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discogram - annular tears two levels

tcr1130ttcr1130 Posts: 122
edited 06/11/2012 - 8:22 AM in Lower Back Pain


i got the results of my discogram today
I have two full-thickness radial annular tears at l3-4 level and l4-5 level.

weve been treating this for the last 14 months... i started with just a central disc bulge at l3-4 14 months ago,.. and now they are saying this..., i am to the point i can hardly sit on my own spine it burns so bad,.,

i have had more epidural ,shots in the last 12 months than i think a person should have.... ( arent there long term affects of doing to many???)

what is the recommended course of treatment for annular tears.. because my pain management doctor has been treating me the last 12 months ,. when i met with neurosurgeon in the office today.. he said he wouldnt do consider anything on a one time visit... im like ive been here every 3 weeks for the last 14 months..... ugh.... where does this end up going... i have failed physical therapy, chiro... his big suggestion was aqua therapy...., how does that heal the tear....., i had a l2 bilateral tsf today ( more epidurals) suppossedly could help mask the pain... ,but they havent to date.... help!!????
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Comments

  • I had endoscopic microdiscectomy and laser surgery to repair. I know exactly what your pain is like and I am so sorry for you. I know that lots of surgeons are hesitant to treat for some reason that I do not understand because it is very painful! Good luck and please keep us posted.
  • before I had surgery the rhizotomy (nerve burn) helped alot. I wish that I would of stuck with that. and yes there can be long term effects of steroid injections. I think that you are only supposed to get 3 or 4 a year.
  • If you are talking about the epidurals with the steroids, yes, no more than 4 per year. I had horrible side effects from the only 4 that I ever had which was over 7 years ago and I'm only getting back to normal in the last year. Some issues will remain forever like my arms. My body hair had completely fallen out 7 times over the first 4 years and would grow back in again. Every time it would grow in it would leave hairs trapped under the skin. Now I have little bumps on my arms that make them feel rough. I hate it! And that is just one of many of the awful side effects that I had. I would never recommend these to anybody, especially a woman of childbearing years.
  • i have had no less than 20-25 steroid shots.. and he has probably tried burning 7 nerves... besides the "saddle" burning pain i get when i sit , standing shoots down the leg.. my bladder from time to time just stops working last two months.... longest i have gone without actually being able to go was 24 hours,, i do notice after each round of shots my bladder shuts down for a while.. where i may try force going 2 times a day just because i know i should be..... what are the long term side effects of steroid shots... and do i find out if some of the bladder problems arent from this overload of steroid shots...

    the only thing i read on the internet is idet is the treatment option for annular tears..... the only thing my doctor mentioned yesterday was double fusion but because my l5-s1 is fused on the right ( i guess since birth) that it would be triple fusion.... but then like i said.,.. im starting all over with this doctor and he is in the same practice so he wants me to do aquatherapy... seriously after 14 months and this is getting really painful last two months and my bladder shutting down.... this sounds like a bigger problem than they are treating me for.....i ended up having to have a c5-6 fusion 2 years ago for almost the same problem - they wait so long the nerve damage becomes so bad the only option is fusion.... is this all that insurance covers.. im at a lost at how long a patient has to suffer before doctors will do something

    as im reading thru more of the boards... is microdiscectomy is a possible way of treating this problem!?
  • is how my annular tare was repaired. Actually removed. I had a radical endoscopic microD but I do know that lots of surgeons will not do this for an annular tare. I met two people on this board in my state that ended up going to my doc because their surgeon offered them no relief for annular tare. I also know that steroids can effect your organs. You really should consider getting a couple of more opinions. Most docs really want to make sure that all of the noninvasive procedures have been exhausted before considering surgery which is a good thing. You do not want surgery unless it is your last resort. Good luck and please keep us posted on your progress.
  • :H

    I have been reading on the microdiscectomy.....

    i have been bothered by the fact.... that one i have had so many of these shots and the last two months my kidneys arent working quite like they did once... going 24 hours without peeing scared me to death.... and everytime i get these shots they dont work for x amount of days!... and im wondering if its from the protrusion or the steroids......

