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#11
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The effect is variable with some responders and non-responders to the anesthetic. Those who respond to the numbing will respond to the RF as well.
I used to work with a guy up here who was one of the pioneers of the procedure for the SI joints.
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Pain since 1990, severe since 2008 MRI 03/08 showed L5/S1 severe dessication, L4/5 moderate disc bulge with annular tear. Some facet arthritis at L5/S1 and L4/5. 50% pain relief with RF neurotomy for left L4/5 and L5/S1 facets 07/08 Pain worsened 12/08 Discogram 03/09 with no pain at L5/S1, concordant pain at L4/5, severe but not usual pain at L3/4 ADR with aMav discs L4/5 and L5/S1 02/10 Recurrent pain 05/10 Current plan to try pilates |
#12
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I believe that it was Charles in Charge that said the MRIs don't work with many ADR. That isn't entirely true. Certainly any titanium ADR can be imaged to some extent but even the older ones such as a Charite can be looked around in an MRI. It is possible for a radiologist to electronically move the artifact caused by the metal away from the facet and an accurate image of the facets to be produced. Laura's even had good enough images to assess the thickness of cartilage on the facet joints. It will be a rare radiologist willing to go to the effort but it is possible. Another possibility is tugging at the facet capsules rather than arthritic facets. The increased mobility can cause the facet capsules rather than the facet joints to become irritated with limited ability to figure out the cause.
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Laura - L5S1 Charitee C5/6 and 6/7 Prodisc C Facet problems L4-S1 General joint hypermobility Jim - C4/5, C5/6, L4/5 disk bulges and facet damage, L4/5 disk tears, currently using regenerative medicine to address "There are many Annapurnas in the lives of men" Maurice Herzog |
#13
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The issues regarding diagnostic certain of facet triggers of pain are definitely complicated even amongst those without ADR and who facet arthritis. My own experience has been the lateralized pain, facet arthritic changes on radiology and concordant pain responses from triple block protocols will result in a successful RF. However, the exact cause of the pain is still controversial. I do believe ADR and the resultant re-alignment could definitely result in facet hypermobility and possibly irritate the facet capsule and ligaments. I guess I'd just suppose that if the MBB did take away the pain, they must be providing the sensation to whatever structure is acting as the pain generator and that this response should be replicated by a properly done RF. My issue is mostly that my lumbar pain right now is central and provoked by sitting and bending forward which still makes me quite suspicious of the L3/4 disc. I'll give it another month and physio before consider the blocks of my L5/S1 facets.
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Pain since 1990, severe since 2008 MRI 03/08 showed L5/S1 severe dessication, L4/5 moderate disc bulge with annular tear. Some facet arthritis at L5/S1 and L4/5. 50% pain relief with RF neurotomy for left L4/5 and L5/S1 facets 07/08 Pain worsened 12/08 Discogram 03/09 with no pain at L5/S1, concordant pain at L4/5, severe but not usual pain at L3/4 ADR with aMav discs L4/5 and L5/S1 02/10 Recurrent pain 05/10 Current plan to try pilates |
#14
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MRI's don't work with the Maverick disc
I was speaking only of the Maverick disc when I said an MRI would not give a good image, as it is made of 100% steel metal alloy (no titanium). I had one done, and it was very blurry and completely useless (even with contrast). With other aritificial discs that have less metal content an MRI might give you a clear enough picture, but not with the Maverick.
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Charles B. Fainberg Back pain suddenly started 9/05, no injury or cause PT, Chiropractic, Epidural Injections - no help DDD confirmed via discogram at L4/L5 & L5/S1 (with issues at L3/L4 but no concordant pain) 3/06 Failed SED (Laser Endoscopic surgery) 4/06 2 level ADR (L4-L5 & L5-S1) with Maverick disc at Stenum 8/06 XLIF Fusion (L3/L4) 9/08 |
#15
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First, point of clarification, no one uses steel in surgical devices unless they're real desperate. Typically, you'll see nickel-cobalt alloys in surgical applications. Titanium alloys are replacing it but they aren't the easiest of materials to deal with.
The radiologist who ordered your MRI or translated your doctor's order into instructions for the tech ran a standard scan. Any metal is going to lead to problems in a standard scan. Titanium less so, nickel-cobalt more so, old style stainless steels much more so. If the radiologist can be bribed or begged into spending the necessary time, the artifact caused by the metal can be shifted slightly, about far enough away from an ADR to see the facets. That's true of all ADRs, including the Maverick. It isn't true, however, of all radiologists I'd guess.
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Laura - L5S1 Charitee C5/6 and 6/7 Prodisc C Facet problems L4-S1 General joint hypermobility Jim - C4/5, C5/6, L4/5 disk bulges and facet damage, L4/5 disk tears, currently using regenerative medicine to address "There are many Annapurnas in the lives of men" Maurice Herzog |
#16
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Pain since 1990, severe since 2008 MRI 03/08 showed L5/S1 severe dessication, L4/5 moderate disc bulge with annular tear. Some facet arthritis at L5/S1 and L4/5. 50% pain relief with RF neurotomy for left L4/5 and L5/S1 facets 07/08 Pain worsened 12/08 Discogram 03/09 with no pain at L5/S1, concordant pain at L4/5, severe but not usual pain at L3/4 ADR with aMav discs L4/5 and L5/S1 02/10 Recurrent pain 05/10 Current plan to try pilates |
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discogenic pain, facet injections, pain generator, si injection |
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