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Friday, June 20, 2014

Spondylolisthesis, explained by a patient

"Spondylolisthesis, explained by a patient
Spondylolisthesis is a typical progression from spondylolysis (a stress fracture on a vertebra) if left untreated.Spondylolisthesis is the forward slippage of a spinal vertebra from its correct position. When this occurs, it is in the lumbar area (the lower back) usually from overuse--it can also be from trauma, a birth defect, or a degenerative condition. Genetics can also play a role, as those with a narrow vertebral bone are more prone to this condition.
Metal rods and screws are used to brace and protect the fusion.
It is common to have this condition with no symptoms and it is usually found and diagnosed while a doctor is looking at x-rays for an unrelated problem. Symptoms may include: lower back pain, stiffening of the back, tingling or numbness down the legs. Spondylolisthesis can compress the nerves, cause a significant amount of pain, and also cause a patient to have trouble with the bladder and bowels.X-rays are necessary to diagnose spondylolisthesis, and also tell a doctor if it is the fifth or the fourth lumbar vertebra. A CT scan or MRI might also be necessary to see if there will be additional risks to the nerves. The most mild treatment is to take it easy for a while and allow it heal; ibuprofen or another anti-inflammatory can help with the pain. Moderate treatment could include a backbrace, physical therapy, and stretches and strengthening of the back. Extreme treatment would be surgically fusing the vertebra. It is common for the surgeon to use titanium rods and screws to brace and protect the fusion, which is both good and bad. The good is that it does protect the fusion very well; the bad is that it makes it a little more difficult to recover. Some tasks might need to be relearned, but it is better than the alternative."



I posted this as a hub on hubpages.com, and also bubblews.com but I also wanted to share it here. Here, I can talk more in-depth about my personal experience, rather than just sticking to the facts.
I had chronic back pain almost my whole life. I can't remember a time in my childhood without it. Every time I complained about my back pain, my mom would take me to the doctor. They checked me for scoliosis more times than I can count. The degree of curvature from scoliosis was too small to cause much discomfort. So we kept playing the back-and-forth game and I finally ended up with an answer, thanks to my mother's persistence.
I was in the 6th grade when I was diagnosed with Sheurman's Hyperkyphosis and also Spondylolisthesis. I've heard that Kyphosis can make Spondylolisthesis much more likely, but I don't know if that is completely true. I was diagnosed by the doctors at Nebraska Spine Specialists. The Kyphosis was obvious from the x-rays, and since the degree of curvature was significant, I wore a backbrace to try to reduce it. I was in my brace for a few months when a group of doctors went over my x-rays together. Then we got a call that changed my life. It's sort of a blur but this is what I remember.
We went to an appointment as a family, and the doctor told me I didn't have to wear the brace anymore. He told us it was very important that I have surgery as soon as possible because it would only get worse, until I was paralyzed from the hips down.
I had surgery, I had no say in it but in retrospect that's a very good thing. My parents spent 10 days in the hospital with me. I had two operations, one to correct each condition. Three vertebrae are left unfused in the middle of the fusions, and eventually I will have to have those fused also because they will be over-used. The doctor didn't tell us that part before the operation, and it has caused some bitterness in my life due to the risks I will have to take for third time when I'm under the knife. I almost bled out on the table during one of the operations. Luckily they were able "recycle" some of the blood that I lost. I was freezing the whole time I was in the hospital and kept having heated blankets piled on me. They suggested that I have a blood transfusion, but my mother was afraid that the blood might not be tested enough and that there was a chance I could catch something from it. I wonder, though, how severe my blood loss woukd have ro have been for her to consent. I learned later that I should have gone and donated blood for myself sometime before surgery. My parents both gotten tattoos in the year before I had surgery so they were unable to give me blood.
I was on a morphine drip and slept a lot, the morphine burned every time I hit the button so eventually I stopped and my mother would press it while I slept. I didn't eat for 10 days, but the nurse said that was normal. I drifted in and out of sleep and sometimes I didn't recognize the people that came to visit. I didn't want visitors, it was too hard to concentrate. 
Recovery was a bitch. I was taller suddenly, from a straight spine. I had also dropped 20 pounds from my body cannibalizing itself while I was in the hospital. I had a really hard time balancing, if it had been only one surgery it would have made things a whole lot easier. It takes roughly 8 months for the fusion to heal, I had to slowly spend more and more time at school. They froze my grades, lucky for me. It set me back in math quite a bit, but there was no way around that. Morphine doesn't make the best study buddy.
Sometimes I still feel like I need pain meds. I don't have any, and can't get any, but that doesn't stop it from hurting. It's always my lower back, and it lasts for days. I tend to lean forward while I do homework, or read, or concentrate on something and it strains my lower back a little too much. Sometimes it hurts for no reason. I really thought that after the surgery I wouldn't have any more pain, but I guess that's life.