BACK & NECK COMMUNITY
Fusion Trouble

Fusion Trouble

I am a 37 Y/O male that underwent a Discectomy in 2000, a Fusion at the L5-S1 to L3-L4 in 2004. I now am having trmors to go along with the pain that I have never had any relief from. I have the numbness down the right leg, pain in my low back into my buttocks, and now uncontrollable tremors. Here is my latest Myelogram done on 10 July 07.
FINDINGS: There is symmetric filling of nerve root sleeves with contrast material at each level. There is no evidence of filling defect or nerve root impingement. There is no evidence of significant disc herniation. The nerve roots within the thccal sac appear unremarkable.
The patient is status-post L4-S1 fusion with bilateral pedicle screws with interconnecting rods and bone graft material at these levels. The patient is status-post bilateral laminectomy at the L4-5 and L5-1 levels. Solid bony effusion masses are seen bilaterally extending from the L4 through S1 levels. The spacer in the L4-5 disc spaced has fused with the adjacent endplates.
The pedicle screws at the L4 level extend through the facet joints on both the left and the right. The superior facets are slightly blunted at their inferior aspects, possibly secondary to erosion from contact with the pedicle screws. These changes are slightly more pronounced than on the prior CT. Degenerative facet disease is seen at this level. There is bilateral facet joint space loss at the L3-4 level, more prominent on the right. There is sclerosis, spur formation, and jubchondral cystic change associated with these joints. Vacuum disc phenomenon is noted, as was seen on the prior study.
IMPRESSION:
1. There is no evidence of nerve root impingement or significant canal stenosis.
2. The L4 pedicle screws extend through the facet joints bilaterally. The superior facets are slightly blunted at their inferior aspects, and this appearance is slightly more pronounced than on the prior study. The patient is not fused at this level, and thus there is likely continued movement of the facet joints relative to the screws. There are extensive degenerative changes at the L3-4 level, as described above
Please give me some kind of help. The Neurologist is wanting to implant a Baclofen, Morphine, or Electrical Impulse Pump. Does this soundlike a wise decision?
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