Disc between L4 and L5 seems to have disappeared

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SageOfCowtown

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Hello to all. I am a 66 year old male, who was hurt on the job in Septeraber of 07. Finally got to see an orthopedist yesterday. He showed me the MRI films, and x-rays he took, and it appears there is no disc between L4 and L5. All the others showed up quite well, but there seems to be nothing in that slot.
He is going to have me go to a pain clinic for epidural injections...he suggested two injections...and then he said I would have to have a spinal fusion. My primary care doctor said the fusion would be of great benefit and would stop the pain.
However, I have been searching the web for information, and all I ever see is that a fusion creates more problems than it fixes. I really don't want to have a fusion, but in looking at disc replacement, I see that it has more problems than a fusion.
I read about a laser treatment at a clinic down in Florida where you stay a week, and walk out pain free, but it doesn't seem to be offered anywhere other than that clinic.
Was just wondering what other alternatives are available, as I may be limited by Worker's Comp in Texas.
Thanks for any assistance you are able to offer me. Have a wonderful day.
 
The laser clinic in Florida is not covered by most insurance and I believe it is pretty much cash up front. I am suspicious of them. If their procedure was so great, why wouldn't other doctors around the country be doing it, too? There have been other threaRAB in the past specifically about that procedure on this board. You could search for it if interested.

Is most of your pain in your lower back or does it run down your leg? Just keep in mind that whatever procedure is done, it is done for pain control.
You will not be restoring your back to the way it once was when you were younger and not hurt.
 
Well, when the doctor showed me the missing disc, he said that was the cause of the acute back pain I am experiencing, and when he showed me the narrowed canal, and said the nerves were getting pinched, that was the cause of the pain radiating down into my legs, mostly the left leg.
 
Thanks for the reply, but the doctor did not give it any name that I am aware of...just told me that was what was causing my back pain.

Have a good one.
 
Hi there. The fact that you have no disc at l4/l5 would not negate the fact that you need a fusion and/or disc replacement. You are bone on bone which is effecting all levels above and below by a void at that level, not to mention the pain from having lost all that disc height there. Your spine is unstable without the disc and something neeRAB to be put there to stablize things.

Then it sounRAB like you have narrowing of the foramina at that level, and maybe laser is useful for this.. sounRAB logical with today's technology. Basically meaning your spine area there where the spinal cord runs through it has calcified and is not allowing the nerves to move about freely there anymore and is actually being squeezed. To open that up they literally hone the area back out to a more normal size to allow the nerves to be free once again.

I am unsure about the lasering you mentioned and being a viable thing, or if WC would pay for it in your state and why this technique would be of benefit to you. Please keep us posted.
:)
 
Thanks for the reply. Had my first cortisone injection today, and can happily say I don't have any pain in my back and legs, after living in hell for 4 1/2 months. What a blessing! I am to be evaluated in two weeks to see where I go from here. Most likely will have to have surgery, but am hoping it won't have to be a fusion. I heard something about an injection of some kind into a disc-less space using something like dentists use for false teeth. Anyone know about this? Also have heard something about a rubber or sponge-like device whaich can sub for a disc...am curios aboth those, as it would seem to be better than fusion.
Hope all have a wonderful, pain-free weekend.
 
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