DAVE HODGE 10 yr PAIN FREE AFTER ARTIFICIAL DISC REPLACEMENT (ADR) BY WILLEM ZEEGERS History of Dave Hodge at intake in 2003 Problems lower back for several years Rugby injury 1987, since then episodes of back pain once or twice a year for approx 5 years, Much worse since mid 90′s. Since ’99 first sciatica, set off by stumbling whilst rugby training a school team. The back feels unsatble. Since falling down some steps on last Christmas recently sciatic pain down my left leg with a ‘drop foot’ (=L5 root left) on the left side. Since that fall on 12/02 you havve a drop foot left side.(=L5 root left) But sciatic pain has since dissappeared but now suffering from quite significant pain in my righthand side lower back (sacro illiac area), making it difficult to stand or walk very far. In fact everything seems to be very unstable and, if I’m honest, has been for a long time. Restricted in walking standing housework, work, sports, lifting, bending, stretching, standing up.All activities are difficult, as you cannot stand for long or walk far. Leaning forward and bending are difficult. You visited neurosurgeon dr Mustaza who is using Prodisc in Leon (Spain, your wifes hometown). He diagnosed good indication for ADR. You visited dr Chan in Exeter, who is using Link disk, with limited experience. You are waiting for discography at Oswestry.Mr Daniel Chan offered: 1) discography 2) three level fusion may be your best hope (?) Your pain Muscle cramps right groin, burning pain outside both calf muscles recently but not now, backpain worse than leg pain,burning deep lumbosacral dorsal. Backpain more after 5 min walking, 5 min standing, 30 min sitting. Pain mild to severe. Increasing. Pain Scores: back 0-1/10, leg right 10/10, leg left 5-7/10. ADL restricted 50%. Roland 15/24, Oswestry score 32/100%. Imaging reviewed MRI 20th November 2002: 1) severe narrowed DDD L5S1 2) black disk L34 and L45 3) moderate bulging L45 with some slight distal sequestration? facet joints are okay 4) clearly left postero-lateral disc protrusion L5S1 maybe some root contact S1 left lateral, no frank compression. Treatment options 0) wait and see, doing nothing 1) artificial disc L45 and L5S1 if discography is concordant 2) unlikely, but if incomplete succes maybe secondary endoscopic decompression of L5 and S1 root left sided? 3) classic decompression not indicated 4) fusion relatively contraindicated because of multisegmental dehydration Discography: memory pain L4/L5 and L5/S1 Surgery: 2 level artificial disc replacement L4/L5 and L5/S
Posted on: Fri, 26 Jul 2013 16:47:15 +0000
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