Annular Tear l4

[Niiko]

I am a 55 year old female and have been diagnosed with an Annular Tear at L4. Prior to the incident that caused the tear, I was extremely active. My symptoms are leg weakness, back pain, intermittant pain in legs or numbness, hand tremors..... and more.

My present physician wants to inject the site with steriod which I object to. He claims it is for diagnostic purposes.  with a success rate - as he has stated - "that is all over the board".  My next option would be a discogram - which I also object to. And from that point surgery, with a success rate that I question..

I would like to know  what is available for treatment that is successfull whether it is therapy or surgery.

[tanglewood]

Hi Niiko,

    If your problem is confined to a single area, then surgery might be a good option from everything I've read and heard, etc. I have issues in too many areas and surgery is not a good option for me. I had a spinal cord stimulator implanted in my back for issues in my neck and I get about 90% relief right now. I have been told that over the years as scar tissue grows and the conditions worsen, my relief will diminish. Still, everyone who has had the SCS said that they would do it again. Don't know if it is a good option for you, but you can certainly talk to your doctor about it. Good luck.

[hockeyfonzie]

Hey there...I had a similar problem at the L5. I had been getting shots in my low back for about 6 months that gave little relief for back pain that goes back for years and years. I also have congential hip disease and had an osteotomy in 1998. That hip is great and it was saved from a hip replacement.

I fell on the ice twice in December and that was the clincher...I went to a specialist and he said get the discogram. I had been told to have one two years ago and said no. But, this time I did it. It showed a grade 5 tear in the L5 disc and fusion surgery was recommended. The doctor also said to get a second opinion.

The discogram is extremely painful but it is a test that will definitely tell you where the pain is coming from. They use dye and do a CT at the same time which shows the inner portions of the discs and can show the tears and such. The pain lasts for a only a few minutes during the test and then it is quite achy for the next day or so.

The spinal injections (I had 5 in about 6 months) are a little painful and then the ache lasts for about another day or so. Mostly a pressure from putting medication into the area...I got relief from the first one into my S I joint but the shots that followed did not do too much.

I had a second opinion in Minneapolis and the doctor recommended a one level fusion of the L5 S1 with a laminectomy and removal of the sensory nerves.

My life was going to hell in a handbasket from the pain and I was getting to the point where I was hardly able to work a full day. I travel by car a lot and I could not do my job as I was on a lot of pain medication and that is just dangerous.

So, after talking to my family I decided to have the surgery.

On June 5 I had the surgery and got out of the hospital on June 9. I believe that the surgery was quite successful and am happy with the results so far. I do not have the pain that I had prior to the surgery...only the pain from the surgery. There are two rods and 4 screws. I believe that when I am healed that I will be nearly normal.

The surgical pain is really bad. I can't even describe it and even with the duladid and oxy it was hard to keep it under control in the hospital. When I left the hospital I was taking 20mg x3 of oxycontin and 2 of the 5 mg oxy for breakthrough pain every three hours. That was for about three weeks. Then I dropped to just 10-325 vicodin for 10 days. It is getting better day by day and I am down to 5mg vicodin 4-6 times a day. I was taking 8 percocet a day before the surgery so I think that is pretty good. The back brace is a pain in the *** but it is helpful and comforting.

Ice and heat are helpful...mostly ice. Walking is great. It makes me feel the best. Considering I could barely walk before the surgery this is a grand improvement.

There was one complication...My foot and part of my calf and leg went numb about 10 days after surgery. I took two rounds of prednisone and that has mostly been resolved. If it stays with the slight numbness in my foot I will gladly trade that for the pain I had before the surgery.

I cant tell you what to do but for me, the shots and all the other **** did nothing. It was the surgery that worked. for me. Now, I do know that with fusion there is a chance of failure and I hope that does NOT happen. Also it could be that the next disc up will fail and I could need another surgery in the next few years.

I took that risk. It worked for me (so far). I did not have a choice and let me tell you...while I feel good I am going to live my life to the fullest. I am not an athlete but my goal is to walk 12 blocks at 12 weeks. It has been almost 5 weeks. I can walk 5 blocks. It is hard but I can do it.

If you can get your pain under control with physical therapy I would do it. A good chiropractor and massage therapist can be a miracle worker.

Good luck with whatever you decide to do. If you want info on my surgeon let me know.