Lytic spondylolisthesis with bilateral paraesthesia

Hi folks, my best wishes to you all.

I'd like to provide a "brief", or outline, of my circumstances, and ask for advice or general opinions, if I may?

15 years ago, I was involved in a violent fracas with a custody (I'm a police officer, BTW) in the rear of a Police vehicle. He was off his face on drugs, wrenched one wrist free of the handcuffs and managed to get the door open as we were doing a good 30-40 mph. I was belted in alongside him and took hold of the free cuff to prevent him killing himself and was wrenched quite badly to the right (I'm tall and my legs were braced against & under the rear of the front seat). Upon the vehicle stopping, he threw himself out (literally) braced a leg against the car and wrenched himself free of me, twisting me violently three times before I gave up and let go. (I pursued & subdued him and carried on my shift).

Within 36 hours, my back/hip went out badly while I was bending over. This saw me visit an osteopath friend of my father's, who quickly sorted me out. It twinged on a fairly regular basis after that, and I'd see the osteopath 2 to 3 times a year for "maintenance".

A year later (almost to the day), I was in a police vehicle which rolled on black ice, compressing me upside down in my seat, until my colleague, who had got out her uncompressed side) told me fuel was leaking and there were sparks! I don't remember getting out, I just did! I was taken to the local health centre where my neck was x-rayed and I was put in a collar for 3 days with whiplash.

Things got a bit worse when we adopted the body armour. Version 1, fully laden, just killed my back, especially after 4-6 hours walking a foot patrol. Eventually, I bought a wide leather duty belt, with back plate and used this for lumbar support, and it helped for a time. But, 7 years after the road accident, I ended up self-referring to Occupational Health, after an application for lightweight armour was rejected by an unsympathetic boss. They found a spondylolisthesis of L5, and stated that the vest, which they weighed at 26lbs, was compressing my spine further and aggravated the condition. This was FURTHER aggravated by a specialist post I had, swinging the battering ram at locked doors, often several times weekly.

I underwent physio, built up my core and got back to health (so I thought) and things got better still when I became a Detective (no armour to carry!), but I still opened the locked doors on almost every forced entry in my area for the next 5 years or so.
Around 3 years ago, what I thought was my left SI started playing up and the private physio I had been seeing told me I needed referred. I saw my GP and then a consultant, who told me there was nothing wrong, without even examining me or looking at me, other than having me lift my left leg while standing. I did not accept his word and pushed things politely, where he referred me
for an X-ray taken from the front. Again, he told me there was nothing wrong, so I asked for an MRI, as I knew HE was wrong. This came back with the return of the now worsened spondylolisthesis.

I was sent for branch nerve blocks while they considered denervation, but two days before, I was called on to open a locked door in an emergency situation. (I had withdrawn from this field at the time, but no one else was available!) The door was solid & took 13 GOOD strikes to burst and afterwards I suffered sharp pain in my back & hip and burning in the ball of my left foot, just at the base of my great toe. This lasted up to the day of the branch blocks, but had subsided and I was advised by a GP that I had likely torn or strained a muscle or ligament.

However, as the branch blocks wore off, I noted strong burning and tingling in both feet. This got stronger as time went on and in days, it was spreading up my calfs, up the outer surface of both thighs, and there was numbness also at times.

Since then, the paraesthesia has worsened, becoming really painful and the sensation of crushing pressure and constant pain at the base of my spine has got worse. I have been signed off work for 14 months now, and have been prescribed Gabapentin, Nortriptyline, Tramadol, Diclofenac, Paracetamol and Omeprazole daily, in varying doses and regularity.

In November 2010, I received a caudal epidural, which worked for 2 weeks, but the paraesthesia came back, and spread to my hands on an intermittent daily basis. I also have numb patches all over my body and need a cane to keep my balance most days.

I was on a waiting list for transforaminal epidurals above and below the injury site, but after a year of cancellation after cancellation, I was seen at a different hospital on an emergency basis, when I brought the matter to attention of my GP.

I received the injections last week and have also been privately referred (by work) to a spinal specialist, for a consultation last October. He basically said I have a lytic spondylolisthesis and - given that I have deteriorated rather than showing any improvement - my choices are :-
A) continued injections - with only temporary relief provided, or
B) pedicle screw fixation from S1 to L4

He wants a positional MRI scan done, as the last MRI was 13 months ago and was supine (where my symptoms alleviate greatly). However, work are starting to balk at the "cost implications".

I practiced Tai Chi and Yoga every day up to simply being unable to do so, following the branch blocks. I now struggle to put my socks on, where before, for as long as I can remeber, I have been able to place my palms on the floor in front of my feet while standing and place my chin on my knees with straight legs. The simplest act can cause extreme pain, like pulses of electricity or heat. In addition, I fumble and drop objects regularly. And sometimes, when I stand afer sitting for a spell, I HAVE to hurry to the bathroom to urinate, as I am on the verge of losing control with no prior warning! Fun...NOT!

Lying down or sitting with my legs raised or extended all alleviate my symptoms somewhat, but I always suffer numbness as a result. The pains, tingling, burning and "vibrating" or buzzing feelings all seem to radiate from my lower back down my legs, but also cause spasming of my entire back muscles on a fairly regular basis.

While my life is on hold and decisions are made as to my future, is there anything any of you can recommend or advise, based on your experiences? Anything at all that I can be doing?

Many thanks (and apologies!) if you have managed to struggle through this. I am now starting to genuinely fear for my career/vocation and need to provide for my family.

Lastly, I am 44 years, 6'2", and 14 stones 4lbs.

I sincerely hope someone can help or advise me on what to do or how I can proceed and help myself.

Best wishes to you all.