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So I Finally Got A Straight Answer On Why Surgery Is Perhaps Not For Me...

caitycccaityc Posts: 268
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
Recently I posted I was inoperable, and the surgeon I delt with was, shall we say, not too pleasant. I never really got the true reason. So today I saw a pain management specialist (which by the way is good friends with the surgeon, but has a much better bed side manor :)), and he explained things a little more. He said that surgeons (especially in AZ since malpractice is a HUGE issue) will not operate just to relieve pain. There must be something really wrong. In my case, I have DDD with minor nerve root compression. I do not have a slipped vertebrae or spinal stenosis, or anything like that. I asked him why then was I in so much pain? He said because the disks themselves had little pain receptors, and that radiates the pain throughout my back. And the nerve root compression, although mild, is causing the sciatica. He said that the risk of injury is so high with a fusion (bladder/bowel issues, paralysis, etc.) that surgeons will not operate to fix pain alone. I guess that does make sense. However, he does want to try another epidural, and if that does not work, he wants me to get yet another surgical opinion. He did agree with me that the pain is warranted (I know it is, but it helps to have the validation that someone understands how painful it is), and that we should try to do what we can do to make it better. There is also the issue of fusing my L5 S1, which then will put pressure on the rest of my lumbar area which is also showing signs of degeneration. :(

He also recommended a procedure where they inject the disk directly. He said this is a very painful procedure, but could provide me up to a year of pain free living. Don't know how I feel about that though. :) Have any of you had that done? If so, what was it like?

Any way, I am just living day by day with this, and I hope the epidural does provide some relief. We will see!!!

Thanks everyone!



  • So, you aren't really "inoperable" but surgeons where you live are not willing to do the surgery. That's very interesting because, in reality, almost all back surgeries are done for pain relief. The majority of back surgeries are considered "elective." Most of us who can't walk due to pain do not think of it as elective surgery! Most of us would consider the ability to walk to be a necessity...but that's not how it is defined in the wonderful world of insurance.

    In most cases, people who have discectomies, laminectomies and fusions do so because they are in pain and have been told having surgery is their best chance at a more pain-free life. These surgeries are not done for life-saving purposes such as an appendectomy or various heart surgeries would be. And, in reality many people who cannot walk get along...so there is no reason to conclude that back surgery is necessary.

    Also, I think many fusions are performed strictly for pain relief. Even though I had spondylolisthesis, my fusion was performed for pain relief. Surgeons even tell their patients there is no reason to rush into surgery. You'll know when the time is right. (translation: when the pain is so bad you can't stand it, or pain affects your lifestyle so much that you cannot perform any or most of your activities....)

    Hmmm....I'm just "thinking out loud." What the PM guy said to you is very interesting. I wonder how many spinal specialists run their practices based on those principles??

    I'm glad you found a doctor who could explain the reasoning to you and who is willing to try some alternatives for you. I hope the injection will provide some pain relief.

    Please let us know how it turns out!!

    xx Gwennie
  • Hiya Caity >:D< , I feel for you, i really do :S . I am so sorry that you have so much pain, i can relate to that completely :''( . Could you get a second opinion? :? What medication do you take? :? The pain relief injections, was it the facet joint injections that they were talking about? :/ I wasnt happy with the surgeon that operated on me ~X( , so i actually went to a different hospital, its an orthopedic hospital, and they are so nice there :O , and work much different to our regular hopitals, plus they are updated on constantly :? , they also specilise on different parts of the back, so for lumbar issues, you see a lumbar specialist :D . I hope this can open up different avenues for you O:) . Keep me updated :) , and message me any time you need to rant ~X( , as we all need that from time to time >:D< .

    Angie :H
  • :* Gwennie, that's what I always thought too. It hurts, lets fix it. Apparently not in AZ. :/ They are a lot more apprehensive here. But, at least I finally had it explained to me.

    Angie, I don't think he was talking about a facet joint injection. He said they go right in to the disk itself. Ouch! :SS He said a lot of insurance companies don't approve it, so it's not done too often, but it really can help.

    I feel like such a whiner when I come on here and hear everything that you all are going through. I am always a level 3 or 4 in pain, which is not bad. It's only when I try to really do ANYTHING that triggers my pain (grocery shopping, cooking, cleaning, etc.). If I take it easy, I'm relatively comfortable. I know there are so many people on this board that are in constant pain. So maybe I shouldn't have surgery. I don't have any real quality of life, but fortunately have a supporting family. I just have to accept that I may never dance again, or go bowling or miniature golfing with my kids, or grocery shop unassisted, or go to a concert, or ride a roller coaster, or walk around a mall, the list goes on. =((

    Again, thank you all so much! I really appreciate your input. I'm so glad I found this board. :)

    >:D< >:D< >:D<

  • If he is talking about injecting something directly into the disc for relief that is called prolotherapy. My doc discussed it once; but says it's not really "mainstream" pain management yet.Fingers crossed your epidural will help.
  • I hope that you dont give up your hope on getting something done to relieve your pain. I went to many 7-8 Drs before I found one that could tell me what was wrong and what to do. I couldnt stand to think that I would have to live my life on narcotics. I know that my problem is probably different than yours, but did they ever do a discogrram to see if you had any tears like I did? I would like to help you with any answers I can to what I did. I just want you to know that I am there for you and hope that you can get something done to help you, as I have. PM me if you wish.
  • They have never done a discogram. I guess because it's obvious on my MRI's which level is effected. I don't know.... You know, it's funny... Almost 2 years ago I had a surgeon that without a doubt knew I needed a fusion and was ready to perform it. The only thing he asked me to do was lose 50 pounds. I couldn't do it. :( He preferred the anterior approach and wanted me to lose some weight first. Not much to ask. When I wasn't losing the weight, he agreed to go in from the back. Then our insurance changed, and I could no longer see him. If I had just done what I was told then, I would have had my surgery, and hopefully been much better. I kick myself for that all the time. However, who knows, maybe it went down that way for a reason. I am a firm believer in everything happens for a reason. I just have yet to discover what that reason is. :?

