Ruptured disc

Posted By  CCF Neurosurgery MD on February 08, 1998 at 11:23:01:

In Reply to: Ruptured Disc posted by Dawn Gibson on February 04, 1998 at 12:26:06:

: I obtained a centrally ruptured disc (L4-L5) as a result of an auto accident in June of 1997.  I have gone through physical therapy and some rehabilitation for the past seven months with little or no improvement.  The majority of my pain/discomfort is in my lower back and down my left leg.  My left leg constantly aches and goes numb if I sit more than 30 minutes at a time.  It is increasingly worse at night and prevents me from getting more than 3-4 hrs. sleep at night.  In addition, I also get severe pain in the back of my calf.  Of course, the insurance company wants me to complete treatment asap.  They would prefer that I have surgery since they believe it is inevitable.  My current doctor has recommended I visit a neurological surgeon to discuss surgery, but only after considering the possibility of nerve blocks.  What are the side effects and/or risks, if any, to have these spinal nerve blocks?  Are they generally recommended?  Also, what are the risks, if any, in delaying surgery?  In addition, I live in Dayton, Ohio and would like to find out how to obtain a recommendation for a surgeon in either Cincinnati or Columbus--there are just a few surgeons in Dayton.  Thanking you in advance for any information you can provide!  

[CCF Neurosurgery MD]

Dear Ms. Gibson:
Given what you described I believe that an MRI of your lumbar spine is warranted again at this time. The reason for this is to verify whether you have any free fragments of disc floating in your spinal canal and/or any nerve root compression. Some people have tight spinal canals and even minimal compression can cause severe symptoms. If there is a structural lesion in your spine it needs to be addressed surgically. Nerve blocks are not typically helpful in the long term especially if there is a structural abnormality causing your symptoms. The surgery for a herniated disc is quite safe to perform (in the hands of an experienced surgeon) and people usually go home on the day after surgery. The recovery takes about 4 weeks.
I hope this helps. We unfortunately do not give out names of surgeons outside this institution. If you have any further questions please write back.
Good Luck