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Old 01-11-2007, 02:30 PM   #1
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Join Date: Jan 2007
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pookie62078 HB User
Vacuum disc phenomenon??? Herniated and Torn Discs Will IDET help me?

Here is my MRI and 6 view Spine Xray with lateral flexion and extension diagnosis:

MRI
The conus medullaris is normal in appearance and location. There is degenerative endplate change at L5-S1 with moderate disc space narrowing and disc desiccation. Otherwise, no abnormal bone marrow signal. There is disc desiccation and mild disc space narrowing at L4-L5 with a posterior annular tear.

Minimal broad-based disc bulge at L3-L4 with minimal ventral flattening of the thecal sac.
At L4-L5 broad-based disc bulge causes mild ventral impression on the thecal sac. Again identified is the posterior annular tear at this level.
At L5-S1 there is left paracentral disc herniation measuring approximately 1.7 cm traversely and 1 cm anteroposterior in dimension. This causes mild ventral impression on the thecal sac and does displace the left S1 nerve root posteriorly and laterally with some effacement of fat. It also appears to abut the right S1 nerve root with some displacement of the fat as well.
Impression:
1. Large disc herniation at L5-S1, eccentric to the left causing only mild impression on the thecal sac. This does appear to efface (not sure of that word, copier left a line there)the ventral fat about both intradural S1 nerve roots and displaces the left S1 nerve root posteriorly and laterally.
2. Broad-based disc bulge with annular tear at L4-L5 with mild ventral impression on the thecal sac.

X-Rays:

Standing radiographs were obtained including lateral flexion and extension views.

There is marked disc space narrowing at L5-S1 with Vacuum disc phenomenon with some mild spurring. There is no subluxation. Pedicles are intact.

Mild to moderate degenerative changes in the lower lumbar spine.

I have had 3 rounds of PT for about 4-6 weeks each, I always ended up quitting right before I was supposed to be done because it seemed to make things worse. I had 1 epidural and 1 caudal injection, which made things sore for a few days afterwards, then back to normal, no help. Then I had the discogram and it hurt quite a bit on L4-L5, but L5-S1 was excruiating, and the same pain that bothers me. L4-L5 was torn a little (on top I think) and L5-S1 was severly torn. I have some pain radiating down each leg, but I can deal with that its the hoorible pain in the middle of my back and left butt cheek and left hip that I can't deal with. The disc space between L5-S1 is very narrow, the Dr had a hard time doing the discogram on that one cause he was having problems getting the needle in.

I am seeing the best neurosurgeon in this area (Dr Palavali, Flint, MI), and he thinks IDET is worth a try, because I REALLY don't want fusion or replacement. This all started about 1.5 years ago due to a car accident, and I'm 28 years old and was athletic.

Could someone tell me what vacuum disc phenomenon is I can't seem to find an explanation on the web that I understand, and I really don't think the IDET will help, but if there is a chance it will I'm willing to try it, It is scheduled for Monday Jan 15th. This has been getting progressively worse, and I have been off work for the past 2 months, and I have been very miserable and depressed. 2 weeks ago the neurosurgeon took over my care from the Pain Management Dr, and switched me from 40mg oxycontin 2x a day and 10/325 percocet 8x a day to 4 vicodin es a day, and I can't even get off the couch hardly. The 4 vicodin es wasn't even enough to keep me from going through withdrals, so on top of the back pain I was having horrible withdrawls for about a week.

I just got the X-rays today, and my Dr has not seen the report yet, and I was wondering if the x-ray report showed anything the MRI didn't show, that he might need to know before going ahead with the IDET.

I kinda understand the MRI report, but if someone could also explain that better I would appreciate it. So any thoughts on this matter would be appreciated since I only have 3 days to cancel the IDET.

Thanks

 
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Old 01-11-2007, 08:43 PM   #2
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Join Date: May 2006
Location: Berryville, Virginia
Posts: 2,382
Justoneofus HB User
Re: Vacuum disc phenomenon??? Herniated and Torn Discs Will IDET help me?

Well the most important thing I would be asking the surgeon is that if IDET doesn't work and it fails.. can you still have a disc replacement and/or fusion at that same level?

Also.. ask him/her if it fails.. what will THEY do. Some docs don't want to touch you after something fails. These are good questions to ask.

If you are not comfortable with a procedure being done.. I would wait until such time you are as sure as you can be.

When I made my decision to have surgery and it was scheduled, I was happy and relieved that I finally was getting a chance at ridding of that horrible pain I was in 24/7.

I can honestly say I dont know too many that have had success with IDET, though there is one on here I believe that it's worked well for. I saw 4 surgeons.. none of them had any real positive statements to say about IDET, as I asked about it for me. Just wanted to pass that along.

All the best to you and please let us know how you are doing. Tammy
__________________
"believe in the beauty of your dreams"- E. Roosevelt

L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!

 
Old 01-23-2007, 12:39 PM   #3
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Join Date: Jan 2007
Location: Grass Valley CA USA
Posts: 3
lara13 HB User
Re: Vacuum disc phenomenon??? Herniated and Torn Discs Will IDET help me?

In response to your question re: vacuum disc, the research I have done shows that it is gas in the disc. What does this mean?? Loss of the cushioning effect of the disc. Your MRI's are almost the exact same as mine and I have undergone a lot of the same treatment but the pain persists. My only sources of pain relief have been epidural steroid injections 4 annually and proir to that, Radio Frequency Lesioning.
I have extensive spurs on my facet joints and the RFL really helped witht that.
I don't know if the IDET will help, I would really like to hear how you did with the procedure. The only consistant answers that I have gotten to all questions of surgery are that, there is a 50-50 chance that it will make it better/worse. Not good odds, but I have fibromyalgia on top of it so my perception to pain is all screwed up.
My only real advice to you is to reduce your intake of the pain meds. I tried for years to get rid of the pain and only when I realized that I would always be in pain to some degree, did I get on with my life.
Like you I was in an auto accident; at 36, 4 yrs after my fibromyalgia diagnosis, and went through PT, Chiro, etc. Seeking pain relief took over my life. Finally, I got on some anti-depressants and started walking through the pain, we're talking 5 minutes at first, it did help though.
I really wish someone would have told me to quit seeking a cure and live my life because now that I am 45 things are worse, 2 vertabrae are fusing on their own, growing together, no surgery, and the pain is much worse than it was before. But Morphine, methadone, none of it took the pain away without causing another seperate problem to deal with. Now I take Norco, double strength Viocodin, 0-3 tabs a day, and I really try to wait till I can't take the pain before I go for the meds.
I hope this helps you, and I really would like to hear how the procedure went. Please update as the IDET is one of the things that have been suggested for me (back when it was brand new) and I don't know anyone who has undergone the procedure.
Best wishes
lara

 
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