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Old 08-18-2012, 01:14 PM   #4
NuclearFart
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What sort of injections were they - epidural or peri-neural? Also, were they performed using an xray/fluoro machine, or was it just done blindly? Did you attempt core/back muscle exercises during the period of injection relief?

Back surgery (especially discectomy & laminectomy) is HUGE business in the US, and if you actually look at the good quality medical evidence, the true therapeutic benefit is quite poor for the average joe with backpain/sciatica. Even if your MRI shows "severe" narrowing at specific levels, the clinical correlation with pain for that specific anatomic distribution is frequently not there; this is why there is ton of "failed back surgery" in the north american system because 1) they operated at the wrong spot 2) the surgery often doesn't work that great anyways when truly evaluated under evidence based medicine. Further to this, there is a not insignificant chance that the surgery will actually make your pain WORSE from the development of epidural fibrosis (basically rampant scar tissue conglomerating around your spinal cord and nerve roots), which is virtually untreatable. The other problem that occurs is destabilization of your back at the surgical level, which invariably leads to shifting that will then cause worse stenosis. This gets treated with surgical fixation -> which then puts additional mechanical stress on the adjacent disc levels -> which then causes premature disc/facet degeneration creating disc bulging & facet hypertrophy that will then create stenosis at that level -> more surgery....etc.

My medical opinion if you are still young and not debilitated by this, is to optimize non-surgical treatments like injections & back strengthening exercises as long as possible, and only use surgery as a last ditch option if you find your pain is intolerable.
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