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What's The Next Step??

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Old 04-27-2005, 05:29 AM   #1
Junior Member
Join Date: Aug 2004
Posts: 23
What's The Next Step??

Please, if anyone can help me out, it would be appreciated. Here's my timeline:

12/10/04- Laminectomy/Discectomy L5-S1
01/15/05- Reherniated L5-S1
3/11/05- Laminectomy/Discectomy L5-S1
4/19/05- Reherniated L5-S1

Dr. Hasn't looked at recent MRI from yesterday yet, But I know it is reherniated. WHY DOES THIS KEEP HAPPENING? I follow all post surgery procedures to a T. Is it because I am a smoker? Is the next step a fusion??? I am only 32, I do not want a fusion. Pain pills aren't working anymore, is it time to ask for something long lasting/ time release, like Oxycontin or a duragesic patch. PLEASE HELP

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Old 04-27-2005, 05:38 AM   #2
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Join Date: Nov 2004
Location: Apex, NC
Posts: 940
whackedback HB Userwhackedback HB Userwhackedback HB User
Re: What's The Next Step??

For just pain relief, you could now ask your Neurosurgeon about getting you an Epidural Steriod Injection (ESI).

Fusion is no longer the only option, you now need to research Artificial Disc Replacement (ADR) and see a NS who specializes in ADR to see if you are a candidate for it. I have a feeling you might be since you haven't had a fusion and it looks as if you only have a single level situation going on. Good luck to you.


Last edited by whackedback; 04-27-2005 at 05:39 AM.

Old 04-27-2005, 09:22 AM   #3
Join Date: Apr 2005
Posts: 83
et318 HB User
Re: What's The Next Step??

Whackedback is right. Fusion is not your only option. ADR is showing some promise in situations such as these. Very popular in Europe but gaining acceptance in the U.S.

Epidural injections may bring your pain down enough to allow your pain medications to be somewhat effective. Given the duration of your problem and the fact that you will likely be doing more research prior to submitting to another surgery, a long acting opioid may be a good option. This depends on the amount of relief you can obtain from your present medications and other issues. If you are taking a short acting med and only get two to three hours of relief then an LA may be a good idea. Discuss it with you doc and see what he says.

Old 04-27-2005, 02:27 PM   #4
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Join Date: Nov 2003
Location: Missouri
Posts: 2,128
carol632 HB User
Re: What's The Next Step??

If you find out why this happens, please share it! I had the same problem at L5-S1...laminectomy...4 months later another lami....10 months later it had to be fused. Just kept re-herniating. That was back in the early 80's. I finally had to have the fusion redone in l997. I wish the ADR was around just a few years earlier, lol. But I agree with the other posters, looking into that rather than the fusion is the way to go. The only drawback that I can see is that no one knows what will happen a few years down the road. But reg. fusion is only going to last around 10 years, too.

I'm really sorry you are going through this and I certainly understand your bewilderment and frustration. Sometimes, no matter what we do, our backs just misbehave.

2 lami's, 3 fusions
bone spur removal
cerv. fusion, 1 level
morphine pump

Old 04-28-2005, 06:48 AM   #5
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Join Date: Aug 2004
Posts: 23
Re: What's The Next Step??

Update. Just found out that my MRI was normal. No reherniation. Although this is great news, I can't seem to understand why my pain is at pre surgery levels. The word is, I have a lot of scar tissue pressing on the nerve root. Will this go away in time?? I JUST WISH IT WOULD ALL END!!!!!!!!

Old 04-28-2005, 10:12 AM   #6
Join Date: Apr 2005
Posts: 83
et318 HB User
Re: What's The Next Step??

Glad to hear that there is no repeat hernation. Scar tissue can be problematic though. Did he explain where the scar tissue has formed. Around the nerve root? Generally in the epidural space?

Surgery to remove scar tissue can be problematic because scar tissue develops due to trauma to tissues. Repeat surgery creates more trauma and that is why we say "scar tissue begets scar tissue"

There are some substances that can be injected via epidural that have shown some effect on reducing scar tissue. I wish there were better studies for those but they are underway.

Oftentimes, a good PM doc will try some neuropathic pain medications if you are having radicular (down the leg) type symptoms again. Occasionally epidural or transforaminal injections can be helpful. In some instances the scar tissue is enveloping the nerve root but not pressuring it. During the formation phase or post-surgically there may be some residual inflammation of the nerve. When corticosteroid reaches that area it may reduce the inflammation and though the scar tissue exists it may not be of enough pressure to cause the irritation to recur.

Good Luck.

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