I had diagnosed with Grade I spondylolisthesis which has progressed to Grade II over the past year. I am looking at spinal fusion to stop the progression and get me back out on the road (hopefully pain free). Does anyone have experience with a one-level lumbar fusion and competing afterwards? I can get the doctors point of view and recommendations but I am looking for input from athletes who have actually been through the process.
PM me for a doc to see for a second opinion. He heals without cutting, not sure if he can help you. But, I do know before I did something this extreme, I’d exhaust all other options.
Thanks for responding. It is always good to have a variety of options.
I look forward to hearing back from you.
Sincerely,
Randy
First off. Always get a second opinion when it comes to back surgery. These are major operations with serious complications (even the seemingly small cuts). The level of the fusion matters too. What level are we talking about? Fusion is the definitive tx for conditions like Spondy and sometimes fusing early is better than waiting till major neuropathy sets in!!
Have not had the surgery.
Am a doctor. Do know that this surgery has a high success rate. A lot of back surgery does not. However, as others have said, before getting cut on, is always a good idea to exhaust other options.
wife had same thing. and had the operation. PM me if you’d like further info.
good luck.
Sorry to hear of your situation. I was in a similar situation several years ago. I started doing McKenzie exercises daily (still do) see http://www.mckenziemdt.org/approach.cfm?section=int and also hanging on an inversion table. Mine seems to be under pretty good control. It took several years of diligence.
Best wishes,
Have you tried any physical therapy? If therapy is unsuccessful you just lose a little time and potentially some small co-pays… if surgery fails, you need additional more serious surgeries. Let surgery be your last option. It’s not a bad option, but it should be your last option.
David: without being a medical expert please don’t give that advice. You realize that McKenzie extension will likely progress her spondylolisthesis if not put her in a wheel chair. Also doing traction on an unstable segment will cause more instability and is CONTRAINDICATED.
I didn’t give any advice - I relayed my experience.
Do you have advice or experience to share?
Your reply to a discal issue not spondylolisthesis.
Hey, I don’t get it. You seem to have some knowledge and insight, but don’t offer to share any. All I’ve seen, unless there was a recent post, is comments critical of my post.
I have had some experience with at least a somewhat similar diagnosis, and I shared my experience. That’s all. Is there some other beef you have?
Again, I have no specialized knowledge in the area and was only sharing my experience. If you have specialized knowledge, we’d all appreciate your sharing that too.
Spondy diagnosis =/= no hope with MDT. I’ve had plenty of success with a thorough MDT evaluation and treatment with patients who come in with spondylolisthesis on the script.
I’ve treated folks conservatively for spondylolisthesis as a PT, but if it comes to point of fusion the procedure is typically successful if necessary (ie fusion for spondylolisthesis, NOT standard LBP). However, I would at least try conservative tx first.
I actually think you can agree with just about EVERYTHING said on this post. Even the guys sniping at each other. most important - exhaust all other possibilities. Everything from eastern to western medicine . . . .even voodoo. Try them all before the surgery. I know I did, to varying degrees of success. Took lots of pills for a while, had a bunch of injections, tried PT. Luckily, all of my PTs and docs were honest with me and said they may/may not be able to help, but were willing to try . . .but did not want to just keep taking my money if not helping me.
I ultimately had a single level fusion. Doctor shopped for a while before finding someone I was comfortable with (talked with ortho and other surgeons). Find a guy you can trust. learn about the surgery and your options (anterior/posterior, what materials they’ll use, etc), and make informed choices. Candidly, it’s tough (I realized why i hurt so bad post op after I watched youtube video of similar surgeries. . . .there’s no love involved, it’s like a bunch of contractors working on a house). Recovery SUCKED for 6 months.
But I raced a tri at just under 1 year post op, and have since turned to running due to time constraints on my life. I’m ninety something percent “fixed” with the missing few percentage points due to my own stupidity and stubborness. Running about 50-60 mpw on a fusion, with limited pain (and increased ROM post-op). I’m not saying this is smart, or recommended. But mine worked, so it can work. Good luck
I want to share my experience and maybe the op can pick some ideas…
I feel really great when there is somebody who can understand my problem when I explain it.
I have been diagnosed a serious Spondy on L3/L4 by 1.5cm shift. This was in 2011, summer. I had to go to the doctor right after IM Switzerland where pain was at the edge and my legs were numb for the whole run course. I dont even know how I made it to the finish line.
Doctor was a top specialist and he clearly told me: from now on, AVOID any sport that makes you feel the pain in that region. Do lot of PT.
So i did follow the suggestion and swimming and running were dramatic so I tried to avoid. Just cycling was 100% fine.
After 5-6 months of some gym and just cycling, I wanted to give a try again on run/swim also. Not easy, still painful so it was some kind of 6 months on/off.
Then around june 2012 I decided to ignore all and come back to full activity.
Did several olympic and 70.3 events but of course performance were very limited. I managed anyway to get into the fun again. Not caring of results at all. Lot of pain in T1 and sometimes in the middle of the run.
At the end of 2012, I said to myself…ok it seems doable. Some days it happens to be super painful and some days it seems I have nothing. Let’s live with that.
Started a new season in 2013 and I had decent results again, with my best race in 70.3 Japan with 4h31’ and qualified for Vegas.
How did I make through all this?
1- I consider the surgery as last resort. Before going on wheelchair (eventually).
2- do a lot of specific gym exercises. I am super lazy on this and I have been doing just the basic things. sometimes too lazy and skipped the gym but I can feel very well the effect when I go regularly.
