Hello again, thanks for the info on surgical methods. Is there a book directed toward the advanced lay audience (with diagrams) focused on spinal surgery? I do well when I have images to go with good explanations.
I am working with Stephen Ritland, MD, in Flagstaff, AZ. He is the "go to" surgeon for minimally invasive spinal surgery. His patient pool includes numerous individual from my town (Prescott) and a number of smaller towns in northern AZ who do not have access to neurosurgical care. His patient pool also includes physicians (including neurosurgeons and other professionals as well as "regular" people) from Phoenix and from the rest of the state, We have a new top level NS in Prescott now but the referrals are still to Ritland--(Flag is about aXXXXXfrom Prescott.) My pain doc sends his staff to Ritland. I doubt there would be such unanimity if Ritland were not highly regarded.
He is currently writing a text for professionals/med students on minimally invasive spinal surgeries. The population in AZ is spread across quite a sparse, broad area and generally when you ask for a recommendation for a neurosurgeon, Steve Ritland's name comes up. He is selective about which patients he choses and conservative about whether surgery is called for in a given case. He talks in a wave of jargon for the most part so I'm seeking a translator. That's why I included the text of my most recent MRI report and a fairly detailed history.
My interpretation of what Ritland proposes is a fusion technique using screws and artificial bone. But I need other user friendly sources to complete my understanding.
He will push back the muscles in the area, saw off the ends of the vertebrae at L4 and L5 (to create some attachment hinge (?)) remove cartilage in the central canal and will form a "window" using the bone graft and screws" opening up the area at L4/L5. The muscle then is repositioned over the graft. Whereas now there is nothing holding those two joints apart (my pain varies from the R lumbar (the original injury side) to the gluts and legs on that side AND is mirrored on the L lumbar area, gluts and legs, I have no spinal stability in that area. I can't predict which nerve in which location will be painful on any given day. I know there will be pain and that it will range from some ability to walk or do minimal household things to a complete disability with shooting pain over most of the area. All HH tasks are my husband's burden which is not fair. I understand Dilaudid 4 mg is strong but it has no effect on the pain. The rest of my spine is normal. I understand this technique reduces pain without creating complete immobility at the joint; thus there is less chance for deterioration elsewhere. Also since this was due to an injury vs some other spinal problem, and I am 60, there is not a huge likelihood I'll have a recurrence before I die. Your thoughts?