Hello, and my introduction =(

[pittpete]

Hey all, Im a 37 year old male whos been dealing with lower back troubles since 1994.
I initially injured my back carrying a 24' ladder and slipping on the ice.
I was 24 and it was the first time I ever had back pain. Pain was only in lower back, with no leg pain.Pain gradually got worse and right leg pain started till eventually it was 24 hours a day unrelenting.After an MRI confirmed a large HNP w/fragment right sided crushing the L5 nerve. I had a microdicectomy w/laminectomy in 1995 and all went well. In 2000 I started having major lower back pains with some leg pain/numbness and was sent for another MRI.
MRI confirmed small right sided HNP both L4-5 and at L5-S1 with slight bulge at L3-4.Minimal scarring at L4-5 from discectomy.Went for physical therapy with traction and the results were well.
Well since 2000 there are times where my back goes out, I cant stand straight and Im out of work for a week or two. Seemed to be the norm.In beginning of 2007 I heard about DRX9000,got another MRI and MRI showed, no herniation at L4-5,HNP right sided at L5-S1 with some S1 nerve root displacement,disk bulge at L3-4,DDD and spondylosis L3-S1.DRX after 12 sessions did nothing for me except lighten my wallet.Which brings me to Dec of 2007.
I was pushing some snow(not lifting),came in laid on the couch and when I got up,BOOM cant stand straight.Nice, just in time for Xmas.Lower back was in total spasm and while laying in bed a few nights later I tried stretching a little and extended my back trying do a self adjustment.Wasnt a smart thing to do and my back hurt worse the next morning.A few days later I started getting pain down my right leg, but it wasnt the same as it was when before I had my surgery.Hurt so bad I was limping and could barely walk.Leg pain started 3 weeks from today and it is improving daily but Im still limping slightly with dull pain behind my right knee,outside my foot and just under my buttock.Also some cold tinglies in the outside of my right foot.Back pain is not too bad.All dermatones point to L5-S1 and the S-1 nerve root which is probably why it doesnt feel the same as when it was compressing L4-5 pre-surgery.
I see a good chiro 1x a week,use ice,moist heat,light stretching and lower back/abdominal exercises and use my TENS unit intermittently and inversion table.
2 Aleve per day has dulled the pain, but Im at a crossroads on what to do next.
Should I be patient and see if the leg pain goes away totally or schedule an appointment with a good neuro/ortho surgeon?
I could handle the nagging back pain, but the sciatica just scares the crap out of me.
Thanks

[B13s]

I wouldn't say that you need to schedule appointment with surgeon especially if you pain is improving , but I would suggest to get another MRI if this is not a problem for you.

[mmglobal]

pittpete... welcome...

Your decision depends on many factors. What's missing from the discussion above is what your discs look like. If they don't look too bad and you are experiencing improvement, it behooves you to wait and see. However, if you have a configuration that will surely fail.... sometimes sooner is better than later, because you preserve the health of the surrounding structures... facets, ligaments, etc. Leaving them for extended periods in a severely collapsed config may eliminate options that you have today.

Discover your options, make informed decisions.

Good luck!

Mark

[pittpete]

Thanks for quick reply.

When you say "what do your discs look like", is a discogram the only way to actually find out or will MRI tell?

I dont think getting another MRI will be a problem w/ insurance carrier

[Poncho]

Originally Posted by pittpete

Thanks for quick reply.

When you say "what do your discs look like", is a discogram the only way to actually find out or will MRI tell?

I dont think getting another MRI will be a problem w/ insurance carrier

Actually, both should give information on the structural integrity of the spine. Both inside and out. The discogram will give even more information related to the tears of the walls of the disc (leakage) and which disc(s) are causing your pain.

If you go to have a discogram - feel free to ask Mark and others in your local area as to which docs have a good reputation performing discograms. Experience counts a lot!

The more information you can get the better.

Take care,
Poncho

[mmglobal]

pittpete.... it's a subjective view of the disc. I'm fine-tuning my theories about waiting for surgery, or even trying minimally invasive surgeries based on recent experiences with clients (and my wife.)

If you have a new disc protrusion and good disc height that may likely heal, both conservative treatment or minimally invasive discectomy may be the best bet. However, if you have a long circumferential tear and bulging across the entire posterior aspect of the disc and moderate to severe collapse, the idea of waiting or having MISS hoping to salvage the disc.... one must balance the increased risk incurred with not fixing the system, AND the reduced chance of success of the less invasive options.

My point is that the further you are down the degenerative cascade, the less likely you are to have success in salvaging the disc AND the more likely you are to damage future options because of ongoing and increasing abuse of other other elements of your spine. Not only can you give up options, but even if you retain the options, the chance of success may be reduced.

Mark