First Caudal Epidural Injection



  • As I said. You take the entire disc out that has an annular tear (total discectomy) - assuming you've confirmed this is the thing causing your pain - and replace it with an artificial one (arthroplasty) or fuse the segment (arthrodesis). These are two surgical treatments for annular tears. With the painful disc gone, assuming it alone was causing the pain, pain should be gone.

    It's basically 'take thing out that causes pain'. It can't cause pain if it's no longer in your body. I hope this makes sense?

    I can't reall comment on what you've all heard or not heard.

  • L4_L5LL4_L5 Posts: 1,128
    edited 12/13/2018 - 7:19 PM

    I’ve heard of good results with cervical disc replacement but not lumbar disc replacement.

    It’s also my understanding that the disc itself does not cause pain but rather whether there’s any nerve root impingement/compression.

    I personally would be very cautious and question proceeding with a surgeon who is saying a lumbar disc replacement or fusion for an annular tear is a good plan to resolve pain.

    You may have a hard time finding someone to operate as you’re only 27. 

    Are you going to France for the procedure?

    I wish you well and nothing but the best and hope you get vast improvement. 

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  • > It’s also my understanding that the disc itself does not cause pain but
    rather whether there’s any nerve root impingement/compression.

    From what I understand, the MRIs can definitely point to obvious signs of pain (like nerve root compression) but they are not the full picture / final say. People can have severe compression on imagery and no pain, and vice versa; people can have absolutely no visible signs of nerve root compression on imagery and yet have severe levels of nerve pain (such as myself). If you looked at a hundread MRIs with varying levels of nerve root compression, you could not tell who was in pain (and what that level of pain is) and who was not, without talking to the person. 

    The annular tears generate pain is various ways. First is that exudate from inside the disc enters the foramin and aggravates the nerve roots, they become inflammed and will continue to become inflammed until the annulus repairs itself. The second is that nerve tissue can actually infilitrate the annulus alongside the healing tissue. This creates a situation where nerve is growing into an area where it shouldn't. There's a couple of other ways, but those are the main ones.

    Sometimes annular tears are referred to as leaky disc syndrome. There are three surgeons who discuss them in good detail, Dr. Tony Mork, Dr. Kevin Pauza and Dr. Marting Knight. I have found their information to be excellent, but I mostly read the journals myself because I'm a scientist (theoretical physics). A CT discogram can show you where all the material is leaking.

    I've had four consultations and three have offered artificial disc and one a fusion, but all of them want me to first try another couple of rounds of epidurals to see if the tear will heal itself up in that time and also two of them mentioned a facet denervation alongside a radiofrequency ablation and discolysis.

    I have my transforaminal epidural on the 19th (next wednesday). 

    As for going to France. It's a possibility. I'd like to get surgery done anywhere in Europe besides my country (Ireland). The reason being, our healthcare is disgraceful. I have my eyes set on Luxembourg, Germany and France, since their healthcare is superb. My girlfriend lives in Spain. So that's an option. But Spain's healthcare, while much better than Ireland's, is not as good as the other three. I want the best surgeon and hospital operating on my back (If I end up with an op)

    Thanks for your wishes!

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