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Old 07-29-2004, 06:35 PM   #1
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healmyback HB User
Can left lateral high signal intensity annular tear be healed in time?

I have a annular tear on L4/5 disc and will be getting the Ephidural shot soon. I hope this will heal it.

Is this very bad where i may need a surgery?

 
Old 07-29-2004, 07:13 PM   #2
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tennisnut HB User
Re: Can left lateral high signal intensity annular tear be healed in time?

Hi heal-

I wrote a detailed response to your question about your annular tear at my thread 'Tennisnut's ADR Diary.' A high intensity zone is where a full-thickness radial annulus tear meets a rim tear. A full-thickness radial tear will never completely heal but can, in time, develop a seal in the outer 1/3 of the annulus. This means that your pain can go away, but that your annulus will always be vulnerable to another fissure. This radial annulus tears can take up to 18 months to 'heal,' but you must be EXTREMELY careful not to stress your disc during this time. No lifting anything over 10 lbs and avoid twisting/bending motions.

The epidural shot may improve your pain, but it is merely an antiinflammatory and will not in any way heal the tear. If it does improve your pain, you must be careful not to start activities that will stress the disc. Do lots of walking.
Currently, there are NO good treatments for annular tears. The results of IDET have been disappointing with only about 50% of patients helped across studies. There is absolutely no evidence that nucleoplasty can help a tear. A microdisectomy will not help a tear. The main surgical options are ADR and fusion. You should do everything you can to avoid becoming a surgery patient.

What is your pain level now? What can and can't you do activity-wise? Can you sit without pain?

--tennisnut

 
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Old 07-30-2004, 02:02 PM   #3
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injured betty HB User
Re: Can left lateral high signal intensity annular tear be healed in time?

healmyback:

Read The Burton Report. A shot is not the answer!!!!!!!!!

Take it easy, do what you can, time heals all wounds.

pain management might be for you.

 
Old 07-30-2004, 02:20 PM   #4
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tennisnut HB User
Re: Can left lateral high signal intensity annular tear be healed in time?

Heal - I forgot to mention one thing. If I had to do everything over again, I would not have done IDET but instead a procedure called selective endoscoptic disectomy (SED). This novel approach was developed by Dr. Anthony Yeung, who is in Arizona. As far as I know, he may be the only doccurrently doing this and is certainly the most experienced. Do an Internet search and you will find his website. What impresses me about his approach is that he has a way of detecting the material that should be ablated and avoids harming any healthy portion of the disc. You might send your films to him and see what he has to say. I'd continue to try to see if PT and pain mgmt can improve your quality of life. But I just wanted you to know that there are options.

It is true that the vast majority of annular tears will "heal" by 18 months. But a minority of patients (who have large tears) will not have their tears heal just through time. I'm not sure if you're still in the 18-month window or not.

--tennisnut

 
Old 08-01-2004, 08:06 PM   #5
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healmyback HB User
Re: Can left lateral high signal intensity annular tear be healed in time?

[QUOTE=injured betty]healmyback:

Read The Burton Report. A shot is not the answer!!!!!!!!!

Take it easy, do what you can, time heals all wounds.

pain management might be for you.[/QUOTE]

Hi Betty!

Thanks for the reply.
I do not want the shot either but I believe i must go through this. I have been taking it easy and it has been about a year and few months since my injury that leaves me 6 more months to heal if I lay low. I belive this shot will help me to minimize my inflamation. My personal docter recommended since he had a ruptured disk and he was healed by this shot.
I know it may not work but I must do everything possible because I do not want a surgery. I feel that my back is healing just a tad but will see how long it lasts. so I might have a chance to recover.
keep in touch

thank you

 
Old 08-01-2004, 10:03 PM   #6
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injured betty HB User
Re: Can left lateral high signal intensity annular tear be healed in time?

healmyback:
If the doctor's back got better with the shot, then it was going to get better anyway w/time. But then, he may be jus telling you this to get you to do the shot. The doctors are really pushing the shots right now. I think that is because so many people are turning them down. They take down the inflammation. Inflammation helps in the healing process. (see Prolotherapy). I went in and let a doctor do this to me and purposely inflame my back. I have to say that I am 99% better now.

If you have a tear and it is causing inflammation, then getting a shot is a short term fix until the tear heals. What happens when the effect wears off? Back to square one with the inflammation. It is the doctor's job to try to get you, the patient/consumer to get the shot. If you refuse it, he can then move onto something else that might work.

pain management/time

 
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