Annular Tears, chemical radiculopathy.

[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?

[mmglobal]

Radiculopathy is radiating pain due to nerve irritation. It typically comes from compression of the nerve because of disc herniations, osteophytes (bone spurs), collapsing disc height or buckled ligaments because of the collapse, facet hypertrophy (overgrown facet joints), congenitally small canal or foraminal spaces or other cause.

Even without substantial nerve compression, some people can have substantial radiculopathy because of chemical irritation of the nerve roots. The herniated disc leaks chemicals that are neurotoxic.

Aren't we lucky.

Welcome to the forum,

Mark

[Keano16]

We'll said. Patient can have radiculopathy without visible nerve compression.

It occurs in grade 5 (and grade 4?) annular tear. It represents on MRI as high-intensity zone (HIZ). To see if particular disc is causing problems discography is ordered.

[CajunRich]

MRI says nothing is wrong

4 Different Physicians are blind due to me having a history of opiate problem.

I have not been dx'd yet with anything. I have had severe lower back pain, Near the lumbar/Sacrum area. Then my upper thies will hurt after I have sat down for a little while. Next my Heels will hurt like heck if I am on them to long or drive for long distances. Actually the driving of long distances has been out lately due to my buttock hurting so bad.

My back hurts so bad I have to cut all my boxer shorts so the waste band does not put pressure on my lower back. A belt is out of the question. On bad days it radiates to my hips. After reading all these forums I feel like there is no real fix which is disheartening. My wife and daughter are really suffering b/c of my lack of participation in events with them. This is the first summer in all my life I have only played golf once. (hold...I have to shift my sitting position The only thing I feel is different than what I have read is my heels hurt but not the top of my foot and not a tingling sensation.

I am tempted to just check into a local hospital and not leave till we get a solid DX. MRI said nothing is wrong. Neurosurgeon said it should only be one side not the other if it was injury related. PT made it worse....Chiropractor did help a bit but did not fix the problem. I do feel my skinny butt is helping inflame the nerves. I am just started celebrex and lyrica (yippie)

I want to know can medication cause this pain? What else should I do ...I am lost. Working nights for years in the hospital I would sleep at night in my chair leaned back right on my lower lumber for hrs in a leather chair. I really feel that, golf and my terrible posture is the culprit of problem.

Any thoughts?

[Keano16]

Get a second opinion... (neurosurgeon or ortho surgeon, use SMISS or SpineUniverse doctor finder).