Wednesday, June 20, 2012

Facets are giving up.

Alrighty guys. It's been a while, 1.63 years since my L4/5 M6 surgery with Nicholas Boeree, may his soul rest in peace.

So it seems the issue with tightness in my back has been my facets all along. I opted for a Facet Block a few months ago. That stopped working after 2 weeks. I then got another one, which, again, lasted only 2 weeks.

A month ago I opted for a facet denervation. I thought this would do the job, but again, only worked for 2 weeks. I'll be getting a booster denervation next month, but i'm already looking at surgical options here. It's getting unbearable.

I wake up with my facets flared up, EVERY MORNING. My lower back muscles are constantly tight and I was forced to buy a Precor Stretch Trainer, which I now have at home and use constantly.

I asked Dr. Jose Joy, an orthopedic surgeon that fused my mom's back 6 weeks ago. He said i'm looking at a fusion in the future.

But then again, I REFUSE TO FUSE. I'm looking at alternatives, of which I've found 2:

1. The Glyder Facet Resurfacing by Zyga with Dr. Pimenta (http://www.zygatech.com/index.php)
2. Zyre Facet Replacement with Bertagnoli (http://www.dr-bertagnoli.com/facet-replacement.html)

I've seen other companies that offered solution but seemed a lot more intrusive and involved a whole bunch of bone cutting. Those companies have dissolved, like Archus Orthopedics.

Anyways, if anyone has any experience with any of these devices, or has any additional ones you might want to add to the reading list, please let me know.

As to why the facets are failing, it could be the M6 allowing too much motion in that segment. I can't imagine a prodisc or any other ADR given how unconstrained the motion is. At least the M6 is constrained. But anyways, I believe ADR with a facet replacement is the absolute total solutions to lower back problems. My disc hasn't given me any issues whatsoever except for this. Used in conjuction with a treatment like facet replacement, i'd be happy moving forward with my life.

I know absolutely nothing about how these devices work. The glyder seems interesting but i'm not sure how it would attach to the facet.

Here's a pic of the Zyga's Glyder:



Here's a pic of Zyre's replacement:




13 comments:

  1. Mike,
    Don't give up yet on conservative therapies, they can do intra-articular PRP injections in the facets, prolotherapy to tighten all the surrounding ligaments, and of course there is ole core strengthening which does relieve pain.Good luck!

    ReplyDelete
  2. Mike,
    Don't give up yet on conservative therapies, they can do intra-articular PRP injections in the facets, prolotherapy to tighten all the surrounding ligaments, and of course there is ole core strengthening which does relieve pain.Good luck!

    ReplyDelete
  3. Wow, Mike! You have been through enough already... Do you remember if your facets were badly degenerated before having the M6 installed by Dr. Boeree (RIP)? I suppose nerve pinching pain could have overshadowed your facet pain somewhat. I have heard of facet replacement, so you may be pioneering another medical advancement. I wouldn't want to "fuse in" a good, functioning ADR unless absolutely necessary. You went through a lot to get it. Hang in there. You'll persevere through this too. :)

    ReplyDelete
  4. I am banned at SPS forum so I must write here.

    Solution for your problem with facets could be endoscopic facet rhizotomy.

    Denervation rarely works because it is fluroscopically guided blind procedure.

    Kind regards

    ReplyDelete
  5. Hey Mike, here is another device to consider. My orthopedic surgeon here in the USA has used this before in a patient that had facet problems with good results. The device helps to "unload" the facet joints, and provide more stabilization of the segment. In the case he told me about, the patient woke up and was pain free apart from the incision pain. I have not done a ton of research on it myself, but might be worth looking into as another option at least.

    http://www.paradigmspine.com/products/interspinous_technology/coflex/en/

    ReplyDelete
  6. I think its worth trying, but first less invasive treatments.

    ReplyDelete
  7. Gday Mike,

    It's Chris (Hooch).

    The real concern for me is I don't see anywhere where you talk about trying to get yourself fit.

    Find a good physio and make sure your TA, multifidus and pelvic floor are activated. This is scientific, and works. It's a start.

    You will always have back pain of some description, so try and build with what you've got. Pain isn't necessarily a reason to stop exercise, and working and exercising through pain will probably be a part of your life.

    Try and find ways to strengthen yourself without flaring things up too much.

    ReplyDelete
  8. Don't get caught up in the idea that your body is fragile, or susceptible to damage, or needs to be protected from activity, you just end up condition yourself to pain.

    I could be wrong, and you could have bad facet probs (try pressing on them, hard. If everything spasms when you press on them, that is a bad sign)

    On the other hand, everything could be strong and stable, and the rest is remnant pain and associated muscle spasms and the like from a construct that only roughly approxiamtes a healthy back.

    If it's only remnant pain, you will make gains by conditioning yourself and applying load to your body. You will still have limitations, but muscle spasms are not disability.

    ReplyDelete
  9. Mike...I recall Jim from adrsupport saying that his wife had facet problems following prodisc. She went to chicago and had prolotherapy by dr. Hauser and hasn't looked back since then. So please try that first

    ReplyDelete
  10. Thank you for sharing this knowledgeable post about disc replacement surgery, Houston TX. Good job.

    ReplyDelete
  11. I also have l4/5 issues like you. I am 36 spent the last 20 years dealing and at the end of my rope. Curious if you had any facet blocks before your surgery. I have and it worked for a brief time so I already know my facets play a big role in my pain. My disc has lost 70% of its height so one doc thinks that pro disc would work for me to help bring back that space and take the force off the Facet. Big gamble

    ReplyDelete
  12. Any updates Mike? How are your facets doing?

    ReplyDelete
  13. Mike. Has the situation with your facets improved lately? I find myself in a similar situation like yours however I received a Prodisc L at the L4-L5 level over a year ago. I am now having some facet issues at the L5-S1 level and much like you refuse to fuse. I am exploring options to help deal with possible long-term issues if they arise THAT DO NOT include fusion. I just received a trial of facet joint injections at the L3-S1 level in hopes that the degenerative changes are either halted or slows down the progression. If you have any updates or information you can share with a fellow "spiney" I would appreciate it. Thanks.

    ReplyDelete