Should I do Discogram or not?

  • Thread starter Thread starter efang622
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I have had a big luraber spine disk herniation on L5-S1 for 13 months , now my L5-S1 there has been considerable internal improvement, but I only have chronic right leg pain. and the pain rate is about 3-5. I have no way to wear it off even I already have tried several non-surgery methoRAB and medication during this year. I almost have no back pain now so my personal feeling is that my leg pain is not cause by my spine disc at all . I talked to the doctors I saw about this but got answer is that it could be ( spine disc).
Now I know I am facing to make a decision that I am going to do surgery or not . I hope I can do a discogram because I also have degenerative disc bulging at L4-L5, I worry the surgery will do at wrong Level. But I already saw several surgeons and no one suggested me to do the discogram even I requested. There is only one Pain Management doctor who did Epidural injections to me said he can do discogram to me as long as I require. I am pretty hesitated about this. I hope some one here who did discogram can answer me a questions:
Should I just do discogarm regardless surgeon’s opinion or do it unless surgeon suggests ? How about your own experience?
I believe as a good doctor, he/ she should and will concern patient’s situation very carefully but my personal feeling is that surgeon always pushes patient to do surgery as soon as patient can. That is why I am so hesitated.
Thanks!
 
You can have a damaged disk and not receive pain from a discography.

You can receive pain while discograpy, and not having damaged disk.

So, you wonder how can I sleep and how can doctor know what disc is damaged? Its very easy answer. While injecting contrast into your discs your doctor will be looking at your spine via flouroscope.

When contrast is injected, it will show what degree of disc degeneration you have.
 
I guess the doctor only can use flouroscope on "sleep" one not on "live" one because it should be very painful. Only doctor can choose " sleep" or "live". this is first time I know it
can use flouroscope in stead of needle.

Thanks!
 
Followyour gut....if it will help you and may help your surgeons, in the long run, do the discogram.
 
efang, Thanks for updating us. I personally don't think that pain is a reason not to do a discogram. Yes, there is pain during the test, but if you're already in pain what's the difference? It's really no worse than what we go through every day. The discogram is an incredible test that shows what no other test can show. I do think, however, that the discogram should be reserved for people who will likely be having a fusion or who have been battling back problems for a long time.

Good luck with the surgeon you will be seeing, and remeraber that if you are not comfortable with them, seek out additional opinions from other surgeons. Once you have had surgery you are stuck with that doctor for at least six months or so of follow-up as other doctors don't like to see a patient that has recently had surgery from a different doctor.

Follow your gut as you work through the difficult decisions you need to make in the near future.

Sending cyber hugs your way!

Brenda
 
I am not an expert, I can only compare your MRI to my MRI's, and from web MRI's.

You can send me on PM, but again - I am not an expert.
 
Kean016,
I am sorry I give up to send report to you because I tried PM and my reports
are too long to be sent. but anyway , Thank you very much for helping.
 
You got it all wrong.

Flouruscope is a type of x-ray machine. And it is used in booth types of discograms.

It is used for neurosurgeon to place needle in a proper position in center of the disc.
 
Brendaks,
Thank you very much for you messages. Right now it is very difficult for me is that going to the surgery or not, because my leg pain is stable , chronic but not too severe.
1) If I don’t do the surgery, this pain will be with me forever.
2) If I do the surgery, I need to take risk of the surgery.
I ask myself this question every day when I wake up. I don’t know what should I do.
Thanks!
 
keano16,

I don't know if I can attached my MRI reports here and let you look at it.
you can tell me your opinion it is " normal" herniation or not., because recently I have no chance to see any Orth or neuro surgeon but I like to know
maybe I don't need to do Discogram at all.

Thanks!
 
I had 2 spinal fusions; 2 major surgeries. Based on my own experience and on what I learned during this three years I can tell you I would never go for spinal surgery without having disco done first. I was explained by my Spinal surgeon at HSS in NYC that discogram is the most accurate test and they don't perform fusion surgeries without having disco done first. Unless they have such a picture perfect Dx which doesn't happen often when it comes to spine. MRI and CT good tests, but they are not very accurate to compare to disco.
In my case my surgeon thought I would need fusion on L-2 also during my second surgery, but when I had disco done, they discovered that I don't need this level done yet. I was so happy b/c I had many other levels done so why add more to already sad picture?:confused:
Anyway, disco is like a map done by PM Dr for your surgeon.

Best of luck to you. You are doing the right thing going for couple of opinions, just make sure you are not going for it in same area where doctors know each other, b/c they do!

Blessings...:angel:
 
efang,

I definitely agree with Moldova. I very recently had an L4/L5 spinal fusion due to left leg sciatica that continued after having a decompression surgery last summer.

My L4/L5 disc after the first surgery didn't look all that bad on MRI's and a myelogram other than a small recurrant protrusion. However, the discogram showed a huge tear in the left side of the disc, and when the disc was pressurized it showed that the disc was bulging out to the back and pushing on my nerve roots which reproduced my pain down my leg. My surgeon that did my fusion said based on the discogram the only thing that would have fixed my problem was a fusion; however, he wouldn't have known this unless I had the discogram to show him exactly what was going on inside the disc.

I also wouldn't have another back surgery unless I had a discogram first.

Another thing - don't get fooled into thinking that you don't have a problem in your spine if you don't have back pain - if you have a disc that is pressing on your nerve roots, it is possible to primarily or only feel pain in your leg(s).

Good luck with your decisions - it can be really tough to feel like you are making the best decisions when facing back problems. Get lots of input so that you can feel as comfortable as possible that you are making informed and educated decisions.
 
Hi efang662,

I underwent 2 discograms (1 "live" and 1 when I was sleeping).

Every modern and qualified surgeon will request for you to go for discogram.
Its not necessary for "normal" herniation (extrusion, protrusion) because compression of nerve roots is then visible pretty clear on MRI.

Yes, first was pretty painful, but this is only method to see in what conditions your discs are, and if you neurosurgeon thinks you have IDD (internal disc disruption) he will not operate you unless you go for discogram.

Its also important to examine what disc exactly is your pain source, and discogram is best solution for this.

Good luck, go for it !!!
 
I can scan them no problem, I couldn't find that the Private Messages has a place to attach the scanned picture. Do you mind if I send to you by e-mail?
 
Thanks all of your advices. I will see my first PM doctor who did trigger point and nerve block for me tomorrow because she said she can referral a top Neuro surgeon to me. I will talk to her if she agree with disco. she can write an order and let me to bring to see the doctor who can do disco. but I just feel some surgeons don't like disco. I don't know why. so it is look like I will do disco without letting surgeon know.
 
Keano16,

I am sorry I haven't known your reply message until today because I haven't got
E-mail notification for someone sending message to me. Yes, I will concern to
do it as long as the surgeon request. but I don't understand the " sleep" one,
if the doctor made you sleep or half sleep, how can you feel pain and tell
him/her where exactly made your pain ?


Thank you very much!
 
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