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    Old 09-19-2008, 07:59 AM   #1
    Alex78
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    Need ASAP advice on back disk free fragment

    Hello everybody,
    I hope you can help me.
    I had different herninated disks, bulding disks already for at least 4-5 years. N prior operations on the back.
    After going through many physical therapy sessions and different test, situation got ever worst.

    MRI showed moderately large free fragment behind the left side of L4 disk, its herniated. Doctors saing its pinched nerve and also causing very acute pain in left leg and they recommend to do an operation. Also, they recommend to do an epidural injection to see if it helps befoer any operations. Moreover, they are guessing may be that free fragment will absorb itself within 6-24 month. Is it possible???

    May be I should go to a Chiropractor? I used to go to Chiropractor and it did help alot, but i am concerned that may be chiropractor is not appropriate because of free fragment....

    Please write me about your experiences and your thoughts what to do...
    Thanks,
    Alex

     
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    Old 09-19-2008, 08:30 AM   #2
    momzworkin
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    Re: Need ASAP advice on back disk free fragment

    Hi Alex! Welcome to the boards!

    What kind of surgery are they recommending?

    As i understand it-yes over a period of time the bone (since it is a living part of your body) works to rebuild itself. We won't get into osteoclasts and osteoblasts and bone callus-but it will eventually TRY to "connect" all its missing parts. THat only works if the fragment stays in place. The bone will try to reattach itself wherever the fragment is which could mean permantly rubbing against the nerve. One of the complications is if it moves around. Another is as the bone tries to reform itself it creates a "clot" to keep it together. If some of the clot breaks away it can go straight to the lungs. THe fat from the bone can carry infection.
    If all they want to do is go in and get the fragment it one thing. If they are talking about a major surgery its another.
    Are you seeing a specialist? If it is impinging a nerve you could, over time, have permanent damage to the nerve.

    I hope you get answers soon!

    Best,
    Momz

     
    Old 09-23-2008, 05:41 AM   #3
    Alex78
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    Re: Need ASAP advice on back disk free fragment

    Hi all
    I dont know yet about what kind of operation. I'll find out in a few days.
    here is the few quetes taken from MRI result:
    " Most significantly at L4-5 there is a new extruded disk herniation behind the left side of the L4 vertebral body emanating from this L4-5 level."
    "New extruded disk herniation behend the left side of the L4 vertebral body. This is moderately large free fragment behind left side of L4. This appears to have emanated from the left lateral disk herniation at L4-5."

    So, this is the main concern for me and it apears for the doctors as well. The biggest complain is I am limping and feel pain in left leg: burning sensations and needles in my leg.
    What should I do....

    One doctor want to do from 1 up to 3 epidural injections before sending to see Neurosurgeon for consultaion. I am aftraid that injections wont help and i just be more suffering.... May be I need to see Chiropractor to relieve pinched nerve, but that free fragment might prevent it... and How moderately large is that fragment. MRI report did not mention about specific size..

    I'll be waiting for your comments.
    Thanks

    Last edited by Administrator; 04-06-2012 at 01:59 AM.

     
    Old 09-23-2008, 08:55 AM   #4
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    Re: Need ASAP advice on back disk free fragment

    Personally when I see the kind of results in your MRI I would not see a chiropractor. While a chiropractor can do some adjustments it gets very risky when you have nerve impingement - the consideration of chiropractic manipulation making the condition worse.
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    Old 09-23-2008, 02:01 PM   #5
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    Re: Need ASAP advice on back disk free fragment

    I agree on no Chiro! Its a free fragment so its not locked in anywhere yet and could move. The tingling and numbness are a sign of nerve damage or impingment. I wouldn't do anything till they know exactly what and where. Only you can make the decision about this. The herniations are your biggest concern right now. Its like toothpaste-once it comes out it can't go back in and your bones need the padding between them or your sciatic nerve is going to get bumped, pinched and irritated.
    Personally the shots never helped me. By the time they did a discogram to see that I was bone on bone I had gone through three shots They are out there for a reason tho so they must be helping someone.
    Is it definalty a bone fragment? What you wrote last doesn't indicate it. It is most likely a disc fragment-the disc isn't bone.
    A disc bulge is due to tears in the annulus allowing disc material to enlarge the disc in the form of a bulge; similar to the way an old tire might bulge out.
    A disc herniation occurs when the inner jelly-like portion of the disc protrudes into the tears in the annulus in one area and has moved or bumped the spinal cord or nerve roots, i.e. pinched nerve. However, the outer ring of the annulus has not been broken through...in other words, no disc material has completely squirted through the outer edges of the disc.

