SPONDOLISTHESIS – OR THE REASON THAT YOU MIGHT NEED A SPINAL FUSION
OUCH. There is nothing worse than back pain when you have it and it’s chronic. Of course, that’s not true, because even when I was suffering from back pain for more than two years, I was well aware that there were many medical conditions that were worse. As an injury lawyer, I consider myself fairly sophisticated (some friends refer to me as “almost a doctor” or AAD). I have seen enough clients with back injuries over the years and have read medical histories and treatment records to know what was happening to me. I knew about all of the conservative treatments from exercise, physical therapy, massage, acupuncture, and chiropractic. Then there were the minimally invasive treatments such as facet injections, epidural steroid injections and then more physical therapy. Those friends that sometimes refer to me as “Almost A Doctor” blame my bad back on a bad golf swing. That might be partially true, but an entire season in 2016 without a single round of golf did not help the pain.
After having an MRI, I saw the images on the screen in the examination room. I could see that the 4th lumbar vertebra was slipping forward out of position on top of the 5th lumbar vertebra. I did not need the doctor to tell me that I had spondolisthesis – a structural malalignment that was not likely to improve on its own. I wanted to tough it out a while longer. I had two month long trials the first part of 2016. During the second trial, I could barely stand and resorted to ice packs under the waist line of my suit pants. Once, the ice pack came loose while I was questioning a witness and slid down my leg to the floor. No one noticed, but I shared the story with the jury during closing argument as I apologized for my lack of immobility during the trial. To a person, the jury was quite amused, as was the judge.
Second Flare Up
In August, I had a flare up and needed another epidural steroid injection. It did not help, but my symptoms quieted after a couple of weeks. I consulted the head of spine surgery at a major hospital, who informed me that I would need a spinal fusion sooner or later. He said it wasn’t urgent but that I would know it when the time was right.
During the fall, my wife and I were to travel to France for two weeks for her special birthday — I won’t say which one. After two days in France, it was becoming increasing clear that I was not going to make it the whole trip. By day three, I was in real pain. By day four, my wife saved me from further indignity and declared we were going home, that was the right thing to do. I was relieved. Wise woman that I married. When we returned home, I called the surgeon and scheduled a follow-up. We scheduled the surgery for after the holidays – for January 4.
As the day of surgery approached, I was increasingly nervous. I’ve been a patient more than I care to admit and have had several surgeries, but fusing my low back was cause for great concern. I’ve seen many poor outcomes following lumbar fusion surgery. That’s the reason that it is important to research the surgeon and the hospital. Make certain that when you arrive on the appointed day, you feel positive about the choices you have made. A positive attitude is an important step along the road to recovery.
My surgery on January 4
I arrived at the hospital at 6 a.m. Once I was readied for surgery, the anesthesiologist with whom I met about fifteen minutes earlier came by with a hypodermic that he injected into my IV line. It’s good that I was lying down because then next thing that I remember I was awakening in the recovery room, known to professionals as the PACU. I learned that the surgery went as expected and that I have four large titanium screws, two rods and a cage implanted in my spine. After being transferred to my room, the nurse got me out of bed using a walker. The next day (Post-Op day #1) I felt great and was scooting around the floor with my walker and seemingly boundless energy. Post Op day #2 I crashed and relied heavily on pain medication. Post-Op day # 3 I was cleared to go home. It was a Saturday. The following day I started using a cane instead of a walker and progressed from there. By the two week mark, I ventured out for a Saturday lunch and have been improving since.
My post-op instructions were: 1) Walk as much as you can; and 2) No BLT for 6 months – no bending, lifting or twisting. If all goes according to plan, I’ll be able to start strengthening by the middle of June. The best thing is that I feel so much better. I’m pain-free – unless I BLT. I no longer have mechanical low back pain. My back no longer hurts when I stand up. I wish I had the surgery a year sooner. When my trial lawyer friends inquire about how I am – I tell them all this and that the value of spinal fusion surgery claims has gone way up!
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By Stewart Casper. Posted April 19, 2017