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Why Would Someone Not be a Candidate for Surgery if There is Pain and CT Shows Problems

2

Comments

  • You're husband is lucky to have you watching out for him. I'm sorry to hear your husband is in so much pain. I hope after the myelogram the Dr. will let your husband know if there's anyway to treat him. I'm not a surgical candidate but do see a Pain Management Dr. for over 2.8 years and have done Physiotherapy and aqua therapy in a therapeutic pool that has helped a little. I use ice and heat to help my back pain also as well as meds. I hope you'll have more answers after the test for your husband.

    I think there's an article, just do a search in blue box above the top of the page of what questions to ask your Dr. and bring a list with you and maybe keep a pain diary for the Dr. to see how your husband is managing at home and tell your Dr. what he can do and not do. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi Winker,

    We're glad you found the Spine-Health support forum.
    winker said:
    Sort of seems like doctors don't really want to do surgery unless you have a clear-cut injury that they can say "here's the injury and exactly the problem that was not there before." Is this true? Do you have to beg so that they don't have you coming back and telling them that it did not work and that it was their fault. This way they can say well I told you it might not work.
    Surgeons definitely want to know exactly where the problem is (as much as can be determined) before cutting on a person. You wouldn't want it any other way. Just because your husband is having symptoms that seem to point to C5-6 doesn't mean a surgeon should feel comfortable doing surgery at this point. There needs to be definitive evidence of a problem at a specific point in the spine before the surgeon is comfortable operating. You said your husband has had a selective nerve injection which didn't work. You may think that that would be a good indicator to the surgeon that the problem is pinpointed, but that's not the way they look at ESIs (epidural steroid injections). For an ESI (or selective nerve root block) to indicate a definitive diagnosis it needs to relieve the pain, at least for a short period of time. Then, if the pain returns slowly over a period of days, that tells the doctor that he's found the trouble spot. If the injection doesn't relieve any symptoms he cannot know for sure that the area injected is the one causing the debilitating pain. Make sense?

    You're getting plenty of advice from others so I'll just leave you with this little tidbit. Laypeople like us tend to easily misunderstand the the results of tests or we don't understand why nothing is being done when we or our loved one is in pain. I suggest that as long as you trust your surgeon 100% (which you must do before allowing him to cut on you or your husband) then you can relax and let him sort out what's going on with your husband. Ask questions if you need clarification and try to give him time to figure out the best treatment for your husband. These things can take time to be done correctly and you DO want the correct treatment for your husband. :)
    Linda

    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
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  • Hi Winker,
    Do you mind giving the age of your husband?
  • Winker, spine surgery success rates are... variable. The high success rates you might hear quoted are for "improvement," but how much improvement? For how long? At what cost? Spine surgery is a big deal- a cervical fusion is going to lay your husband out for quite a while, and require a long recovery. How much improvement would he want to expect before he would go through that?

    When they discuss surgery candidates, there are specific types of spine injuries that are "good" or "excellent" surgical candidates, and there are risk factors that will make a person a less likely candidate. So if your surgeon is telling you these things, listen. What he is saying is that the chances of great improvement are lower because of the reasons he's giving you.

    Now, there ARE surgeons out there who will cut anyone with a sore back. But surgery comes with risks, pain, recovery, rehabilitation- wouldn't you want to have some belief that there will be a good outcome? There are some spinal injuries for which the 1-year outlook for surgery and physical therapy are the same. Physical therapy is a lot less painful to recover from than surgery!
  • Hi Winker, a while back I was having what I thought was neck problems, with pain and numbness in my arm and hand. For the last few years doc's said it was cervical. Finally they did a ENG..turns out is a Bracial Plexus problem. That's shoulder area...surprised me too. Please get your hubby a ENG before you jump into a cervical surgery. I dodged the bullet maybe he can too.
    butterbean
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  • Wow, it was really good to hear from you people. Now I don't feel so alone. But wow, what a world we live in those of us with back problems. No one can know what it is like unless they are experiencing all of this. But what gets me is that back in the day when my mom had a slipped disc, they immediately operated and fixed it. Same with my aunt. This must have been in the early 70's. It seems that now a days doctors are all refusing us surgery! I am on medicare and medicaid a combined HMO insurance. It always feels like the doctors don't think I am worth really helping. I am so distressed at all of this and my condition.
  • titanium-manttitanium-man Posts: 12
    edited 12/21/2013 - 5:50 PM
    birdlynn said:
    Wow, it was really good to hear from you people. Now I don't feel so alone. But wow, what a world we live in those of us with back problems. No one can know what it is like unless they are experiencing all of this. But what gets me is that back in the day when my mom had a slipped disc, they immediately operated and fixed it. Same with my aunt. This must have been in the early 70's. It seems that now a days doctors are all refusing us surgery! I am on medicare and medicaid a combined HMO insurance. It always feels like the doctors don't think I am worth really helping. I am so distressed at all of this and my condition.
    I understand totally birdlynn...I am dealing with insurance issues at this time approving a needed scan for the neurosurgeon. If you find the correct doctor, he will totally pursue and push for you to get to the bottom and exact cause of your issues. I have a superb doc who is on the insurance hardcore personally as well as his staff to get everything done that is needed. Best wishes for you as well as a great Chrismas!
    -Ti man

    C5-C6 Fused, Syrinx from C4-C7, Bilateral SI joints are fused from car accident using iFuse by SI Bone
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