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  • Ivor
    Member
    Post count: 3

    I shall start by telling you my history.

    At the age of 18 is when I started having problems with my lower spine. Im now 42 and have undergone 5 operations on my lower spine to treat frequent disc prolapses between L4-L5, L5-S1. All these operations were performed via open surgery with the incision always being around 5 inches long. A microdiscectomy has never been offered to me. My 4th operation was a spinal fusion just using bone grafts, no metal work. This proved unsuccessful as I had another disc prolapse between L5/S1 afterwards which required another discectomy.

    During my last disc prolapse I lost feeling in my left foot and could not pull my toes towards me. Despite my last operation the feeling has never come back. My surgeon said he could not remove all of the disc bulge and said it would cause more damage if he tried.

    Recently I had another MRI scan as I continue to suffer low back pain and sciatica. The scan revealed severe disc degeneration between L4-L5, L5-S1, a small disc prolapse between L4-L5, a central and left sided disc prolapse between L5-S1. A cyst was also diagnosed within a disc fragment. Finally scar tissue at the L5-S1 nerve root.

    Now I have been told nothing more can be done for me. I asked for my MRI disc and was mortified when I looked at the scan images because I was alarmed what my untrained eyes were seeing. Im not happy being left like this and fear what may happen as I get older.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    You have had a very rough course from your prior spine surgeries and the attempted fusion you underwent unfortunately had a low rate of success. Without mechanical stabilization of the vertebra (rods and screws or an immobilization brace), fusion rates are very low (maybe in the 50% range).

    You have lower back pain and sciatica. What is the percentage of both together? Do you have more back pain than leg pain (70/30, 60/40) or the reverse?

    The disc prolapse at L5-S1 can possibly be surgically treated and your lower back pain can also respond to surgery. You need to find an experienced and thoughtful spine surgeon to perform a complete work up.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Ivor
    Member
    Post count: 3

    Thank you for replying.

    As for my pain in my lower back, sciatica then I would say it depends on what I do. I can only walk/stand by using two crutches. Upon standing from sitting the pain is probably 70% in my lower back, however after around 10mins of standing/walking the focus of the pain shifts down my left leg and then becomes 50/50.

    I do have an additional problem with my bowels as I tend to lose control on a regular basis. However when I received my MRI results via a telephone call I was told nothing in the scan suggested my spine was causing a problem with my bowels.

    What alarmed me the most about my scan is the discs above L4 were clearly visible. Between L4 to S1 it was just blackness and even more scary was how the vertebrae between L4-L5 are virtually touching each other. The disc at this level is non existent.

    Finally its worth adding that I live in the UK. All my treatment was via the NHS and like I said earlier the likes of disc replacement or microdisectomy were never offered to me. These techniques are generally reserved in my area in private hospitals which I cannot afford. I don’t even have the money for a consultation let alone treatment!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Your symptoms sound to be severe but believe it or not, better for a potential solution. Your back pain as described seems to be from a typical severe degenerative disc disease condition called isolated disc resorption (IDR-see section under “causes of lower back pain” under “conditions”).

    Your leg pain I was worried was caused by chronic radiculopathy (nerve injury that won’t heal-see website) but leg pain that increases with standing and walking also has a stenotic cause called foraminal or lateral recess stenosis. See the website for these conditions.

    Your bowel condition may have nothing to do with your spine but I have seen patients with severe lower back pain have bowel control issues on occasion due to the intense nature of this lower back pain.

    Maybe if you can make a case to the NHS for your back pain being caused by IDR and foraminal stenosis (possibly by using the information off this website and the paper in spine I just published which covers your condition), the NHS will consider a TLIF fusion of L4-S1 which very well could be the answer to your symptoms.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Ivor
    Member
    Post count: 3

    Thank you again DR Corenman for your reply.

    I had a look at the Isolated Disc resorption on this website and found it most interesting. The MRI scan you used in the article looks similar to mine except I would say mine is a more extreme version of it.

    A few days ago I received a letter from my hospital to see a pain management specialist who I have seen many times before. He normally performs an injection via epidural although it will probably be 5 months before I actually have this done due to the waiting times on the NHS!

    So far this is the only treatment available to me although I am seriously thinking of taking your advice and seeing my General Practioner again with a view of seeking another spinal surgeon. The problem is this can take a very long time.

    Thanks again for your help it is much appreciated.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8408

    Please let us know how your treatment progresses.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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