back surgery. Especially fusions. Thank God I never got fusion surgery. I should have listened to my "little" brother and gone straight to the Pain Management Specialist. I would have saved over 80,000 for the both worthless surgeries that I had.

I"m keeping your dad in my thoughts and prayers Sunny. Keep us updated.

Jimmy, I have made paragraphs in your post. Some of our members have tracking issues when reading & it makes the post easier to read. Thank.
Jimmy

Post Edited By Moderator (straydog) : 5/2/2014 8:39:38 AM (GMT-6)

Jimmy

Welcome to healing well, it's a great group full of knowledgeable people but above all it's people who really understand what you are going through.

I'm a spinal patient. Just had my fifth back op in four years. For me it's been a case of getting one thing better for something else to go wrong. I'm a month out fro my last spinal fusion. I'm not stupid enough to realise that I'll ever be free from pain. I think that's why it's so important to have a good pain management doctor as there comes a time when you have to realise that surgery isn't always the answer. It hard, as I think we are brainwashed almost into believing that surgery will fix things, but experience tells us that isn't always the case. I'm reading a really good book just now by an American spinal surgeon, who himself has had back problems. It's called Back in Control by Dr David Hanscom. It really makes sense as it addresses the emotional side of pain too. I'd recommend it.

Hope you start to feel better soon.

Jane

Susie,

"Jimmy from what you have described for surgery by chance did you go to one of those Laser Spine Institutes?"

Bingo! And yes, you have the name correct. Run, don't walk, away. Each operation cost $85,000. Up front they claimed the cost would be $30,000 per surgery.  My insurance paid half of the $85,000 on each. 

LSI promises the moon, the sun and the stars and you get nothing. It is a huge scam! They should be ashamed at giving people false hope and taking inordinate amounts of their money to add insult to injury.

I feel ashamed that even I was bilked into having not one but two operations at that organization. I should know better having degrees behind my name and working for 32 years in pharma in the private sector and the large medical centers of New York, New Jersey and Philadelphia.

It's been my experience that only one out of 15 patients gets substantial relief from back surgery.  I am very down on it and after talking to that Neurologist brother of mine, who says he would rather live with the pain than have surgery, I am personally very against any type of back surgery. 

Even total disk replacement has not matured to a point where it is not fraught with potential problems down the line. Maybe in the near future there will be some breakthroughs in that area but right now it is a very complex and risky operation. Until then, I will stay with this Pain Management Specialist who is doing a great job so far.

You are correct on the "Physician Operative Report". But It is extremely detailed and extremely valuable. Sunny13's Dad should insist on getting a copy right now.

You are also correct on Pain Management Doctors. I would say mine has knocked my pain down to about 25% of what it was.

Be well and stay with a good pain management physician.

Thanks Susie,

Jimmy

Jane,

I'm glad to hear that both you and your doctor have agreed upon no more surgeries or fusions.

How is your range of motion after so many fusions? I hope tolerable. I'm also happy to hear that the medications you are taking are giving you some substantial relief. Don't be afraid to speak up and ask for additional pharmacological management if you need it. There is no sense to suffering in silence. 

I wish you a speedy recovery and many pain free days ahead.

Thanks again for the recommendation of "Back In Control" I'm definitely going to pick it up.

Keeping you in my well wishes,

Jimmy

 

Hey White Beard!

You supplied some very good information. Thank you.

I too have DDD of the entire spine with varying degrees of intensity depending on the area. My most severely afflicted area is L1 through L5 including S1.

I also have had many neuro and orthopedic surgeons tell me that the cervical discs are the most accessible and give the best chance at relief. I have heard of occasional failures with cervical surgery to relieve pain but I have, now that I think of it, have heard of more successes.

 

Wow! You had a C6/C7 herniation with free floating fragments in the Cervical spinal canal! That truly was an emergency.

I think another reason why cervical surgeries/fusions are more successful than Lumbar is the fact that there is tremendously more leverage in the lower back region than in the neck. This leverage can translate into problems especially when fusions are done in this region which leads to increased leverage above and below the site of lumbar fusion.

That is great that the C6/C7 fusion lasted 25 years. It must be some kind of record! You are so lucky. I hear many peoples stories of fusions lasting less than 10 years. With your track record that C4/C5 will last at least at least 20 years!  Again I suspect that the cervical fusions do last longer because of less leverage.

I hear your reluctance to have a L5 Discectomy and fusion. I would react to that one the same way. If they are thinking of removing the disk, why not consider an artificial disk instead of a fusion. I understand there is a widely used artificial disk that has it's drawbacks, however I just read of a new artificial disk that came out. It is supposed to eliminate the problems experienced with the disk that is in common use today.

Please stay away from the institute I mentioned White Beard. They are corrupt and rotten to the core. There is nothing wrong with using a laser at times during certain spinal surgeries. In fact, it is preferable in certain situations.  Their procedures only use a laser sparingly. However they place the word Laser prominently in the name of their institution to make themselves seem high tech and cutting edge.

Thanks again for sharing your insights and welcoming me,

Jimmy

 

Hi Jimmy and welcome to the chronic pain forum at HW. I've refrained or refused any back ops and will continue to do so based on my 25+ years of working Ortho /Neuros and not seeing many successes. Unfortunately my knee surgeries have been countless, some worked, others did nothing.

Glad you joined us and look forward to hearing more.

Susie,

I paid around $44,000 out of pocket for the first operation. As you said they are out of network for, I think, all insurance companies. I had Horizon BC/BS PPO 90%/10%. and that was out of network! Insurance paid out about the same amount. For a grand total of $88,000 on a worthless operation.

Seven months later I had the 2nd operation.  However, after their false and misleading promises as to the cost and the expected outcome of the first operation, I threatened to sue them. I made them sign a contract to accept my insurance pay out as full payment for services rendered on the 2nd surgery. I think the grand total they got out of my insurance carrier was around $55,000. (Leeches!) - I paid $0. Unfortunately the 2nd operation was also a failure and did not relieve my pain.

So now I am sticking with the pain management physician. I believe I told you he has knocked the pain down to about 20% or 25% remaining, which is still bothersome.  I take Oxycontin 10mg Time Release Bid, Norco 10mg Tid, and Neurontin (Gabapentin) 300mg HS. During the last visit to his office he told me to take the Neurontin AM and PM but I found it made me sleepy during the day and it was not safe driving.

One good benefit of being on these drugs is that I don't drink alcohol anymore. I never was a lush but I found that I was drinking more recently to help relieve some of the pain.

You were spot on about LSI Susie! Thank you for the well wishes and you take care of yourself.

Jimmy

 

 

Hi White Beard,

Vicky and Susie. This might be of interest to you also.

I don't believe The Spine Institute is associated with the LSI (Laser Spine Institute).

The video describes that Tiger Woods is suffering from back pain.

Their site below contains interesting info on Adult Stem Cell treatment and not embryonic stem cells. If you scroll down they also go into disc replacement with the ProDisc-L and ProDisc-C which seems to be the best out there.

http://www.laspineinstitute.com/

Jimmy