Back surgery-fusion/disc replacement

[PinkTights]

Hello...

I am curious to hear from pilots who have/had severe, chronic low back pain that resulted in surgery. In particular, pilots who have had fusions (especially multi-level) and returned to the cockpit successfully or otherwise, especially long term.

I am facing surgery at the L4-5 and L5-S1 discs. I've sought numerous opinions (this has been on-going for several years) and these are the recommendations:

1. Hybrid surgery - fusion at L5S1 and disc replacement at L4L5
2. Two level total disc replacement (Total disc replacement-TDR)
3. Two level fusion

My insurance company doesn't view disc replacement/TDR as a proven procedure for degenerative disc disease, therefore options 1 and 2 are apparently out. The hybrid surgery is recommended to stablize/fuse the lowest disc, and then use the prosthesis/TDR at the second level (rather than fusing it also) to allow movement and protect higher discs from deterioration. It looks like my options may be limited to the two-level fusion only, unfortunately. I've heard from some pilots that this can accelerate the deterioration of adjacent discs over time.

I would love to hear any and all stories...and also recommend to all to take care of your back! I have always been very active -gymnastics, golf, sailing...the human spine is truly amazing and affected by everything. I have done years of physical therapy, pain management/injections, chiro, etc. All to no avail. As I consider this surgery, I am eager to know the experiences of others.

E

[Loose rivets]

Have you considered the Wallis device? It was offered to me, but logistics made the timing very difficult, I didn't have it done, so can't make any comment other than hearing it was developed in Southampton England.


Interspinous Process Spacers (http://www.spine-health.com/treatment/spinal-fusion/interspinous-process-spacers)


What NOT to do is have an inter-vertebral disc destroyed with a heat catheter.

I've written a lot about the lower spine over the years.

[manrow]

Brief initial reply:-

I have a colleague who had identical condition to yours about 20 years ago, who is now somewhat disabled. He is busy today but passed the following advice - do not have the surgery. Further explanation over the next few days can be expected.

[murrayj1]

I am the ex Pilot MANROW refers to who had a similar condition to you starting 20 years ago. First of all we all realise that every back is different. No two invasive procedures are identical as neither are the skills of differing surgeons. Notwithstanding this however, I too began with degenerative disc disease 20 years ago. I also have had multi-level fusion and disc replacements at L4/5 and L5/S1 plus every conceivable treatment you could think of from Facet Blocks, other Injections, Intradiscal Electro Thermy, Acupuncture, all the Physio and Osteopathy forms you can imagine and more recently the implant of a Spinal Chord Stimulator (to attempt the reduction of pain), attending Pain Management Clinics etc. My list of pain drugs is considerable, 3 of which are controlled drugs and one that would I assure you attract a high street value. Bottom line is that I am 'Failed Back Syndrome' or in other words surgery that did not succeed. This rate of failure after intervention is much more common than surgeons often admit. I still have respect for my surgeons but the fact is your spine and nervous system are so very complex and it remains still somewhat of a science and a gamble. On the positive side, the various procedures got me back to flying in various spells for 5 years over a 15 year period albeit it was hard going. Eventually, 10 years ago I was forced to medically retire and I now spend my day lying mainly on my left side punctuated by bouts of stretching excercises and coping techniques I have learnt at my Pain Clinic. The effect on my family has been considerable. However, I made the elective surgery choices in hope and blame nobody. My advice would be to AVOID SURGERY at all costs UNLESS dangerous nerve damage that will handicap you is threatening. Excercise as much as you can while pushing through the pain. Get to a pain clinic and especially a Pain Management course. (They are available in the private sector if you can't wait for an NHS one, assuming you are in the UK). If you do go for surgery, it may go well, and I sincerely hope that it does but in preference use a Neuro rather than Orthopedic specialist. I hope this is helpful and not too verbose but I did want you to get a reasonable idea of my experience coming from it seems an almost if not identical case background. One final point. I spent my last 5 years flying almost exclusively long haul. There is a hypothesis that suggests degenerative disc disease may not be best aided by the constant almost unnoticeable vibration transmitted through our seats in flight. I would also recommend an American website 'losethebackpain' at [url=http://www.losethebackpain.com/]

[A2QFI]

Very slightly off post in that I am not talking about a pilot. My late son was knocked off his push-bike and landed in the road with a damaged back. Over the years the pain got worse and the number of positions he could sit or lie in became fewer and fewer. He was offered the surgery but was told that it it might work or he might finish up in a wheel chair. This was over 15 years ago, in USA. Maybe the technique and success rate have improved. Good luck, what ever you decide!

[Gentleman Aviator]

Hello,

Micro-discetomy at L4/L5 L5/S1 6 years ago.
It made a massive improvement to my life.

Unfortunately, it did not clear out sufficient space, so I have recently enjoyed a total disc replacement.

My surgeon for the first operation was one of the UK's most experienced back surgeons.

For the second, I chose one of the leading exponents of disc replacement surgery.
Perhaps discuss with John Sutcliffe at London Spine Clinic.
Over 400 disc replacement operations by him so far.

Good luck

GA