[ctwitmer]

okay. I received the reports on the discogram. As Dr. M said, he did not see any leakage or any problems with the discs, but looking at the CT scan, apparently there is.

I realize I still have to review these with the surgeon, but I'm looking for input from others. Here's a summary of the reports:

L2-3 was the control disc and that was classified as a grade one disc.

L3-4- "[I] did complain of some discomfort on the right side, but this was not concordant, noting that it was higher than [my] normal pain. the contrast did appear to be confined within the central portion of the disc."

L4-5 it is noted that filling was entirely on the left side of the disc. [I] had no significant discomfort although there was a feeling of tightness on the left side. Because of this, a needle was replaced on the right side entering at L4-5. opening pressure was approximately 30. Initially, 1.75 cc of contrast was injected with the peak pressure of 65. [I] did complain of a burning sensation. With another .5 cc of contrast, peak pressure was 90 with increasing symptoms. [I] state[d] this is the same pressure sensation [I] get although it is not a burning pain [I] get. [I] rated [my] pain as fairly severe at 9/10. (I don't remember that part. When they wheeled me to recovery before I went to the CT scan, the pain was simply unbearable. I can't believe I said 9/10. Felt like a 37.) again, discography did not appear to show any significant spread of contrast posteriorly, consistent with the grade 1 disc.

in summary, I have essentially normal findings at L2-3.

There is discordant pain at L3-4 and fairly severe concordant pain with septum at L4-5. Again, L5-S1 could not be accessed because of significant degenerative changes and sacralization of that level.

Those are the findings of the discogram.

From what I read about others, there could be other pain generators at L3-4 because the pain is discordant.

L4-5 has concordant pain, so that means it's because of the disc.

and there could be a variety of things wrong with L5-S1 because of the degenerative changes and sacralization.



the impression from the post CT scan is more revealing. I've not actually seen the images, but here is the impression:

"1. Disc bulging and superimposed Dallas grade 3 annular tears at the L3-L4 and L4-L5 levels."
2. apparent variant anatomy [L5-S1]

so I take away from that that while they may not be severe, the tears are likely the cause of my problem. perhaps then that means that the pain at L3-L4 is in fact concordant and not discordant??

again, I go back to my earlier point. Is there any sense in redoing the discogram sans versed so I'm able to report better? Or since the CT scan revealed tears that I just concentrate on that? What do you all think?


finally, I should note that I took Tuesday off completely because of pain and had to leave work early yesterday. I made it through the day today only leaving a few minutes before five, but I called the pain clinic and asked for something stronger than the ultram.

this past week has been really difficult because it's been all consuming. The pain is all I think about...