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  #11  
Old 07-10-2012, 08:40 PM
Slackwater Slackwater is offline
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Quote:
Originally Posted by ally View Post
Thank you for your comments, very helpful.

As for that any Dr. having time to read your entire file i agree that may be asking alot depending on how big it is. I had not picked up my copy of the what the Dr. wrote on my diso-gram till after I saw him, but when i took , what 2-3 minutes to read it , it plainly said disc. L4L5 no pain, so that is what I was mostly upset about, well and of course his not wanting to talk to my sister sitting right beside me. I always take her when i can if it is for something this important, she knows alot more questions to ask that I.

My MRI apparently did not show much at all, so this is why they sent me for a disco-gram. He basically told me nothing can be done go home and try to live your life LOL, I understand that fusion is not an option in my case because there is a good disc in-between the two bad ones, but when I mentioned that I was interested in a disc replacement all I got from both Dr.s I have seen so far is , they dont recommend them. So i just didnt say anymore to them about it as they were negitive. Oh well differant Dr. differant day lol......
I ~trust laid-up-doc more than what I think/write. She wrote about a "unimpressive MRI". Both you and she got the discography. I somewhat understand what she wrote. I suggested looking around to see if the nocimed.com software is installed anywhere in your area to double confirm(?) the discography before making a surgical decision, with a secondary objective of looking for a non-surgical alternative.

The UCSF video ( 89 minutes ) gave perspective below. I watched the video again last weekend. Low Back Pain: Causes, Conservative Treatment & Surgical Intervention - UCTV - University of California Television The UCSF suggestion is avoid surgery with PT / Pilates and weight loss if that is possible. My limited opinon is I do the same. I suggest seek medical opinons as you are reasonably able with your sister.

Did your MRI speak to nerve compression, central canal, foraminal, or lateral recess?

The discogenic pain, determined by discopgraphy, or possibly by magnetic spectroscopy or T-1rho, might give more weight for surgery vs. PT / Pilates.

Both your doctors/surgeons deferred on the Artificial Disc Replacement. That is valid from their perspective, training and (limited) experience. You mentioned going to Texas for TBI. That will provide another perspective.

Non-contiguous ADR / TDR is not written up in the literature from what I recall.
Non-contiguous Fusion might be written about, possibly in the context of scoliosis.

Slackwater_SF
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  #12  
Old 07-10-2012, 09:08 PM
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laid up doc laid up doc is offline
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i also had the benefit of having had a disc denervation procedure (transdiscal biacuplasty) that worked very well until my disc was reinjured... leading to new symptoms that i learned at the time of surgery were due to the fact that part of my annulus was just destroyed, but not in a way that would show up on an MRI. my situation was a bit on the unusual side to say the least, but because the biacuplasty had worked so well, i knew that all of my really bad intractable pain was discogenic. the proof in the pudding was that the really awful ache was totally gone from the moment i woke up from surgery.

(and for the record, i endured a 2nd discogram to make sure that the same disc was the culprit before having surgery. as SW said, surgery is NOT a decision to be taken lightly!!!)

your situation is very different in that you have 2 nonconsecutive discs involved... that's rather unusual. i don't know of any surgeon that would fuse 2 nonconsecutive vertebrae, and i have never heard of any lumbar patient having 2 ADR's that weren't consecutive. this may be part of why the surgeons you have seen don't have much to offer you. add in your possible MS and well... it's very muddy in your waters.

so i have a few questions that may help you:
1. did they mention whether there were annular tears on your discogram? were they in any one direction? if so, does that line up with your pain at all?
2. was the pain you had during the discogram similar to your "typical" pain?
3. do you have a pain doctor at all? they're very good at identifying pain generators, and may help you decide if surgery would relieve your pain. as you may have noticed, there are more than a few folks who have had ADR and/or fusion who have failed to improve, many times due to inadequate identification of pain generator(s).
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US non-spine MD - laid up no more!!!
had recurrent annular tear L5/S1, failed everything
M6L done 10/19/11 w/ Dr Clavel getting back to my old self more and more every week!
laidupdoc@gmail.com if my PM box is full

The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician.
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  #13  
Old 07-16-2012, 01:10 PM
ally ally is offline
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ok, Im going to write what my MRI said lol
The lumbat vertebrae maintain satisfactory height, alignment, and marrow signal intensity. Intervertebral disc desiccation and mild loss of intervertebral disc space height are identified at the L5-S1 level. Some mild intervertebral disc desiccation is also noted at the L3-L4 level. The conus terminates at the level of the superior end plate of the L1 vertebral and is unremarkable in appearance.
L1-L2-3 No disc herniation noted. no significant spinal canal stenosis or neural foraminal stenosisis seen.
L3-L4 Minimal bulging of the intervertebral disc is identified. No significant spinal canal stenosisof neural forminal stenosis is noted.
L4-5 no disc hernation is noted. no significant spinal canal or neural forminal narrowing is seen.
L5-S1, A mild broad based poaterior disc protrusion is seen. Protruding disc does not produce significant canal stenosis. Bilateral facet joint arthropathy is also identified. No significant neural foraminal compromise is identiefied. No definite neiral impingement is appreciated.
My mid-back pain has not been adressed at all, they tell me they think it is my back compensating for my lowe back trouble.
Thoracic MRI summary says.
The thoracicspine itself is unremarkable in appearance, without disc herniation or spinal canal compromise noted.
Incidental note is made of cervical DDD with suspected spinal canal norrowing at several levels. Further avaluation with dedicated cervi8cal spine MRI is recommended.
Incidental note is made of a cystic-appearing structure along the anterolateral aspect of theT5vertebral body on the left. Although this tructure has a simple cystic MRI appearance the precise nature of the finding in unclear. Finding can be further evaluated with a CT, in desired.
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Diagnosed with DDD on my L3/L4 and L5/S1
Have not had a second opion yet but will do that when i get all my results officially. Tried PT and also shots with no relief.
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  #14  
Old 07-16-2012, 04:02 PM
ally ally is offline
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Also on the discgram, No tears were found, although one Dr. pointed out on the picture that it was leaking on L3-4 lol, so i dont know for sure.
The pain was the same as I have normally now, and more.
I still think they need to look more into my mid-back pain.
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Diagnosed with DDD on my L3/L4 and L5/S1
Have not had a second opion yet but will do that when i get all my results officially. Tried PT and also shots with no relief.
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