Disc tear/leg numbness?

[Adrienne]

I'm currently choosing between ADR and fusion at L5/S1. The problem, besides the obvious, is that there is nothing on the MRI, CAT, XRay, to indicate a problem besides a grade V tear at L5/S1. Definitely hurt on the discogram.
The thing that has us scratching our heads is that I have a numbness down both legs, particularly when I walk and no one can say for sure if that's caused by the tear.
It sounds like something mechanical but my discs aren't bulging and all the nerves, stem to stern, are hunkus dorus, undisturbed. The theory du jour is that the oozing nucleus is annoying the neighboring nerves but everyone concedes that it should probably play out to pain, not numbness.

So my question is: Have any of you had a simple tear (albeit large) with no other overt problem and had accompanying leg numbness? I'd hate to go after the wrong spot; the pain certainly isn't fun but it's really the numbness/weakness that's driving me to the operating table.

I know my question is a long shot but what the heck, it's only bandwidth. And you never know!

[trkdoc714]

Adrienne,

I reviewed my medical test reports. They all point to L5-S1 as the culprit for leg pain and numbness (bilaterally). This disc has been operated on twice. The first and second surgery notes indicated disc particles/ fragments were present that didn't appear on the MRI taken days earlier.

It was explained to me that when discs dry out, the disc can lose fragments from normal movement which can irritate the nerve root(s). I guess it depends on the position and size of the tear.

Mine has been characterized as dessicate (dried up) and supposedly will continue to lose pieces as time goes on. The good thing is the body will absorb these as long as they are small, very small. The larger pieces can move and may cause both pain and/ or numbness.

May your holidays be bright and disc particles be small,

Bob

[Harrison]

Adrienne, this apparently has been the case, at least as reported by a few patients on this forum. Sue comes to mind, she posted here a few years ago. I can't recall if "Sue" is her screen name, but I'll check...

[LBP]

I had similar grade tears at both my l4/5 and l5/S1. My tears came from a prior surgery. Should have been a medical malpractice case but I didn't know what was wrong at the time and no one wanted to touch me (medically). Early on, after the first couple MRI's I was told I was 'unremarkable.' But the pain told me otherwise, After years of seeking out various treatments and drs, I finally found a great PT and paim mgmt dr that helped me find my dx of annular tears. After conservative treatment, I finally got the surgeon referral. I seem to recall my surgeon, Dr. westerlund actually looking back at the early MRIs and compared to my discogram/CTscans and explained to me that while there may not have been significant bulges, the discs were darker indicating not healthy and possible tears. After years of the discs not healing, and 2 diskograms later, and fighting insurance for ADR surgery, I finally had ProDiscs implanted at both levels in April 2008. It was explained to me that the material that leaks through the tears from your disc is irritable to the nerves. For me when I bent over repeatedly, or in general over did things, my back would hurt, feel swollen and I had tingling feelings in both of my heals and sensitivity with one of the offshoots of the sciatic nerve that wrapped around behind my ankles. During PT I found that my piraformis muslce was chronically irritated and painful, and that my illac crest area was particularly tender. Sometimes for short periods I couldn't even weight bear on one of my legs because my sciatic pain was horrible after trying to do some otherwise normal physical activities with my niece and nephews.

I am still recoverying from ADR surgery but still happy I choose ADR. I just tried to return to work 6 mos post surgery, and jumped in too hard too fast. I saw my surgeon's office yesterday, had lots of xrays, they said everything looked great, but feels that since I was not working for 5 years before I finally got my surgery, I've weakened a lot and it will just take longer to regain strength and stamina to return to work. He recommended just working hard on building strength through appropriate exercise.

[Adrienne]

Thank you all for your replies, it make me feel a bit more confident about moving forward with the surgery. I've heard again and again that MRI's are simply an overview and there's a lot that can't be seen so maybe you're right about the disc particles and leakage from the tear. It does make sense.

A friend of mine with severe back pain went in for a fusion and when they cut him open they found a tear with crystallized leakage pressing against a nerve. They simply removed the crystal, sewed him up and sent him home.

LBP, congratulations on your recovery! Sounds like you just need to take it slow a bit longer. Quite understandable in light of five years.

Yes, small disc tears to one and all. Thanks for the lovely sentiment Bob. Merry Christmas and Happy Everything.
Adrienne