Hello, I'm new here, and have a lot of questions.
I have been having lower back pain for quite a few years now and it is getting to the point where I am not comfortable sitting, standing, or even lying down. I am taking 6-8 Lortab (hydrocodone) 10-500 per day, 200 mg. Tramadol (1 per day) extended release, and Xanax (50 mg) 1 to 2 at night to sleep.
I am getting my pre op tests done now to have L5-S1 fusion. I have been out on short term disability through my job for the 2nd time now due to my back problems (I am a bus driver).
The first time I was out on this short term disability the first surgeon I saw told me I needed a discectomy(sp). I went for another opinion and the next guy was a complete jerk, dismissed my pain and told me to lose weight & excercise (this is not why I think he was a jerk, he made strange sexual comments to me in front of my wife)and go to PT.
I went to PT and it made my back hurt worse.
Tried to do everything I could to avoid surgery.....a few epidurals, branch blocks, facet injections. Went back to work for about a year, and I could not stand the pain or do my job in this condition.
I went out on disability this time and went to the first guy who said I needed a discectomy, figuring he would set me up for surgery. He ordered another MRI, and when he got it back he sent me for a discogram. The PA I spoke with at the place I was sent to get the discogram said "this is a torture procedure, you should get another opinion before you have this done".......so that's what I did. Now, the new guy is saying I need a fusion, not a discectomy. I am so frustrated right now, I don't know who I'm supposed to believe, and I'm running out of time to have surgery done and get back to work- we are only allowed 6 months to be out of work, and if we aren't ready to return we have to voluntarily resign for medical reasons.
I'm trying to give my whole scenario but this is becoming long winded/ in the last 2 MRI's I've had they have found a couple of syrinx's that weren't there 2 years ago, before having all of those injections. I can't help but think that these syrinx's were caused from all of the injections.
MRI results from 2 years ago:
The marrow signal is within normal limits. The disc hydration is decreased throughout the lumbar spine. Mild loss of disk space height seen at L1-L2.Other levels appear relatively preserved in height.Overall alignment is preserved.Mild straightening noted.No spondylolisthesis.
The conus terminates at L-1. Possible subtle cord signal change conus. Further assesment of the thoracic spine with and without contrast may be of use. The paravertebral soft tissues appear within normal limits.
L1-2 exhibits a mild diffuse bulge with small central disc herniation. Associated mild canal narrowing. Foramina are patent.
L2-3 exhibits a mild diffuse bulge with associated mild canal narrowing. Foramina appear patent.
L3-4 exhibits exhibits mild diffuse bulge with associated moderate canal narrowing.Approximately 9x16 mm. Formina appear patent. Mild facet hypertrophy.
L4-5 exhibits a mild to moderate diffuse bulge with associated moderate to severe canal narrowing. Approximately 9x13 mm. Associated broad based right lateral recess and forminal disc bulge with associated moderate right forminal narrowing. Mild left forminal narrowing. Mild facet hypertrophy.
L5-S1 exhibits a mild bulge with small central right paracentral component. Likely touches upon traversing right nerve root. Mild canal narrowing. Formina are patent.
1. Multilevel degenerative changes of the lumbar spine.
2. Greatest narrowing seen at l4-L5 and L3-L4
3. Right paracentral component at L5-S1 may touch upon traversing right nerve root.
4. Subtle cord signal change along the conus. Recommend thoracic spine MRI with and without contrast.
Whew !! Sorry.....
2nd MRI results are with the surgeon, I accidentally left them with him when I gave him my films........but basically more degeneration and the finding of a syrinx, that wasn't there before. He ordered another MRI of my mid back regarding the syrinx..........here's the results from that MRI:
Small syrinx within the distal cord at T12 redemonstrated. This has a maximum diameter of approximately 2mm. This extends over a length of 5 cm. This appears unchanged from the prior study (4-22-11) however was only partially imaged on the prior exam. The remainder of the cord unremarkable.
Minor early diffuse degenerative disc disease changes. No significant disc protrusion or spinal stenosis. There is a small synovial cyst or possibly a Tarlov cyst within the foramen on the left at T10-T11.
There is a upper thoracic dextroscoliosis. No vertebral body lesions detected.
I apologize about how long this is. I am scared to death of this fusion surgery and not feeling confident in all of the different opinions. I also feel I am being rushed into making a decision because of my job and insurance. I need advice, can anyone help? Thank you so much !!!!!