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Negative Discogram - Surgery

CoyoteCCoyote Posts: 120
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
Hi I'm a 45 year old female. Always very active, loved working, being busy. I had very manageable back pain for 20 years, but then I injured my back 3 years ago on a roller coaster and never recovered. Stopped work 2 1/2 years ago. Had all conservative treatments, still unable to manage pain. Pain is mostly in the back - some aching in buttock, leg, foot. Pain constant at around 4 - but activity increases it to 6 - 7 within a couple of hours, unless I rest. I also have acute episodes (pain 10+++) that take about a month to recover from.

MRI shows bulge/small herniation at L4/L5 - the disc is clearly dark, has lost height. All other discs look good. Take Lyrica, Oxycodone, Ibuprofin - make me feel good, but useless/stupid. I did have one epidural steroid injection at L4-L5 which worked wonderfully for two weeks - but the second steroid injection caused EXTREME menstrual pain, plus non-stop period for 8 weeks.

Decided to investigate surgery - had a Discogram last June - but it was NEGATIVE!!! One surgeon said - "No surgery" and kicked me back to pain management. Second surgeon says - "I'll operate, but it's up to you." I've seen that sometimes they can give you too much medication during a discogram (they gave me tons - but I remember the discogram very clearly - NONE of my discs FELT A THING!)

Had facet injections November 2009 (if the pain's not discogenic, then maybe it's the facet joints, they said), which were kind of nice, but wore off quickly - more trouble than they were worth - and didn't cover 100% of the pain.

I feel very strongly this one spot in my spine where I feel the pain emanates from, but I just can't understand why it didn't show up in the discogram.

Surgery seems to be my only option left to reduce the pain, but - THE DISCOGRAM SHOWED NO PAIN CONCORDANT WITH MY REGULAR PAIN.

Any advice? I'm so grateful this forum is here, and all the kind people offering advice/help/comfort. Thanks.



  • but I was under the impression that a negative discogram means the pain isn't coming from the disc, bearing in mind that at least 40% of the population has asymptomatic bulges.
    Having said that I think it would be wise to get more opinions from more surgeons, also keep trying all non-surgical options as once you have had a fusion there is no going back and it has been known to make things worse.
    Have a look around the forums.
    I'm sure others wiser than myself can make more suggestions.
    Welcome to SH by the way.
  • Welcome to Spine-Health. You'll find a lot of information throughout the site with videos and articles and the forums have great and supportive members.

    What kind of pain are you having? I had pain in my lower back, in my hips and radiating down the back of both of my legs to my knees. I had a hard time standing or walking too long and sitting relieved the pain. I could bend forward at the waist just fine, but not backwards.

    I had a disc bulge at L4/5, but the symptoms I had came from facet joint problems and stenosis at the L4/5 level. There are a lot of things that can cause pain, not just the disc. That's why I asked about your symptoms - you may be having the same problem I was having.

    I would suggest that you find a fellowship-trained spine surgeon, either neuro or ortho, but someone who only works on the spine. I get my treatment from a spine center that has onsite physios, surgeons and PT. Having everything all in one place is very nice.

    Take care and please let us know a little more about your symptoms, etc.

  • Thanks for your suggestions - I think you're right, I need to see another surgeon.

    I guess I'm curious about other people's experience with discograms. The second surgeon I saw said he wouldn't have even ordered a discogram, he just would have gone ahead and done surgery, based on my symptoms and the MRI. Some doctors don't worry about having a discogram done and other doctors insist on having them done.
  • Every doctor and surgeon is different and that's why second, third or more opinions are so important. It's also extremely important to have 100% confidence in your surgeon and/or doctor. You need to find someone you trust completely.

    What's really odd but true is that you can take your MRI and MRI report to 10 different doctors and get 10 different opinions. I guess that's why I feel so strongly about finding a spine specialist. They're very aware of how complex the spine and its radiating symptoms are that, if they're good, they will usually be able to narrow down the problems and eventually find the treatment that's right for you.

    You might want to check out the Injections area. That's the place where members talk about discograms. You might find more info there that you're looking for.

