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  1. #1
    aka: Bucky Fikes
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    Lumbar Surgery - My turn under the knife....again! Laser Spine Inst / Conventional?

    Nearing my 5 year recovery anniversary next Super Bowl Sunday for my Cervical Spine Fusion w/plate. Even before this event, I was suffering with low back pain, enough to start dealing with a Pain Mgmt doc, P/T, drugs, blah-blah and the "No Surgery For You!" mantra, at the time. I have been battling this ever since and it has literally been life changing in my ability to work and do day-to-day things without paying the price of chronic, non-stop, sometimes debilitating pain. The last 4+ years I've been riding. I started as recovery for the neck thing and never stopped. Riding as been a huge part of my pain management. It used to relieve it significantly but now, not so much. In fact, it's aggravating it. The last 4 years has been me in a semi-retired state, spending my days trying figure out and then doing the best physical activities to get relief. I am one grumpy bastard.

    After pressing the issue, I finally got another MRI done and have been referred to a Neurosurgeon which I have had 1 consult where we reviewed my MRI. In some aspects, I'm "not that bad" on the imaging side of the coin. However, the reality side of the coin (my back and pain) says different. The brunt of my condition focuses on L4-L5. Annular bulge/osteophyte complex and ligamentum flavum and facet hypertrophy leading to moderate central stenosis. This has become worse since my MRI 3 years ago. My facet arthropathy has moved into the "Severe" category at that same L4-L5 level. For the last 4 years, I have been having Radio Frequency Ablations (Nerve burning) and that was helping, but not so much, now. I'll have another one in a week or so. Things are worsening and I'm feeling it. Enough to have kept me off my bike for nearly a month due to both pain and serious motivation loss knowing what I'll be dealing with pre and post-ride. THIS IS NOT GOOD NOR ACCEPTABLE.

    At first the doc gave me the usual "non-surgical" suggestions until we got on the same page with all the riding I do, some gym activity, past P/T, and then he sort of gave in suggesting that surgery would be the option. In his initial suggestion, standard open back laminectomy and fusion of this 1 level. I see him in 5 days to discuss further and get more questions answered as he had me do a series of flexion x-rays which had never been done in the past. Question to those here that have been this route with traditional open back surgery, what was your recovery like? How much time before you were back on the bike? Complications?

    Has anybody been through the Laser Spine Institute? I have been in contact with them and they have seen my MRI and have determined that I would be a candidate for their procedures. I've done a fair bit of homework on them and it seems once you cut through the marketing hype they use to keep their business model moving, their processes are successful and recovery times really good due to the more endoscopic nature of their procedures and no "cutting" of muscles. So far they're suggesting NO fusion. They would go in and correct the annular bulge with laser treatment and also clean up the facet arthropathy. Without doing a laminectomy and fusion, I'm not sure yet how they deal with the stenosis aspect of my case. I'll be talking about that with then soon. It will cost me more. How much, I don't know. I have pretty damned good PPO insurance but they are "out-of-network" with all insurances and I don't have numbers, yet. I'd also have to do 5 days in Scottsdale, AZ for the procedure. It's a long drive but not a deal-breaker for me. Anyway, anybody have ANY experience with Laser Spine Institute? I'd love to hear any good/bad thoughts on the subject.
    Always ride with a purpose.

  2. #2
    Nothing seems to kill me
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    No dealing with LSI. But I feel your pain, my brother. I have had back issues since my teenage years and have been laid up more times than I care to mention. I have had so many MRIs, Xrays, Cat scans and even Ultrasounds over the years and all I end up with is "Not really seeing anything that would cause you pain, so here ya go, have some opioids and call me when you wake up in 6 to 8 weeks. I have not been to the doc in over 3 month because all they want to do is jack needles in my back and feed me pills. Neither of which help or do I care to take part in.
    And like you, biking used to help. But for the last 1.5 seasons it has limited my ability to enjoy living. Where I used to get at least 50-60 miles a week, I'm lucky to get half of that. And epic 30-40 mile rides that I love so much have been put on hold.
    I do have some good days. But like yesterday afternoon, I was in so much pain I felt like I was going to vomit and pass out.
    Sorry for the commiserating. Keep us in the loop on how things turn out and from one old grumpy bastard to another, Good luck.
    Hello, my name is human and I came down from the stars.

