What Are the Most Common Medical Steps before Revison Surgery

[LBP]

For those who have had ADR surgery without getting better and were unsure whether it was a failed surgery, something else going on, or some residual nerve issue from the ADR surgery that needed to be treated:

What where the new steps you went through with your surgeons/pain management dr etc.?
What diagnostic tests were ordered?
What injections did you try?
When (how long after your surgery) did you start going down this road?
What was the end result?
Have you been able to return to work?

[annapurna]

In no particular order, we tried:

Facet diagnostics injections
Facet Rhizo
SI joint Rhizo
Trigger point injections to control muscle spasms
Discogram at adjacent and ADR levels
flat film xrays for placement/subsidence
CT
MRI
discussed by did not pursue CT myleogram
Nerve conduction testing to rule out impingement and scarring
Antispasmodic drugs
Muscle balancing
Chiropractic
acupuncture
Rolfing
prolotherapy
partridge in pear tree
dove in pine tree....

Laura started about 6 months after her ADR and pursued all of these for about 5 years. She currently following the Marshall Protocol and the symptoms have resolved but it is unclear if the MP did something or if the symptoms are resolved short-term because the main drug for the MP has an anti-inflamatory side-effect. She was able to work the whole time so she was extraordinarily fortunate in that regard.

Don't take this as a guideline, as most of the techniques were about as useful as Click and Clack's wallet vac treatment on Car Talk. Also, don't take this as condemnation of the techniques. Some of the alternative stuff might work and perform for you better than it did for Laura. I would learn from our experience and ask up front how many treatements are needed before change would be expected so you don't run into a practitioner who's always pushing for "one more visit."

[AJ]

What where the new steps you went through with your surgeons/pain management dr etc.?

Saw consultant surgeon who did original surgery and consultant anaesthetist who leads pain management. Reviewed tests, prescribed pain management medications and physiotherapy programme.

What diagnostic tests were ordered?

Mri, x-ray, ct scan, physical examinations

What injections did you try?

Caudal epidural - part for pain relief, part diagnostic

When (how long after your surgery) did you start going down this road?

5 years after surgery (2007). Had no problems before then.

What was the end result?

Fusion L5/S1 with charite left in situ, Unsure what will happen to charite in L4/L5

Have you been able to return to work?

Dismissed by work April 2009. Applying for disability payments

[LBP]

Thank you for the info, I hope more are comming.

I have a delimna because I don't know which path to take. I am really curious to know whether anyone has had NEW nerve related symptoms post ADR that seem to be related to what happened during surgery. Also whether anyone has tried new kinds of injections...these ganglion injections in the lumbar region???


The first pain mgmt dr I went to refused to do injections and just wanted to push heavy duty pain meds...which didn't work and I couldn't work on them or without something else.

Next did approx 4 mos of intense exercise via PT, plus rolfing, plus pilates
no change in the underlying symptoms, did get stronger but not solving pain issues

Next my surgeon's associate (surgeon moved his practice cross country ) gave me more anti inflammatory. helped some for daily activities but not for returning to work.

Next I sought out a physiatrist (physical med dr) who said he couldn't help but I should see a pain mgmt dr for GANGLION injections at the lumbar level because perhaps the anterior approach of ADR may have disturbed web of ANS nerve system. BUT I wasn't all that impressed with this dr - I left very frustrated because he wasn't willing to talk about my options. I tend to think this might be a good idea but no one seems to be doing this on this forum??? Why not?

As an alternative, I went back to my surgeon's office to meet their physiatrist..and her recommendation is to do a CT scan, she suspects a problem with another level ! That disturbs me. She doesn't believe in diskograms which makes me not have a whole lot of confidence in her especially since my spine surgeon heavily relied on 2 of my prior diskograms to recommend ADR in the first place.

I feel like I am starting from scratch but I really feel like at least a good chunk of my new or ongoing pain issues may be partly due to the surgery disturbing my left leg nerves, and maybe there's some SI or facet issue even though both were ruled out pre ADR surgery.

I am lost because the one surgeon I really trusted is now gone and it was so hard to find him in the first place.

Thanks

[Harrison]

Hey LBP,

Just to touch on a few points you raised, in case you did not see this recently posted topic in the Article Library, it may surprise you:

American Pain Society guidelines for low back pain

These guidelines seem to be in conflict with what (some? many? most?) spine surgeons have been practicing; but I'll defer to the medical societies -- they can go "in the ring" and have it out. In the meantime, we patients are waiting...

I'll chime back in later...

[Harrison]

LBP,

I saw your post in the other forum -- good question: who funded that study? I looked, I couldn't find the sponsors! Any detectives here that can help?

Sorry, I got distracted. Back to you. The one thing I picked up on from that particular "study" was the general statements against injections -- it would seem of various kinds -- for pain treatment and even discography. We've talked about this a lot in the past, and it is indeed controversial.

We should discuss this again soon. In the meantime, I must attend to some deadlines.