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  • Abbeygirl
    Post count: 40

    Hi Doctor
    I would first like to thank you for the great service that this forum provides your answers have been very helpful in the past i will try and make this short i feel like i have been around the block 1000 times in the last 16 months i had a laminectomy about 15 years again and had a good result the approx 16 months ago had a decompression surgery at the same level I am at this point on oxyicontin 40mg per day endemp for nerve pain as well as trying to keep me sane I have had about 3 ct steriod injections with no relief was sent to pain management doctor who sent me for a mri scan and then I went back to the pain management doctor with results he then said that he would do facet joint injection on both sides L5/S1 level and the level above i had that procedure done went back to pain doctor a week later he ask how i went with the injections i told him that i had no releif at all but it did not make my symtoms worse just a bit sore where the injections went in then he wanted to do radio frequencey treatment but i said if i had no relief from the facet joint injection was it worth doing radio freqency treatment so he sent me to a nerosurgion to see if I was suitable for a spine stimulator had to go back to him before I could get in to see the surgion so I went back to him and he wanted to do the radio frequency test any way to cut a long story short went back to surgion she said not to worry about a spine stimulator that my disc at the L5/S1 level needed to be fused so I went for a standing up Xray a bone scan also a nerve conduction test and back to surgion with the results she said they were good and that she could do the fusion then she sent me for a second opion that Doctor said the same thing only that I should have a discogram done went and had that performed worst pain I could imagine the results fro the discogram are L3/L4 the discogram was signifcantly positive at this level there is a significant defect in the anterior aspect of the annulas which results in contrast tracking into the circumference of the annulus through this defect immediately reproducing the patients low back pain a broad based posterior disc bulge is noted L4/-5 THE DISCOGRAM IS NEGATIVE AT THIS LEVEL A NORMAL DISC IS demonstrated on the ct L5/S1the discogram was strongly positive at this level with symtoms immediately reproduced the ct scan demonstrates that the disc space is significantly narrowed with a posterior disc extrusion demonstrated which contacts the descending nerve roots at this level vacuum phenomenon and annular disc degeneration is noted CONCLUSION Positive discograms at L3-4 and L5-S1 with a normal disc demonstrated at the L4-5 level so went back to the surgion she said that she would send me me the consent forms fo a one level fusion L5/S1 Then the insurance company sent me to one of there doctors he said that i should get the radio frequency done so now i am really confused i am in so much pain just want to get better i do not know what is like in the states but i am very confused not real keen on surgeery but i can not live like this for the rest of my life but if there was a alternative i would do it in heart beat but I have tried just about everything so if you have any ideas I would greatly appreciate it I allso have my discogram on disc not sure if I could send it to you or not ????Sorry for the long topic just really confused and you are the only doctor that makes sense thanks again doctor for this forum

    Donald Corenman, MD, DC
    Post count: 8660

    Have you posted before as your identifier is familiar?

    You have had facet blocks at L5-S1 with “no results” and a discogram with a painful disc at L5-S1 and L3-4 with a “normal disc” at L4-5. You however do not describe your symptoms. Do you have back pain, buttocks pain or leg pain? Please see the section on the website regarding “How to describe symptoms” to convey a description of your pain.

    What level (or levels) were your two prior laminectomies?

    For the sake of time, let’s assume that you have strictly back pain only. Facet blocks have a diagnostic window for pain relief. Just like going to the dentist where he or she will inject your jaw and it “stays numb” for three hours, any relief for only the first three hours is important to note. Typically, most injectionists do not have you record a pain diary (see website for instructions) which I think is highly important. If you can remember back to the first three hours after your injection and do not remember any pain relief, then rhizotomies will not be helpful to relieve pain.

    Again, if lower back pain is your only problem, you might be a candidate for a fusion of only the L5-S1 level based upon your discogram. You need to understand what a fusion will and will not do for you. Read the section on fusion in the website to get a better understanding. Read “Preparation for spine surgery” and “Recovery information by surgery” for a better understanding of what you can expect.

    Dr. Corenman

    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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