Aa
Fears about DDD
I am a 26 year old female dealing with severe degenerative disc disease at the C4-5, C5-6, and C6-7 levels, spinal stenosis, foraminal stenosis, and radiculopathy on my right side. (neck, shoulder, arm, elbow, wrist, and hand) I had surgery on October 24 (posterior laminectomy) to take the "minimally invasive" approach due to my age. The surgery was not a success; I now have recurrent disc herniation and symptoms 100x worse than they ever were pre-op. They are now suggesting an anterior discectomy and fusion at all three levels... reluctantly. My surgeon (and three others) continue to stress the fact that I am so young for this procedure, but it's the only thing that can fix my neck and associated problems. They said that they've never seen this level of degeneration in someone my age... EVER. I'm just looking to see if anyone has a similar experience or knowledge about degenerative diseases - I am very concerned that there may be more wrong than they are willing to disclose or may even know. I am just really afraid of what this will mean for me for the rest of my life. I have to get this fixed to avoid paralysis and relieve the unbearable, chronic pain. Please advise if anyone has some knowledge about the subject!
MEDICAL PROFESSIONAL
Hello dear and welcome to the medhelp forum. I understand your dilemmas. I am sorry to hear about your health. The basis of posterior laminectomy is removing the roof of the spinal canal, which houses the cord; lamina resection allows spinal cord space to move backwards and to prevent compression. The limitations are, if the cord has already developed a backwards curve from the normal lordosis, it will prevent the cord from moving back from the crowded spinal canal. Other causes that might be responsible for the surgery failure are nerve root injury at the time of surgery and reherniation. Discuss your apprehensions with the operating neurosurgeon. Preop permanent nerve damage needs to be excluded and fusion at the involved levels is the only plausible surgical option we have, to stabilize the spine. Wish you all the best.
Our forum search rectangle may not come up for you, I just typed over the words that say "Search This Community," and here is a link to a whole list of posts at our website concerning your situation:
http://www.medhelp.org/forums/search/74?utf8=%26%23x2713%3B&query=degenerative+disc+disease
http://www.medhelp.org/forums/search/74?utf8=%26%23x2713%3B&query=degenerative+disc+disease
The website spineuniverse.com is a great place to find out more about your DDD, they explain things very easily, they have good illustrations, and this will help you feel less fearful about your whole situation. You MUST become acquainted with that website, just settle in and do some reading when you are up to it.
As to causes of this thing, there are quite a few, but it is known that your cervical degeneration is fairly common in young adults. However, there are a number of conditions that can cause a serious case of it, including plain old ordinary rheumatoid arthritis, which can show up in many parts of the body... people usually feel it in their hands first, and this is a disease that very young people have even. Spineuniverse talks about other causes.that may or may not apply to you, including some genetic problem with Vitamin D, perhaps too much fluoride... this would be true if your teeth looked kind of brown. Anyhow, that's what I know about causes.
I personally believe that fusing all three vertebrae is one good solution. See, if you do just one, which I presume is what they did before, this leaves the other discs still subject to the same continuing destruction, unless they thought they could improve perhaps less diseased discs thru moderate followup treatment. Another solution, which only your doctors can know if it will work or not, is replacing your discs. They have some new ones now that are far more flexible than the old ones, people can actually get up out of bed a couple days after surgery and, in disc replacements in the lumbar spine, they can walk down the hall when in the days before surgery they had to come to the hospital in a wheelchair. One more possibility, which the docs would have known this, is when you go thru a major spine surgery like you did, this changes the position of your whole spinal makeup, the ligaments, tendons, musculature, EVERYthing gets pulled and tugged and moved around, and this can cause major muscle spasms that can be quite painful. So, even tho this may not be the prime source of discomfort, at least the docs should consider you may need moderate massage therapy to ease those spasms.
What would be interesting to know is how the rest of your discs are doing. I mean, could be in time they, too, will disintegrate, and you'll be right back where you were, just in another location. Also, I think it would be important for someone to at least take a stab at the origin of this DDD, so that can be addressed along with the new surgery, so as to perhaps prevent any further problems down the road with both this fusion and any future spine problems.
I mean, there is no question that you've got to get your spine straight, it is completely wrecked up, and after one attempt at surgery, you are REALLY in a lot of trouble now, and I'm speaking of your pain picture, not your prognosis. For, even tho I completely understand your fears, and probably trepedation at whether this new surgery will work or not, having DDD is fairly common and is dealt with often by surgeons, despite your age and their concern. Surgeons are ALWAYS concerned about operating on the spine, because of the risks. Also, I wonder if the first surgery corrected the report you gave about the foramen impinging on the nerve roots (foramenal stenosis).
See, I know your situation very well, because I have a crumbling lumbosacral spine, I was in a car wreck that fractured my thoracic spine, and as I aged, the whole thing just fell apart, I'm disabled and on medication, and I am terrified of my back giving way.
One thing that might lessen your discomfort about this whole thing is to get yet ANOTHER opinion, even tho you have three now, only this time, if you are planning on allowing the same surgeon or the surgery to be done in the same hospital, is to go to some top people in a hospital in a university setting, even if you have to travel, just to kind of doublecheck behind everybody else and give you some more confidence in what you are about to go through, and perhaps if these people are really first-rate that you get this opinion from, you might consider letting them do the surgery. Also, someone there MAY have run across DDD in someone your age, despite DDD in the cervical spine not being totally out of line, nevertheless yours may be more severe than average, creating these surgery and more surgery problems for your team.
