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Herniated T12/L1 disc

Hi
I would like to ask dr Joshua if possible a question, but am i in the right spot..

I have a herniated T12/L1 disc... this happened in 2004 and since then i have been in severve pain... to say this... i have pain always... if i do anything for more than 2 hours or keep pushing myself i end up in horrid pain...

the pain is across the middle of my back, sometimes my legs tingle, i have muscle wastage across the left side of the lower part of my bottom, and at times my left leg goes numb and i walk with a hobble.

My Mri report: stated severely herniated T12/L1, centrally as well as the left side. i have seen specialists here in australia etc...My orthopedic surgeon said i cannot work, no repetative bending twisting etc... i wear a back brace almost all the time.... and have been told its too dangerous to operate unless my condition worsens...
But? i have heard they operate on the thoracic area overseas quiet often... i have tried, physio, pilates, pain managment, at the moment accupunture but nothing is helping..i walk but if i over do it i end up in bed but at the same time when i don't walk i get pain...
i am taking panadeine forte. they wanted to put me on Norspan but i didn't agree with it.
Is there anything any doctor could do for me? I am at my wits end trying to improve my quality of life as its not life really.

Thankyou
Virgnia

Answers:


If your symptoms are determined to be caused by this disc herniation, and indeed you have weakness and muscle atrophy as well as pain, it would seem to me that operative treatment should definitely be considered. The herniation is at slightly above the level of the conus, which is where the spinal cord terminates in the spinal canal, making the surgery more complex than just a regular lumbar discectomy. Also, the diaphragm inserts at this level so surgical exposure of this level can be difficult. What is needed is an experienced neurosurgeon specializing in spinal surgery, and he needs to evaluate the situation including history, physical examination, MRI pictures, possibly EMG.

Thoracal spine disc herniations can be safely operated (when an operation is indicated) by an experienced team consisting usually of a neurosurgeon and a thoracic surgeron. Often such operations are done using the transthoracic approach, which means that the operation requires opening of the thorax (chest) via an incision made in the side, between the ribs. This is why a thoracic surgeon participates in the procedure.

In summary, you need to be evaluated by a doctor with experience in this specific field.Thankyou for your reply it is much appreciated...

what if forgot to ask you, is what is the diameter of ones spinal canal... i am a small person and they said it has herniated over a third into the spinal canal..

is this serious from your point of view...

thank you... i am now considering seeing another neurosurgeon and hopefully one day i can be rid of this pain...

Virginia

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