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    Old 06-08-2004, 09:26 AM   #1
    lapis136
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    Question Surgery for a collapsed disc

    Can anyone tell me which surgery is most likely to be recommended for someone who has suffered a sudden and painful herniated prolapse on L5, which then resulted in a collapsed disc and Cauda Equina syndrome?
    Also, what is the difference between a 'desiccated' and a collapsed disc, and which one would be most expected to cause neural compression ?

    Many thanks.

    Last edited by lapis136; 06-08-2004 at 09:32 AM. Reason: grammatic mistake

     
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    Old 06-08-2004, 09:36 AM   #2
    injured betty
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    Re: Surgery for a collapsed disc

    [QUOTE=lapis136]Can anyone tell me which surgery is most likely to be recommended for someone who has suffered a sudden and painful herniated prolapse on L5, which then resulted in a collapsed disc and Cauda Equina syndrome?
    Also, what is the difference between a 'desiccated' and a collapsed disc, and which one would be most expected to cause neural compression ?

    Many thanks.[/QUOTE]

    Have you had an MRI? Your MRI should show if there is an inpingment on the nerve. Make sure that you check all of your options before any surgery. There is a report on the net called The Burton Report, a periodical, that gives you more information that anyone needs. Great resource though.

     
    Old 06-08-2004, 12:11 PM   #3
    Fiona_Jo
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    Re: Surgery for a collapsed disc

    [QUOTE=lapis136]Can anyone tell me which surgery is most likely to be recommended for someone who has suffered a sudden and painful herniated prolapse on L5, which then resulted in a collapsed disc and Cauda Equina syndrome?
    Also, what is the difference between a 'desiccated' and a collapsed disc, and which one would be most expected to cause neural compression ?

    Many thanks.[/QUOTE]

    I had a collapsed disc L4-L5 region and the surgery I had recently (May 25) was a fusion procedure; which included a discectomy, titanium intrumentation, and a bone graft from the left hip. I agree with Betty a person never wants to enter into surgery lightly, however I had many tests; an MRI, and a EMG (nerve study), which confirmed that were was definite nerve compression (leading to permanent nerve damage). I had gotten to the point where just leaving my house was difficult and I was in constant pain. Daily activities I used to take were granted were becoming impossible to perform. I'm usually a very active and I would walk 2-3 miles a night, but I couldn't even walk a block without severe pain. In addition the nerve compression had led to foot drop, which was very unsettling.

    While it is still very early in my recovery, I'm already noticing strength returning to leg.

    Anyway, I'm not sure what your particular situation is. But if you have any other questions, please don't hesitate to ask.
    Jo
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    Old 06-08-2004, 07:59 PM   #4
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    Re: Surgery for a collapsed disc

    [COLOR=DarkSlateBlue][SIZE=3][FONT=Palatino Linotype]A dessicated disc is one that is "dried up"...it has lost all its moisture. A collapsed disc is one that has protruded and pieces of it have squeezed out, flattening the disc.

    As for the type of surgery, I feel fairly safe in saying that they will do a fusion.

    Oh, I think the collapsed disc is more apt to be the one causing neural compression...parts of the disc have fallen away and are laying on a nerve.

    Don't make me swear by this, okay? But I think I have it right.

    Carol[/FONT][/SIZE][/COLOR]
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    Old 07-09-2004, 08:32 AM   #5
    lapis136
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    Re: Surgery for a collapsed disc

    [QUOTE=injured betty]Have you had an MRI? Your MRI should show if there is an inpingment on the nerve. Make sure that you check all of your options before any surgery. There is a report on the net called The Burton Report, a periodical, that gives you more information that anyone needs. Great resource though.[/QUOTE]

    Injured betty:

    Yes I have had MRI's taken, but the report was only about three lines long and said there's nothing much to see except every-day DDD. A neurologist told me a year ago though that I need an Epidural to treat a trapped nerve, but then seemed to change his mind when it came to putting it in writing. I have also been told by a Pain Clinician who saw my scans via email that the L5 disc looks SO thin (collapsed?), he assumed I must have been born with an extra vertebra which I've never been told about!!

    On the MRI, the disc itself is extremely thin and dark black in colour with a major protrusion sticking-out at one end. When I was first shown the axial view quite a while back, there was a large dark 'thing' pointing down into the spinal canal. When I ordered copies of that scan, however, I was only 'allowed' to have three sheets, and the missing sheet was (of course) the one with the dark pointed 'thing' on it. Now the latest copy of that MRI session doesn't seem to have the offending frame at all anymore.

    If you have any thoughts, I'd be interested to know them.

