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  • angiecamp
    Post count: 1

    I have been in pain with my lower back for 18 months now. In that time i first went to physical therapy for 8 weeks and went on a leave of absence from work for 3 months to get better. didn’t work. now i have been through more physical therapy, all of the injections that i can have, 2 MRI’s and a discogram. The discogram showed very bad arthritis at L4,L5 and L5S1. Also leaked contrast in L4, more leakage in L5 and L5S1 held no contrast at all. I am in horrible pain everyday. I am now on another medical leave from work. My spine doctor sent me to a surgeon that wanted to do a 3 level fusion. Denied by insurance company of course. Then put in to do the spine stimulator. Once again denied by insurance company. It is under appeal now. It’s been 3 weeks. I don’t know what to do anymore. I can’t get any help! I can’t afford to pay for anything myself as i have a 2000.00 deductible which i am way past and have thousands of dollars in doctor bills to pay off still. My doctor switched my medicine now to morphine 15 mg ER and Gabapenten 300 mg. No help. I don’t know what to do to make the insurance company see what hell i am living in?

    Donald Corenman, MD, DC
    Post count: 8459

    Severe lower back pain for 18 months with a leave of absence from work is significant and i am glad you underwent a workup. Do you have any buttocks or leg pain or is the pain squarely located in your lower back?

    I am unclear as to the results of your discogram. DIscograms are rated by pain, pressure and morphology (the appearance of the disc on the X-ray and the post-discogram CT scan). The discs are named for the vertebra they are sandwiched in-between. For example the L3-4 disc is the disc in-between the L3 vertebra and the L4 vertebra.

    Discogram pain is rated on two different parameters; type of pain and intensity of pain. If you report the same pain during the pressure run up as you normally experience, this is called concordant pain (also known as P2). Pain that is not familiar with pressure run up is called discordant pain (also known as P1). The intensity of pain is rated by a 0-10 visual analog scale (VAS).

    Pressure is recorded during the run-up and noted as opening pressure (the pressure needed to start the dye flowing into the disc) and the maximum pressure obtained.

    Finally, the disc internal architecture is noted. Is there a full tear in the disc wall with dye flowing into the epidural space, minimum discal disruption or a normal disc appearance?

    See if you can get a copy of the discogram report and note these parameters on the forum.

    Dr. Corenman

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