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iSpine Discuss Finally... in the Main forums forums; I just got back from the appt. For the first time in 19 months I actually have some validation. This ...

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Old 05-08-2009, 07:41 PM
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Default Finally...

I just got back from the appt. For the first time in 19 months I actually have some validation. This doctor said that the annular tear that I have causes pain in 99% of people who have it and is probably causing a large part of my symptoms.

He also said that even though it is controversial, people with annular tears can have a great deal of pain with no nerve compression due to chemical radiculitis. This is where the chemicals in the disc leak out and inflame the surrounding nerves. I have always suspected this, but most doctors brushed it off.

The last part of the process is the insurance but I think I have that covered.
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Chiari 1 malformation - successful surgery 1-22-09
C5-6 herniation (extrusion) with moderate central canal stenosis and bilateral foraminal stenosis.
Prodisc-C @ C5-6 surgery on 5/28/09
VATS thoracic fusion @ T3-4 and T6-7 on 9/11/09
Fusion w/cage @ C7-T1 on 11/12/09
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Old 05-08-2009, 08:41 PM
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Very good news. I'm glad someone is finally taking your pain seriously.

I hope they come up with a treatment plan that is effective.
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Cathy

46 years old. 12-15 years of intermittent pain, 2 years with constant pain.

DDD, L4-5 and L5-S1, pain confirmed by discogram.
PT, ESI's, Facet injection and block, Acupuncture - all no help.

2-level (Prodisc-L) ADR surgery with Dr. Bertagnoli, May 26, 2009.

Currently taking Opana-ER (tapering off) and oxycodone
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Old 05-08-2009, 08:46 PM
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I guess I forgot to add that we are going with the Prodisc-C.
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Chiari 1 malformation - successful surgery 1-22-09
C5-6 herniation (extrusion) with moderate central canal stenosis and bilateral foraminal stenosis.
Prodisc-C @ C5-6 surgery on 5/28/09
VATS thoracic fusion @ T3-4 and T6-7 on 9/11/09
Fusion w/cage @ C7-T1 on 11/12/09
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Old 05-08-2009, 11:03 PM
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'79,

You mean the pain in not in your head? Gee whiz, I'm shocked. I thought all these doctors were sane while all those living in constant debilitating pain were crazy. AHHHHHHH!

At least your doctor took the time to discover the source of your pain. It's nice to know that someone's on your side and it's not in your imagination,

My best to you, Dale
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Dr. B in Bogen, Germany
Severe nerve damage in left leg, still working on it
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Old 05-08-2009, 11:32 PM
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Ahhhhh yes, chemical radiculitis. I had that. Hurt like a bugger too.
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Disc Bulge C4/C5, Disc Degeneration T11/T12, Bi-Lateral tears L5/S1, Diagnosed w/ Lumbar Disc Derangement w/ Radiculopaphy. Treatment: IDET, Percutaneous Discectomy, SI Joint Injection, Facet Block. All failed. Empire BC/BS Denied Coverage for ADR-lost all of my appeals. MVP also denied coverage.

Anterior/Posterior Fusion L5/S1 -1/20/09
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Old 05-09-2009, 01:45 AM
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I had several years worth of disabling low back pain while my surgeons told me, "you're films look way too good for you to be having the the kind of pain your are reporting."

After a 5 year ordeal that included 3 years of disability, my 2-level lumbar ADR gave me my life back.

Chemical radiculitis is only controversial in the ranks of the uniformed. Kind of like discography.

Mark
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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Old 05-09-2009, 01:52 AM
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Exactly Mark! My MRI's always looked "normal" to the doctors. When I finally went to orthopedic doc #4, he decided to do a discogram. Sure enough, you could see the dye leaking out into the canal.
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Disc Bulge C4/C5, Disc Degeneration T11/T12, Bi-Lateral tears L5/S1, Diagnosed w/ Lumbar Disc Derangement w/ Radiculopaphy. Treatment: IDET, Percutaneous Discectomy, SI Joint Injection, Facet Block. All failed. Empire BC/BS Denied Coverage for ADR-lost all of my appeals. MVP also denied coverage.

