Disk replacement?

[John Connor]

After reading this thread I figured I'd ask here and see what others think.

I have had sciatica due to a disk hitting my nerve. I had that from 2000 until 2010. Now I got an MRI a few years ago and the disk is gone, poof, no more. So I visited two spine doctors. The last recommended that I just lose the weight. I'm six foot and weigh about 340 pounds so obviously this puts strain on my back. I am working on losing weight now though. Will that be enough to relieve the stiffness I feel in my lower back or will I need a disk replacement or spinal fusion? I don't think I want a spinal fusion and from what I read it's a serious surgery and that you should bottle your "kids" before surgery just in case you can't produce anymore. I guess they go in through the stomach.

 

[RossMAN]

I was wondering who still uses floppy disks?

Wrong kind of disk, I hope it gets better soon.

 

[John Connor]

I still have a bunch of 3.5 disks and a ZIP disk plus the floppy drive and ZIP drive.

 

[Paladin3]

I just turned 49 and first hurt my back in my late 20s. Excess weight has always been a problem for me and I've been sidelined half a dozen times with severe pain from a pinched nerve in the lower back. I've been through physical therapy four times and it seems to take about a month for me to recover. The last few times I haven't need the physical therapy because I knew what to do.

When my weight is down and I walk and exercise enough my back is strong and no pain. During the winter I get less exercise and am more prone to have problems. The pain seems to come when I haven't been putting in the effort to keep my back muscles flexible and strong. Losing weight, exercise and stretching should help you, it does for me.

Good luck on losing weight. I've dropped 25lbs in the last six weeks by spending more time outside and less time at the dinner table. Most folks think it's as easy as "just stop eating" and have no idea.

Stay strong, brother, for you and your loved ones.

 

[Carson Dyle]

Clearly, losing weight is where you need to start. I'd worry about any surgeries you might be considering after you've lost at least 100 pounds or so. No, I'm not being a smartass. The way you feel now and the way you'd feel at 240 or 200 or 180 ... no comparison.

 

[TheVrolok]

Will weight loss be enough to resolve your back pain if you've got significant degenerative disc disease now? Probably not. Will it help? Dramatically.

Would also likely lower perioperative risk and improve recovery and results if you were to elect to proceed in the future.

That said, you have to be realistic with your expectations from surgery. I am not a surgeon, so I am by no means an expert, but you have to realize that surgery may help, but you'll likely have some pain forever.

Get that weight down, you'll feel tremendously better in so many ways. Have you considered any type of weight loss surgery or medical weight loss (and I'm not talking about those fly by night strip mall weight loss centers)?

 

[lxskllr]

Clearly, losing weight is where you need to start. I'd worry about any surgeries you might be considering after you've lost at least 100 pounds or so. No, I'm not being a smartass. The way you feel now and the way you'd feel at 240 or 200 or 180 ... no comparison.

All of this. My back's screwed up, and has been since my 20s. It's gotten a bit worse over time, and I can count on it going out at least once a year if not more. That's on top of chronic low end pain I can mostly ignore. Back surgery is the very last solution I'll try if it gets bad enough. Anything can happen when you get your back worked over.

All this is to say you should take care of the non invasive stuff first, and see if it helps enough. Losing weight is a good idea generally, so you have nothing to lose.

 

[stargazr]

The same thing happened to me 10 years ago. Loss of disc space, it was called. I had a fusion because at that time, I didn't feel that artificial discs were good enough. My back was very unstable, and I felt I had to try the fusion. It did become more stable, but I still have chronic lower back pain. If I do too much, it occasionally flares up. Sometimes it's as bad as it ever was, like I'm just getting over now.

I would not get a fusion again. It puts a strain on the disc above. Maybe the artificial discs are better now, so you would not lose that moveable joint. In the meantime, I suggest learning lower back stretches and do them consistently even in the state you're in.

 

[Ophir]

If you took an average, fit human being and strapped a 150 lb weight vest on them 24/7, would you be surprised if they had a jacked up back?

Lose the weight.