    and the only talk i have heard from the doctor is that IF
    i was a workers comp case he could do a minimally invasive procedure - sounded like he burns out the area where the disc is bulging... but since im not workers comp the only thing they said was a double fusion....... which is such an extreme to not have any options in the middle of that... and then they said because of the vestigial disc i have l5-s1 that area couldnt hold the double fusion above it... so more than likely they would have to do three levels.... but lets do aqua therapy........ i wish doctors could feel the pain you feel ... they might respond faster..... a numb pelvis area... and pain in right thigh and right leg pendng how i stand on it.... i have failed 6 months of physical therapy... and no less than 20-30 steroid shots and 7 nerves burned in the last 12 months.!!!!!

    where do i go from here!!???????
  • i saw the neurosurgeon today....my head is spinning from all this..... i was fitted for a brace today, have to wear that ... he is going to try and get me approved for an Idet procedure....... He is saying i need a double fusion..... possibly a triple ( because of a l5-s1 partially sacrilized/vestigial disc) ) i will find out in two weeks if i have been approved for the IDET procedure... he says that is only about 50% successful - but seems so worth trying before a double fusion -

    would like anyones advice/input during this time.....

    thank you!
  • is it a sacrallumbar brace? I have one and it works wonders! I really hesitate to state my opinion on what you have asked because it is only my opinion but here goes. I would not touch a fusion surgery unless I was unable to move at all. The odds with that surgery are not so good either and can actually increase your pain. Although there are some people that have had great success with fusion. I am getting by with my back brace, rhizotomy's and meds for now. I am also sacrilized at L5 and my doc says that it most likely makes that area stronger. If you really have to consider surgery, get as many opinions as possible and check the surgeon out as well as you can before hand. Good luck to you and please keep us posted.
  • Morning

    The brace he gave me is the same one he said i or anyone would wear after fusion surgery., he wants me to try this for two weeks and see if it helps with the instability at the l4-5 level.....my head could only wrap around part of this as he was telling me this yesterday... i thought id be going in to fight him just to get pain meds... and i was listening to all this....

    i just dont understand where and why did it come to this again... ive been doing this 14 months - i fought to have the mri re done this summer.. telling them the pain was getting worse........ where is the imbetween stuff from steroid shots to fusion surgery..... i dont know what will happen or where this will go., for now i will try the brace .... check out the aqua therapy next week... and wait to see on this IDET procedure.....


    i appreciate your post "painintheback" opinions from people who are going thru or understand are important to me just as much as listening to the opinion of doctors... the more i have the better a choice i can make for myself...

    thank you!!
  • they have said i have to / need to have a two level posterior lumbar fusion.... to tell ya the truth i got some information from him and left needing to process this... i am scared to death... i have had a neck one level fusion... and while it didnt take care of all the problems.. i am far better after it.... just all you ever hear about are the horror stories of back surgery.... and while i think im good at hiding pain from everyone else... i dont do well with it.... i dont know what to do.. talked to my primary today ... i am the youngest patient he has that would have a two level.... scarey thing more is that they cant guarantee that i wont need one later down the road for the other levels......

    ive been a year and a half with the pain... i am to the point where i cant even move in the pool without increasing the leg pain........ thing is you get use to this pain.... i dont know if i can handle that kind of pain (surgery - ) i cant imagine how painful this is......

    just plain scared at this point
  • your dilemma. Can not tolerate the pain anymore but know that there are no guarantees that a fusion will be successful and the fact that it puts more stress at other levels means high likelihood of another fusion. You really do have a very difficult decision to make. But you are doing the right thing by gathering as much info as possible so that you will make a well informed decision. Have you had at least two opinions or more?
  • I have talked to all the doctors - had all the tests - the last spect scan/bone scan/ ct scan - showed the levels are getting far worse then they were a few months ago - im getting to where i can not sit anymore .... i meet with the neurosurgeon this week to talk about a date.... this is the same office that did my cervical fusion - but not the same doctor - i had the best neurosurgeon in this area to do my neck - part of me is scared i have his associate - but also know he wouldnt be there without this guy trusting and believing in him - i just havent had much time to get to know this doctor - and know that this is the man thats going to get me thru this!!! can not lie - just plain scared!!! about all this!
  • worse and that you're moving in the direction of surgery. Understandably your scared.

