It's a long story of course, but the cliff notes is that I've had some very persistent lower back pain for over 5 years now. Early on, imaging identified bilateral pars fractures on L4, and both spondylolisthesis and mild stenosis L4/L5. But, I believe those may have been incorrectly identified as the source of my problem. In fact, it appears that my pain is stemming from the SI joints.

I had some steroid injections that sure seemed to help, but the relief was very short lived. My doc now wants me to have a Rhizotomy. This is apparently where they go in and destroy the nerve to shut it up.

So I was wondering if anyone here has had this procedure and had success. Any feedback is appreciated.

Just posting for support for you man. I was recently diagnosed with bi-lateral PARS defect in L4 as well and they want to do rods and screws. I know they say surgery is a last resort so I'm pretty concerned about getting it done.

I would get a qualified surgeon 2nd opinion.

I herniated a couple of discs 18 years ago. L3/4 and L4/5. Also spondylolisthesis and some arthritis in the facet joints. Some kind of defect in the S1 joint to the pelvis with incompletely formed vertebra something something.

I had all the imaging, nerve conduction tests, physical therapy, and injections. Finally about 6 years ago I had surgery to open up where the nerves come through and also clean out the junk from the herniated discs.

It was 100% successful.

Imaging will show defects but not pain. Just because a defect shows up does not mean it is the cause of the pain. The nerve conduction tests verified which nerves were involved. Like you, the injections were very short lived relief, but to some extent they do identify the general area for the nerve being involved.

The very best exams were very similar in how they were done. One by a Physical Therapist, the other was the surgeon's PA. They had me stand, then they twisted me, pushed my hips one way and my shoulders another, etc. When the pain hit it identified exactly where the nerve was being impinged.

The imaging verified defects there, and it gave the surgeon guidance on exactly what he should do.

As to zapping a nerve, I would not do that. It might stop the pain but it doesn't fix the defect. And, does it mean that nerve no longer sends instructions to muscles and/or relays sensations to your brain? Would you lose some function?

Back surgery can be very successful if the diagnosis is good and the surgeon is good. While it is not the first treatment to try, I would choose it again. But I would not do the nerve zap. jmho.

quote:

Originally posted by JohnV:
Just posting for support for you man. I was recently diagnosed with bi-lateral PARS defect in L4 as well and they want to do rods and screws. I know they say surgery is a last resort so I'm pretty concerned about getting it done.

If they're talking about fusing L4 to L5 for you, I was told the didn't want to do that until the pain goes down the legs (which they say one day it will for me). So far, that's not what I've been experiencing. So I think I have two issues (in close proximity).

Sounds horrible I have three vertebrae with problems,lower back,

I would do many hours of research with other patients,prior to making a decision.

When I looked into bariatric surgery, 16 months ago,
At the advice of some doctor in a hospital,
I found out about the good and bad aspects.

There was no way I'd go through that b.s.

Yes there were a half dozen wonderful stories,
But over half we're not what I would call favorable

quote:

Imaging will show defects but not pain. Just because a defect shows up does not mean it is the cause of the pain. The nerve conduction tests verified which nerves were involved. Like you, the injections were very short lived relief, but to some extent they do identify the general area for the nerve being involved.

The very best exams were very similar in how they were done. One by a Physical Therapist, the other was the surgeon's PA. They had me stand, then they twisted me, pushed my hips one way and my shoulders another, etc. When the pain hit it identified exactly where the nerve was being impinged.

^^^^^^^^^^^^^^
This is excellent advice.

It’s all that twisting around to seek clarity that’s causing your back problems.

Just joking of course. Your avatar is my favorite. I always look at it closely.

I hope you find effective pain relief. Speaking of which, did you see my recent “analgesics” thread?
https://sigforum.com/eve/forum...0601935/m/4650010405

Don’t know if this is same or similar as the procedure you mentioned.

I have had at least 6 procedures at the L-3 through L-5 level which utilized a microwave emitting needle to ablate or burn the sheaths off of pain signal carrying nerves.

I have spondylosis as well as other malformations stemming from several back surgeries and old age.

Still had persistent pain. The ablations have been a change for the good. Changed my mobility and life. Have to renew every 2-3 years.

I believe that’s what I’ve had at least 6 times. I call it nerve ablation. According to what I just read on the net it’s a facet Rhizotomy.

An electronically powered needle was inserted into L4-5 area to burn nerve sheaths that carry pain signals.

I’ve had 3 back surgeries from age 31 through64.

Still had persistent pain.

This procedure was life changing for me. Didn’t stop all pain but most.

Procedures in sets of 2. I’ve had 3 sets over 10years.

Works for me.

quote:

Originally posted by r0gue:

quote:

Originally posted by JohnV:
Just posting for support for you man. I was recently diagnosed with bi-lateral PARS defect in L4 as well and they want to do rods and screws. I know they say surgery is a last resort so I'm pretty concerned about getting it done.

If they're talking about fusing L4 to L5 for you, I was told the didn't want to do that until the pain goes down the legs (which they say one day it will for me). So far, that's not what I've been experiencing. So I think I have two issues (in close proximity).

Good info thanks. I do have some mild and annoying symptoms but I’m in zero pain, at least for right now. Which is what’s causing me to reconsider surgery. But long term nerve compression isn’t good either. So I don’t know what to do. If I was in pain the answer would be obvious. In my case, it’s not so much.

I’ve chronicled my back injury here before and won’t rehash it except to say get the best neurosurgeon you can find. Get at least two opinions. Go down the fusion road as a last resort. I’ve had two major lumbar fusions that did nothing to help my pain, each took months to recover from and it was easily the worst time of my life. I’m 53 and have been dealing with this shit since I was 28 or 29. I have a pain management doc I rely on and have to see her every month. I *really* hope the nerve ablation procedure helps you.

Thanks for the advice and info guys. I probably should get another opinion. The trouble is, I have a hard time giving them clear intel on the symptoms. So we kind of have to reach an understanding as the issues seems to change (perception). Like, the pain moved left really means, the cortisone worked on the right, and not I notice pain on my left.