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Chemonucleolysis for L4/L5 & L5/S1 annular tears

I have annular tears at L4/L5 and L5/S1 confirmed by a positive discography and CT scan. The pain I am experiencing is concordant with the tears. I am taking Neurontin for the leg pain, Norco when needed for back pain, and am wearing a back brace until further notice.

I have been seeing an orthopedic spine surgeon since March. We've done an MRI and EMG and I failed 2 epidurals, with the last making things worse as a nerve was hit. This surgeon says the only option he can offer me is a double fusion, but because I am only 23, would like me to try minimally invasive options first. He mentioned ADR, as well, but said there is a lack of information on its effectiveness.

The minimally invasive spine surgeon wants to do a chemonucleolysis procedure on both discs, which basically involves injecting an enzyme that is designed to dissolve the gel inside of the disc. I have read this procedure is rarely done in the United States anymore, so I am mainly looking to see if anyone has ever had the procedure with success. This surgeon is from Russia and chemonucleolysis is very popular in Europe.

Thanks in advance!

-Steve
10/28/13 - ALIF, PSF, decompression at L4/L5 and L5/S1
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Comments

  • I don't know anything about chemonucleoysis, but looks like you have lots of research ahead of you and some tough decisions. Best of luck to you. I hope you are able to get the pain resolved soon.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • I have never heard anything about chemonucleoysis either, and wish you the best of luck as you make that decision. I am 26 and 2 months out of a spinal fusion at L5/S1.... my orthopedic didn't want to do it because of my age but my neurosurgeon said it was the only option.... after weighing the options, I went through with it. I am doing well. Please keep us updated on the research and ultimately your decision and recovery!
    Olivia Douglass
    MIS TLIF L5/S1 on 5/1/13
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  • GailKGGailK Posts: 1
    edited 12/15/2015 - 11:49 PM
    stevet said:
    i have annular tears at l4/l5 and l5/s1 confirmed by a positive discography and ct scan. the pain i am experiencing is concordant with the tears. i am taking neurontin for the leg pain, norco when needed for back pain, and am wearing a back brace until further notice.

    i have been seeing an orthopedic spine surgeon since march. we've done an mri and emg and i failed 2 epidurals, with the last making things worse as a nerve was hit. this surgeon says the only option he can offer me is a double fusion, but because i am only 23, would like me to try minimally invasive options first. he mentioned adr, as well, but said there is a lack of information on its effectiveness.

    the minimally invasive spine surgeon wants to do a chemonucleolysis procedure on both discs, which basically involves injecting an enzyme that is designed to dissolve the gel inside of the disc. i have read this procedure is rarely done in the united states anymore, so i am mainly looking to see if anyone has ever had the procedure with success. this surgeon is from russia and chemonucleolysis is very popular in europe.

    thanks in advance!

    -steve
    hi steve: i just read your note on wanting info on this procedure and you asked if anyone has done it. well, i went through this procedure 30 years ago after rupturing my disc at the

    same position of l4, l5, s1 and it took about one year of wearing a tenns unit to recover from the pain but i finally got healed and for 30 years have been successful. lately, i am

    experiencing sciatica problems and thought it was diabetic neuropathy but now i believe i am experiencing pain from having my disc shrunk 30 years ago, again the procedure went

    well but a doctor explained to me last week that when you shrink a disc, it causes an imbalance of all the other discs... and thus can create problems via sciatica etc. so just to let you

    guys know, even though the us doesn't do this procedure anymore, due to people having had reactions to the enzyme, it did work. unlucky for those who reacted to the enzyme

    though, they died due to an allergic reaction! everything has its risks.


    ********************************************************
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    https://www.spine-health.com/forum/newbies-welcome/new-member-introductions/what-should-be-included-your-first-thread
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    liz -spine-health moderator

    GailK
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