    Thanks for your help.

    L

     
    Old 07-09-2004, 08:35 AM   #6
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    Re: Surgery for a collapsed disc

    Fiona Jo,

    Thanks for your reply. It certainly sounds very hopeful that your surgery is beginning to work. If only I could find a doctor who will be honest and offer me the same op.

    Does my description of my MRI's which I outlined above to injury betty sound at all familiar to you? How's the surgery settling down now? Are you able to be active at all? I do hope so.

    All the best and thanks for the info.

    L

    Last edited by Administrator; 03-26-2014 at 01:10 AM.

     
    Old 07-09-2004, 08:37 AM   #7
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    Re: Surgery for a collapsed disc

    Hi Carol,

    Thanks for the description of a collapsed disc. I've outlined the description of my disc to injured betty and your own description of a collapsed disc does seem to describe exactly what I have - unfortunately, my doctors only call it 'a slight touch of DDD' and claim there is 'no surgical target'. I don't think they're being completely honest, do you?

    Thanks (rather belatedly) for the info though. It is much appreciated.

    L

    Last edited by Administrator; 03-26-2014 at 01:10 AM.

     
    Old 07-09-2004, 02:05 PM   #8
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    Re: Surgery for a collapsed disc

    [COLOR=Sienna][I]No, I don't think your doctors are being upfront with you....why, I don't know. If I were you, I would find another specialist to work with. Those missing films, and that missing part of the report bothers me, too. These people just don't seem to have all their ducks in a row and I sure don't want that kind to be putting the knife to my back!

    Good luck, and please keep posting and stay in touch.'

    Carol[/I][/COLOR]
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    Old 07-09-2004, 02:55 PM   #9
    LS56
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    Re: Surgery for a collapsed disc

    I'll give a dissenting opinion. I too have what my surgeon calls the "dreaded black disc disease". This is a dessicated, herniated, whatever disc that shows up as a black line between two vertebrae on the MRI. The black means that there's not a lot of fluid left in the disc to serve as a shock absorber. The black also, however, means that there is still space in between the vertebrae. As he put it to me, this is a no-win situation. He's not had good luck with surgery on black discs, because the only (only!) thing they really cause is pain. And unfortunately, back surgery is not very successful at relieving back pain. However, he's not had good luck at leaving them alone, either, because then the patient still has the pain. So his no-win situation is: leave it alone and have the pain, or have back surgery with a long recovery period (he too recomended fusion) and the end result is a good chance I will still have pain. And in fact I might end up with worse pain than I started with, along with scar tissue as well (which can cause nerve compression and pain all by itself). So it could be that your doctor is telling you the truth: there's not a good remedy sometimes for some back problems. My black disc is just bad enough that it causes pain, but surgery is not necessarily a good option because the risks are quite high that I'll still have the same - or even more - pain afterwards.

     
    Old 07-09-2004, 04:36 PM   #10
    lapis136
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    Re: Surgery for a collapsed disc

    [QUOTE=LS56]I'll give a dissenting opinion. I too have what my surgeon calls the "dreaded black disc disease". This is a dessicated, herniated, whatever disc that shows up as a black line between two vertebrae on the MRI. The black means that there's not a lot of fluid left in the disc to serve as a shock absorber. The black also, however, means that there is still space in between the vertebrae. As he put it to me, this is a no-win situation. He's not had good luck with surgery on black discs, because the only (only!) thing they really cause is pain. And unfortunately, back surgery is not very successful at relieving back pain. However, he's not had good luck at leaving them alone, either, because then the patient still has the pain. So his no-win situation is: leave it alone and have the pain, or have back surgery with a long recovery period (he too recomended fusion) and the end result is a good chance I will still have pain. And in fact I might end up with worse pain than I started with, along with scar tissue as well (which can cause nerve compression and pain all by itself). So it could be that your doctor is telling you the truth: there's not a good remedy sometimes for some back problems. My black disc is just bad enough that it causes pain, but surgery is not necessarily a good option because the risks are quite high that I'll still have the same - or even more - pain afterwards.[/QUOTE]

    But there are also a lot of people who post on this board who seem to have very successful surgery too. What about minimally invasive or endoscopic surgery? If something is compressing a nerve, it makes no sense at all to leave it alone and do nothing. That just means that either there will be no improvement whatsover (if you're lucky!) or just a steady inexorable decline to look forward to. I'd rather find an alternative to both of those options and, just like you, I don't have the patience to wait for self-fusion to occur!!

    L

    Last edited by lapis136; 07-09-2004 at 04:39 PM.

