Stemcelldoc's Weblog

November 2, 2010

Discectomy: Nip and Tuck of the Disc

Discectomy is the surgical removal of a portion of the disc that is  thought to be causing pain.  The disc may have a bulge (distention) which presses on a nerve root causing leg pain(sciatica).  Removal of the disc bulge is intended to relieve pain.

Disc bulge with pressure on nerve root

How successful is lumbar discectomy?  Not particularly.  Loupasis examined  long-term outcomes after lumbar discectomy.

The long-term results of standard lumbar discectomy are not very satisfying. More than one-third of the patients had unsatisfactory results and more than one-quarter complained of significant residual pain.  7.3 % of patients required additional lumbar spine surgery frequently due to repeat herniation.  A predisposing factor to poor surgical outcomes was a job requiring significant physical activity.

Surgery weakens the annulus (side wall of the disc) predisposing the disc to re-injury and herniation as illustrated in this video.

At the Centeno-Schultz Clinic  x-ray guided injections of PRP, platelet derived growth factors and mesenchymal stem cells are non-surgical options for debilitating lower back and leg pain.

January 8, 2009

Lumbar Degenerative Disc Disease and Discectomy

Lumbar degenerative  disc disease is very common.  Virtually everyone at some point in their life has lower back pain.  Fortunately for many the pain resolves never to return.  For others their back pain becomes chronic and erodes the  quality of their life.  These individuals seek the advise of professionals which  include surgeons.

Yesterday I had the opportunity to evaluate a patient who was seeking a second opinion for her severe left sided back pain.  A surgeon had recommended a discectomy.  Her MRI showed moderate degeneration of the L5/S1 disc with a slight protrusion. 

lumbar1

 

 

 

 Her examination was significant for  exquisite tenderness in her left buttock with only mild tenderness in her back.  At the Centeno Schultz Clinic we are committed to identifying the source of a given patients pain.  We accomplish this through diagnostic injections performed under intermittent x-ray.  Back pain can arise from many sources which include muscles, ligaments, facets, the sacroiliac joint as well as the disc.  Due to this patients severe tenderness over her left buttock I injectioned  her  left sacroilliac joint which to her surprise provided her with 100% pain relief.  

 

 

The sacroillac  joint is a source of lower back and buttuck pain in approximately 15% of the population.   

si-joint

 

 

 

 

 

 

 

 

This patient  did not need a discectomy but rather a thorough assessment of her back pain.  spine-surgery

 

 

 

 

 

 

 

 

 

 

 

 

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