Back Surgery

At the stage where the back is really impacting my life negatively - have not been a great student of strengthening my core etc so haven’t really given the strengthening alternative a go.

Just sick of it though and contemplating surgery.

Who’s had it?

If so;
What type of condition was it for?
Did you try alternatives and were they effective?
Was surgery a success?

@Heffsgirl

My mum did at age 69.

It was successful in that it fixed the physical problems (lower lumbar vertebra degradation and arthritis) which were causing her pain.

However the surgery was so tough that that she never fully recovered from it and never got her mobility back to the point she was at before the surgery.

Bear in mind that she had knee replacement surgery on both knees in the preceding 5-10 years and made full recoveries from both but was younger then.

I personally wouldn’t have back surgery unless I was relatively young and my prognosis was that I’d be reduced to immobility by my back for a significant period of my (hopefully) later life if I didn’t have it. It’s such tough surgery and recovery and the back is such an important component to overall quality of life that the cost-benefit ratio has to be significantly higher for this surgery over others.

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Why wouldn’t you try this first?

Im sure any surgery option is going to say that rehab and strengthening is mandatory post op to give it the best chance of success. If you have to do it as part of the surgery process anyway, wouldn’t it make the most sense to try it anyway before hand.

Good luck, back pain can be really tough on people.

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I had spinal fusion at L5 S1 (discectomy) early December. I suffered terrible back pain for 12 months, its origins unknown (probably culmination of a few things). I was diagnosed with a deteriorated disc.

I viewed surgery as a last resort. I spent the 12 months doing pilates, swimming, walking, physio, massage, pain medication. None of these things, or a combination of them helped.

My recovery has gone very well and I have been off pain killers since late December. I am more active now than before surgery, walking 40 mins a day up hill, gentle weights program and hydrotherapy. I don’t live in constant pain.

However, I don’t believe my recovery would have been so well had it not been for all the core strength training I did prior. In fact my neurosurgeon advised me he won’t operate unless a patient can demonstrate they have tried all non surgical options first and for at least 6 months. I now understand why. Good core strength is key.

So my advice is:

  1. Try everything else first. Work on your core strength. Try it for 6 months.
  2. Get some scans done and get a diagnosis. It may assist with point 1.
  3. Make sure your health insurance would cover back surgery. Mine did not and I couldn’t wait the 12 months for my top cover to kick in.
  4. Point 2 will help determine what type of back surgery you might have. Research and see the pros and cons.
  5. The surgeon is key. Mine was a neurosurgeon with a very conservative reputation. He was very realistic about my potential recovery and made it a point to tell me on numerous occasions that surgery is not a cure. It may relieve some pain.

Good luck. Back pain infringes on every part of your life and I understand the want to get something done to relieve the pain.

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I totally agree and I need a kick up the ■■■■.
Was just having a think about options.

Thanks for the in-depth answer.
I’ve had scans and it’s in the same area as yours but my L5 has slipped forward by 20mm and is crushing the nerves. As well there is foraminal stenosis.

It put me in hospital for 2 weeks early last year and I’ve had multiple cortisone injections into the spine - one of which worked on the left side but nothing helped the right side. And I think the left side has worn off today.

I’ve done Pilates for a few months but my core is still non-existent. Havibg trouble with finding time for myself amongst a 6 month old, 2 year old who still doesn’t sleep, work and a dog who’s just recovering from a brain tumour. I need to though.

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Good luck with it.

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Argh you poor thing. Have you tried Lyrica for the nerve pain? Nerve pain down my left leg was the last straw for me. I understand how hard it is to find time. My kids didn’t sleep until they were 3 or 4 years old - i’m sure years of fatigue affected my back.

Instead of having a lunch break, i found a physio/pilates studio close to work so would go whilst at work.

I think it will be important that you set up a routine now that enables you to look after yourself - walking, pilates etc. Even if you have surgery, you will need to have this time for recovery. One of the risks for this sort of surgery is the extra load it puts on other vertebrae, which may lead to more interventions, which is why post surgery exercise is critical.

Good luck - if you are looking for a specialist in Canberra PM. I’m happy to talk to you about the surgery and recovery. Back pain is ■■■■■■ awful.

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I have a bulged disc that flares up from time to time. One exercise that really helped was the Reverse Back Extension (Reverse Hyperextension) Exercise.

A lot of people that have back issues tend to target the core and back directly which naturally makes sense but many like myself have weak hamstring and buttock muscles. With those two massive muscles groups ignored, I guess the lower back has very little support from the hips down. Also the sciatic nerve runs down through here which causes many people problems.

You can replicate the exercise on a medicine ball (taller people will need to have the ball on a bench), I just wish more gyms had the weighted machine for those wanting to do this exercise.

Great link on the exercise here: http://bodybuilding-wizard.com/reverse-back-extension

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When mine (disc) goes proper, and I can’t walk, … the quickest way to recovery is the spine stretching bench at the Hossy Physio dept, it opens the vertebrae and let’s the disc slip back into place and reduce the pinching, hence swelling and aggravation. If I can get in quick enough, 2 - 3 sessions a week for about an hour apiece, will have me back to limping about within a week,… and pretty much sorted in a fortnight.

I’ve often thought about getting some inversion boots wondering if they’d do roughly the same thing at home, and I wouldn’t have to wait, … but I just have no idea how I’d get into them and hanging arsse up whilst immobile and scared to move. … :thinking:

I wouldn’t recommend this exercise at all for the OP if he has an anteriorly translated lumbar vertebrae.

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I think there are quite a few different back conditions and resultant surgeries so hard to comment.

