Circumferential Herniations
 

Does anyone know what a circumferential herniation is? My doctor just said that it has gotten a lot worse and now needs surgery.

Shebo

Shebo from the route of the word i would guess(only a guess) that it is all around herniation. So not just one sided, but all around the whole disc. Did you ever send your info out to the other doctors?
judy

Judy is right... instead of having a left sided, right sided or centrally located herniation, you have one that covers more than 50% of the posterior annulus. (going from memory... I'm not a doctor, yada, yada, yada)

Mark,
That's what I pictured in my head but I wanted a confirmation. It went from a right sided herniation (last year) to this. If it is squishing out all around then there isn't much holding the vertebra up. No wonder the pain has gotten so bad. Thanks for confirmation. I hope your thoracic pain gets better. I'm talking about having an ablation done also.

Judy, you had asked me about the doctors in another post. I explained that I was waiting for new tests and a local neurosurgeon. Now that I don't have any local doctor options. I am sending my info out. Thanks.

Shebo

My wife's disc was like that. She tried a discectomy anyway. It was astronomically successful. Sadly, it was only successful for 3 months before the disc collapse got worse and she had leg pain on the other side. Her ADR surgery was successful. In retrospect, her's was one of the cases in which jumping straight to ADR would have been better. Bertagnoli told us that before her discectomy, but we thought we'd try anyway.

Mark

link
 

Not sure if this is the correct link though hopefully it'll be corrected after I put it up if not however it gives all this information in detail:

ChiroGeek's Home Page

Thanks for the link. I forgot about this site. I couldn't find anything about circumferential herniations but I will look again.

Shebo

circumferential and concentric
 

Shebo,
Here is where I saw it in chirogeek and remembered I had read about it:

An annular disc tear occurs when the substance of the annulus fibrosus "rips" or "tears" and allows ... the concentric tear, which is a splitting apart of the lamellae of the annulus in a circumferential direction; and the radial tear, ...
Anular Disc Tear - General - Cached - Similar

I also googled the two and came up w/the similar information.

Thanks for the info. Now what to do about it...

Ah, the surgical decision....

If your symptoms are bad or you risk permanent nerve damage, AND you have a smoking gun diagnosis, AND you have access to a very low risk, high success rate surgery... then your decision is easy.

If your symptoms are not bad, OR you don't have a smoking gun diagnosis, OR the surgery you might get is high risk, low success.... then your decision NOT to do surgery is easy.

Unfortunately, we all fall somewhere in the middle of all this and have to make the very personal decision about what to do... There is no 'one size fits all' here. Only tough choices. (Like I'm articulating something you don't already know... )

Mark

It seems so simple when you write it all out. Like yours, my herniations are in the thoracic and causing horrible, debilitating pain. So the surgery is high risk, low success and the symptoms are bad. What to do?

Obviously this is a very personal decision. IMHO, if the indications are clear... if you have the smoking gun diagnosis.... more me... I'd do the smallest surgery that has a good chance of solving the problems, with the best surgeon for that procedure.

Without a smoking gun, I still may take the best shot if things are that bad. It's tough to discuss this because each case is so unique.

All paths are a gamble.

Shebo i wanted to give you some hope. I suffered from some horrible thoracic pain for few years as it increased in intensity and frequency. My doc did listen and thank me for my patience when trying to figure it all out. Well one day i brought him an article on thoracic discography and so he went with it. It showed 2 extremely painful discs (they had bulges, herniations whatever you want to call them alone with tears) the discography brought tears to my eyes and i rated the first one a 20 our of 10. The rest were kind of painful, some of them, but compared to the first one i only rated them like a 5. I was sent to DrRegan after my doc decided the day before surgery to not try it when Regan was right here in our area. So a few months later i had the VATS procedure to remove the 2 painful discs. Almost a year later i had developed a severe kyphosis and needed the thoracic surgery to straighten my back., Well i have no more pain in that area. DrRegan's surgery took away the horrible pain. My doc when doing the kyphosis surgery and osteotomy's did lamenectomy's down my whole thoracic spine also so i hope i am set in that area.

Sorry this was so long. I was once in your situation, but i was probably weaker in dealing with the pain and would do anything with the chance of getting me back to the dusty trails.

hoping to give you some hope
:Djudy