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Old 06-01-2003, 12:48 PM   #1
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Join Date: Apr 2003
Location: Ohio
Posts: 747
mokita HB User
Red face If Disc is Torn/leaking -is that Rupture?

Hi all.

This may be a stupid question, but I am not real clear on this.

My L4 has a tear and a 'significant' leak onto nerve. Would that be considered a 'ruptured disc?' I never thought to ask doctor. Or is this just a tear (just a tear, like it doesn't hurt! :eek

TIA

Karen

------------------
9/22/00 24 hour labor, baby posterior, left tailbone killing me
12/00 MRI - PCP said nothing amiss - but, had to begin taking vicodin
2/8/02 - 2nd baby born after long, painful pregnance as weight gain
2000-11/02 various PT + pain meds
11/02 Referred to Neuro
3/03 NEW MRI - shows slight bulge L3-L4,slight DDD Neuro Refers to PM for ESI
3/03 PM Doc orders ESI
3/21,4/1,4/8 - ESI's no help
5/9 - Discogram - shows Tear L4 w/ significant leak onto nerves, DDD
Doc sched NEW discogram 'cuz performing doc oversedated, False Negative
New Consult w/ Dept Head Cleveland Clinic 7/8

 
Old 06-01-2003, 01:43 PM   #2
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Join Date: May 2003
Location: Keyser Wv USA
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Hello first of all let me say how lucky u r to have no pain I would say there is no nerve compression ( thank god ) I am no prfessional but have a little knowledge of disc problems because I have L4 L5S1 herniation and I have major pain (or should I say had major pain) getting better now I think, anyway back to your disc there are 2 parts to a disc the inner and outer they have names but u get the point anyway the inside material is like crabmeat the thickness I mean and the outside holds this part in. If the inside comes out I have been told this is a herniation now there r different kinds of this small, medium, and large they have measurments like 3mm 4mm 5mm but you get the point. As you age the disc become dry and little cracks appear there is a reason but it would take to much time to explain but u can go to a search engine like goggle and type in (disc herniation) and gain much knowledge) anyway with time and taking things easy theres a good chance they will heel thereselves. You can help to by asking your doctor to give u some excerises to help strenghing your back and stomach muscles. If anyone disagrees please tell your opion.I am not a doctor by anymeans.

 
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Old 06-01-2003, 03:23 PM   #3
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Join Date: Apr 2003
Location: Ohio
Posts: 747
mokita HB User
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Hi there! I am sorry if my statement was misleading regarding the pain. I was being sarcastic it's how I deal with bad situations - humor. Anyway... I also have a numb right foot/tender right ankle. Sometimes, the tingling goes up as far as my knee. I always have aching pain in tailbone/right hip area. I even have tenderness on pubic bone/right hip bone. If they're pressed on, I can jump off the table. Sharp, stabbing pains sometimes in right hip/tailbone/dimples above buttocks on both sides. Sometimes the tingling in foot is painful, like needles. Most relief at night from tinging sensation. Worse is when I sit for over 20 min.

The reason I posted this particular question is that I got to thinking about my MRI which only showed a mild bulge (3mm); that's where the ESI's came in and did little/no good. Then the discogram which showed the "tear/significant leak onto nerves". I understood the herniation to be the inside of disc travelling to outside and causing problems w/ nerves. But, is a Tear with leakage considered a herniation? That's basically what I'm wondering so when I'm searching the net....I'm getting all the information that applies to my condition.

I know there are so many people here who have dealt with numerous disc problems/doctors/procedures/tests,etc.. that, for my own enlightenment.. ?

Thanks so much. Sorry my (bad?) humor messed up my question. I really WISH that it wasn't humor... this has been a particularly bad pain day as I overdid it yesterday. In tears... and depressed. I want so badly to feel NORMAL again. I just want to be able to play with my little ones, dance w/ my husband, feel like I used to... and I'm coming to the conclusion that that very like may NEVER happen.

Sorry to go on and on....
Thanks for listening and posting! Hope you're having a pleasant Sunday!

Karen

------------------
9/22/00 24 hour labor, baby posterior, left tailbone killing me
12/00 MRI - PCP said nothing amiss - but, had to begin taking vicodin
2/8/02 - 2nd baby born after long, painful pregnance as weight gain
2000-11/02 various PT + pain meds
11/02 Referred to Neuro
3/03 NEW MRI - shows slight bulge L3-L4,slight DDD Neuro Refers to PM for ESI
3/03 PM Doc orders ESI
3/21,4/1,4/8 - ESI's no help
5/9 - Discogram - shows Tear L4 w/ significant leak onto nerves, DDD
Doc sched NEW discogram 'cuz performing doc oversedated, False Negative
New Consult w/ Dept Head Cleveland Clinic 7/8

[This message has been edited by mokita (edited 06-01-2003).]

