Siactca

Awww I feel your pain. That is exactly how I was, things are slightly better, I am still in terrible pain but not like I was. I have resulted to medical Marijuana oil and cream and ,Ibuprofen the gel capsules. I do Yoga, ride my bike, use tens unit, heat , ice, never end session with heat because heat relaxes your muscles but it also inflames them. These are things I do daily just to be at a number 5 pain level. I’ve had 3 epidural injections but to no avail, took all the poisonous drugs, physical therapy, chiropractor, massage and acupuncture. I’m waiting to be set up with surgery, I’m scared but I’d rather take a chance with that before I live like this. I worked really hard all my life planned very well and was able to retire right now at age 55yrs, 4 mos into my retirement I was living my best life and then BAM!! sciatica came and has been with me for the last 9mos. I hope this helps and I’ll be praying for us both. Fight it with everything you got... WE GOT THIS

I've had sciatica many, many times over the years but the signature for the condition is pain down ONE leg.  In October 2016, I started having pain down BOTH legs with a lot of leg weakness.  Diagnosed by a CT/Myelogram with contrast...the "gold standard" spine test...at L2/L3.  Bi-lateral foraminal stenosis...a narrowing of the bony canals in your spline where the nerve roots pass through from your spinal column. 

I'd already had a decompressive laminectomy at L4-S1 for sciatica but this is very different.  My nerosurgeon recommended another fusion (already fused L3-S1 with rails and screws...TLIF...they go in from the back...12 days in the hospital...4 months rehab...six months brace).  For this, he wanted to do a Lateral Lumbar Interbody Fusion (LLIF)...they go in from your side and insert a spacer device that looks like a mini-car jack.  After insertion, they screw it open with an actual Allen wrench and back fill it with a bone graft from your hip.  The expansion of the vertebrae opens the foraminal canals and relieves all the pressure causing the stenosis.

Miracle op.  Woke up, ran down the hall, climbed stairs, zero pain.  One night in the hospital, no brace, no rehab...like it all never happened.  The LLIF is the best kept secret in spine surgery!!!  I've attached my before and after pics.  Search YouTube for "Globus LLIF" to see the technique and then "Globus RISE" to see the expansion device.  See if this is what you need.  Works on any lumbar vertebrae...even two levels can be inserted in the same op if needed.  Have fun...

I am blown away by your pictures and story around the LLIF. Please could I ask your opinion on my situiation?

It sounds like I need may this, although absolutely do not want to have another spine surgery!

In Sept. 2017 I had L4-L5 laminectomy and fusion for stenosis and spondylesthesis at L4-5. I still have spinal canal stenosis at L3-4 as well as some disc slippage of L3 over L4, but to a lesser extent and the neurosurgeon decided we should fuse the really bad L4-5 level  first and then wait and see. The weird thing is that I felt good enough after that first surgery to be walking 5-6km per day for the first 4 weeks and then I developed nerve pain and numbness  in left foot. It has since spread up left leg and is starting in right foot. My surgeon is talking about a 2nd fusion at L3-4 but cannot explain why all my symptoms are as if coming from S1. The other levels are clear and canal at S1 is open wide.

Further, my surgeon says that if we do a 2nd laminectomy and fusion at L3-4, it may not even make any difference to the symptoms. Hence, I am not in any rush to return to the opearting table. My GP reckons I may have sustained some nerve damage and if its does heal it will take a long time. The origin of pain does seem to be a stenosis since walking is the worst culprit for starting the nerve pain.

What an inspirational post! Thanks, genieBo for all your thoughts. I leave for vacation tomorrow and I'm wondering what kind of vacation it's going to be. Any degree of relief is certainly welcome. I'm not sure I'm going to even bother with the epidurals. I think I should just listen to the doctor and have the surgery. I hope your retirement becomes more enjoyable as time goes on and you remove yourself from that vicious cycle. Your desire to beat this is commendable. Thank you for putting me on track and I'll stay in touch. Thanks for the prayers also. Right back at you! God Bless. 

My neuro is a veritable god to me...ok...demi-god.  Saved my wife's life when an ENT discovered a 3 mm un-ruptured MCA aneurysm in 2010.  Craniotomy revealed that it was really 8 mm, wrapped around her artery and so thin it would have killed her within 30 days.  Took him over 8 hours and four tries to clip it since it had already bled years before and was stuck to her brain.  Man refused to let her die.  Amazing talent.

So when I needed my first sciatica laminectomy, he was my only choice to do it.  Then came the L3-S1 TLIF...told me my spine was a "junkyard".  What do you expect after 45 years of playing hockey!  Then the LLIF a few years later for the L2/L3 stenosis.  Told me he could remove the L3-S1 metal and re-fuse me L2-S1...or...do the LLIF.  No brainer.

The actual procedure involves a General Surgeon opening you up from the side and moving "stuff" around so the neuro has a clear path to your spine.  (Don't ask what all the "stuff" is...)  Then the LLIF by the neuro; the GS does the close.  It really was a miracle op...except...it was TOO good!!!

Six months later, I started having some lower back pain that he traced back to the LLIF.  He found sooooo much bone growth around the fusion that some of it was impinging on other nerves.  A quick laminectomy this January solved that problem.

If the doc says that another decompression will not fix you, I'd find a neurosurgeon who works with a GS and who has lots of experience with the LLIF procedure.  Want to have someone who knows what they're doing.  There are multiple device types that can be implanted depending on your needs.  If you look closely...really closely...at picture #3, you'll see that the posterior edge of the device is opened wider than the anterior edge.  This is to preserve the proper curvature of the spine at that point.  Each device has different capabilities; doc has them all ready and makes the choice after he sees what he needs. 

Also, they actually use a surgical version of a good old Allen wrench to expand the device and adjust the edges precisely.  Being a Sicilian from Brooklyn, I had to give my guy an OFFICIAL Mafia wiseguy nickname after the surgery.  He's now known as Tommy The Wrench!!!

Again...I'm "Not-A-Doc" so you'll have to do your research and find the right surgeon.  Just know that the LLIF is a huge secret...hardly anyone knows it exists even though it's been around a while.  If your doc doesn't do it, he'll steer you in another direction.  I'd get an opinion from an LLIF pro and see what your options are.

Does BIO-FREEZE work? I saw that stuff at target. I bought some stuff called capsaicin but it hasn't helped much in the week that I've been using it. I tried a heat this morning before I left for work but probably should keeping doing the heat for  a few days to see if anything comes out of it. 

I get pain when I try to stand or sit in my right butt area. 

The second-best topical on the planet if Voltaren Gel (RX in the US, generic diclofenac elsewhere).  GREAT anti-inflammatory and pain reliever.  On the OTC side, BioFreeze is OK along with Aspercream with 4% Lidocaine or straight Lidocaine patches.

The absolute best is called "Lotion" which is available only in certain states from certain dispensaries by people with certain medical cards.  The most incredible stuff ever...works on 5 minutes...