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Bass Ackwards?

airborne72airborne72 Posts: 245
edited 06/11/2012 - 7:58 AM in Spinal Injections
Had a multiple level PLIF (LS-S1) in January 2011. Initially I thought it was going to be a wonderful improvement. However, after about two months I began to experience more and different persistent pain (legs and lower back). After several diagnoses/evaluations/medicines I was given an ESI early this week.

It was not fun and so far has not proven to be of any benefit. Sort of like going to the dentist to get a cavity filled but not being provided any novacaine. It hurt! The pain subsided, but I still have the memory.

Here's my question - was this intervention a waste of time? Has anyone else on the list had an ESI as a method of pain control after their fusion? Is all of this bass ackwards? And, for those of you with a similar situation, did you realize any benefit (if so how long did it take and how long did it last)?
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Comments

  • BotzBotz Central FloridaPosts: 223
    I have had a number of ESI's after my L5-S1 fusion (AUG 07). Some have given me immediate relief others have taken a week or so to kick in with 100% pain relief. Typically I only receive one injection. If I don’t get relief I request a second. So far I have not needed the entire series of three. The relief last between three to 6 months.
    I have had them with and without sedation. Twilight sedation kicks my butt. After the procedure I'm pretty much out of it for the rest of the day and night. I have been given a Xanax prior to the procedure and it had the same effect. The last few I have received were with no sedation and I have to say it was a piece of cake. I only had a minor amount of discomfort during the procedure.
    I have a failed fusion due to the surgeon only adding rods and screws to my right side. At the time he thought less was better and I stupidly agreed with him. So the real fix for me is to have the Rods and screws added to the left side of my spine. For now I’m going with the ESI’s until I can face another surgery.
    Art
  • Thanks for the reply Art. I was beginning to think that maybe I was weird and no one else had anything to contribute.

    After several weeks I have not realized any relief/benefit from the injection. Last week I met with my surgeon and we (mostly me) decided that I would pursue routine physical exercise for the next two months to see if any thing changes (for better or worse) and then make a decision about subsequent approaches. He mentioned cutting me open again to look and see, but I am really "gun shy" about that.

    Your situation sounds very unusual. Seems to me that if anyone (doctor, carpenter, mason, etc.) applied structural repair that he/she would do it symmetrically (same on both sides).

    Again, thanks for your response. I truly appreciate it.
  • BotzBotz Central FloridaPosts: 223
    Jim,
    I did the physical therepy thing and it made things worse. Who did your ESI? A pain management Dr. or the surgeon? I have a pain management Dr. That seems to be able to hit the spot.

    Did they only do 1 injection? Most folks go thru a series of 3 injections. Before I had the fusion surgery I went thru several rounds of three and got good pain relief.

    My problems started in 1999 when I dumped rain water out of a sailboat. Had the lamincetomy/discetomy. All was good for about 10 years than so much disk had been removed that I developed DDD. It's all been down hill from there. Fusion in 2007 started out good but after recovering from the surgical pain the nerve pain returned.

    I had another esi 11/9/2011 that is giving me about 50% relief. I have another one scheduled for next week. Hopefully that will improve my pain and get me off the pain meds again.

    If not I will be going back to a new surgeon early next year to get this mess finally fixed right.

    Good Luck!
    Art
  • Art:

    Thanks again for your response.

    My injection was performed by a pain management doc who is an associate in the medical group (about 30 doc's) that includes my surgeon. He was a "good guy" in my opinion. Their procedures and practices were very efficient. In fact, while I was laying on the cart awaiting my turn I was doing the math in my head. The amount of money that was changing hands was significant.

    My "bad back" was first diagnosed in 1978 after I complained of low back pain while I was in the Army. I was determined to have a grade 1 spondy. Since then I lived a very active lifestyle that probably aggravated the situation. My capabilities decreased as my pain increased. On two separate occasions with two separate ortho surgeons over a 20 year period of time I was told that spinal fusion was the solution. In late 2010 I physically could no longer tolerate the situation and agreed. My non invasion intervention prior to surgery included physical therapy and chiropratic. No drugs and no injections.

    However, when I had my decision making conversation with my surgeon in early January of this year, I asked him about the possibility/utility/potential success rate of a spinal injection. He said he would give me one, but it would be a waste of time. He said surgery (two level fusion) would be the solution. In fact, he said that with a confidence rate of 95% he could make me feel better.

    I have taken many more meds after my surgery than I ever did before my surgery. But, my pain level is chronically higher after my surgery than before. Who knows? Life is a gamble and it becomes even more risky when you introduce surgery into the equation.

    One thing I have learned from all of this is that everyone responds differently to different interventions. For some it's ice, for others it's heat. For some it's rest, for others it's activity. For some it's sugery, for others it's not. For some it's chiropractic, for others it's not. For some it's medicine, for others it's not. And, these interventions may work sometimes and not at other times. For me the ESI did not work.

    My current therapy is cautious and regular exercise with the goal of invigorating my metabolism and increasing my muscle stength/tone in my midsection. I am 60 years old. The physical clock is ticking and as each day passes I lose some degree on my "return of investment" in the gym. Medication will always be available, but youth slowly evaporates. Therefore, I am concentrating on that type of therapy hoping that I will recognize some improvement (increased range of motion, stamina, strength) before my next appointment with my surgeon (mid January). We both agreed that we would make a decision then regarding future medical intervention (exploratory surgery).
  • BotzBotz Central FloridaPosts: 223
    Wow exploratory surgery to see what's going on.....OUCH! What if nothing is found? I think I would avoid that at all costs. Have you had a recent MRI/CT scan? They should pretty much be able to see what's happening. You said you had a multi-level fusion. When you had the ESI did they inject multi levels? Maybe they didn't get the pain generator.

    I'm not too far behind you in years, I'm 53. I could use a lot more exercise due to the fact I sit at a desk 9 hrs a day.

    Take Care,
    Art
  • Art:

    I believe that my pain generator is mechanical, as opposed to nerves. My pain begins as soon as I stand up after getting out of bed, and then it gradually worsens through the day (even with low dosage of percocet). It feels like someone is screwing a big ass screw into my lower spine.

    Oddly enough, I entered the OR with the understanding that I would undergo a minimally invasive surgery (small incision; 2 hours in the OR; and only one night in the hospital). That all changed once the surgeon cut me open and realized what he was dealing with. He said my bones were so gnarly that he had to go ahead and cut me deep and wide. I have two long scars as a momento. I spent 5 hours in the OR and 3 nights in the hospital. I am not complaining. Even the best med technology can't always reveal what's on the inside.

    To answer your questions - since January I have had an MRI (April) which indicated that my spinal cord had some swelling. CT scan (October) revealed normal bone regrowth with no visible abnormalities. The ESI was inserted at the S1 level only.

    I agree, exploratory surgery sounds a bit primative. That's why I am trying exercise to see if it will "get me right" or "do me wrong" within the next 60 days.
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