Anterior/Posterior Fusion L5/S1 -1/20/09
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Old 05-09-2009, 02:04 AM
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Thanks for the responses everyone. I guess the hardest part now will be the wait for surgery. As much as I am glad that we have finally gotten to the bottom of thing, it doesn't do anything for the pain.
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Chiari 1 malformation - successful surgery 1-22-09
C5-6 herniation (extrusion) with moderate central canal stenosis and bilateral foraminal stenosis.
Prodisc-C @ C5-6 surgery on 5/28/09
VATS thoracic fusion @ T3-4 and T6-7 on 9/11/09
Fusion w/cage @ C7-T1 on 11/12/09
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Old 05-09-2009, 02:08 AM
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When observing endoscopic surgeries with Dr. Yeung, he showed me a sciatic nerve root that was covered with a substantial layer of fat. He said something like, "This patient might have substantial nerve root compression with no symptoms because the nerve is insulated from the neurotoxic chemicals that are excreted via the disc herniation. Later that day, he showed me another nerve root and said something like, "Do you see the way this nerve root is all pink and exposed. There is little or no fat layer insulating the nerve root. This patient might have a minor bulge or protrusion that does not substantially compress the nerve root, yet may still have severe radicular symptoms associated with the chemical irritation of the nerve." This was 5 years ago... I'm paraphrasing... but this is a lesson that I'll never forget.
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
President: Global Patient Network, Inc.
Founder: www.iSpine.org
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Old 05-09-2009, 01:13 PM
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I almost cried when I read a couple of these posts.

My last MRI mentioned an annular fissure. The doctors I've been seeing have said as Mark quoted "your films look way too good for you to be having the the kind of pain you are reporting." If that doesn't make a person think they are a hypochondriac, I don't know what will.

I hadn't put the two together until now, I couldn't prove anything to anyone because they thought that I was 'extremely sensitive', or 'the princess and the pea syndrome' as my husband often says. And yes, one day he will pay for that remark.....

And guess what...they don't 'do' discograms or facet blocks up here, at least in any of our great hospitals, one of which is a teaching hospital. I was stunned when I heard all of you talking about them here, and then being told that they are outdated here...because they now have MRIs to look at.

jchebert1979, I am so pleased for you. It sounds like you finally have all your ducks in a row, and on your way to the other side. Congratulations on your perseverance. I'm looking forward to more posts about your continued success.
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DDD
Herniated discs C4/5 & 5/6, L3/4, L4/5, L5/S1
Severe compression of spinal cord in two levels
All conventional therapy exhausted, including spinal injections, PT, massage, etc.
In appeal with Gov't Insurance for Out-of-country coverage for ADR hybrid surgery of above discs.
Recently discovered that I am severely allergic to all common metals used in surgical hardware except for Titanium.
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Old 05-09-2009, 03:32 PM
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I'm glad my short time here has been of help to some people. I need to write a proper introduction but there is so much information to include that I keep putting it off.

I do know what you mean about doctors making you feel like a hypochondriac. For the first year, I was in such severe pain that I could not think straight. I knew I was not depressed, but I was in so much pain that I could not read, watch tv, talk, etc. My mind was in constant overdrive with fragmented thoughts, repetative thoughts, etc. I thought I had schizophrenia. It wasn't until the pain subsided a little bit that I realized that this is the kind of reaction you are supposed to have when you are in severe acute pain. Most people have experienced it before, just usually it subsides.

In that state I couldn't express myself well and everyone including family and friends all thought that I was depressed or crazy. Looking back on it I am disgusted that doctors did not pick up on it. I wasn't offered pain medication (that didn't work anyway) until well after a year.

Looking back on it, it's interesting that when I started feeling just slightly better, the MRI's showed the annular tear to be a little bit smaller (it is still there though). I didn't even realize the connection until yesterday.

I know it's a cliche', but you have got to keep fighting. Every day for well over a year I had to fight the urge to end my life because of the pain. It is still hard today, but I think I am coming to the end of this struggle. Just have to keep fighting until the end.
__________________
Chiari 1 malformation - successful surgery 1-22-09
C5-6 herniation (extrusion) with moderate central canal stenosis and bilateral foraminal stenosis.
Prodisc-C @ C5-6 surgery on 5/28/09
VATS thoracic fusion @ T3-4 and T6-7 on 9/11/09
Fusion w/cage @ C7-T1 on 11/12/09
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Old 05-09-2009, 05:30 PM
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Thanks for pointing out that the fissure causes more pain, sometimes 'invisible' pain. The doctors I've been dealing with here obviously don't know anything about it, that it could be a possibility.

The fissure may have been present in the first MRI, but just not mentioned...who knows.

My pain management doctor is the best physician I have right now, outside of my surgeon in NYC. She actually cares about what is going on with me, and has not expressed doubt or cynicism over any of my sometimes confusing symptoms. Unfortunately she can't fix anything but my pain right now, but until I found her, I wanted to end my suffering every day too. I literally owe her my life. No, my pain is not gone, but it certainly is manageable now.

