Diagnosis of My Back!!!

First I would like to thank you all for your prayers we had a safe journey  up and back. This is what I found out at the doctor's office yesterday. I'm not looking forward to this surgery that's for sure, but it's at the point  now that I have to have it because of the compression on the nerves in  my spinal canal. So sometime after the 18th of May (my grandaughter's  High School graduation is the 18th, and I don't want to miss it) I will be  having surgery at Des Peres Hospital in St. Louis so please remember  me in your paryers.  I put some information here about what Spondylolisthesis is and the  surgical treatment that I will have done. I will have Decompression and Fusion on the L4 and L5.  L4 is the one that has collapsed onto L5. I have Degenerative Spondylolisthesis as opposed to being injured  or being born with it. I am so thankful to have had the RNY and loss of 120lbs because this  is not going to be an easy recovery at the weight I am now so I can't even imagine what it would be like at 300lbs!! I do have a wow moment!!! While I was at the doctors yesterday I had a injection into my right hip joint ,I had a lot of these in the Pain Management Clinic. but this time when he started to give me the shot he was pressing  on my hip to find the right spot to put it and he said!!! You have no fat on  your hip!!!! I said that is not exactly a bad thing, he said no, but that it wasn't  but, he was used to having to push down into the fat to find the joint and injection site and he didn't have to do that with me.!!! Happy Dance, Happy Dance!!! Brenda Diagnosis of Spondylolisthesis

Degenerative changes in the spine (those from wear and tear) can also lead to  spondylolisthesis. The spine ages and wears over time, much like hair turns gray.  These changes affect the structures that normally support healthy spine alignment.  Degeneration in the disc and facet joints of a spinal segment causes the vertebrae  to move more than they should. The segment becomes loose, and the added movement  takes an additional toll on the structures of the spine. The disc weakens, pressing the facet  joints together. Eventually, the support from the facet joints becomes ineffective, and the top vertebra slides forward. Spondylolisthesis from degeneration usually affects people over  40 years old. It mainly involves slippage of L4 over L5.

changes in the spine (those from wear and tear) can also lead to spondylolisthesis. The spine ages and wears over time, much like hair turns gray. These changes affect the structures that normally support healthy spine alignment. Degeneration in the disc and facet joints of a spinal segment causes the vertebrae to move more than they should. The segment becomes loose, and the added movement takes an additional toll on the structures of the spine. The disc weakens, pressing the facet joints together. Eventually, the support from the facet joints becomes ineffective, and the top vertebra slides forward. Spondylolisthesis from degeneration usually affects people over 40 years old. It mainly involves slippage of L4 over L5.

 

Symptoms

What does the condition feel like?

An ache in the low back and buttock areas is the most common complaint in patients  with spondylolisthesis. Pain is usually worse when bending backward and may be  eased by bending the spine forward.

Spasm is also common in the low back muscles. The hamstring muscles on the  back of the thighs may become tight.

The pain can be from mechanical causes. Mechanical pain is caused by wear and tear  on the parts of the spine. When the vertebra slips forward, it puts a painful strain on the  disc and facet joints.

Slippage can also cause nerve compression. Nerve compression is a result of  pressure on a nerve. As the spine slips forward, the nerves may be squeezed  where they exit the spine. This condition also reduces space in the spinal canal  where the vertebra has slipped. This can put extra pressure on the nerve tissues  inside the canal. Nerve compression can cause symptoms where the nerve travels  and may include numbness, tingling, slowed reflexes, and muscle weakness in the  lower body.

Nerve pressure on the cauda equina (mentioned earlier), the bundle of nerve roots  within the lumbar spinal canal, can affect the nerves that go to the bladder and rectum.  The pressure may cause low back pain, pain running down the back of both legs, and numbness or tingling between the legs in the area you would contact if you were seated  on a saddle.

 

Surgery

Surgery is used when the slip is severe and when symptoms are not relieved with  nonsurgical treatments. Symptoms that cause an abnormal walking pattern, changes in  bowel or bladder function, or steady worsening in nerve function require surgery. The main  types of surgery for spondylolisthesis include

laminectomy

posterior fusion with instrumentation

posterior lumbar interbody fusion

Laminectomy

When the vertebra slips forward, the nearby nerves that exit the spine can become pinched or irritated. In addition, the size of the spinal canal in the problem area shrinks, placing pressure  on the nerves inside the canal. To fix this, the lamina of the bony ring is removed to ease  pressure on the nerves. The procedure to remove the lamina and release pressure on the  nerves is called laminectomy. When the operation is done for spondylolisthesis, it is normally combined with a fusion of the involved vertebrae (see below).

Posterior Fusion with Instrumentation

A spinal fusion is normally done immediately after laminectomy for spondylolisthesis. The  fusion procedure is designed to fuse the two vertebrae into one bone and stop the slippage  from worsening. The fusion is used to lock the vertebrae in place and stop movement  between the vertebrae, easing mechanical pain. When combined with laminectomy surgery (mentioned earlier), fusion helps relieve nerve compression.

In this procedure, the surgeon lays small grafts of bone over the back of the problem vertebrae. Most surgeons also apply metal plates and screws (instrumentation) to prevent the two  vertebrae from moving. This protects the graft so it can heal better and faster.

 

 

After Surgery

Rehabilitation after surgery is more complex. Patients who have surgery for spondylolisthesis usually stay in the hospital for a few days afterward.

Some surgeons require patients to wear a rigid brace or cast for up to four months after fusion surgery for spondylolisthesis. Patients who've had fusion surgery for a severe slip may also be required to stay off their feet for four months.

After lumbar fusion surgery for spondylolisthesis, patients must normally wait four months  before beginning a rehabilitation program. This delay is needed to give the fusion a chance  to start healing. Patients typically need to attend therapy sessions for six to eight weeks and  should expect full recovery to take at least 12 months.

Ideally, patients are able to return to their previous activities. However, some patients may  need to modify or discontinue certain activities to avoid future problems.

When your treatment is well under way, regular visits to the therapist's office will end. The  therapist will continue to be a resource for you. But you will be in charge of doing your  exercises as part of an ongoing home program. I know -TMI- But I am glad you were curious enough to read it all.

 

 

wow Brenda that is really something, but i am glad that you are going to get something done that will maybe allow you to be pain free ....and before your doctor probably said it was from being fat huh? So you will be having your surgery sometime in May I pray that it will make it all better.  love and hugs.  Did you get anything to help with the pain right now till then?

No he never gave me anything, he said his office was not a pain management clinic,  so I am taking the Darvon. I did get the shot for my hip there but nothing else.

What did you think about my wow moment? Good huh! Brenda

I'm glad you're getting this fixed!  Please let us know the exact dates you'll be in the hospital so we can be sure and pray for you. 

Thanks Traci I will post it when I get a date. Brenda

Dear Brenda,

Hi there. How I wish I could take all the pain away from you-and the surgery! No sense in BOTH of us having to go through it huh? Im sorry. I have been praying for you to get some answers and some relief from the pain. I have never even heard of Darvon? Do you think he would be willing (your PCP that is?) to give you something stronger JUST until you get your surgery since now you know exactly whats wrong-and any PCP is going to know this is serious AND very painful? Its worth a shot, isnt it? I wish you luck. I wished I lived closer so I could be of some kind of help for you!!

Please keep us posted. I love you and I miss you! I will definitely keep you in my prayers-as well as our prayer chain for church. Please let me know if there is something I can help you with....k? Lots of Love, Janet