  3. #3
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    I feel for you too. I've had two micro discectomies (sp?) For me the first surgery came quick. Second one was after 1 year of being on narcs, other meds physio and what ever else. I even went for 8 spinal injections. Finally second surgery. Ever since then I've been good, not great I have on and off numbness in my left foot. I occasionally get back spasms. The worst just this Saturday. I was practicing my bunny hops in front of my wife and kids. On my last one the moment I pushed down on the fork and started to pull back my whole lower back froze. I haven't been able to do much since. I'm not trying to hijack your thread just saying keep your chin up and recover well.

  4. #4
    aka: Bucky Fikes
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    Thanks for the replies. Long winded post, I get it.

    I have an update to the situation as of late yesterday. I went in and saw my Neurosurgeon for visit #2. After the first visit, he had me go in for a series of standing/flexion x-rays which have never been done. The good news from that is that it sort of downgraded my situation in that in the MRI, he was suspect of lateral movement or lack of stability at the L4-L5 level and that was why he was approaching a fusion. The x-rays show no movement of the joints so he said the good news is no fusion but he can treat endoscopically by doing a Laminectomy that will open the canal and alleviate the stenosis and open things up. He said this will help with the Facet Arthropathy (Arthritis) as well and recovery time will be about 8 weeks. I'm pretty stoked about this aspect as the "open surgery" just had me wigged due to severity and recovery time. I think this diagnosis will keep me here locally rather than going the route of LSI which logistically and financially, was a real reach for me considering that my insurance will cover 90% of this procedure here locally and would be about $10,500 out of pocket plus 5 days of living expenses and travel costs.

    No date set yet but I'm doing pre-op clearance with my GP next week and scheduling immediately after that and it will be sometime in November. I'll be back on a bike winter is over and able to rebuild on nice tacky trails into springtime. I'm going to force myself into some pain and suffering along with gym work between now and November in hopes of not falling too far behind and at least going into this as strong as I can stand.
    Always ride with a purpose.

  5. #5
    The Bubble Wrap Hysteria
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    OMS - Please keep us up dated on your pre & post op. I am almost in the same boat. I have a L4-L5 Posterior Disc Bulge & L5-S1 Posterior Disc Osteophyte herniation which is traversing left S1 nerve root. I've tried to force surgery as an option and all the doctors say is not the total solution at your age. I have a friend who's father when through surgery for his bone on bone L3 - S1......I've seen pictures of the support structure they implanted to stabilize his spine. I'm not sure if I want to go through that but on the bad pain days.......I certainly am more open to it.

  6. #6
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    I had two low back fusions, the second one greatly improved my condition. Currently L4-L5-S1 are fused. So, to some extent, I have been there and done that. Of course all cases are different.

    Please let us know how things work out.

    Best wishes.

    Lumbar Surgery - My turn under the knife....again! Laser Spine Inst / Conventional?-img_1239.jpg

    Left side swollen at time of pic.

  7. #7
    aka: Bucky Fikes
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    Oh SNAP! Those lengthy scars are exactly what I'm trying to avoid! That's why I'm pretty stoked about this Laminectomy process being endoscopic. It's all muscle dilation as opposed to cutting and scarring.

    How's that working for you now and how long before you got back on a bicycle after surgery?

  8. #8
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    Oi.
    Iíve got a blown L5/S1. Luckily, surgery hasnít been necessary yet.
    So far, stretching, core exercises, biking and the rare 8-day prednisone burst keeps it tolerable.
    I fear it may worsen as I get older.
    Good luck OP! Really hope you can get some safe, permanent relief. Soon.

  9. #9
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    Laminectomy would be way better than all the cutting.

    These scars are from my second low back fusion which was pretty successful. I was back on the bike in about three months but it has taken over a year to regain most of the strength I had before the back troubles started.

    Anyway, I am doing OK now. Not perfect, but OK.

    Terry

  10. #10
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    Do they do this procedure on cervical bulges, too? I have a C4-C5-C6 fusion, and now my wife has a bulging C6-C7 disc. We'd really like to avoid a fusion. She had a cortisone shot and it helped some, but those are definitely a temporary fix.

  11. #11
    aka: Bucky Fikes
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    Quote Originally Posted by honkinunit View Post
    Do they do this procedure on cervical bulges, too? I have a C4-C5-C6 fusion, and now my wife has a bulging C6-C7 disc. We'd really like to avoid a fusion. She had a cortisone shot and it helped some, but those are definitely a temporary fix.
    If the issue is a bulging disc, a discectomy might be a possibility and depending on circumstances, they can be done endoscopically. She might be a candidate for laser spine institute where the disc treatment is done with laser which supposedly produces better results.
    Always ride with a purpose.

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