I'm actually able to go out and weed some of my two acres of gardens for ten minutes or so now Terry, what are you doing next weekend? Surely with that green thumb and fixed back, you would be thrilled to take on another project
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DDD
Herniated discs C4/5 & 5/6, L3/4, L4/5, L5/S1
Severe compression of spinal cord in two levels
All conventional therapy exhausted, including spinal injections, PT, massage, etc.
In appeal with Gov't Insurance for Out-of-country coverage for ADR hybrid surgery of above discs.
Recently discovered that I am severely allergic to all common metals used in surgical hardware except for Titanium.
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Old 05-09-2009, 10:03 PM
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My pain management doctor was a life saver for me too. She never doubted my pain. She said that there was a lot we don't know about pain, and why some people have MRI findings that look awful but have no symptoms, and why some have MRI findings that show very little yet they have terrible pain. But, she never once doubted that my pain was real. For that I am grateful.
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Cathy

46 years old. 12-15 years of intermittent pain, 2 years with constant pain.

DDD, L4-5 and L5-S1, pain confirmed by discogram.
PT, ESI's, Facet injection and block, Acupuncture - all no help.

2-level (Prodisc-L) ADR surgery with Dr. Bertagnoli, May 26, 2009.

Currently taking Opana-ER (tapering off) and oxycodone
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Old 05-09-2009, 11:31 PM
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I'm glad your getting somewhere. This thread is the story of my life. very low level nerve pain pre-op. Now post op. almost 1 year and I have so much nerve rediculitis its not funny. Talk about Failed back surgery.

Yet my MRI look prisitine according to my original ortho and another neuro. Even the neuro guy said contents of the disc are not neurotoxic. Ha...

If anyone knows of any Australian Neurosurgeons who don't think like this p.m. me .....

I really take my hat of to you guys who handle the pain and have multiple levels. I've just got 1 level and its damned painful.
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Old 07-20-2009, 12:07 AM
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Default .

I also have a tear and think that its a major cause of my pain..

jchebert1979 does the 1979 give your age ?

Im 29 and was born in 1979...

As for your depression..you can bet it all comes from your spine...
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C4-5: Mild disc height loss with central annular fissure. Small broad-based left paracentral disc protrusion. Moderate central canal stenosis-the disc protrusion abuts and mildly flattens the left ventral surface of the spinal canal.

C5-6: Disc desiccation with mild height loss.Diffuse discosteophyte bulge and uncovertebral joint hypertrophy, moderate central canal stenosis- Severe neuroforaminal stenosis bilaterally, right greater than left.
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Old 07-20-2009, 12:20 AM
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In 1979 is when I hurt my back the first time, falling of my motorcycle as a teenager. I may have been on the way to "Saturday night fever". I fell of the bike a few more times after that.

Boy do I feel old, no wonder my spine is a mess.
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Nov 09: Prodisc-C ADR 2 level C 4/5/6
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Old 07-20-2009, 12:57 AM
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Default ^Fuzzy that beard is nice...

^Fuzzy that beard is nice....ZZ-Top style...
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C4-5: Mild disc height loss with central annular fissure. Small broad-based left paracentral disc protrusion. Moderate central canal stenosis-the disc protrusion abuts and mildly flattens the left ventral surface of the spinal canal.

C5-6: Disc desiccation with mild height loss.Diffuse discosteophyte bulge and uncovertebral joint hypertrophy, moderate central canal stenosis- Severe neuroforaminal stenosis bilaterally, right greater than left.
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Old 07-20-2009, 09:24 PM
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You just gave me some of my own validation.
The first thing I ever had wrong with my back was an annular tear. That was 1998. I never got better and continued to have leg pain for years. I was told it healed and they don't cause pain. For years I thought I was a wimp or started even believing I must be crazy. It may sound crazy but when a herniation finally showed on MRI (in the same place the annular tear was), I was actually relieved that had something there to make them believe me. Of course I was not happy to have progressed to that herniation and everything since. I wish they would have not treated me like I was crazy...had me believing I was crazy...Who knows how I may have changed the way I did things if I had known that annular tear was a huge warning.

Thanks for the info..
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Annular tear L5-S1 1998
Herniated disc L5-S1 2004,PT,ESI's,discectomy 2005
Dynesys 2/2007
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Old 07-20-2009, 11:26 PM
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Default re annular tears..

I have one that L3 that seems to be holding it's own now(knock on wood) for quite a number of years (like 20) and the more problematic discs are the ones that already had surgery on them (discectomies) at L4 and L5S1.

A good online resource for reading about annular tears and more is ChiroGeek's Home Page

Good luck.. if the tear is a pain generator or one of the pain generators it can give some real grief...
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