3- Use ipobrufen on the days where I can not even stand up from the bed. Seriously, once every 4 weeks, I am paralyzed in bed and cant get to work. So, ipobrufen gives me the opportunity to not take a day off. Ipobrufen is the only thing I found that relieves the pain a bit.
This season I am targeting something bigger, the full distance.
This is my experience but I don’t feel to suggest to do the same. My doctor considers myself crazy and he can’t believe I am doing what I do.
Why do I do this? Because I love sport and I can’t stand home on the sofa even if it would be an easier and less painful life.
What are the risks if I keep doing this?
this a question for the experts…I never found somebody who could answer clearly to this question. Can I aggravate the situation? If yes, what could happen worst case? Wheelchair forever?
Randy I can only give you experience. Please not only get second opinions but try several non cutting methods first. Take the recovery seriously. Hope you can avoid sx.
Grade 1&2 L3, L4, L5 - I broke them in an ultra event (gymnastics as a kid/thrown in the pool under the age of 1/lifelong athlete).
First 6 mths were the worst! I thought someone whacked me hourly on the back with a steel pipe. At the 3 month mark I finally had X-rays as I had no idea what could be causing such pain. When the Doc put the film up the first thing I noticed was how level to the ground my sacrum/pelvis was - that made me so happy to be ‘level’ - then I saw the nasty breaks.
Took that first 3 mths of pain and just rested and barely trained. Once I knew what I was working with - I got in the pool for resistance work to make the muscles stronger. Some swimming -mainly a lot of PT under water. Probably spent close to 8-10hrs/week doing rehab of some kind that first year. Any bike/car aciidents since - just reinstate this training method and body responds quickly.
I’m pro- chiropractic and it was a matter of finding someone that could gently drop supine coming in through the abs. I still get that treatment maybe once a year now. Initially weekly for a few months.
Also pro-PT - remember with the breaks comes injury to the ligaments supporting the spine itself. A good lig inj can take 1-3 yrs to heal! PT/rehab rocks for this.
Things I’ve eliminated - never sleep on my stomach. During massages I place a small lift under my hips (either a small pillow or a folded sheet). Always strengthening something.
If I feel like the feet are getting tripped up too much - that usually means a rolling of the hips is happening and favoring the weakend side - psoas strengthening/stretching combo (same with glutes/hams). My other sign that the back is about to go out - my feet will go numb. Before when I was participating in ultras the numb feet I thought was from too much stagnation (sitting on the bike seat-too many miles of running) - looking back think it was the 3 broken bones and rotation.
One of the best things that could have happened for my back - my second sports car was stolen and cut in half (very bad day)- for safety I bought a cross over w heated seats and better lumbar support. The sports car was down and in and rocked my hips back too far (LOVED that car!) the slow box I’m driving now has where I can tilt my pelvis up. Having the feet underneath me instead of in front made a huge difference in pain. Not sure I will ever get back into a tiny car again. Think about the vehicle you are in.
Work - I do massage (chiropractor and massage therapist just all manual work) so am in either a fencer stance or sitting. Movement is key after stabilization takes place. Walking always helps.
Although I didn’t get surgery - I did race again after the initial break. The 3spondys happened nov 2004 during my only deca iron finish - a yr later I finished a 5x. Many many ultras in between - 2 more deca attempts (and normal events) finishing up in 2010 suffering through a 48 mile swim and a pretty serious bike wreck at mike 760bike. Swimming which you would think would make it worse actually is the one sport that makes me feel better. I’d love to return to the ultra world - but work is preventing me, not my spondys or other breaks.
If your health and life warrant the surgery ok - but sx if can be avoided consider the healthy alternatives. It is all work, and personally I think worth it. Hope you get some relief soon!
Congenital or acquired? If acquired, how? What spinal level? Any neural signs? Experience and treatment will vary widely depending on the history, yo.
And another spondy sufferer checks in.
I am 58, and have a level 3 (1.7 cm) slip of my L5 over S1. Five years ago I was competing lots in duathlons and tri’s and made a few trips to the worlds. I had no idea I had any spinal issues until the constant pain in my butt finally sent me to the doc for an x-ray. There it was, caused by a small, deformed L5 vertabrae which was basically a birth defect. (Spina Bifida Occulta).
It took almost a year to escape from “pain jail”. I had a couple of ESI’s to calm things down back there, and ceased running altogether while I began a regimen of directed PT exercises. Doc started me on Tramadol 50 mg 2x day to reduce sciatic pain. I had to learn running all over again, as I had been an over-striding heel striker, which created lots of tailbone impact. Using a Woodway treadmill, I slowly regained my ability to run. My running is now more controlled, with higher cadence and less lumbar extension. Regular massages, regular PT exercise, Tramadol and common sense have all contributed to getting me back to running and competing in du’s without surgery. Mine would have been (or will someday be) a complicated, multi-level PLIF operation. I don’t do any heavy dead-lifting anymore, nor do I jump off roofs and do backflips off the diving board, but heck, I’m almost 60.
One spine doc was recommending the fusion while another recommended buying time through conservative treatment. The one thing that I had going that you may not was the fact that my problem was there from birth, and the L5 & S1 have ground together into a disc-less “notch”, reducing the possibility of further slippage. Both spine doctors are very pleased with were I am now. One said that I have created an “envelope of muscle” through my dedication to the exercises. I liked hearing that, it made sense to me.
Best of luck to you, whichever way you go. I know where you are at, stay positive and be determined.
Rich G
Charlotte, NC
My husband has this issue and uses an inversion table. Should he continue with the inversion table?