Hello all you who were following the "chiropractic" thread. I had my appointments yesterday and saw two phsicians following the MRI. Very interesting indeed.
I have mild degeneration of the L5-S1 disk, with slight bulging on the spinal chord and the left nerve root.
I saw the neurosurgeon first. He felt that the MRI looked GREAT, especially considering my age. He thought that there was not enough degeneration there to be causing me symptoms and pretty much reiterated that he feels that I need the spinal fusion. He feels that a correction of my upper spine will give me significant pain relief in both the upper and lower spine.
Then I saw the pain specialist (I don't even know what their official title is...). He interpreted the MRI very differently. He felt that there was enough disk protrusion to cause my pain symptoms. He also felt that the left nerve root was crowded, thus causing the pain down my leg that could come and go periodically. He did find that I have weakness in my left leg. He also looked at a bunch of old and not so old bloodwork that I have had done and felt that there may be some endocrine problem going on, so ran further tests. He scheduled me for epidural injections of the lower spine next week, which I am totally fine with. He also wants to try the intrathecal catheterization at about the T7 level. This will allow him to actually bathe the spinal chord in either morphine or phentanyl, or whatever drug works to get rid of the pain. He said it would have a lot more effectiveness with nearly no side effects. Although, drug would still get into my system and I would still have that to worry about if I were to get pregnant. This doctor felt that having spinal fusion would only INCREASE my pain. He did say, however, that some spine surgeons will allow a catheter, such as this, to remain in the spinal canal and do the corrective surgery with it in place, and some will not.
One thing that bothered me is that he has only ever had one other scoliosis patient, and she was 16 and already had the scoliosis surgery. He was not able to get past the hardware to get the catheter in high enough to give her pain relief in her upper spine, just her lower spine. So she still has to take oral medication to control the pain. I basically told him that my goal was to be medication free. He said that it was an honorable goal, but was basically unlikely to happen do to the pathology of my spine.
My one big concern is that, he does not have any experience in inserting this catheter into a scoliotic spine. I'm sure it's not as easy as it would be for a straight spine and it is a two or three day stay in the hospital while they try to figure out what works. So his lack of experience with someone like me makes me uneasy. Also, it is a "patch" fix. My scoliosis is progressing and I will likely need surgery within the next couple of years anyway, so...??? He also wants to send me to PT (I said I would blow a gasket if he suggested this, as it has had little effect in the past). I brought up my concerns that all they have ever done for me is give me exercises and when I master them, they give me more, and more, and more and increase repititions, etc... You get the drift. I said I have a life to live and I walk over a mile every day. Then he looked at me sheepishly and said he just wanted them to give me massage and heat therapy to break up some of those muscle spasms in my neck and upper back. I felt a little bad, although I wasn't rude to him, and I agreed that it would most likely work at giving me at least temporary pain relief.
My other thought on this is that I think it would be great if he could get the catheter in place, then have the surgery. That way, if the surgery doesn't give the desired pain relief, I will have medication on board at the level of the spine and won't be bound to oral meds or patches that have to travel through the whole body. If the surgery does work, the catheter could be left in place and as I age, I may need it later (if the catheter hardware doesn't deteriorate). Or the catheter could be removed altogether. It's not permanent unless you want it to be.
Is there anyone with experience with anything like this? The intrathecal, epidural, surgery, or combination therapies? I would love to hear experiences or advice even if you haven't had it. Thanks in advance. You are ALL a great bunch to talk to. And I mean that!
I have mild degeneration of the L5-S1 disk, with slight bulging on the spinal chord and the left nerve root.
I saw the neurosurgeon first. He felt that the MRI looked GREAT, especially considering my age. He thought that there was not enough degeneration there to be causing me symptoms and pretty much reiterated that he feels that I need the spinal fusion. He feels that a correction of my upper spine will give me significant pain relief in both the upper and lower spine.
Then I saw the pain specialist (I don't even know what their official title is...). He interpreted the MRI very differently. He felt that there was enough disk protrusion to cause my pain symptoms. He also felt that the left nerve root was crowded, thus causing the pain down my leg that could come and go periodically. He did find that I have weakness in my left leg. He also looked at a bunch of old and not so old bloodwork that I have had done and felt that there may be some endocrine problem going on, so ran further tests. He scheduled me for epidural injections of the lower spine next week, which I am totally fine with. He also wants to try the intrathecal catheterization at about the T7 level. This will allow him to actually bathe the spinal chord in either morphine or phentanyl, or whatever drug works to get rid of the pain. He said it would have a lot more effectiveness with nearly no side effects. Although, drug would still get into my system and I would still have that to worry about if I were to get pregnant. This doctor felt that having spinal fusion would only INCREASE my pain. He did say, however, that some spine surgeons will allow a catheter, such as this, to remain in the spinal canal and do the corrective surgery with it in place, and some will not.
One thing that bothered me is that he has only ever had one other scoliosis patient, and she was 16 and already had the scoliosis surgery. He was not able to get past the hardware to get the catheter in high enough to give her pain relief in her upper spine, just her lower spine. So she still has to take oral medication to control the pain. I basically told him that my goal was to be medication free. He said that it was an honorable goal, but was basically unlikely to happen do to the pathology of my spine.
My one big concern is that, he does not have any experience in inserting this catheter into a scoliotic spine. I'm sure it's not as easy as it would be for a straight spine and it is a two or three day stay in the hospital while they try to figure out what works. So his lack of experience with someone like me makes me uneasy. Also, it is a "patch" fix. My scoliosis is progressing and I will likely need surgery within the next couple of years anyway, so...??? He also wants to send me to PT (I said I would blow a gasket if he suggested this, as it has had little effect in the past). I brought up my concerns that all they have ever done for me is give me exercises and when I master them, they give me more, and more, and more and increase repititions, etc... You get the drift. I said I have a life to live and I walk over a mile every day. Then he looked at me sheepishly and said he just wanted them to give me massage and heat therapy to break up some of those muscle spasms in my neck and upper back. I felt a little bad, although I wasn't rude to him, and I agreed that it would most likely work at giving me at least temporary pain relief.
My other thought on this is that I think it would be great if he could get the catheter in place, then have the surgery. That way, if the surgery doesn't give the desired pain relief, I will have medication on board at the level of the spine and won't be bound to oral meds or patches that have to travel through the whole body. If the surgery does work, the catheter could be left in place and as I age, I may need it later (if the catheter hardware doesn't deteriorate). Or the catheter could be removed altogether. It's not permanent unless you want it to be.
Is there anyone with experience with anything like this? The intrathecal, epidural, surgery, or combination therapies? I would love to hear experiences or advice even if you haven't had it. Thanks in advance. You are ALL a great bunch to talk to. And I mean that!
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