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Bad appointment with Surgeon (UK) Discgram & alif/plif questions

patriotspykeppatriotspyke Posts: 18
edited 06/11/2012 - 8:48 AM in Back Surgery and Neck Surgery
Went to see my surgeon today. Ive already had a C5/6 disc replacement and that all went well around 6 months ago. Ive also had a bad back for over 1 year. An MRI showed a herniated disc at L5/S1 and 4 other as desiccated. A few weeks ago I had nerve root blocks, they did not work. Now yesterday I saw a nice surgeon and he said from his view I needed a fusion as either plif or alif. He called my actual surgeon in. He was so rude, he said there was no way the root block would not work, I said they made me worse and actually paralised my leg for 18 hrs, also it gave me bad cramps and pain. He then said to the other surgeon he could not tell where the pain was coming from and it was important that he knew if it was leg or back. I said it is back but when the back is bad it goes into the leg as nerve pain and also cramp etc and I could not walk that far. In a nut shell they need to know where is from. He stropped out the room to his next patient and I heard him say well this is the worst back ive seen today, intimating my issue was little! Nice…. Anyway the nice surgeon said he thought it was an issue and the herniated disc was a problem but may not be the root cause. So they are now going to do a Discogram to find the root cause of the problem. They said if I get really bad pain then it confirms that I will need ALIF or PLIF.

Getting really tired of all the injections and going in circles with this but understand why they have to. Can anyone explain the significance of the discogram, and when it produces huge pain why that would mean surgery (alif/plif) is needed. And if no pain happens what that means? Either way I still have a herniated disc so just confused as to what the 2 different results from having no pain and having pain from the discogram mean?



  • Hi patriot,

    I haven't had a discogram but my understanding is that the point is to determine if a disc is a pain generator. If you have significant pain in a particular disc, that would possibly justify removing it. Make sense?

    As for your nerve root block, I've had one of those, plus other steroid injections, and the last injection I had confirmed the specific nerve root which was giving me pain. The injection is diagnostic for the surgeon--if you get immediate relief, then the pain comes back slowly over the course of a few days, then BINGO! they know exactly where your problem is coming from. If the ESI doesn't do anything, or as in your case, gives mixed results, it is difficult for the surgeon to interpret the results. This was all news to me until my surgeon's PA explained it to me prior to my surgery. I'd had an ESI and when I saw him a week later I was saying that I thought I'd failed the test because it helped initially but my pain came back. He said, no, that's exactly what we were looking for.

    I hope this helps a bit. I'm glad you've found a surgeon who treats you with respect. It's SO important to have a good relationship with your doctor. I hope the discogram is diagnostic of a pain generator disc and then you can talk about having it removed, and how. Let us know how it goes for you, and in the meantime try to relax and realize that this journey you've been on may be close to being over. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • cheers, its just so anoying. I just want this ended.

    Straker, you have PM also :)
  • Unfortunately, not all problems can be repaired by surgery. So proving that the disk causes the problem is a very important step- if not, they could do surgery and you would be no better, or even worse!

    I would choose the careful surgeon.

    Also, as for whether saying that the previous patient was the worst he would say minimized your pain- it's pretty common for people with back problems to come off of very healthy lives. I do get a sense that a lot of people with "fresh" injuries do not have a lot of perspective of where their problems fit in with others. Serious problems are traumas, instabilities, cancers, infections etc that threaten the spinal cord immediately and could leave a person paralyzed or at the very least with severe nerve damage.

    Is it possible that the person before you had some serious disorder of the spine, and that comment had nothing at all to do with you?

    I can tell you that there are a lot of people, even here on SH, who would describe our spine problems by a lot of words, but annoying would not be up there. Devistating, debilitating, disheartening... those might be more like it.
  • it was shouted out, even the other surgeon said "sorry about that"

    You had to be there it was very inappropriate. I was more upset as he had already done my ADR in my neck so not like i am a stranger to him! he is technically one of the best surgeons in the uk, just no manners!
  • Unless you were the first patient that surgeon saw I don't think it was a comparison of you to that next patient. Also you don't know what was wrong with the person in the next room so maybe even if it was just the two of you that person may have been far worse.

    Be that as it may, why were you seeing a different surgeon in the same office? It is a little rude to get a second opinion from the same place. Almost like saying "hey doc I don't believe you so I'll ask your younger partner".

  • Ok i was booked in to see my normal surgeon. I walked in to be greeted by a different surgeon. Why I have no idea, welcome to the UK. They palm reviews off on junior surgeons to reduce their list. I was one of the last they saw in the day at 5pm. My surgeon does not talk to you much more to other doctors and surgeons, its like your not there. My wife was fumming. But as I said he is technically great which is what really counts. Yes others may be worse but in all honesty that is not my concern or the surgeons. I have my issues and he should deal with them and me. Thank god the nice surgon was there to help fight my case! He was just as rude before my ADR surgery with belitteling comments. Not the 1st time ive had to deal with his bad bed side manner!
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