  • I'm sure you realize this, but a discogram will not do anything for you if you are having facet or stenosis problems. It's strictly to find disc issues. Other tests will be needed if your surgeon suspects something other than a disc problem.
  • Our pain sounds kind of similar, except I only get an ache down one leg to my foot, and the main pain is in my back. Also - only lying down relieves my pain; and then I need to move around a certain amount so I don't get stiff. I spend a lot of the day lying around. I always try to be as active as possible, but if I push it too far, I pay - I won't be able to leave my home for 2-3 days for the pain.

    The first surgeon I saw was a neurologist - working in a spine center, doing only spine work, big hospital. The second is an orthopedic surgeon (the one who would never have ordered a discogram) - same thing - spine center, spine work, big hospital.

    I had 3 sets of facet joint injections, but they didn't resolve all the pain. So it's part facet joint but not all. They say I don't have stenosis.

    I'm really seeking surgery in the hope that at least I can drop the medications - I'll accept a very limited, quiet, chronic pain life - I just don't want to live it (so) medicated.

    Thanks for your comments

  • I would see another surgeon, I wouldn't want a doctor to operate on me that didn't do all the tests. My doctor didn't do a discogram because I already had one done 2 years before and was negative, and my disk was so bad on the MRI, he told me I didn't need it done. He was sure from that. You don't want to have a surgeon thats going to operate on you for the heck of it. I would try a ortho or a neuro surgeon, if you have already tried both kinds of surgeons. It can't hurt, you only have one back, you want to make sure you have the best care and the best surgeon.

    Good Luck. ;)
  • Cath - thanks so much for all your ideas/suggestions. I think that's where I've been so confused, and now you've given me a strategy for dealing with getting all these different opinions - you just keep going until you find someone you trust, and gotten the answers you want. I'm not there yet.

    I will check out the injections section. Thanks.
  • The second doctor was good too - he said he would have done it just based on my MRI - because that clearly showed damage.

    You said your discogram was negative too? You didn't experience pain? But your MRI showed that your disc was torn up? Is that right?

    I see you just had surgery in February! I hope it went well - how are you doing?
  • My first time around yes, the disk was fine on the discogram but I had problems that showed up 2 years later on the MRI, except I could feel it at the time 2 years before. :S :(

    I'm healing from it all, slowly but surely. Its a process that takes a while. ;) 4 weeks as of yesterday.

    I sent you a PM
  • SpineAZSpineAZ WiscPosts: 1,084
    From what I've heard from the 2 spinal surgeon's in the practice I go to - is that the real use of Discogram's is highly debated. Some people come out with negative findings yet during surgery tremendous disc problems are found.

    So perhaps another opinion with another Orthopedic Spine Surgeon and/or Neurosurgone.

    I recently had surgery and my OSS has now said that he's glad he did surgery and if he'd relied only on the discogram he might not have been as eager to get in there. My problem was more spondylolisthesis relate3d (as was my 1993 surgery).
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • If your discogram was negative thats a positive sighn that you might be able to avoid major surgery as fusion or artificial disc replacement hopefully.When they do discogram they put pressure on that disc and as long as its not leaking, like mine was, and its still holding up with enough space to keep nerves from being traped thats a positive result for you i would think.My problem was also l4l5 after suffering for 18 years finaly had discogram confirm it was leaking and having major surgery=artificial disc replacememnt, then fusing it in there 2 years later, its been down hill ever sense.If they can locate the area of the nerve thats causing your issue, i would only allow them to do maybe laminoctomy to open up the nerve space or something simular for its much less invasive surgery. With any major surgery such as artificial disc replacememnt or fusion, it changes the natural movement in your spine and in most cases causes a whole new set of problems al the way around.Wish you the best and hope they can locate the direct cause of your pain and find that nerve and free it up with the least invasive procedure posible,which ever that might be.Because major spine surgery can be a life changing experiance as i found out the hard way and would not wish it on anyone.Nobody wants to end up on there failed back surgery victim list as many of us here have. Good luck. Sincerely Yours; Alexhurting
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Thanks so much for your sound advice - I'll keep searching. I am so sorry for your pain. Thank you for replying to my thread.
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