     
    Old 09-26-2008, 06:12 AM   #6
    Alex78
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    Re: Need ASAP advice on back disk free fragment

    Hi everybody,
    thanks for replies.
    I have some news to report.
    I went to the spine/back specialist surgeon. He stated that I dont have a free fragment brake, but what it looks on the film is that I have slipped disk that came out and it bend it and that is why it causing a pinch nerve. That is why i have pain in left leg.
    He thinks, at this point I do not need a surgery. He suggested to do several epidural cortisone injections, to see whether there will be any improvments. I dont know what to do, because the doctor is getting paid by works comp. May be I should see another specialist like a neurosergion..????

    Thanks again
    I'll be waiting for your thoughts.

     
    Old 09-26-2008, 06:30 AM   #7
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    Re: Need ASAP advice on back disk free fragment

    What your doctor recommended would be the first thing most doctors would recommend. The injection bathes the nerve in a steroid medication and hopefully works to make the swelling go down. When the nerve is no longer irritated, the pain in the leg will go away too.

    The ESI is really the first line of treatment for this type of injury, so I think you can feel comfortable in this doctor's suggestions.

     
    Old 09-26-2008, 06:51 AM   #8
    momzworkin
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    Re: Need ASAP advice on back disk free fragment

    It seems to me that doctors these days follow a similar conservative protocol. Naproxen (or anopther anti-inflammatory); physical therapy and three ESI shots of steroids. When these three are exhausted they talk surgery. If they had done a discogram or other more in depth study before the six months of conservative treatment it would have been very clear that I was bone on bone and was porlonging the inevitable.
    It might be wise to seek another opinion on how bad your herniation is. Once the stuff oozes out of the disc it can't go back in. Its your call. Workman's comp may not even support another decision. I don't know how flushing the area with steroids is going to cause the nerve to not be impinged by the bent disc but I am not a doctor.
    I am praying you will get some good answers!

    Blessings,

    Last edited by Administrator; 04-06-2012 at 01:59 AM.

     
    Old 10-29-2008, 02:29 PM   #9
    Alex78
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    Re: Need ASAP advice on back disk free fragment

    Hello everyone,

    I want to give you guys some update and seek advice again.
    I still did not do any injections. Still on pain meds. I just saw today a chiropractor for the consult. He recommended to do accupuncture and spinal decompression. I did some research about it and it suggested that it helps in my case. What you guys think or had experience in that.
    Thanks,

     
    Old 10-30-2008, 07:34 AM   #10
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    Re: Need ASAP advice on back disk free fragment

    Hi Alex! I have been wondering about you!

    I am in no way trying to knock Chiropractors-they have alot of knowledge of the spine and in some case provide great relief. That said....

    He is not a spine specialist. Are you able to seek another Ortho or Neuro opinion? Did they do anything but regular x-rays? Mri? Cat scan?

    Iamlost on how accupuncture would help. I don't know about decompression. I think you need to ask your current doctor/spine speciaist what he thinks. He is the one who has trained extensivly in this area and may well tell you a non-surgical decompression may work. I would hesitate to do anything without talking to that specialist! You could do more harm than good.

    Anyone else have experiance with Chiro decompression?

     
    Old 11-05-2008, 09:07 AM   #11
    Alex78
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    Re: Need ASAP advice on back disk free fragment

    Hi all,

    I did go to the neursurgeon just a few days ago. I got conflicting info from 2 different doctors. One doctor (spine surgeon) more than a month ago, stated that the disk is not broken (see my previous post with desrciption of the MRI) Now, the neurosurgeon stated that the disk is broken like it says in MRI report.
    He suggested to do 1-3 epidural injections, then some physical therapy, then repeat MRI and see if the broken piece shrunked or not. If it did not shrunk do the surgery...

