[DavidQ]

Hi all,

I herniated my l5/s1 in April 2010.

I had one epidural injection, some pt, and thought I was mostly recovered from the sciatica that had made life pretty tough for a while.

I had an occasional relapse that would involve muscle spasm in my low back, but no sciatica. Probably two times over two years, and about two weeks of limping until I was feeling normal.

Then, February 2012 I went xc skiing with a friend in washington. I thought I was careful enough, but felt things starting to tighten afterwards. By that night I was in quite a bit of pain.

I spent the next two weeks doing what I figured was the usual limp to recovery. But then as my muscles relaxed, I found myself with pretty severe sciatica. I could get around, but it is very painful to stand and walk for more than a couple minutes at a time, and I usually have to squat and rest.

My regular orthopedist who I see about my back first put me on prednisone for a week... that left me feeling VERY depressed for a few days, and no better.

I was sent to get an MRI, the report is at the bottom of my post. Looking at the pictures myself, I'm struck by how much darker all my discs have gotten in the last two years.

I just had a lumbar epidural yesterday. So far I'm feeling maybe a little bit better. I'm doing PT weekly, and working from home, stretching, and using an inversion table every day lately.

If this does not fix things, my orthopedist told me surgery is likely, a microdiscectomy to remove the herniated fragment of the disc.

I met with a surgeon who I liked very much, and will meet with him again in a couple weeks now that I've had my epidural.

My main questions for the forum:
1). How do I know if it is time for an ADR? Is it a matter of assessing my level of disability and making sure to consider that option before a fusion? Or is a loss of disc height and significant herniation enough to consider it? I realize I do not have the level of pain that many other posters report, as I'm mostly unmedicated except before bed.

2). If I do elect to have a microdiscectomy, I assume the door to ADR is still open down the road?

I feel a bit lost, as most surgeons in the US don't seem too keen on ADR until it becomes a bit more "mainstream".


Based on what I've read, I'm considering a strategy of:
1). microdiscectomy only if needed.
2). Try to stay healthy as long as possible, in hopes of ADR or stem cell therapy many years from now, when hopefully one or both of the technologies have had more time to mature.

Any comments or thoughts are very much welcome.
Thanks,

-David

My recent MRI report reads:

Impression:
Degenerative Disc Disease and facet arthropathy with retrolisthesis, l5-s1, with l5-s1 right paracentral disc extrusion/sequestration narrowing the right lateral recess, contacting and displacing the right s1 nerve root.

Findings:

There is minimal retrolisthesis, l50s1 with ddd most pronounced at this level consisting of disc dehydration, disc height loss, anterior spondylosis, and endplate marrow change. The conus medullaris terminates at a normal level and is normal in signal intensity and configuration.

L1-2 through L3-4: No focal protrusion, canal stenosis, or neural foraminal narrowing is demonstrated.

L4-5: Central protrusion is seen without canal stenosis or neural foraminal narrowing.

L5/S1: Right paracentral disc extrusion/sequestration is seen, extending inferiorly, measuring up to 1.7cm (sagittal image 8) superoinferiorly x 1.0cm mediolaterally x 1.0cm anteroposteriorly, contacting and displacing the right s1 nerve root.