What to do?
Short story, had a 11mm herniated disc L5-S1, discectomy and laminectomy done november 2010, had another MRI done august 2011 showing 3.5mm hernaition...So assuming did not fix the problem...With the herniation left the left lower leg partially numb, from foot to knee...Have no dorsal flexion...Nerve damage seams to be permanent, but is not main concern...Have done at least 100 pt sessions, Still experience low back pain...Had 2 transforamal injections done in november 2011 and a medial branch block, results showing pain not coming from facet joint...Drs want proceed today to do more injections to see if they will help, but did not receive any relief from previous 2...Mentioned doing a fusion of the one level and getting a discogram, but drs seem to want to approach with more injections to see if they will help..I hurt my back by lifting a heavy object in a squat position and twisted at the same time ...It is a work comp claim, and insurance company not giving any problems with authorizing everything thus so far...Tired of taking medication for low back pain Kadian 60mg a day, 30mg oxycodone a day, lunesta for sleep(was taking ambien), was taking lyrica for nerve pain now taking cimbalta which is very similar...Nerve meds making me have bad memory loss...Want to get input from others with experience on what you would recommend to do next....Thanks for all your help...Want to get back to everyday life and do things I love to do...unfortunately it is still painfull in the low back, can sit , stand, move, and for no reason will act up and cause pain. After the MRI done in august of 2011 it still shows a herniation of 3.5 mm...
Re: What to do?
Some follow-up questions: did you experience any relief between the discectomy and laminectomy and the MRI? You stated that nerve damage was not your primary concern, but what is that concern? I'm guessing back pain...
Also, you mentioned the doctors want to do a fusion and discogram. Do they want to do a discogram for diagnostic purposes, then a fusion if the disc is the pain generator?
Is the herniation causing stenosis? Spinal or foraminal? Do you have any signs of instability? Is the disc bulging/protruding/extruded?
Nerves can heal slowly, once they are no longer impinged, so don't write off that possibility. I had an extruded disc causing spinal and bilateral forminal stenosis. The three epidural injections helped for two days each. The PT, chiropractor, and oral steroids did not help much. After two years of struggling, I had a one-level fusion in early December 2011 and am already much improved. I did have an increase of radiculopathy about one month post-op, which is starting to dissipate. My theory is that the circulation to the nerves improved and they let me know how mad they were! I continued a lot of my PT exercises up until the surgery, and I think doing so has really helped my recovery.
If the first two injections did not help, and the surgeon is just planning on doing the same thing again, I would recommend trying something different. Between my second and third, I had an EMG which showed nerve root irritation at a lower level than my herniation, so I was hopeful that changing the injection site would help for the third round. It didn't work out, but I felt like I wasn't just spinning my wheels.
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