Annular Tears, chemical radiculopathy.

[mmglobal]

Originally Posted by guymontag

All the more reason to avoid a discectomy if you can.

I don't agree on avoiding discectomy. All spine surgeries should be avoided if possible. However, if you are a good candidate for a discectomy; properly done in a timely manner, it represents an excellent opportunity heal up and avoid bigger surgeries. I DO NOT believe the "90% of discectomy patients never need another spine surgery" statement that we hear from the surgeons. I do believe that for SOME of us who do not respond well to conservative treatment, it represents the best chance for long term success. (Long term success may be defined as simply avoiding bigger surgeries for some number of years... not necessarily forever.)

Mark

[Maria]

I had one discetomy in '89 that went well. Big ol' open surgery and while it was somewhat cumbersome to recover from it went really well in retrospect.

Sadly I had a knee surgery following that which landed me in a long leg cast and I believe encouraged the demise of L4 which was probably going downhill fast anyway after the L5S1 discectomy of '89.

The L4 percuteneous discectomy results were worse than awful. I mean horrific. But then again we're talking the early stages of percutenous discectomies and it should have had a good result considering I utilized the services of a Neurosurgeon but back then he was older nearing retirement and I didn't inquire as to his experience with this type of surgery vs. some others he was probably much more experienced with.

I had a good result with first surgery and terrible with 2nd. More lumbar surgery has been recommended. I grow older and have more medical problems including osteoporosis of lumbar spine. Sometimes it's not just that our spines are getting older but so are we and the propensity for other medical/health problems that will have to be considered should we need or choose to have a major spine surgery.

Please keep this factor in mind as well.

[guymontag]

Originally Posted by mmglobal

I don't agree on avoiding discectomy. All spine surgeries should be avoided if possible. However, if you are a good candidate for a discectomy; properly done in a timely manner, it represents an excellent opportunity heal up and avoid bigger surgeries. I DO NOT believe the "90% of discectomy patients never need another spine surgery" statement that we hear from the surgeons. I do believe that for SOME of us who do not respond well to conservative treatment, it represents the best chance for long term success. (Long term success may be defined as simply avoiding bigger surgeries for some number of years... not necessarily forever.)

Mark

Your probably right. Since my point of view is skewed as I am in more pain/ feel worse off after the op than before. So perhaps the operation is a very good operation, but its application and the way the surgeon determines whether your a good candidate is poor.

Strictly speaking, the operation was 100% successful, as I have no nerve impingement, leg raises ok, bend ok. Just unfortunately I have nerve irritation due to something?

Thanks Maria, that looks interesting. Has there been any case study on this product? I actually feel that the glucosamine is working, maybe its just the placebo effect, but I feel I am improving over the long time.

[Maria]

If it helps that's what counts or perhaps coincidentally you're just getting better. I've heard a number of older persons taking this report good results with knees but not really in terms of low back pain.

[Eddie G]

I have an annular tear at L5-S1 and I am going in for anterior/posterior fusion with pedicle screws on Tuesday. I have exhausted all non-invasive treatment and everyone feels this is the best option left. I cannot sit without pain and my quality of life is one step above a poop fly. I cant wait until this is over!

My discogram 2 years ago did show the annular tear but the pain was only recreated once. It has to be recreated twice to merit a positive result but I think the valium may have clouded my judgement at the time. The latest discogram reacted twice though my judgement was still cloudy. They also found a tear at L3-L4! Asympotmatic. I heard THAT before.

I'll let you know if the fusion fixes this pain issue.

[martyusa]

Originally Posted by Eddie G

I have an annular tear at L5-S1 and I am going in for anterior/posterior fusion with pedicle screws on Tuesday. I have exhausted all non-invasive treatment and everyone feels this is the best option left. I cannot sit without pain and my quality of life is one step above a poop fly. I cant wait until this is over!

My discogram 2 years ago did show the annular tear but the pain was only recreated once. It has to be recreated twice to merit a positive result but I think the valium may have clouded my judgement at the time. The latest discogram reacted twice though my judgement was still cloudy. They also found a tear at L3-L4! Asympotmatic. I heard THAT before.

I'll let you know if the fusion fixes this pain issue.

Eddie, Let me tell ya. My discogram @ L4-L5 was maybe a 4-5 and very tolerable. L5-S1 was the worst pain that I had ever felt in my life. Annulus was/is torn and the dye leaked through. Make sure they know what the pain indicators are!!!!

I had a posterior fusion "without" a vertebral spacer @ L5-S1. So now I have these screws and PEEK rods in my back and the pain indicator is still there. A lot of mis-communication and a lack of understanding what exactly was going on.

Before you do anything, make sure you know EXACTLY what is going to be done before you have an 8" scar on your back and the physical therapist getting pissed because he feels that all of "his" work will be for naught. (exact words)

[guymontag]

I feel for all of you guys. GOODLUCK Eddie. I hope you are pain free soon......


Speaking of noninvasive methods.

My biggest challenge initially when I started to get the pain was the fact that the more I sat, the more pain I got. I realised then that it was not a case of nerves needing to heal after the microdiscectomy.

I really have to thank chirogeek for detailing his pain. I've taken his mantra of just not sitting. I really think that the major reason why an annular tear never heals for people is that at least 40-50% of your waking hours is spent sitting somewhere. That's 3 times the pressure than standing.

Weight is probably another issue as well. Before my op I was 74kg, I think i'm down to 67kg. Not out of choice either. It maybe my body trying to reduce the pressure on the disc. I'm not suggesting anyone who has a annular tear lose heaps of weight, but it would relieve pressue off the disc.

The glucosamine is something I picked up from some site suggested by a Tim Durnin a phyiso or chiro, who was recommending it to anyone who had annular tears. since the disc is similar to cartlidge, I think it is a good supplement to rebuilding the disc faster than just a normal diet. Again no studies have ever been conducted on the efficacy of Glucosamine for annular tears. Why not? well they should but it won't make any money for surgeons and if found better than a placebo would lose money for them. Also glucosamine is an ingredient in the SED injection proceedure performed By Dr Yeung.

I read also on that biologix site Spinal Restoration - Products

that the disc healing process, starts with a clot buildup.

My theory,
Since the disc is always subject to varying pressures and toruques,
Usually this clot build up will break as it is not strong enough. It will then clot again, possibly the leaking nucleus fluid is part of this healing process, but sitting pressure never allows the clot to become stronger. Hence constant discogenic pain that increases as the tear opens up wider.

By not sitting, and taking pressure off the disc your allowing the clot to form. Even though the clot is not strong enough initially it will form again. Since your not sitting as much the initial clot has made some progress. So it rebuilds on the matrix. Again it might not hold and nucleus fluid escapes, but its a cumulative thing but over time the tear heals. It can the correlate to the feeling of "flareups" as I have experienced and what Doug the Chirogeek has written about. A period of sciatica that then subsides and he's left will a burning pain.

Just thoughts and ramblings...

[library]

I have never heard of this term before. Is it considered as a particular classification inside of lumbar radiculopathy?