Lumbar DDD and Pain
 

Hi! I am new here and want some suggestions on how to procede to my next step of care. In May of 2008 I had a laminectomy/discetomy on L5-S1 for a herniated disc with nerve compression. The surgery worked great for a few years but now I am in a constant state of pain. My last MRI was in 2011 showed bulging discs and severe facet arthritis and degenerative disc disease. I am currently on Pain management with oxycotin. I went to a spine specialist and he said he could do a fusion but that my other discs are at risk so he said it was a 50/50 chance of helping or hurting worse! I have also done multiple lumbar epidurals (no pain relief) and facet injections (no relief). I am now doing PT but the therapist told me that the fact of the matter is I have a bad back and nothing really is going to help. I still am trying the PT but alot of it is lying on my back and it takes me a couple of days to recover from it. I just recently got approved for SSDI ( thank goodness!). I'm just tired of being in pain and getting really depressed. Any ideas on what I could do next besides surgery? Thanks for listening.

Hello Pendora
 

Welcome to Neuro Talk. There are alot of folks here that have back issues. I hope more will chime in. Have you gotten multipal opinions about your DDD?
In some ways, I understand what you doctor said about not doing more surgery for fear of making it worse. That is why going for multipal opinions is good. There is something called the domino effect, where the ones above your fusion and below it fail, leading to more fusions. That is a rut you don't want to get into for sure. I have had two fusions. No more for this gal....
PT gets to a point where it just doesn't work. Have you tried acue puncture?
Ketamine infusions? The other ones you mentioned didn't help me either. There will be support here, no matter what you face. Welcome again to this site, and feel free to explore the forums. There is alot of compassion here. ginnie:hug:

hi....i too have no surgical options.....ginny's suggestion of more opinions is good....
you could also look into a pain pump or spinal cord stimulator....i'm going with a pain pump trial.....pete

DDD and Surgery
 

I would recommend the fusion surgery. Do the least amount of levels recommended. Sadly, back pain and DDD usually result in more surgeries but they make a difference between. I have had 4 fusion surgeries. This last one is the most major one. After each surgery I have been able to have increased mobility and decreased pain. Its worth the surgery if you have debilitating pain. I recommend researching your surgeon!!! My first surgeon was a hack but my 3rd and 4th surgeries were done by the spinal team at Harborview Hospital in Seattle and this team teaches at the UW, so they have amazing abilities and area capable of the state of the art surgical strategies. It is definitely worth the surgery with the proper orthopedic spinal surgeons.:hug::hug:

You my friend are the victim of the "Domino Effect" because of your first surgery. That's what happened to me. I had 2 laminectomy/discetomies and my spine just fell apart. This was back when they had to OPEN the spine, and not the "micro" surgeries they can do now. :rolleyes:

So I've been disabled and in horrible pain since 1995. Three heads of Neurology at 3 different hospitals wouldn't even TOUCH me because my back was such a mess. :rolleyes: Actually I'm glad because fusion would just cause more problems -- MORE domino effect.

I can't say that surgery is your answer. I can say that surgery is ONLY for mechanical problems. It will NOT be the answer to your pain. Chances are good that you will have the SAME pain or worse after surgery. Plus with fusion, there are always the chances of the instrumentation coming loose, breaking, etc. So there are problems with any surgery.

The ONLY way I would have that surgery is IF my spinal cord was being impinged or if I was in danger of permanent nerve damage. That's the ONLY way I'd have it done. Otherwise, i'd stay in physical therapy and pain management.

I wish you the very best. Keep us posted, okay? God bless and take care. Hugs, Lee ;)

Thank you for all your responses! I never thought about acupuncture so I will research it. My back surgery was also an open surgery. I will continue with PT. So far I have been to four different doctors(neurosurgeons and orthopedic) and they all seem to agree. I am in no rush for a fusion surgery. I asked about a disc replacement but I am not a candidate for that. I'll keep checking in and keeping you all posted. Oh yeah, I just got a script for a TENS unit. Has anyone here used it?

Yes, I used a tens unit. It didn't really help much, cause it doesn't go DEEP inside as far as stimulation. The point of it is to deliver electrical stimulation to the nerves and mask the pain -- but it just doesn't go deep enough. It's only topical. There is the Spinal Cord Stimulator that they can implant, and I've had that too. They implant leads in the upper part of your back that delivers the electrical stimulation to the nerves, and the "generator" is placed lower in the body, below the waist. I had it implanted for 6 months, but then developed a problem with the "generator" where because I was thin, it started working itself out of me! :eek: I should never have had it in the first place, they discovered, because I didn't have enough "fat content" in my body.

Ask your doc about the Spinal Cord Stimulator (SCS) and see what he says. Hope you get some pain relief soon! God bless and take care. Hugs, Lee ;)