    Again, thank you so much! I may take you up on that PM offer. :)
  • can show tears, which even very small can cause major pain, and only surgery will fix. That is why I asked. I dont understand why they wont do surgery. Can you find another Dr possibly at a spine institute? I am crossing my fingers. I just know a torn disc will just keep leaking damaging fluid into muscles and that is why I had fusion. Let me know how it turns out for ya. I will be in your corner for ya.
  • don't work, then he is referring me to another surgeon. Nobody has mentioned a discogram. Maybe the type of pain I am having is not indicative of a tear? I don't know... I just wonder if there will ever be an end to this. I would just like an answer either way. I'm wondering since the general consensus is no surgery, then maybe I shouldn't have it. Maybe there is a reason it's not happening. Maybe I would be worse off if I had surgery. ~X( It's so frustrating!
    If I knew for sure that surgery wouldn't help me, then I could begin to try to accept that this is it for the rest of my life. The little hope I am clinging on to is kind of doing more harm than good. Does that make sense?

    Robin, can you say that you feel better now that you've had surgery? Are you glad you did it? I know there are many people on here that are no better than they were before surgery. I know there are plenty that are better, but what category would I be in? You know what I mean? :S


  • I dont know if it has made me feel better or worse, I know that I can walk straighter than before. Pain wise, right now, not any better. But I am hoping this improves with the hardware out as the test did make it better.
    It is so hard not knowing. I went through it for 2 1/2 years before they found the torn discs. I know how you feel. I just knew that until I was confident that there was nothing else to do, that I was not going to give up. I didnt and dont want to live out my life like this. It sucks big time.
    I hope you will find some answers to your situation. It is something that although you must do alone, please know that I am hoping and praying for some answers for you. PM me anythime. Have surgery tommorow morning and so I will be out of it for tomm. But will be back on Sat. :SS
  • tomorrow. Please keep me updated on how you are doing. You will be in my prayers.

  • Good luck tomorrow. I hope you will post all about the surgery to remove hardware. It is hard to find information about it online. We'll all miss you while you're in the hospital!

    Caity ~ I feel for you. It is one thing to be able to make your own decision whether you have surgery, or not. But to have the option taken away would really bother me.

    I'm sure you could find someone to operate on you, but maybe you wouldn't want to go to that surgeon!! Could you go to a nearby state?
  • He said that surgeons (especially in AZ since malpractice is a HUGE issue) will not operate just to relieve pain. There must be something really wrong.
    I have been told the same thing. A good surgeon will tell you that there are no guarantees that you will get pain relief from the surgery (at least in most cases). That is why they don't operate solely for pain relief. To justify a spine surgery, most surgeons will only operate if there is a mechanical problem to be fixed or to decompress a nerve root or your cord. The optimal result would be that by fixing the problem it will relieve your pain, but this isn't always the case, as many of us know. DDD is not really an operable condition, as there really isn't anything they can do to stop it. But if you have stenosis, a surgeon can open up the canal or the foramen. If a disc bulge is not touching your cord or nerve roots, chances are that surgery won't fix your pain, because there is nothing to decompress. But if the bulge is penetrating your cord, they will operate to relieve the pressure on the cord. I hope this makes sense, but I've probably managed to confuse ya'll as much as I've confused myself, lol.

    But then again, I'm not a medical professional so I could be wrong in all of this.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • You are absolutley right, and your explanation makes perfect sense. That is essentially what he told me, and I'm glad I'm not the only one who has heard of this. :)

    I don't have stenosis, or vertabrael stip, just minor nerve root compression. I had been told my 2 doctors that my L5 S1 is totally collapsed, but was then told by the pain management specialist that there is still "some" disk there. Not much, but there is still some there.

    Thank you so much for your response. It makes me feel a lot better to know you've been told the same thing. #:S

  • It seems to me that your doctors are being brutally honest...and courageous. Fusions sold as effective pain relief is one of the most abusive derelictions of duty committed by the medical community. The fact of the matter is that there are no statistically valid studies confirming that fusions can be even nominally correlated, let alone causally, to pain relief. In fact, a good number of people wind up in worse pain after having fusions.

    Make your own judgment, but there is a reason that the medical community doesn't apply technology to studying long term fusion outcomes. How many of us whom have had fusions have been asked to participate in long terms statistical studies? I doubt such programs even exist. I do know that fusions are a very lucrative business, conducted with greater proportional frequency than in many other places in the world. Connect the dots.

    Fusions are proven in providing spinal stabilization, reducing and helping mitigate further damage, numbness, and paralysis. This is definitive. Unfortunately, in terms of pain relief, it is a gamble of the dice, as the technology still is fairly invasive and can cause permanent damage and a worsening of pain...or even a good outcome. Again, it is a gamble.

    In summary, I wouldn't dismiss what your doctors said.

    Cheers, Mate
  • I actually tend to agree with you. I am a firm believer that things happen for a reason, hence, no fusion thus far. I've often wondered if I would actually get any pain relief from a fusion, and have been told there is a possibility it will not work. It's just discouraging that there is no real "cure" so to speak for my pain. Again, I am very fortunate to have a VERY supportive family. But I don't work, I am the "Mom", and I feel bad that things are the way the are, but oh well. :(

    Again, thank you for explaining it to me the way you did. It just helps to make things clearer as to why I've been having the "luck" so to speak on finding a surgeon.

  • :? Do you have DDD??? >:D<

    Angie xx :H
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