Might be irrelevant but my Mum had her neck fused maybe 2 years ago because of chronic pain. The view was that it was caused by a rear ender around 25 years earlier. Anyway, no doubt her movement is vastly diminished. However her pain is gone.

As with others, I think surgery is a last resort. However if required it can provide relief.

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You can save yourself the $$$ and do these for a posterior or posteriolateral protrusion (pro-tip: having seen a disc in real life there’s no way one of those is slipping)

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Actually been doing that since the mid 90’s for 15 -30 mins every day after work on the advice of a Physio, … (& JFTR, they are who I trust most,… wouldn’t give tuppence for any Chiro I’ve seen perhaps bar one), … keeps it in check for the most part, … but sometimes it just goes, sometimes if I just look sideways whilst under load.

Especially if I have been a bit slack on the sit ups/core work.

Swimming a couple of K’s a couple of times a week really helps too.

It’s a bit of a regimen, … and TBH, … if I could afford the time off, … I’d go in for the disc fusion, and get the “Sportsman’s Hernia” sewn up at the same time, … and a mm or so shaved off my shoulder joints while I was in there to cure the bursitis in them… :roll_eyes:

One day.

#OldWreck

Fair enough EB. I would consider you very well respected poster on BB, particularly when it comes to fitness and health. So I heed to your advice.

Oh and the fact I have no idea what anteriorly translated lumbar vertebrae is, so…yep.

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Haha. It’s essentially a more accurate description of “there’s a bone that’s a bit forwards of where it should be”.

As someone who has had back issues (well, 1 major issue then just general fatigue related soreness from labouring etc) and actually has a reverse hyper in their garage; it is very hit and miss with regards to its efficacy as a therapeutic tool. Typically it’s the type of exercise you would introduce very late in a rehab program when the patient has demonstrated they’re ok with a whole host of other stuff (mostly flexion).
Given the condition the OP is in (and has) it’d be far more likely to aggravate it at this point.

The old “my back went looking sideways” is a bit of an odd one as it’s commonly caused by, in effect, your nervous system having a freak out and not registering your movement properly. It then contracts everything around the spine as violently as possible which is what compresses the discs and causes one to “go”.

You may be able to replicate the traction with either an inversion table or with a band looped around something well above head height:


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Yeah - I have been on Lyrica but I found it made me too groggy to deal with the dog having seizures through the night and also had to help out with the 2 year old not sleeping so wife could deal with new born.

I did take 150 mg last night as well as 50 mg Pred but it hasn’t helped my left side, whilst my right side has been better.

I’m in Melboutne and under David De La Harpe who I’ve found really good.

OP;

I don’t have much to add in the way of specific surgeries but most of what has been said already holds true (plus a few more points)

  • surgery should only be used when all other options have been exhausted, and for every success story there’s a dozen failures or people who need multiple operations
  • bones are inanimate and require musculature as well as connective tissues to maintain their position. I would imagine if you were to go down the surgical route they would fuse L4 and L5 or L5 and S1, however this will obviously reduce your mobility substantially and you’ll need to make it up elsewhere. By failing to have adequate strength and endurance in the muscles of the trunk (anterior, posterior and lateral) you significantly increase your risk of an injury elsewhere
  • although bones are inanimate, they (and the discs) do respond to loading. That is, should you do exercises that place sufficient enough stress on the structures to induce an adaptation then you can improve things like disc degeneration, osteo-arthritis etc
  • although medical imagine provides a very detailed insight into what is occuring, they do tend to carry a nocebo effect (the opposite of placebo; you have a negative experience based on a negative view of the experience). Many things that show up on images (particularly MRI) are perfectly normal occurrences in normal aging but tend to get sensationalised. For example: 33% (give or take as I can’t remember the exact figure from the study) of people in their 20s without low back pain show a herniated disc. Me personally: my MRI tells me I have 2 disc herniations (L5 and L4) with nerve impingement on my right side yet I have no sciatica symptoms at all, squat and deadlift over 200kg on a weekly basis and the only low back pain I get is from sitting down for long periods, have not slept well for a few days or in times of stress
  • living creatures in general are quite robust, and you’d be amazed at the type of injuries and tissue damage that people have recovered from. This is the injury a powerlifter I know returned from to squat 500kg+ and reclaim his all time record
    “Broken sacrum, multiple endplate fractures, stenosis, tons of arthritis, herniated discs at L4-L5 and L5-S1 and other crap. I basically don’t have any disc between L4-S1 – the imagery is black.”
  • emotional, social and psychological factors play a far greater part in pain (particularly chronic/ongoing) than what most people would imagine, and in most cases play a bigger part in the pain cycle than the physical or biomechanical component ie the “damaged” part of the body. The pain you are experiencing is very real for you, though I have little doubt that without kids, a sick dog and if you were sleeping 10 hours a night the pain would be far less severe
  • in instances of chronic pain, the bodies tissues because more sensitive and a pain response is triggered much more easily than pre-injury (particularly when couple with the aforementioned psycho-social element). Surgery will not fix this, and many painkillers can actually make it worse, particularly if used extensively (basically body builds up a tolerance AND the tissues will become even more sensitive to compensate). Funnily enough, exercise (and it can be any form though iirc needs to be reasonably vigorous once you are capable) and things like cognitive behavioural therapy appear to be most effective in treating this (if you want to learn more search for both “central sensitisation” and “peripheral sensitisation”

Typically I take a rather anti-surgery and anti-drug stance in the treatment of anything (don’t get me started on cortisone), however even I will concede that depending on the severity of the L5 anterolisthesis a surgical route may be the eventual outcome.

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