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Neurology (Expert Forum)
Advice for pending IME, chronic low back pain
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Advice for pending IME, chronic low back pain
by Debi-E, Mar 12, 1999 12:00AM
Posted By CCF NSG MD /gh on April 18, 1999 at 19:17:49
Topic Area: Neurosurgery - General
Hello Dr!.thank you for responding to my earlier post re: chronic back pain following microdiscectomy, laminectomy & spinal decompression at L4-L5...w/ almost complete block of L5 nerve root at myelogram..again surgery was 6/25/98...this is a W/C injury and I have requested an Independant Medical Exam thru the W/C Board..to be schedule this month...in the meantime...can you please explain to me what failed back syndrome is? As I previously mentioned I have constant, at times disabling low back pain and numbness is my legs when sitting for any length...the worst part is when I walk or stand for any time or distance...it is as though my "frame" is out of whack and the pain becomes extreme...it is hard to describe...but I feel as though I am locking up in my back..I wear an AFO brace on right foot (ft. drop) and walk with a cane...also I had bladder problems prior to surgery, (cauda equina)that has not resolved...will it?...My neuro warned me surgery could increase pain & numbness...he was stopping further damage...does this sound like failed back syndrome, what should I ask the specialist, a neuro I hope. I also have Deg.Disc.Dis. and arthosis & sponylosis...(no slipped on 10/7/98 x-rays w/Neuro) I take Darvocet 2-4hrs, Flexril 3Xday and Ambien for sleep...also Prozac for depression...W/C Dr.(Phystiatrist.(sp)..Rehab Dr.) rated me at MMI on 1/21/99 and on a PPI of 19% to whole person...8 months post op...do you think this is all the recovery I'll have? Please..any advice you have as to what questions to ask, what meds to take...anything would be greatly appreciated!! You do a fabulous job...I thank God for this Web Site...thanks!
Topic Area: Neurosurgery - General
Hello Dr!.thank you for responding to my earlier post re: chronic back pain following microdiscectomy, laminectomy & spinal decompression at L4-L5...w/ almost complete block of L5 nerve root at myelogram..again surgery was 6/25/98...this is a W/C injury and I have requested an Independant Medical Exam thru the W/C Board..to be schedule this month...in the meantime...can you please explain to me what failed back syndrome is? As I previously mentioned I have constant, at times disabling low back pain and numbness is my legs when sitting for any length...the worst part is when I walk or stand for any time or distance...it is as though my "frame" is out of whack and the pain becomes extreme...it is hard to describe...but I feel as though I am locking up in my back..I wear an AFO brace on right foot (ft. drop) and walk with a cane...also I had bladder problems prior to surgery, (cauda equina)that has not resolved...will it?...My neuro warned me surgery could increase pain & numbness...he was stopping further damage...does this sound like failed back syndrome, what should I ask the specialist, a neuro I hope. I also have Deg.Disc.Dis. and arthosis & sponylosis...(no slipped on 10/7/98 x-rays w/Neuro) I take Darvocet 2-4hrs, Flexril 3Xday and Ambien for sleep...also Prozac for depression...W/C Dr.(Phystiatrist.(sp)..Rehab Dr.) rated me at MMI on 1/21/99 and on a PPI of 19% to whole person...8 months post op...do you think this is all the recovery I'll have? Please..any advice you have as to what questions to ask, what meds to take...anything would be greatly appreciated!! You do a fabulous job...I thank God for this Web Site...thanks!
Doctor's Answer
by CCF NSG MD /gh, Mar 12, 1999 12:00AM
_
Dear Debi,
Failed back syndrome is a general term for those patients who do not improve in symptoms in spite of surgery. This can be due to a number of reasons and can be quite frustrating for both the patient and the physician. At times patients may have continued pain due to ongoing pathology in the spine and, in theory, surgery should help those people. Other patients have continued pain despite adequate surgical treatment and can evolve into chronic pain syndromes. The term is a bit loose in definition, but you get the picture.
What may be the best solution for you at this point is difficult to assess. These situations are best diagnosed and treated by the physicans that know your story intimately. If you are unsure of the diagnosis or do not agree with the treatment plan, then get a second opinion. Do know that there are many ways to manage patients with spine problems and you may get differing opinions.
Good luck.