 

[Scarpozzi]

I suggest avoiding surgery at all costs unless you can't move at all. I would be more worried about the surgery doing more damage...but that's just me.

I've got problems with my lower disks....it's a heredity thing. I first got injured when I was around 22 years old....picked up a Sony Trinitron monitor one Friday at work....then went backpacking that weekend... Was probably a combination of both that did the initial injury. Monday morning, I woke up and couldn't walk. Sciatica caused my left leg to seize up and I ended up doing weeks of PT to get walking right again. About once a year I would hurt myself again just doing normal stuff. I've got a hip that pops now and it's probably related to the same defect. My all time max weight is probably 238. I'm probably 220 now because I've not been running lately (have taken 2 months off after running 2 half marathons and a marathon the first 50 days of the year).

I started running distance again a few years ago and found that running hills has helped work the muscles below my lower back... (upper buttocks muscles) It's also helped work my core and those together have helped my lower back. Sadly, there's not an easy fix. It takes lots of time and dedication to lose weight. If you think you want to cut weight, progress is slow in the beginning, but little things become cumulative. Start by analyzing your calorie sources and see what you can cut....use the MyFitnessPal to track everything you eat and don't lie to yourself about what you're actually taking in. Then get a Garmin watch or use your phone to track walking distance and start moving. If you walk 3 miles (1 hour), 3 days a week, you're burning 1000 calories weekly....3500 calories is a lb. Start looking at things that way. The more you move, the better your back will feel...it's counter-intuitive. Added bonus for us...you won't be here posting if you're out walking or running.

 

[hanoverphist]

coming from a 6'3" guy that topped out at about 360 at my worst, even dropping down to 290 was a phenomenal change in both my soreness (back and knees, feet as well) and energy levels. im still dropping weight, and plan to get down to about 220 before deciding how low i want to go. lose the weight then deal with the surgery stuff when you have a realistic idea of what to do.

 

[eits]

Don't get a spinal fusion. Get a disc replacement, 100%, if necessary. It could, also be possible, however, that correcting your biomechanics and anterior pelvic tilt and working on core strengthening to stabilize the lumbosacral region would be very helpful in relieving your symptoms.

There's a great layperson's book by Professor Stuart McGill, who's THE spine guy all around the world. No one knows more about the spine more than him. It's called 'Back Mechanic'. You can get it on Amazon. Read it and see if you can pick anything up out of that. There's a good chance you'll find relief.

Keep me posted on how you're doing.

 

[Darwin333]

Exactly how bad is your pain? I have some fucked up discs too but I'd have to be completely debilitated to risk a surgery where they want me to freeze my sperm just in case... Despite my back pain at least I can still have sex.

My doc told me a spinal fusion was the only real option for me but flat out said that he refused to do the operation unless it got so bad that I basically couldn't get out of bed. Mine said it was like 6 months (weeks maybe?) of bed rest during the recovery.

 

[John Connor]

Thanks for all the input folks. I appreciate it. I do want to lose the weight first before doing any kind of surgery and that is what the second spine surgeon recommended that I do. If I do need surgery, I think a disk replacement would be more likely. I have read a lot of bad news about fusion. And disk replacement came out in circa 2004. From what I read it's a pretty good surgery.

Exactly how bad is your pain?

I don't have pain per say. It's this very, very bad stiffness that is very debilitating. I can't stand for more than about 30-45 minutes and doing any physical activity is a bitch in that the stiffness has me needing to sit down and rest my back. I just can't physically stand. It's most likely the inflammation and the first spine surgeon wanted to give me a shot of steroids in my lower back, which according to both my cousins who are nurses that is the best anti-inflammatory stuff they have. I read about it and I didn't like some of the side effects and the second spine doctor said it would only offer temporally relief. So I passed it up.

 

[slag]

Like everyone else has said, lose the weight first, then look at options. You're carrying weight for 2 people on one frame. Once the weight is gone, you'll feel like a new person and I bet most of your pain will go away as well. I imagine you also have sleeping/breathing problems and those will get better with weight loss as well.