PLIF in Jan l5-s1.. Need help with MRI

  • Thread starter Thread starter bry0310
  • Start date Start date
B

bry0310

Guest
Hi I am a 35yr old female who has suffered with chronic back pain since MVA in 2008.. I have had all the conservative treatment ie: MeRAB, PT, Epidural and Facet injections, etc.. I seen a neurosurgeon a few weeks ago and had another MRI done the results were..
Endplate degenerative changes with Schmorls nodes T12-L1 L1-L3. No acute associated marrow edema.. No other focal lesions. T12-L2 Endplate degenerative changes.. No canal or foraminal stenosis.. L4-L5 Facet hpertrophy with ligamentum flavum thickening mild to moderate.. L5-S1 Facet Hypertrophy with ligamentum flavum thickening. Degenerative Disc Disease with dessication, posterior central annular tear with 4mm associated posterior central disc protrusion, moderate deforming the ventral aspect of the thecal sac.. No focal neuro compression, Minimal canal compromise but mild foraminal stenosis.. Impression: Multilevel Facet degeneration bilatterally L4-L5 L5-S1.. Moderate degenerative disc disease L5-S1 with disc protrusion and annular tear posteriorly... I do have left sided sciatica symptoms thats horrible while sitting.. Pain is a burning pain in my buttocks and back of my thigh cramps and burns.. After a while the pain and cramps go into my calf and top of my foot just burns and tingles and the backs of my calf start the same burns and tingle pain.. Are these MRI results and constant back pain and intermeddiate sciatica consistant with a plif being done.. I did see an Ortho-Spine surgeon who said he would do ADR if Insurance would cover or a fusion if necessary.. I may need it or maybe i dont want to accept the fact Its wither surgery or get to a point it does alot more damage.. Sorry for babbling but I have never posted anywhere only read them.. Anyone with an answer or had the same issues a reply would be awesome..

Thanks,
BRY
 
Welcome to the board. I hope you will enjoy your participation on this forum and pick up some useful information as well.

I would ask yourself what is your pain level and how long can you live with it being like it is or possibly, getting worse? I waited over 3 years with complaints similar to yours, and I wish I had agreed to surgery sooner. I was not a candidate for ADR, but I would explore that option if you are a candidate.

With degenerative changes, things are not going to get magically better on their own. Chances are, the degenerative process will just continue.

Is your leg pain worse than your back pain or is it the other way around? Fusion is usually quite successful in resolving leg pain. When it is just back pain, it can be more difficult to resolve the pain.

I couldn't say if fusion is the appropriate surgery for you or if perhaps you could get by with a smaller procedure....It is always a good idea to get several opinions from spinal specialists from different practices before making up your mind about something as big as a fusion. Once it is done, there is no going back...so you want to be sure it is the right procedure for what ails you.

There are many good choices among fellowship-trained neurosurgeons and orthopedic spinal surgeons in your area. I would take your time, do your research and find a doctor you respect, like and trust before making a decision.
 
I should add that along with your sciatic pain, if you develop bladder or bowel involvement, it could be a sign of cauda equina syndrome, and would be considered a medical emergency. You would want to contact your spinal specialist immediately or go to the emergency room to have it checked out.

Also the longer nerves are compressed, the greater the chance of developing permanent nerve damage....This is something to consider when deciding whether to have surgery and when.
 
Thanks for the reply.. My pain level is at 5/10 on a good day which seldom happen.. 7/10 normally.. Most of the pain that is in my back but the leg/butt pain is getting worse each day it seems like.. I am gonna have a discogram done to make sure its just the l5-s1 disc level causing the pain source.. The MRI was very dark at that level and disc space had narrowed grad 2 he called it.. The l4-l5 disc looked normal the discogram should substantiate that I hope.. I have read that if the discogram is positive and the CT that follows then fusion is the most likely thing that will help.. Im hoping in a way its not positive but then will be back at square 1 and really confused at the pain source.. I have had RF ablations at l5-s1 facet joints and they didnt help either.. Nerve test showed some damaged nerves but they seem to think its from the DDD and annular tear leaking on the nerves at the l5-s1 disc.. I just want to be pain free.. My daughter is only 9 mos old and i have 2 teenage boys and want my life back.. 1 thing that makes me want fixing is that I have seizure disorder from the MVA and dont need anymore health problems.. God bless
 
Back
Top