     
    Old 07-09-2004, 05:54 PM   #11
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    Re: Surgery for a collapsed disc

    Hi there:

    Just wanted to pop in and say my nerosurgeon has sort of hinted at the same thing that LS56 is talking about. I am going for my MRI on Wednesday to see if there is any nerve impingment but he says even tho I have severe DDD in L4 and L5 he doesnt see me having any surgery done. He has mentioned the epidural injections tho so I have alot to think about if the MRI doesnt show and nerve stuff going on. Of course if there is nerve stuff going on he said he could fix that so I guess we will see.

    Just another thought on this, have a great day.

    Janice

     
    Old 07-09-2004, 06:05 PM   #12
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    Re: Surgery for a collapsed disc

    [QUOTE=Janice1033]Hi there:

    Just wanted to pop in and say my nerosurgeon has sort of hinted at the same thing that LS56 is talking about. I am going for my MRI on Wednesday to see if there is any nerve impingment but he says even tho I have severe DDD in L4 and L5 he doesnt see me having any surgery done. He has mentioned the epidural injections tho so I have alot to think about if the MRI doesnt show and nerve stuff going on. Of course if there is nerve stuff going on he said he could fix that so I guess we will see.

    Just another thought on this, have a great day.

    Janice[/QUOTE]

    Hi Janice

    That sounds like pretty good news! Do let us know how it goes on Wednesday, and if you could ask your doctor to show you exactly what an impinged nerve looks like on an MRI, I'd be really interested to know what you see.

    Good luck!
    L

     
    Old 07-10-2004, 05:46 AM   #13
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    Cool Re: Surgery for a collapsed disc

    hi i agree with carols opinion to,keep us posted

     
    Old 07-10-2004, 07:36 AM   #14
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    Re: Surgery for a collapsed disc

    [QUOTE=carol632][COLOR=Sienna][I]No, I don't think your doctors are being upfront with you....why, I don't know. If I were you, I would find another specialist to work with. Those missing films, and that missing part of the report bothers me, too. These people just don't seem to have all their ducks in a row and I sure don't want that kind to be putting the knife to my back!

    Good luck, and please keep posting and stay in touch.'

    Carol[/I][/COLOR][/QUOTE]

    Hi Carol and siberiandog,

    I'm afraid this is going to be quite a long one, so maybe you should get a coffee before you start!

    Thanks very much for your reply - it makes me feel a little less like I'm deluded and more like I'm smelling fish. This whole nasty game with the UK health service has been going on for years now, and all it has done for me is make me house-bound and more or less bed-ridden.

    The fact is that (so far), I have seen three different Orthopaedic Surgeons, four different Neurologists, four different Physiotherapists, 2 hydrotherapists, one Acupuncturist, one Osteopath, one hypnotherapist and even one Faith Healer but nobody has eitther been able or willing to really help me, or even tell me (IF they know) why I'm in such a bad way. The Osteopath DID, in fact, initially inform me that I have CES and wanted me to go straight to ER but, by the next day, she had decided that she'd changed her mind and just recommended that I try laying on my back with my knees drawn up to my chest.

    To date, I have only received the offer of an Epidural injection from the local hospital (two years after I first needed it!), but since this offer was made by a Pain Clinician who gave me no explanation whatsover about what I needed the Epidural for or what it was expected to do to 'what', I refused the hospital's 'kind offer'.

    If a doctor is unwilling to explain the 'whys' and 'whats' of a medical condition to a patient, then who is going to accept treatment from him or her? I may be desperate, but I'm not stupid.

    Oh yeah, I nearly forgot. One of the Ortho. Surgeons I was (supposedly) 'being treated by' did actually admit to my GP (MD) that he was having difficulties due to 'a conflict of interests', but since I've never bothered going back to him, I can only suspect (very strongly!!) what that 'conflict of interests' is. His job, his felow doctors, his pension!!!?

    There's a lot more to tell you about, but I'll spare you the details!

    Thanks for the input though. It's much appreciated.

    Last edited by lapis136; 07-13-2004 at 08:29 AM.

     
    Old 07-10-2004, 09:06 AM   #15
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    Re: Surgery for a collapsed disc

    My surgeon told me after a MRI and discogram that my L4-L5 disc was collapsed. He explained it was as if it was completely flattened with no fluid left in it. I was told at this point it was destroyed and would not ever heal, just continue to be more and more painful. And that because of this I was an excellent candidate for a Anterior Lumbar Interbody Fuision. I had my surgery June 30 (10 days ago) and would do it all over again. I'm so glad I did it. It's still early in the healing process for me but I already have had great results and just hope it keeps getting better every day.

    Elaine
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