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Am I canidate for Lumbar Surgery, Tired of Pain Meds and Pain!
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Am I canidate for Lumbar Surgery, Tired of Pain Meds and Pain!

Hi, I havent posted here in awhile because of a death in the family. I am a 55 year old female ,injured my back on the job in 1999, havent worked since 2000. I have different diagnois, Degenerative Disk Disease vs degenerative Facet Joints, VS SI disease. I take Methadone 60 mg a day, ( down from 90 mg a day ) as well as Lortab for breakthrough pain and use a TENS Unite, which doesnt do much.

I have been taking Methadone for almost 5 years and realize I can not continue to take this the rest of my life, but workmans comp refuses to do much of anything as my case is about 8 1/2 years old already.I saw a neurosurgeon in 2001 and he was willing to do surgery then, but I wanted to try the more conservative route. I have used Soma, tons of Vicodin, Lortab, Norco, Gabapentin, ( Neurontin ) Amiltripiline, LIdocaine patches, Physical therapy, A TENS Unit, Epidurals, SI joint Injections, Facet blocks, and other modalities. My last dr. wanted to do a morphine pump, try accupressure, or refer to surgery again, but workmans comp balked, but I was able to get my regular dr. to do a new MRI to take to my workmans comp dr.

Here is the latest report of MRI.
There is mild disk space narrowing present at the L3-L4, and L4-L5 levels with decereased signal intensity present within the intervertebral discs indicative of degenerative desiccation changes.
L1-L2 level, no herniated or significant bulging disks without mass effect upon the thecal sac or nerve roots with the neural foramina patent bilateraly. No spinal stenosis.
At the L3-L4 level, there is a DIFFUSE POSTERIOR DISC BULGE WITHOUT EVIDENCE OF A DISC HERNATION.
There are HYPERTROPHIC CHANGES INVOLVING THE LIGAMENTUM FLAVUM AND FACET JOINTS RESULTING IN MILD CENTRAL CANAL NARROWING, WITHOUT SPINAL STENOSIS.There is a ASYMETRIC  DISC BULGE
ENCROACHING UPON THE PROXIMAL INFERIOR RIGHT NEURAL FORAMINA AT THIS LEVEL. THE LEFT
NEURAL FORAMINA IS PATENT.

At L4-L5, there is a SMALL CENTRAL POSTERIOR DISC HERNAITION AND A SMALL RIGHT FORAMINAL DISC HERNATION.THERE IS MILD ENCROACHEMENT UPON THE ANTERIOR THECAL SAC AT THIS LEVEL WITHOUT
SPINAL STENOSIS. There may be Mass Effect Upon the exiting nerve root at this level SECONDARY TO THE RIGHT FORAMINAL DISC HERNIATION.
L5-S1, no hernations or significent bulges.

IMPRESSION; SMALL CENTRAL AND RIGHT FORAMINAL DISC HERNIATIONS AT L4-L5
MILD CENTRAL CANAL NARROWING AT L3-L4 SECONADARY TO A DIFFUSLY BULGING DISC
AND HYPERTROPHIC CHANGES INVOLVING THE LIGAMENTUM FLAVUM WITHTOUT SPINAL STENOIS.
MILD ENCROACHMENT UPON THE RIGHT NEURAL FORAMINA AT THIS LEVEL SECONDARY TO A ASYMMETRIC DISC BULGE.

The lumbar spinal X-ray I had a month earlier showed the following; AP, Lateral and bilateral oblique radiographes of the lumbar spine demonstrate mild to moderate multi level degenerative change primarily of the lower lumbar spine.
with endplate osteophytes. There is height loss at L3-4, L4-5, and L5-S1. No listhesis or spondylolisthesis.
Mild degenerative changes at the sacroiliac joints.
Impression. Mild to moderate multi-level degeneratisve change of the mid lumbar spine.

I have several questions, one being, how can I have a Small central and right formanil  disc herniation at L4-5 ?
Isn't there just one disc between each vertarabrae? And the bigger question I need to know is this reviewign the MRI results along with the Lumbar XRay, is there any procedure that a surgeon could do on my back to releisve the pain? Remove the disc, etc.?I have tryed the conservative route for over 8 years and I am now 55, I can not work, am on SSI and Social Security and am tired of constant pain. My initial MRI showed only the herniation at L4-5 not anything else. If someone could explain the laymans terms for this MRI and possible surgical treatments, I would be very appreicative. Epidurals do not help, and the only other option I had at one point was a IDET, which the pain managenment dr. says is worthless in the long run. Please advice  if you can. Thank you in advance.  
                                                                                                                                              Fluffypurrcat
Related Discussions
Avatar_m_tn
Looks like many problems but the L4-L5 disc looks like the main problem especially if you pain is in your lower back...

I'll give you 3 choices and all good...  Laser Spine Institute will open room in the bone giving more room for the nerve root so the nerve moves away from the buldge... I had it dont on C6-C7 and its working after having surgery last week...  This place is the most expensive... Next is MicroSpine *******   they are great too and it will be cheaper...  Dayton Laser Spine Center will remove the buldge and stop the buldge from returning... Most insurance will cover it... All these places are outpatient  and surgery will be about an hour then an hour or so after surgery you'll finish recover and get to leave...  

Next to fix your degenerative discs from further problems read my profile... it may even stop the pain right now without surgery... worth a try and if you have arthritis you'll also have great improvement there too...
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