    I too have a congenital fusion at L5/S1 with ddd on the lowest 3 levels, plus annular tears on the 2 lowest levels. I'd be curious what kind of symptoms you have.

    I'm also curious what the docs are planning to do.Thanks in advance for keeping us advised.



  • well i saw the neurosurgeon today - they are now deciding if i will have a two level xlif or tlif... i guess if its the xlif i will be the first in this area to have a two level xlif - there seems to be a little buzz in the office about these doctors getting to possibly do the first two level..... but with that aside... luckily i have a doctor that is waying my best interest on which surgery needs to be done... so he is consulting with many doctors before i get the call as to which it will be........ if we do the tlif it will be dec. 29 .... (merry xmas to me, merry xmas to me : )

    as for what my pain has been like throtty - i have been doing this for a year and a half..... it started sadly by bending down to pick a weed out of my sidewalk... went down and immediately my back and leg went out... i could barely walk for weeks... the pain was horrible... sciatic mostly - i had been going to physial therapy for my neck fusion and happen to ask her if she could tell me what i could do for my back - well everything changed from that day - we immediately switched to low back ( mackenzie methods) and i continuely got worse and worse.... i tried 6 months of physical therapy - she was to the point warning me if my bladder or bowel function went or i started dragging my foot to get to hospital immediately - thats how close i think i was to that bursting...... in janauary of this year i went back to neurosurgeon and we started drug therapy and steroid shots .... over the course of probably 20+ shots and several nerve burns ( rhizotomy i guess thats called) and medial nerve branch he was able to get some of the pain out of the leg... but my low back has never come back - i have no range to arch my back - backwards... and only a little to go forward... i can not bend over... i have to bend down.. and that kills.... my back feels like im squishing it - which is how i explain it to them - it burns terrible - shots down the right leg if i move incorrectly... but it feels like my weight of my upper body is squashing my low back ( and my weight is presently 105) ... my back is best laying down - can do tiny walks .. sitting kills... absolutely kills me.......

    ive rambled... but wanted to thank everyone for there support and replies... it means alot... this will be a taxing xmas holiday - i havent told my family yet... because i dont want to stress them ( they dont deal with this stuff well ) and we have a baby coming into the family next week - so want to keep the time light and happy right now - will tell them all at a later time .....

    anyone that has had a xlif i would love to hear from... they say there is little long term info on this procedure..... not knowing if im having it cant worry about it right now... but i will post when i know which it is .....

    thank you!
  • Good luck with your surgery...
  • well they decided on a two level tlif.... will have done right after christmas.......

  • with your surgery. Probably a good idea to wait until after the holidays. I had surgery right before Christmas last year ans that was not fun. Good luck and keep us posted.
  • I hope you're surgery goes well. I'll say a prayer right now so I won't forget, that everything goes well and you will be eventually pain free. Know that all of us here are wishing you the best. That's great your surgery is so soon. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • :H I am having my 2 level posterior fusion on Thursday. Been in pain for 2 1/2 years, be glad they found your tears, it took them 2 years to find mine. I have 3 levels with tears and they are doing 2 levels, becasue the third isnt bad enough, but like you I am scared. Had Xmas with my kids and new grandaughter at Thanksgiving. Knew that I wouldnt be up to it after. Dont worry about the pain. I send my friend to my Dr after I finally found one that could find the problem. She has had problems for 4 years. She had her fusion done in Sept and is doing great. I was supposed to have mine done first, but had to appeal with Ins co twice to get it done. Anyway, the first week is worse and if you have a good dr he will conrol pain. Then after second week it just keeps getting better. Have faith in your Dr. Everything will turn out ok. Thats what I am telling myself. Prepare your house for surgery by putting everthing at wiast level that you can. Have a recliner so you can have options besides bed. I will be thinking of you, and know that you and I will be great down the road.
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