???????

CALLA · #1 (**permalink**) 11-27-2006, 08:02 PM

What does L5 Laminectomy defect is noted mean, and disc space is narrow at L5-S1""

Anyone????

Michelle · #2 (**permalink**) 11-28-2006, 03:18 AM

I'm no expert, but I believe the lami defect is because they remove a part of the bone surrounding the nerve root's exit, to give it more room, hopefully decreasing irritation on it. That shows in later studies as an area where the bone is gone. Since part of your disc was removed to get it off the nerve, there is no longer as much material there between the two vertebrae. That's the 'narrowed disc space'. The disc degenerates faster once it's been cut on. This became my problem after 2 of these surgeries at the same level. Unfortunately it caused a lot of pain whenever I was upright because the disc just couldn't support my spine. Did you lose a lot of disc height?? Does it give an adverb like mildly/moderate/severe? I had very similar reports and were told they were 'negative findings' despite the pain it was causing.

CALLA · #3 (**permalink**) 11-28-2006, 04:20 AM

Hello Michelle,

Thank you for the info...I have been having a really hard time lately with my low back pain/leg etc...

It has been 2 years since my L5 Laminectomy and Bilateral Foraminotomy at the L4-5 & L5-S1 levels.

Quote:

Does it give an adverb like mildly/moderate/severe? I had very similar reports and were told they were 'negative findings' despite the pain it was causing.

So Melanie, how did they finally figure out what was causing ALL the problems you were having?? I sometimes think that when I am not getting any results that these docs think it is all in "my head".

Ugh...............sometimes I want to just throw in the towel. It is such a frustrating ordeal!!

Anyways, THANX AGAIN!!! Calla

Michelle · #4 (**permalink**) 11-28-2006, 04:57 AM

I know the feeling of walking into the office, perversely hoping you'll be told there's something drastically wrong on your films, just so you have an answer for your pain. I'm so grateful that I was lucky enough to have docs who actually tried to convince ME that it wasn't in my head. The biggest clue as to my problem was the fact that I had no pain in the am. On getting out of bed I was fine. Almost instantly after standing up, I'd have pain in my back. By the end of the day the pain was all down my leg, and so bad I wanted to throw up. All my studies were done lying down, so there was no evidence of the area collapsing when I stood. But it was. It took a discogram to 'prove' that was where the pain was coming from. In the absence of anything else wrong on MRI other than 'narrow disc space', and with the evidence of the pain coming from the disc, they were pretty confident that they were doing the right thing. It took a lot of injections, PT, acupunture, etc before they'd even consider this, and while understandable, it's frustrating. I was lucky enough to have a general doc who knew me, and knew I wasn't drug seeking or anything, and he also was friends with my ADR surgeon. I really have to thank my GP for that. Just because you don't have a huge bulge or tear, doesn't mean the disc isn't causing your pain. Ask for a discogram. I had been told before that the pain was from surgical scar tissue, and nothing could be done. I didn't accept that, and kept looking. All I can say is keep at it. You'll eventually find something that will help, even if it's just a good pain management program. If your doc keeps treating you like it's all in your head, switch docs. Get a referral to a spine specialist. I feel for you in your battle. But hang in there-it does get better! I'm a bit of a ProDisc fan, so if you want some info on that, let me know.

annapurna · #5 (**permalink**) 11-28-2006, 05:22 PM

Michelle is so right about innocuous structures on MRI or other imaging being big pain generators. I'm lucky enough to have a fabulous injectionist for a PM doc and he always tells me "the needle doesn't lie". I have facet arthritis behind my ADR and alway ask my PM doc if the amount of degeneration means I should have more or less pain. He tells me that he has seen perfect-appearing facet give intense pain, and horribly arthritic facet that are painless.

Moral of the story, if your imaging studies don't show a clear culprit for your pain, don't give up. Ask for injection-based tests like discograms, medial branch blocks, selective nerve root blocks, etc. Spine structures don't have to look bad to hurt.

Best,
Laura