Do i need to insist a Discogram before surgery?

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efang622

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I have severe right hip and leg pain 10 months ago, I did a MRI which found I had spine disk heiniation , the hip pain is wear off a lot but since then I have been in constant pain on right leg ( calf area) , I usually get more pain if I walk or drive more . I did another MRI two months ago, which shows the interval reduction in size of the L5-S1.but my leg pain almost has no change ( no better and no worse) .I saw a Neuro Surgeon last week and he said I still can try non-surgery method but He suggested surgery in L5-S1 lever ( Micro-diskectomy), when I asked if I can do discogram to make sure which disk cause my leg pain ,because I worry about so mach if the MRI doen't show the real reason which cause pain. he said he doesn
 
efang, where does the pain radiate down your leg? If it is along the S1 dermatone (back of thigh, possible bottom of heal and lateral side of foot) then that matches up with the disc problem identified on your MRI report (L5-S1). If that is the case, there really is no reason at this point to do a discogram.

It is when the pain doesn't match up with the MRI that a discogram is sometimes helpful. Doctors don't like to do discograms routinely since it is very invasive, painful, and expensive for your insurance. Your MRI also identifies a disc bulge at L4-L5, but if you don't have pain that corresponRAB with that disc (L5 dermatone), then you don't need surgery there.
 
Yes, my radiate down on my right leg ( back side of calf area) , sometimes in right hip.it matches up with L5-S1 disk problem.

Thank you very much!
 
I do know (on regular localized pain in your back) those annular tears hurt like the dickens, they CAN heal though I have read so that is a good outlook there, I had severe pain on my annular tear for a few months, and in my next MRI there is no mention of it so I assumed it healed- who knows. Since you do have dermatomes that match up to the corresponding sensory areas to your MRI and the disc that is bothering you, I don't think a discogram is beneficial, and I have read they are PAINFUL, you don't want one unless you truly NEED to do it. IF you are wary on this surgeon, go for a 2nd opinion and see what that one says too, you always want more than one opinion when dealing with surgeries and the decisions. Healing from a micro-d is not terrible, and the incision is not huge, its not that bad of a surgery to be honest. If you were dealing with a fusion I'd say heck get THREE oninions if you were still so wary.

Good luck to you. I don't think from what you've said you'd need a discogram, but its always your decision when it comes to your back and surgeries, read on the dermatomes and look at the graph to compare your pains to the disc in question, that will help you in your decisions.
 
Do get another opinion and see if there is a Spine Specialist in your area. Keep in mind that when a diskectomy is performed, there is the chance that re-herniation can happen. SounRAB like there is a lot of arthritis going on in your back as well. Discograms are painful but at this point I don't think you need one.
 
Yes, I will get other opinion. My Neuro Surgeon said he will do Micro-the diskectomy and will not remove the part of bond ( not fusion) , but I heard
after first diskectomy, the disk is easy to be herniated again, so that is why
I am very hesitate to do the surgery.
 
Most definately insist on a discogram. I had back surgery without one and have had many years of severe pain. After changing surgeon, new surgeon he did a discogram and it relveled problems that were not seen on MRI, good luck and all the best for you.
 
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