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L4-L5 disc herniation and spondylolisthesis

From: laxgirlie13 - on 06/03/2010 8:25pm

Hey..
I'm a 16 yr old female with a herniated disc at L4-L5 and my L4 is slipping forward and my L5 is slipping backwards due to spondylolisthesis. I've been dealing with back and radiating leg pain since a recent injury during my lacrosse season and i was diagnosed at the end of April 2010 which took me out of all sports, gym and etc. I've had 2 MRIs and an x ray and a CT scan. I tried physical therapy for 2 weeks but that had only aggravated my condition. I've also dealt with a period of cauda equina. I've also had an epidural steriod injection with a short steriod pack and a longer one and since the steriod injection I've only gotten worse with the pain, numbness, and tingling sensations (which started in my left leg from the buttocks all the way down to my toes and is now starting in my right leg) and some weakness. My spine specialist is suggesting a discectomy but he may do two levels of fusion if my back is worse when he does surgery. I have absolutely no idea what to do next.
I'd gladly appreciate any help or suggestions.
Thanks

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on 06/05/2010 9:40am

I feel your pain and to have that at such a young age...what grade is your spondylolisthesis? Mine is btwn a grade 2 and 3. You must also have some sort of foraminal stenosis to cause some degree of root nerve compression that causes your leg radiculopathy. Id try all conservative methods first, then surgery. Its a bone issue which is hard to fix by itself. I'd bet u also have pars fractures or defects. Best of luck to u:)

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on 06/05/2010 9:44am

One more thing, cauda equina is nothing to mess around with, that usually ends up in emergency surgery. How was urs treated?

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on 06/05/2010 1:03pm

for my cauda equina i just got another epidural.. i'm going to a pain management dr on the 14th. and my spondylolisthesis is a grade II on both..

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on 06/08/2010 11:23am

Hi,

Per my MRI, I have moderate spondylosis present at the C5-C6 and C6-C7 interspaces with disc space narrowing, anterior vertegral body endplate osteophytes, and 2 herniated discs.

At any rate, the horrible pain drove me to research what was going on and I stumbled across spinal decompression therapy on the internet as a way to fix the problem. I have been getting treatments 3x/week for the last three weeks and I am no longer in pain.

Check this out: www.americanspinal.com

Hope this helps. : )

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on 07/18/2010 10:47am

Hi laxgirl13, I'm recovering with very little pain from L4,5S1 fusion done 3 months ago for the same diagnosis. It's just an opinion,but the success of the procedure depends on the skill of the surgeon. As an RN with a lot of OR exposure in a lot of hospitals(medical sales rep) even though you're in a lot of pain, you need to shop around and get several opinions from both neurosurgeons and orthopedists. Don't settle for a doc connected with a community hospital. That's really a crap shoot. The best of them can be found in large teaching program medical centers usually in large cities. Don't go for the convenience of a local hospital that's where the "also rans" have staff positions. They don't perform enough of these procedures in a day, a week, or a month to be good at it.
In all surgeries its just a numbers game. Ask your surgeon if he does spinal work exclusively how many of these procedures he does a day, a week etc ask for several phone# of patients he or she operated on a week ago, amonth ago a year ago and ask them about outcome. Don't go into this blindly. Do your research and good luck to you.

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on 07/19/2010 8:07pm

Because of your young age, you definitely should get a second opinion. Always best to look for a fellowship trained spinal surgeon. These are surgeons who spent a year after residency learning everything "Spine" before joining a practice or institution. Alot of times with a high grade spondy, they need to reduce and stabilize that level through interbody fusion or other methods. You really don't want extensive work if you don't need it, since you are only 16 and fusing is a tough option for someone so young...which is why I'd get a few opinions.

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on 07/20/2010 7:20pm

If the forward slip is compressing your nerves, only surgery will cure it. This will usually mean a fusion.
If the disc herniation is compressing the nerves - a microdiscectomy could cure your symptoms, by removing the offending disc fragment. Though your symptoms may still re-occur in years to come, if you have a degenerating disc.
Steroid and pain-killing injections are reasonable if the nerve is inflamed due to irritation. The inflamed nerve causes more compression and irritation, and is a vicious cycle. By reducing the pain and swelling, this sometimes cures the symptoms. If not, surgery would be the logical next step.
There is a cascade of treatment, starting with the most conservative, and it seems that you are being well advised of this.
Good luck!

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on 08/05/2010 8:26am

sorry everyone for not responding.. i've been a little busy. i totally agree with everyone.. Anne D. my surgeon had actually reviewed my case with another experienced spine ortho for the same reason.. my age. the other ortho called my house to speak with me about my symptoms and had advised the a discectomy.. the same surgery my spine ortho had presented. both of these drs are located at the same facility away from the hospital. i had asked my surgeon how many of these surgeries he does a yr and he said probably close to 150. and believe it or not he did the same surgery on the same day right after he did mine!!! i had the discectomy done in june and i was feeling a lot better up until 2-3 weeks ago. my leg pain isn't as bad as before but it's slowly increasing every single day. i actually go to see my spine surgeon next week so i'm hoping i'll be able to start physical therapy and see if that helps. and the other thing that totally amazes me is that before my surgery i had absolutely no back pain but it was terrible in my legs.. but now i'm getting back pain. :(

best of luck to everyone :)

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on 08/10/2010 1:31pm

Hi laxgirl, I just came across your posting so dont know what's happened. Did you have the surgery? If so how're you feeling? Let us know.

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on 08/11/2010 10:23am

yup i did have the surgery (discectomy) and i'm going back to the spine ortho tomorrow to see what i can start doing.. i'm hoping PT. well for about a month after surgery 100% of my leg pain was gone but the past month i've been experiencing sciatica again and back pain that i never felt even before the surgery :(. my only hope is that i didn't reherniate the disc because then i'll have to go for a fusion because of the spondylolisthesis on L4 and L5.

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on 08/13/2010 1:44pm

I have L4 L5 S1 hern. I stretch everyday and work my abs, very seriously work on my streching , legs, hamstrings, lower back. You have to get to know your body before try exercising. I am pain free do to my regement of work out. Do little at a time each day and be concious of your work out. you must be patient with yourself. I take no drugs for my pain.

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on 08/19/2010 11:36am

Hi lexie girl13, physical therapy usually begins within a few days after surgery .ASAP get an RX from your surgeon and start . Keep moving around when you're home. Don't sit for more than 30 minutes at a time. If you need pain meds , take them but only around exercising. . Sitting around works against you..If you can, start a walking program, increasing the time every day in 10 to 15 minute increments. Recovery from spinal surgery is connected to building your core muscles,( the abs) since they must take over the work of your back for the rest of your life.. The blood supply to the back is lousy so circulating the blood from all over the rest of your body is required to heal properly. That can only happen through exercise.
Get moving and keep moving!! Best of luck .

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