Annular Tear L5/S1

[cp7959]

I'm looking for some advice or experience with Annular Tears. I have a Tear at L5/S1 which happened during 8/2009. I do all the right things. I eat right (lost 25 pounds), Core, stretch and strengthening exercises daily and do no bending, twisting or heavy lifting. I have a Teeter Inversion table and hang upside down like a bat daily.

The pain is primarily sciatica down my left leg. Back side of thigh to top of foot. It's fairly constant, but fluctuates in degree of pain. It's odd that my tear is center to right, but my symptoms are left leg. Very little back pain. MRI showed the tear (Hiz), but no compression and good disk height.

Does anyone have any experience or know of anyone that has had success with Annular Tears? Do they or can they really heal as the medical community states. Haven't seen a chiropractor, don't think they have anything to offer. However I could be wrong, do they have any "magic bullets"?

I'm hoping surgery is not in my future. However from my research it looks like ADR or Fusion is the only treatment. However my Ortho. surgeon who did my cervical fusions and Stenum repairs suggested if needed, he could do a micro discectomy and remove the troubled area.

Any help is appreciated.

PS - Just to save time from any WEB site suggestions. I have seen every WEB site imaginable about tears, including chirogeek.

[Keano16]

Hello,

I have lots of experience with annular tears and I have read lots of scientific literature about this issue.

My recommendations would be:
1. Finding a good "minimally-invasive" spine surgeon
2. Doing discography (nobody will do any treatment for annular tear until they confirm pain with discography)
3. Depending on tear size trying to shrink the disc and seal tear with laser (PLDD). Alternatively, biacuplasty sounds like a good solution. No experience with biacuplasty though.
4. If tear is bigger, then endoscopic treatment is next step
5. If tear is unsolvable my this two minimally-invasive methods, solutions are ADR or fusion. This step also includes finding a good surgeons in your area that is skilled for this types of surgeries.

Considering you suffer from 2009, I think chances of tear healing are small! I think micro-discectomy is not a good step for annular tears, especially based on literature I've read.

All best

[newhere]

i have my lower back pain for almost 10 years. finaly this year i was diagnosed with right diagnose. Degenerative disc desease with annular tear in l4 l5 disc. so in my case,tear didnt heal at all. will go to endoscopy for this. dr will try "heal" tear and remove degeneration parts.
if you have some specified questions, feel free to ask

[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?

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.

I suffered with sciatica since August of 2009. However, every time it settled I did stupid things like lifting a coach, cleaning my basement with lots of twisting and lifting. I did not "taper back" until I got my MRI results earlier this month showing a tear. So not sure if I'm still early in the game or not.

As for time, the only example I have is my doctor had a tear which then turned into a full blown herniation. He was telling me he was in incredible pain for 18 months, did lots of PT (as much as he could stand), changed his diet and at about the 18 months it resolved itself. That was 8 years ago. He may be one of the lucky ones?

I have read medical literature that says most tears resolve in 6 months, up to 2 years and less than 10% require surgery. The problem is finding those who have had a "resolution".

Thanks again for your input and please feel free to share any experiences with me.

[cp7959]

Newhere - 10 years is a long time. Sorry to hear you've been living this horror for so long.

What is the condition of your disk? Has in collapsed, impinging on a nerve root? Do you have sciatica symptoms or just low back pain? How was the tear diagnosed, CT, MRI, Discography?

Is your Dr. and Neurosurgeon or Orthopedic?

Thanks in advance.

[newhere]

Originally Posted by cp7959

Newhere - 10 years is a long time. Sorry to hear you've been living this horror for so long.

What is the condition of your disk? Has in collapsed, impinging on a nerve root? Do you have sciatica symptoms or just low back pain? How was the tear diagnosed, CT, MRI, Discography?

Is your Dr. and Neurosurgeon or Orthopedic?

Thanks in advance.

Yeah almost 10 years because i have been toold i have some birth-anomality on my spine(didnt research alot about spine so much then) so i think - ok if is a condition from my birth i MUST live with this. I hate so much my stupid dr. because of this. she didnt want send me to a neurosurgeon because she thinks its from the day i born :S...oh man she is so arghhhhh.
Anyway,from my sight, the disc is around 60% damaged because discography gives results of rupture 3/5(or 6). so, mri shows some abnormality on my disc,but to confirm it i do a discography. i dont have sciatica but have veeery bad low back pain. After so much years of chronic low back pain, i will try to resolve it with minimaly invasive procedure called selective endospopic discectomy with annuloplasty,you can google it if you want.....
I must admit i have also strong pain in thoracic area for 2 years now and still i dont know exaxtly source of the pain. cheers

[longroadahead]

I had a Grade 5 annular tear in March of 2010. After my discogram they did a CT Scan and the Grade 5 tear was the finding at L5/S1.

Now my L5/S1 Grade 5 Annular Tear has turned into a large disc extrusion sometime in 2011 (I assume). MRI finding in 3/2011 one year later.

Right now I am heavily researching options and have had LBP since 2008.

[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.

[michelesmarty]

Originally Posted by cp7959

I'm looking for some advice or experience with Annular Tears. I have a Tear at L5/S1 which happened during 8/2009. I do all the right things. I eat right (lost 25 pounds), Core, stretch and strengthening exercises daily and do no bending, twisting or heavy lifting. I have a Teeter Inversion table and hang upside down like a bat daily.

The pain is primarily sciatica down my left leg. Back side of thigh to top of foot. It's fairly constant, but fluctuates in degree of pain. It's odd that my tear is center to right, but my symptoms are left leg. Very little back pain. MRI showed the tear (Hiz), but no compression and good disk height.

Does anyone have any experience or know of anyone that has had success with Annular Tears? Do they or can they really heal as the medical community states. Haven't seen a chiropractor, don't think they have anything to offer. However I could be wrong, do they have any "magic bullets"?

I'm hoping surgery is not in my future. However from my research it looks like ADR or Fusion is the only treatment. However my Ortho. surgeon who did my cervical fusions and Stenum repairs suggested if needed, he could do a micro discectomy and remove the troubled area.

Any help is appreciated.

PS - Just to save time from any WEB site suggestions. I have seen every WEB site imaginable about tears, including chirogeek.

Chirogeek is an amazing site with lots of help there.