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I had a three level fusion from L3 to S1 and it did resolve the nerve pain, much to everyone's surprise. I had been told the nerves were had sustained permanent damage and would not recover, so we all were surprised when the pain went away after about the 4th day post surgery. I still have some numbness in both toes, but other than that I'm doing great. I had a lot of instability in my spine that was not apparent from MRI imaging, both standing, sitting and prone.

Facet joints can cause a great deal of pain. In my case, the facets at L3 had worn down to little nubs, which was allowing my spine to move in ways nature had not intended. This was trapping the nerves and causing all kinds of issues. They are synnovial joints just like any other fluid-filled joint in the body, like the knee. When there is too much wear and tear on these joints, they respond by trying to lay down more bone, which results in bone spurs or osteophytes. This sets up the arthritic condition that is so common with the facet joints.

The facets can also become inflamed. In an attempt to protect the stability of the vertebral segment, the adjoining muscles go into guarding posture which usually results in muscle spasms along the spine.

It is fairly easy to find out the extent of the pain this is causing by having a diagnostic facet joint block. The doctor will inject a numbing agent, along with a steroid into the suspected joint. If the patient's pain goes away immediately, you can be pretty sure, the joint is a source of the pain the patient is experiencing. (The patient is asked to keep a pain diary while the numbing agent is wearing away.) This is the diagnostic part of the injection. The steroid is included to help calm down the inflammation in the facet.

Sometimes it is helpful to consult with a different doctor if you feel you are not getting any fresh ideas from your current surgeon or PM. If I had accepted what I was being told by several surgeons after my first fusion, I would have accepted my condition as it was, having been told "this is as good as it's going to get." By now I would be walking in the house, but using a wheel chair for all activities away from the house, because I could only stand on my feet for a minute or two before the pain become intolerable.

I felt very strongly that mine was a mechanical problem because when I sat down, the pain would go away or was at least tolerable. So I kept looking for answers. I was willing to accept that there was an outside chance that those surgeons were right, but what they were telling me didn't explain why the pain went away when I changed position.

While I saw many spine surgeons, my original surgeon ended up being convinced I had instability and did the surgery.

I might add, we never suspected that I had facet joint "issues." None of the doctors ever mentioned facet joints to me....It was only near the end when my surgeon had decided to revise my first fusion and was trying to figure out if he was going to do one more level or two, he ordered facet joint blocks for more information. But it was not until he opened me up that he found the extent of the damage to my facets. He was completely taken by surprise, and ended up having to do spinal reconstruction at the L3-4 segment.


Sorry this is long. I guess that's enough details about me! I'm happy to answer any questions you might have.

TT.
[QUOTE=tetonteri66;4767890]I had a three level fusion from L3 to S1 and it did resolve the nerve pain, much to everyone's surprise. I had been told the nerves were had sustained permanent damage and would not recover, so we all were surprised when the pain went away after about the 4th day post surgery. I still have some numbness in both toes, but other than that I'm doing great. I had a lot of instability in my spine that was not apparent from MRI imaging, both standing, sitting and prone.

Facet joints can cause a great deal of pain. In my case, the facets at L3 had worn down to little nubs, which was allowing my spine to move in ways nature had not intended. This was trapping the nerves and causing all kinds of issues. They are synnovial joints just like any other fluid-filled joint in the body, like the knee. When there is too much wear and tear on these joints, they respond by trying to lay down more bone, which results in bone spurs or osteophytes. This sets up the arthritic condition that is so common with the facet joints.

The facets can also become inflamed. In an attempt to protect the stability of the vertebral segment, the adjoining muscles go into guarding posture which usually results in muscle spasms along the spine.

It is fairly easy to find out the extent of the pain this is causing by having a diagnostic facet joint block. The doctor will inject a numbing agent, along with a steroid into the suspected joint. If the patient's pain goes away immediately, you can be pretty sure, the joint is a source of the pain the patient is experiencing. (The patient is asked to keep a pain diary while the numbing agent is wearing away.) This is the diagnostic part of the injection. The steroid is included to help calm down the inflammation in the facet.

Sometimes it is helpful to consult with a different doctor if you feel you are not getting any fresh ideas from your current surgeon or PM. If I had accepted what I was being told by several surgeons after my first fusion, I would have accepted my condition as it was, having been told "this is as good as it's going to get." By now I would be walking in the house, but using a wheel chair for all activities away from the house, because I could only stand on my feet for a minute or two before the pain become intolerable.

I felt very strongly that mine was a mechanical problem because when I sat down, the pain would go away or was at least tolerable. So I kept looking for answers. I was willing to accept that there was an outside chance that those surgeons were right, but what they were telling me didn't explain why the pain went away when I changed position.

While I saw many spine surgeons, my original surgeon ended up being convinced I had instability and did the surgery.

I might add, we never suspected that I had facet joint "issues." None of the doctors ever mentioned facet joints to me....It was only near the end when my surgeon had decided to revise my first fusion and was trying to figure out if he was going to do one more level or two, he ordered facet joint blocks for more information. But it was not until he opened me up that he found the extent of the damage to my facets. He was completely taken by surprise, and ended up having to do spinal reconstruction at the L3-4 segment.


Sorry this is long. I guess that's enough details about me! I'm happy to answer any questions you might have.

TT.[/QUOTE]


On the contrary I appreciate you taking the time to write such a detailed post to help me. Since I have such a big spinal canal (genetically). The MRI with contrast shows no neural impingment in any direction. The radiologist said my problem is Facet joints and the spine surgeon said that I have the spine of a 60 year old. I am in my 30's. I have massive arthritis in these joints and recommended facet blocks.I see they are probably all rough and grainy scraping up against soft tissue. Thats how I imagine them to be. I have just started fishoil and glucosamine and trying to stay off the chemicals as much as I can if I am going to manage this longterm. he said I hardly have any disc left and anymore out would be a fusion and he refuses to fuse me at this satge so I better learn how to manage it. He said he operated on me due to footdrop and not pain. It's nice to get some opinions from people who experienec the same issues though. Aristotle said that in order for a doctor to cure a patient he himself must have been inflicted with the condition too.





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