 
Old 06-01-2003, 06:14 PM   #4
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Join Date: Dec 2002
Location: Concord, CA, USA
Posts: 676
successtory HB User
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Hi Karen,

A tear is basically a big 'crack' in the disk wall. There are 2 parts to the disk. The nucleus which holds the caustic gel-like substance that gives lubrication and softens shock impact is the "insides" of the disk. The walls of the disk are actually a ligament-type material (think of a fishing wire)...it is wrapped so many times it spiderwebs itself into bone-strength. With this in mind....here are a few descriptions of medical terms.

TEAR: A tear is when the web has separated from other parts of the web. This 'crack' allows the nucleus material to leak out (which is what causes the pain when it hits the nerves....like an ice cube on an open tooth cavity....oooooooo<shiver,shake> ).

FISSURE: This is when the disk separates from it's connection to the spine.

RUPTURE: A rupture is a really big tear...a hole in the disk. The reason people can still walk or (basically) function with a ruptured disk is because there are 4 quadrants to a disk (split a circle into 4 equal parts). So when only one quadrant ruptures or tears...there are still 3 good quadrants to keep you walking. The reason I wasn't walking anymore (personally) was because all 4 of my quadrants were ruptured...there wasn't anything left--a couplea pancakes for disks.

HERNIA: There are 2 kinds of herniations and several levels as mentioned before. The 2 kinds are inverted or contained hernia and the other is external. The inverted or contained hernia is the nucleus poking out of it's own barrier...but not breaking the disk wall barrier--it is contained within the disk. The external herniation is when the nucleus wall is poking out of the disk wall into the abdominal cavity or into the spinal chord. The herniation is poking through the tear or rupture in the disk wall.

I hope this gives a little better picture of what is going on and answers your question...did I answer your question? hehe

Talk to ya later Karen.



------------------
successtory
Oct 2000: Repetitive Stress Injury-Inverted Hernia
Feb 2001: MRI. Shows only slight bulge at L4-L5
Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.

 
Old 06-02-2003, 03:25 AM   #5
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Join Date: Apr 2003
Location: Ohio
Posts: 747
mokita HB User
Talking

Successtory....

Thank you so very much. Yes,I think you have. So, what I have is a tear. (just a tear )But, it could end up being ruptured? Is that right? Do herniations sometimes CAUSE a tear? AND, finally, I understand the caustic innerds causing pain when it contacts nerves (the doc basically told me that is why I'm hurting so much, my little disc is leaking directly onto nerve.) - is the reason for pain with the herniation because you are Losing your Cushioning? or, in your case, a pancake replaced your cusion - and it wasn't up for the job?? [img]http://www.healthboards.com/ubb/rolleyes.gif[/img] Sorry, couldn't help it -- after your icecube reference.... )

Again, thank you... you are so helpful. I just want to know exactly what I'm experiencing so I can better make decisions. I KNOW that they are NOT convincing me to have IDET. They'll have to come up with something better than that. I'm looking @ nucleoplasty and endoscopic discectomy as proc. to discuss w/ them. What's your take? if you don't mind me asking.

Karen

------------------
9/22/00 24 hour labor, baby posterior, left tailbone killing me
12/00 MRI - PCP said nothing amiss - but, had to begin taking vicodin
2/8/02 - 2nd baby born after long, painful pregnance as weight gain
2000-11/02 various PT + pain meds
11/02 Referred to Neuro
3/03 NEW MRI - shows slight bulge L3-L4,slight DDD Neuro Refers to PM for ESI
3/03 PM Doc orders ESI
3/21,4/1,4/8 - ESI's no help
5/9 - Discogram - shows Tear L4 w/ significant leak onto nerves, DDD
Doc sched NEW discogram 'cuz performing doc oversedated, False Negative
New Consult w/ Dept Head Cleveland Clinic 7/8

 
Old 06-02-2003, 07:28 AM   #6
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Join Date: Mar 2003
Posts: 226
Bcorica HB User
Post

Hi Mokita

It is so funny that you asked that question about tears. I finally asked my doctor on friday, what the difference was, because I was very confused myself.

I asked my doctor to explain it to me like I was a ten year old, because I was not getting it the way he was explaining it to me, and that is how I like it explained. I told him to make it short and sweet.

