Newbie question, meds v rhyzotomy

[mmglobal]

Do you have clear positive facet injections? Performing a rhizotomy without evidence that the pain is coming from the facets may be ablating tissues with no benefit.

A pain level of zero to four would be success after a procedure for most of the spine patients I know.

Are you fit? If not, with the relatively low pain levels, can you still get fit?

Mark

PS... I know that your pain level does not seem low to you. Many spine patients I know tend to underrate their pain. (Especially engineers and athletes!)

[diver110]

Originally Posted by mmglobal

Do you have clear positive facet injections? Performing a rhizotomy without evidence that the pain is coming from the facets may be ablating tissues with no benefit.

A pain level of zero to four would be success after a procedure for most of the spine patients I know.

Are you fit? If not, with the relatively low pain levels, can you still get fit?

Mark

PS... I know that your pain level does not seem low to you. Many spine patients I know tend to underrate their pain. (Especially engineers and athletes!)

I would need to get a facet block first. Have not had that done yet. I am pretty fit and have done extensive PT. I don't have much in the way of leg weakness or sciatica, just localized L3 pain. The major hassle is sitting. Undrugged, it is very hard to do.

[mmglobal]

If you get a dramatic, positive result from the injections, the decision to move forward with a rhizotomy will be pretty easy. I would try to get the most targeted decision possible. If you do a panel of 8, 10, 12 injections, you will not know which facets to nuke. I don't like the idea of doing large numbers of rhizotomies because I don't believe that tissue should be destroyed without good cause. Hoping to 'get it all' with one giant over application may seem like a good theory... but I don't believe that there is anything so benign that more is better. With spine, less is better.

Also, with large numbers of injections, IMHO false positives are possible because of the large volume of steroid and anesthetic will make you feel better even if the injection is in the wrong place. I think they could inject my hip and my back would feel better.

Be skeptical... especially about info you get on the internet! I'm not a doctor and may be completely wrong. (Your doctor may be completely wrong too, but he has more credibility than I do.)

Good luck... please keep us posted.

All the best,

Mark

PS... what kind of diving??? Sky, SCUBA, springboard, (dirty jokes skipped here.)

[diver110]

Well, I saw the pain doc today, one of the top pain docs in San Diego. He was unenthsiastic about long-term vicodin use, but allowed how some people are able to do so. Others have issues with addiction/dependency/withdrawal. There appears to be little downside risk to rhyzotomy, so I am going to have that done (after first getting a diagnostic facet block). The problem with rhyzotomy is that it is at best an intermediate term fix. The doc said that as it is repeated it tends to become less effective.

To respond to the query, I used to scuba dive, but have retired from the sport. Ah, the joys of aging.

[cherylstewart67]

rhiz did not work for me; laser at an LSI would be longer lasting. hope this helps.

[Keano16]

Originally Posted by diver110

Well, I saw the pain doc today, one of the top pain docs in San Diego. He was unenthsiastic about long-term vicodin use, but allowed how some people are able to do so. Others have issues with addiction/dependency/withdrawal. There appears to be little downside risk to rhyzotomy, so I am going to have that done (after first getting a diagnostic facet block). The problem with rhyzotomy is that it is at best an intermediate term fix. The doc said that as it is repeated it tends to become less effective.

To respond to the query, I used to scuba dive, but have retired from the sport. Ah, the joys of aging.

Endoscopic rhizotomy is long-term solution.

Regards