L3-S1 facet nerve rhizotomy

Hi,
I have been diagnosed with a L4-L5 left broad herniated disc that is butted against the nerve root and is also bulging in the foramen, but is not on the spinal column.  I have had chronic back pain for over 1 1/2 years and radiating left hip/leg pain for 4-5 months.  I have had three epidurals, with the first one giving me 3 days relieft and the following with the following actually making me feel worse.  The neurosurgeon I went to said that I was not a surgical candidate, "your symptoms don't match."  Later, with my own investigating found out that the epidurals are used to see if a patient would benifit from disc surgery.  I have also been through physical therapy (my occupation or was my occupation) doing the McKenie approach which made matters worse even causing both my feet to go numb. Recently, I have had 2 facet joint blocks with fair to good success, mainly success with the radiating pain and less with the back pain.  My pain management doctor has recommended a rhizotomy since I had success with the blocks.  The only draw back that he informed me of was the possibilty of neuromas forming at the burn site and of course the nerve regenerating causing the pain again. (I'll take the regeneration, means that the burn didn't go all the way through the nerve)  He also told me that his patients pain relief go from 3 months to 1 1/2 years.  After all this input, is there any advise or information that you can add to this.  Thanks in advance for your reply.

[CCF Neuro[P] MD, RPS]

Dear Jeanne:

Sorry to hear about your pain.  Rhizotomy is somethings that you should go to a place where they do alot of Rhizotomies.  It should be done with EMG at the same time as the surgery to enhance the selection of nerves and not to cut too many.  I think that in my opinion, this would be a last resort surgery.  I would make sure everything fits the nerve pattern.  Once they cut the nerve, I would not count on regeneration to fix a bad surgery.  The distance that the nerve has to travel would be almost too long for good regeneration.  

Also, I would get at least a second opinion concerning other possibilities.  Surgery is a last resort method of treatment.  It can it's own problems and thus make things worse.

Given that piece of advise, go and spend the money to get the best.  This is your life and no one wants to live in pain.  Best of luck.

Sincerely,

CCF Neuro MD

[JEFFEREY]

Hi,
I have just been told that I'm a candidate for a chemical facet nerve block, and possibly a facet nerve rhizotomy.  I was thrilled when the local block worked.  Only, now I've been reading variuos stories on the net about the pro's and con's of these procedures. My own Doc says I should do the steriod block first and see how that works, but he says this may not last.
If I do decide to go with the rhizotomy, I noticed CCF Nuro MD responded with caution to Jeanne, saying she should go to a clinic with experience in rhizotomy.  Are there any such clinics in Milwaukee, WI or even Chicago.  Thanks.

[CCF Neuro[P] MD, RPS]

Dear Jeffrey:

I would agree with your doctor and get an initial steriod shot and if that reduces the pain then you are a good candidate for surgery.  I would go (talk) to the places where the surgery is proposed and find out there record for surgeries.  Your local physician should be able to help you out in this matter.

Sincerely

CCF Neuro MD

[ravi raj]

i am 25years old i had spina bifida at s1 region and mild rolapse at l3 l4 region and i am suffering from erection dysfunction from last two years so please give me suggestion
                                               thank you

[ravi raj]

i am 25years old i had spina bifida at s1 region and mild rolapse at l3 l4 region and i am suffering from erection dysfunction from last two years so please give me suggestion
                                               thank you