So here is my short version of what the difference is, and how the doc explained it to me, or better yet, how I understood it.

Okay......Here we go:

If the tear is leaking and the gel goes outside of the annular wall of the disc, then it is a herniated disc. If there is a tear, and the gel is still contained inside the annular wall (not leaking), then it is considered a herniated disc, disc buldge or a contained herniated disc.

So with a tear that is leaking, it can be called several things, such as: a disc tear, herniated disc or a ruptured disc, depending on the circumstances.

A tear that is not leaking, can be called a herniated disc, contained herniated disc or a disc bulge.

However, you can have a tear, and it not be herniated, but just a tear. That is when it isn't leaking, or buldging in anyway. Most likely you will not have any leg pain, just the back pain.

The reasons why we can experience leg pain:

If the herniated disc is leaking outside of the annular wall, the gel (thats what I like to call it), can leak out of the tear, and on to the nerves causing inflammation and irritation, and that is why it is so painful.

If the herniation is contained inside annular wall, it can buldge out far enough, to compress on the nerve, causing pain in the legs.

Doctors like to confuse us, because they will call a disc tear different things, depending on the situation explained above. It has taking me a long time to understand, and I still don't know if I am 100% correct on this.

Successstory, explained it just like a professional, but of course stupid me, needs things explained to me like a child. I have been having a really hard time concentrating anymore, so I need things short and sweet.

Someone on here explained it to me before, and I was to embarresed to tell them I didn't get it, and I didn't want them to have to explain it to me again, in fear that they would get mad, so I just let it go, until friday.

One more thing to add to the confusing, you can also have a herniation, that only herniates when you sit or stand, and that is why many times a MRI won't pick it up, because the test requires you to lay down. That is why when you lay down, it someimes releives the pain, because the pressure is taking off your disc.

Okay, that is enough of my silly little lessons that took me over a year to find out. Boy, my mother would be so proud [img]http://www.healthboards.com/ubb/rolleyes.gif[/img]

Karen, I hope this helps you, and anyone please correct me if I am wrong.

Take Care,
Brenda [img]http://www.healthboards.com/ubb/heart.gif[/img]
__________________
May 2002: Injured at work
June 2002: Had MRI
June 2002: Had ESI's
July 2002: EMG
Feb 2003: Prolotherapy
March 2003: Discogram, Showed left posterolateral radial tear @ L4-L5 and more diffuse annular tear @ L5-S1.
April 2003: Transforamital Injection
May 2003: Intra-Discal Injection, Finally got some relief from the hip, groin, butt and leg pain. This injection worked the best!
May 2003: Second Opinion, Doctor Suggested Disc Replacement as my only option.
May 2003: Postponed Nucleoplasty
June 2003: Went to Psychiatrist for depression.
July 2003 - Present: Trying to take one day at a time, and learning to adapt to a new way of life.

 
Old 06-02-2003, 08:19 AM   #7
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Join Date: Apr 2003
Location: Ohio
Posts: 747
mokita HB User
Post

Thanks Brenda!!!

I am finally starting to get it! I know for a fact that mine is leaking ONTO the disc as my doctor verified that when I went for follow-up to discogram. That's why he (my doc) disagreed w/ his partner/the performing disco-doc [img]http://www.healthboards.com/ubb/dance.gif[/img] (couldn't resist!) that the disc showed negative. My doc couldn't believe there wasn't replicated pain as there was SO MUCH of the disc gel leaking directly onto nerve. THAT's why my doc referred me toBig Dog doc@ Clevel Clinic and will most likely, have another discogram done there by Dr. Mikheil.

Anyway... thanks for the explanation. It is one of those things that I mean to ask - and forget. I even take a list... I forget to write that one down! [img]http://www.healthboards.com/ubb/confused.gif[/img]

So.... at my next apt w/ the CleveClinic, I will be prepared!!!

Karen

------------------
9/22/00 24 hour labor, baby posterior, left tailbone killing me
12/00 MRI - PCP said nothing amiss - but, had to begin taking vicodin
2/8/02 - 2nd baby born after long, painful pregnance as weight gain
2000-11/02 various PT + pain meds
11/02 Referred to Neuro
3/03 NEW MRI - shows slight bulge L3-L4,slight DDD Neuro Refers to PM for ESI
3/03 PM Doc orders ESI
3/21,4/1,4/8 - ESI's no help
5/9 - Discogram - shows Tear L4 w/ significant leak onto nerves, DDD
Doc sched NEW discogram 'cuz performing doc oversedated, False Negative
New Consult w/ Dept Head Cleveland Clinic 7/8

 
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