If you read this blog, you know I have a chronic back issue called spondylolisthesis. However, this past year, I have had my crew at our Colorado HQ working on it and there’s nothing like results to again show me how important our treatments can be. Let me explain.
What is Spondylolisthesis?
Spondylolisthesis means that one vertebra is moving forward on the other as shown above. This can cause lots of problems, including a breakdown of the facet joints at that level (not shown) and nerve irritation. The amount of motion is graded a 1-4, based on how far one vertebra has moved forward on the other.
I first injured my back in a motorcycle crash in medical school. I broke several transverse processes, which stick out the side of the spine. I likely also injured several other things at that point, but imaging back then wasn’t that sophisticated.
I would get annual epidural injections in my back to keep the pain at bay. These switched from high-dose steroids to platelet lysate (PL) many years ago. Comparing the two, PL was far superior to high dose steroid shots, in that an epidural steroid injection was a bit like a sugar high. You felt great for a while and then crashed hard. The platelet version was nice sustained relief. However, last year, Dr. Schultz noticed a spondylolisthesis at L5-S1 on my x-ray during an epidural injection. So my disease there was finally advancing. Hence, I needed more.
I’ve now had two treatments that have involved using my own platelet rich plasma, platelet lysate, and platelet poor plasma focused on the spondylolisthesis at that level. First, these three types of orthobiologics are different. Platelet-rich plasma (PRP) is my own blood platelets that are concentrated to high levels (14X). Platelet lysate (PL) is made by breaking open those platelets to get the healing growth factors out and then resuspending those in my plasma. Finally, platelet poor plasma (PPP) sounds like what it is, it’s the plasma left over from the creation of my platelet-rich plasma.
Next, each of these was injected into a different spot. My high-dose PRP was injected into my facet joints, the PL was injected around my irritated spinal nerves (epidural) and into the loose ligaments, and my PPP was injected into atrophied muscles. This is what we call a DDD procedure.
My Heavy and Aching Legs
As long as behave myself, I don’t have much back pain. I do have back stiffness after sitting for a while. I also have difficulty straightening back up if I’ve been sitting for any length of time. In addition, my legs get “heavy” and I have lots of aches and pain, everyplace from the outside of my thigh to my toe joints. I know all of this relates to sloppy movement at the L5-S1 segment, swollen facet joints, and irritated low back nerves that supply all of those spots in my aching legs and feet.
My Legs Work Again!
My mother has a saying, the shoemaker’s son has no shoes. I am a bit like that myself, although it’s generally not my son, but me! There always seems to be a patient to treat or a project to do that’s more important than getting my back treated. So after my first spondylolisthesis treatment earlier this year, I should have another in the spring, but that never happened. However, I did get one at the beginning of June. It’s been a bit of a minor miracle for me, as my lateral x-ray view showed no spondylolisthesis. Meaning my L5 was no longer forward on my sacrum (at least lying face down).
After feeling pretty good for a few months after the first treatment and actually returning to a little Crossfit, my inability to get my butt back on the table for a second treatment had caused me to regress back to where I began. Hence this past 1-2 months I have had a harder time keeping up on our Colorado hikes. My legs just felt heaving and my thighs, knees, and feet ached. I literally felt like my lower half of the body was 80.
Yesterday, I was walking our dogs in the mountains and I needed to run from point A to B to keep one dog from blocking the path of a mountain biker. I not only did it, which would have been all but impossible just last month, but I actually had some pep in my step. I have also noticed that my legs no longer feel heavy or ache. Getting up from a chair now feels normal, rather than a 5-20 second period where I needed to push myself to straighten and get my achy legs to work.
What We Do is Important
So what are my options? I could have gotten epidural steroid injections, but that’s just a sugar high as discussed. In addition, the high dose steroids would have been eating away at my tissues. I could have gotten a lumbar fusion way back when, but right about now my SI joints or L4-L5 would be wearing out because of the adjacent segment disease (ASD), meaning another surgery. See my video below for more on ASD:
However, after seeing patient after patient saved from surgeries due to procedures like these and then experiencing my own recovery, all I could think about yesterday after being able to get that dog out of the way because I could sprint again, was that what we do is important!
The upshot? At the end of the day, I am so glad to be able to be normal again. I could feel my body grinding to a halt because my nerves were getting beat up. Just the little things of being able to get up from a chair and not having to hide the fact that I was like an 80-year-old is a big deal. Being able to run to get my massive wolf-dog out of the path of a biker is also a big deal. Hiking without aching feet is huge. So I now know first hand what my patients have been telling me about all of these years. What we do is important…