Annular Tear L5/S1

[Keano16]

Originally Posted by cp7959

Keano, thank you for the response.

I don't know to much about PLDD. Is the procedure broadly available? Or is it mostly performed out of the U.S or I think a Dr. Cho in Colorado?

PLDD is available worldwide for past 25 years. Its primarly used for small herniations but with time and when in experienced hands, it can be a good alternative for endoscopic surgery and micro-discectomy, in carefully selected patients.

I would not consider a Discography unless I was getting ready for surgery. From what I understand there are studies supporting discography, there are also studies showing discography creating pain in asymptomatic disks? So who's right, who's wrong? If it comes to that for me I hope I pick the right one.

You are right. From my point of view there are two issues here:
1. Experience of surgeon who is performing discography
2. Equipment for discography (read: discography should be pressure controled, but OR's rarely have this peace of equipment.

Also, intradiscal steroids post-discography could be a good screening method!

[Maria]

I've had that has been identified since the mid 90's at L3 and had 3 discograms done between 2001-2005. Had discectomies at L4 and L5S1 in late 80's and early 90's and later around 2001 was looking into ADR. Recomemndations were to do ADR on L4 and L5S1 in 2003 (didn't do it) and then in 2005 to have ADR at L4 and fusion at L5S1 (didn't do it either). Basically pain lessened to the point I didn't feel like having more surgery.

My L3 annular tear showed a disrupted disc but not enough for replacement re ADR. Not sure that would have been the case w/fusion.

Has anyone recommended Epidural steroid injections or selective nerve root blocks (not sure if either are appropriate tho just wondering) I had them 3x/year for about 10 years and got great relief but had much more back pain than leg pain.

I think it's more common for annular tears at L5S1 to progress and become more problematic than at L3. Most of my ESIs were aimed at L4 and L5S1 as did one I think at L3 and it didn't help w/pain at all so discograms must have been right on re identifying pain generating disc levels.

[Hooch]

Did you read Doug's story on chirogeek? I had to use the wayback machine to see it.

His was the first story I thought of. In case you didn't see it, I think after a failed microd and about 6 years the pain went away, but he was left with some significant limitations, but could get around ok.

If it is chemical radiculitis, I dont think anyone knows what the future holds for it. Maybe it settles, maybe it doesn't.