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S1 & L5/L4- Picking a good MD for surgery (help me)

eeglemaneeegleman Posts: 1
edited 01/17/2016 - 10:52 PM in Lower Back Pain
I have had 3 MRI's since 2010. The reports show a worsening of situations. There is moderate disc space narrowing at the L5 and S1. Modic type 1 endplate changes are also seen in this area. Arthritis is present as well as disc degeneration. Annular tearing in the L4/L5/S1 area. L5/S1 has disc bulge and facet arthropathy is also found.

Ok, that's my medical situation. I am 48 years old, male, and I so confused on how I should proceed. I live in New Jersey, but I'm willing to visit any doctor on along the East who is experienced in resolving my medical issues. I have chronic pain walking, bending, and transitioning to a seated position. This chronic pain has absolutely effected my way of living.

I had Physical Therapy, and that didn't solve anything. I then met with a spine surgeon [edit] determined that it would be best to cut the nerve endings in my lower back, but first he did a procedure to numb the nerves to see if that resolved my pain. It didn't. [edit] seemed ticked off every time I asked him a question and he failed to even see me or call me after the surgery. Therefore, [edit] is no longer a consideration of mine except for maybe an enemy or two.

I need realistic suggestions from readers on how to proceed along with doctor recommendations. Also, friends have mentioned getting an epidural shot. Does my problem sound like I should get this. [edit] said I wouldn't benefit from the epidural. Please help me. I welcome all suggestions. Thank you, and good health to all of you.

It is not permitted for members to name, give recommendations of medical professionals or facilities or to comment on a MRI finding. All responses will be based on members own experiences and not to be taken as medical fact

Liz, Spine-health Moderator


  • LizLiz Posts: 7,832
    Please take the time to read this post and refer to it when you have questions

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    Liz, Spine-health Moderator

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • SavageSavage United StatesPosts: 5,476
    You mentioned doctor failed to call you after your surgery.
    I may be missing it, but what kind of surgery did you have?

    Are you working with your primary doctor? Who then referred you to spine surgeon?

    My experience with surgeons is that ...if they do not believe you to be a candidate for surgery at this time, their consult is done and they refer you back to your original doctor.

    My primary tried working with my pain about two years and then referred me to pain management doctor.
    That was best thing for me!

    He did several tests and treatment for my spine and lessened my pain.
    And has kept me out of ER with the out of my mind pain.
    That's huge for me!

    I was never a candidate for spine surgery..but my pain management ..spine expert..doctor, while monitoring and treating my spine, would have referred me to surgical consult if needed.

    Your doctor would be best to ask re epidurals, as he would know your spine and conditions best.
    I have had several epidurals over the years, by my pain management doctor.
    Some have been successful, some have not.

    When they are not successful for a particular area of my spine, my pain management doctor does not continue doing epidurals in that area.
    I explain my symptoms and he remembers saying...yeah the epidurals didn't help there, so won't do again...and he comes up with another plan.

    But epidurals with success, will be repeated when symptoms reappear. The time between my epidurals is years for me.

    The other benefit, in my mind, re epidural for lessening of pain...is when doctor is using the fluoroscope .....
    to guide him for area for injection, he is able to see that spinal area on the screen.
    And, I think, the extra visual of assessing my spine is valuable as it's getting good, more up close and personal exam.

    Spine-Health Moderator
    Please read my medical history at: Medical History

  • I'm scheduled for my third (and final) in February. I had one in Oct '15, and Nov '15.
    The latter of which provided me with false hope of recovery.
    I went back to running again, and promptly regressed into a world of pain.
    After this third epidural, I cannot get one for another six months, so I am scheduling surgery for March '16.
    Epidurals will not solve all problems. I have acute spinal stenosis from a bulging L4-L5 and significant forminal narrowing in the L5-S1 area.
    I am a candidate for both a discectomy as well as a laminectomy. Not sure if I qualify for an L4-L5 fusion.

    Most important: I am on my second back doctor. Don't be afraid to shop around.
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