In the meantime, I sure hope they're giving you all kinds of pain meds, perhaps a soft neck collar would take a LOT of stress off your neck, and I can at least suggest heat as being really great temporary relief, which might include a hospital whirlpool therapy a couple times a week, maybe, until your surgery is put on the calendar. I keep a heating pad plugged in next to where I lay on the couch to watch TV, and I'll put that where it hurts in my back, which is basically all over the place, and it feels SO good.
I hope at this point you are making arrangements for taking some time off from work, if you are working, or if you are raising children at home, you will need some help with that, someone to come in somewhat regularly, and YOU need to rest, rest, rest. Pain is overwhelming, it can make a person panic. It brings me to tears more than I like to say. Right now I am in pain, but my neuro is supposed to change my meds at next appointment. Also, you may be able to obtain some sort of disability monies, becuz EVERYbody needs hospital, doc, and surgery money when something big like this happens since insurance, or in my case Medicare, only covers so much.
I'm not an expert on DDD, altho I do have a very bad back and know your feelings very well, so do a forum search, there's a rectangle to the side of these forums where you can type in your DDD spelled out, and it'll take you to a bunch of past posts concerning the issue. And that spineuniverse.com website, again, is worth taking a look at. Keep us posted. GG
As to causes of this thing, there are quite a few, but it is known that your cervical degeneration is fairly common in young adults. However, there are a number of conditions that can cause a serious case of it, including plain old ordinary rheumatoid arthritis, which can show up in many parts of the body... people usually feel it in their hands first, and this is a disease that very young people have even. Spineuniverse talks about other causes.that may or may not apply to you, including some genetic problem with Vitamin D, perhaps too much fluoride... this would be true if your teeth looked kind of brown. Anyhow, that's what I know about causes.
I personally believe that fusing all three vertebrae is one good solution. See, if you do just one, which I presume is what they did before, this leaves the other discs still subject to the same continuing destruction, unless they thought they could improve perhaps less diseased discs thru moderate followup treatment. Another solution, which only your doctors can know if it will work or not, is replacing your discs. They have some new ones now that are far more flexible than the old ones, people can actually get up out of bed a couple days after surgery and, in disc replacements in the lumbar spine, they can walk down the hall when in the days before surgery they had to come to the hospital in a wheelchair. One more possibility, which the docs would have known this, is when you go thru a major spine surgery like you did, this changes the position of your whole spinal makeup, the ligaments, tendons, musculature, EVERYthing gets pulled and tugged and moved around, and this can cause major muscle spasms that can be quite painful. So, even tho this may not be the prime source of discomfort, at least the docs should consider you may need moderate massage therapy to ease those spasms.
What would be interesting to know is how the rest of your discs are doing. I mean, could be in time they, too, will disintegrate, and you'll be right back where you were, just in another location. Also, I think it would be important for someone to at least take a stab at the origin of this DDD, so that can be addressed along with the new surgery, so as to perhaps prevent any further problems down the road with both this fusion and any future spine problems.
I mean, there is no question that you've got to get your spine straight, it is completely wrecked up, and after one attempt at surgery, you are REALLY in a lot of trouble now, and I'm speaking of your pain picture, not your prognosis. For, even tho I completely understand your fears, and probably trepedation at whether this new surgery will work or not, having DDD is fairly common and is dealt with often by surgeons, despite your age and their concern. Surgeons are ALWAYS concerned about operating on the spine, because of the risks. Also, I wonder if the first surgery corrected the report you gave about the foramen impinging on the nerve roots (foramenal stenosis).
See, I know your situation very well, because I have a crumbling lumbosacral spine, I was in a car wreck that fractured my thoracic spine, and as I aged, the whole thing just fell apart, I'm disabled and on medication, and I am terrified of my back giving way.
One thing that might lessen your discomfort about this whole thing is to get yet ANOTHER opinion, even tho you have three now, only this time, if you are planning on allowing the same surgeon or the surgery to be done in the same hospital, is to go to some top people in a hospital in a university setting, even if you have to travel, just to kind of doublecheck behind everybody else and give you some more confidence in what you are about to go through, and perhaps if these people are really first-rate that you get this opinion from, you might consider letting them do the surgery. Also, someone there MAY have run across DDD in someone your age, despite DDD in the cervical spine not being totally out of line, nevertheless yours may be more severe than average, creating these surgery and more surgery problems for your team.
In the meantime, I sure hope they're giving you all kinds of pain meds, perhaps a soft neck collar would take a LOT of stress off your neck, and I can at least suggest heat as being really great temporary relief, which might include a hospital whirlpool therapy a couple times a week, maybe, until your surgery is put on the calendar. I keep a heating pad plugged in next to where I lay on the couch to watch TV, and I'll put that where it hurts in my back, which is basically all over the place, and it feels SO good.
I hope at this point you are making arrangements for taking some time off from work, if you are working, or if you are raising children at home, you will need some help with that, someone to come in somewhat regularly, and YOU need to rest, rest, rest. Pain is overwhelming, it can make a person panic. It brings me to tears more than I like to say. Right now I am in pain, but my neuro is supposed to change my meds at next appointment. Also, you may be able to obtain some sort of disability monies, becuz EVERYbody needs hospital, doc, and surgery money when something big like this happens since insurance, or in my case Medicare, only covers so much.
I'm not an expert on DDD, altho I do have a very bad back and know your feelings very well, so do a forum search, there's a rectangle to the side of these forums where you can type in your DDD spelled out, and it'll take you to a bunch of past posts concerning the issue. And that spineuniverse.com website, again, is worth taking a look at. Keep us posted. GG
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