    My biggest symptom now that i am limping and cand sleep on left side it hurts...
    But in general its not as painfull as it was 2 month ago.... see my post for all history.

    Now I wonder who is telling the truth???
    I was wondering what are the side effects from those steroid injections that they want me to get??? I do have high BP...

    Should I go to another neurosurgeon???
    what you guys think about chiro and the spinal decomression and the epidural injections??
    Thanks,
    Alex78

    Last edited by Administrator; 03-17-2014 at 05:42 PM.

     
    Old 11-05-2008, 12:55 PM   #12
    momzworkin
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    Re: Need ASAP advice on back disk free fragment

    Hi Alex! I have been wondering about you-haven't heard from you in a while!

    I would NOT go to a chiro as many have said in this thread-what you decide will be up to you though. It sounds like you have more failth in him than the two doctors! Can you circle back to the Ortho and ask him to re-read your MRI? Tell him about the second opinion-they really don't care if you get one and will actually encourage you to. It won't look like you didn't believe him-just wanted a second opinion. He might rethink it after reading the Neuro's report. Both, tho, have suggested the steroid shots. The shots have helped a lot of people. As i said before-they usually follow this very conservative therapy before considering any kind of surgery. Anti-inflammatories, PT, steroid shots are all ways of reducing the inflammation in your back so the discs can calm down.
    If it were me-I would go report in hand back to the first doctor. Hopefully he is the kind who realizes he is not a "God of Medicine"-LOL.
    Stay in touch!
    Blessings,

    Last edited by Administrator; 04-06-2012 at 02:00 AM.

     
    Old 11-06-2008, 01:26 PM   #13
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    Re: Need ASAP advice on back disk free fragment

    Hi Alex,

    You should consult your treating physician before engaging in any activity mentioned below.

    I had/have extruded disc material at L5-S1 touching my sciatic nerve on the left from auto accident 4/24/01. Symptoms included severe nerve pain in buttox, left thigh, left calf and numbness in foot and toes, limping and of course excrutiating pain. Surgery was recommended but never performed. I had 3 epidural injections that seemed to interrupt the nerve pain. Walking daily in a four foot deep pool seemed to get the disc pressure off the nerve and keep me from loosing all muscle tone. Massage helped the blood supply in my left leg. Iceing my back with 2 to 8 pounds of ice seemed to help as did inversion therapy. I also tried accupunture and other therapies as well as traditional PT. The good part of the story is that I have recovered substantially and no longer suffer from daily nerve pain the bad part is that it took 7 years and hundreds of hours of therapy.

     
    Old 11-10-2008, 02:37 PM   #14
    Alex78
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    Re: Need ASAP advice on back disk free fragment

    Hi All,
    here is the latest update:
    Went to another physician (pain management MD) who does all kind of injections.
    He also states that there is a break and epidural injection Steroid Cortisone ijection might help to releive pain and help to reduce the limping and actually help to shrink the free fragment.

    The doctor suggest to do epidural injection Cortison with the local anesthesia. I am concerned that it will be too painful with only local.... He said another option I will be put in sleep while he guide flouroscope. But he preffers that I would be awake with local anastesia so he would ask me question what i feel and etc....

    What you guys thinking about local versus puting a sleep ???
    He also said there is a 1 in 1 million chance of serious side efects like:
    bleeding, infection, paralysis....
    So, those who already went through those injections, please share your experience about it.

    Thanks
    Alex78

     
    Old 11-19-2008, 05:37 PM   #15
    Alex78
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    Re: Need ASAP advice on back disk free fragment

    Hi all,
    i had a first epidural injection today (steroid). Pain is very bad. Numbness in my left leg continued for the 1 hours after procedure. Bu now i feel pain like it was almost in Septmber... pins and needles in my leg...
    Doctor said that numbness shoud go away within few hours.. so far it not going much...
    What shoud I do....????

    I need of all you help on this...
    waiting for all of your responses.
    Alex78

     
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