Sciatica

I had new X-rays dont on the 27th and having new MRI done on the 21 of April. Thanks for the reply. I am going to message them to make sure I am getting both a cervical and lumbar.

Had total blood work done on April 2nd . Everything looks good but the medicine did elevate something but it was mildly.

I am taking 1200mg of gabapentin (4 300mg a day) with no help or I dont think it helps.

No I live in Connecticut and have seen numerous doctors over the years. Each surgery was done by a different doctor. Hopefully this new neurosurgeon stands by me and if I have issues left after ACDF he helps to address those.
I found that once a surgeon works on you and results are mixed they lose interest and recommend shots or SCS which the last did.
You need to advocate for yourself and continue to find answers.

That is why I am here. Thanks again.

@jds54
I am in Rhode Island and agree that it is ideal to have a surgeon you like and trust and it is very important to educate and advocate for yourself.

I have the same orthopedic spine surgeon who did my ACDF in 2022 (c5-c6), who also did my lumbar spine decompression/fusion (l3-l5) in 2024 and who will do my ACDF on c6-c7 in May. He was my 4th opinion surgeon who was highly rated. He is friendly, smiles a lot, listens to and answers all of my questions, is respectful and very experienced.

I had good outcomes for both surgeries and trust him to do a good job on the next. It is sad to hear when people are “kicked to the curb” by their surgeons when there are issues post surgery. You would think they would want to help investigate further what may be causing their patients’ symptoms. Your surgeons should have really listened to your symptoms list and evolution over time. They should have investigated your cervical spine via MRI before thoracic because issues arise that need immediate attention more in the cervical spine than thoracic spine based upon research I had done.

I pray everything goes well for your ACDF surgery and you get some relief. The recovery is not as bad as lumbar spine surgery, but I had open lumbar decompression /fusion surgery which cut through muscle (don’t think it is as invasive as laminectomy).

If you find that you still have symptoms in your lower body after ACDF surgery, I would get updated X-rays and MRI of your lumbar spine to see if you have newly compressed spinal cord/nerve roots/nerves due to bone/ligament growth or herniated discs/slipping vertebrae. You may require some stabilization at some levels with decompression/fusion. I needed it due to sever stenosis at l4-l5 due to my l4 slipping over my l5 (spondylolisthesis).

Thanks for your input. The last surgeon who did my L4/L5 laminectomy in 2021 ordered a Lumbar and thoracic MRI together in September 2024 only for the possibility to trial a SCS. I was totally against the trial because I felt something else was going on. Thats why I reached out to new doctor. I met with his PA who noticed the C6/ C7 on top of thoracic MRI showed same problems as MRI in 2016 except the Radiologist failed to point out that problem this time and she caught it. Within 4 days I had the cervical MRI and showed all of my cervical issues.
I always get a CD of images after scan.
I was shocked to see the images I was seeing.
Over these years of pain I have become adept at reading images and spinal cord is only being compressed at the cervical area now. The 3 back surgeries corrected any spinal stenosis issues. There is some foraminal stenosis at L3/L4 which a couple of Transforaminal epidurals did confirm local irritation but does not relieve the lower extremity bilateral symmetrical leg heavy leg feeling and feet issues. I recently repeated SI joint injections which had no effect,
I can only suspect that it is actually cord compression which effects everything below my cervical problems which is Funicular or Tract pain.
I actually had to suggest to pain management doctors where to try injections because they seemed clueless at times. Healthcare in this country is not in a good place. Everything is about how many patients to see in a day with little effort to help people and listen to issues.
Hopefully I have found a doctor that has listened and this ACDF works out,

@jds54 I think you are on the right track. I did have funicular pain and that was when many doctors didn't understand that this type of pain existed, so I have made it my mission to communicate this because surgeons miss it. 5 surgeons missed my correct diagnosis even though they all read the imaging. It was because I read literature from a surgeon at Mayo, and then looked up the term, "funicular pain" and that lead to medical literature with cases like mine. I had been rejected 5 times, so I sent that literature to Mayo with my request to be seen by that surgeon who was Jeremy Fogelson.

Yes, the spine surgery cured all my pain which proved that it was the funicular tract pain. There is no diagnostic test for this, but if you had a steroid spinal injection that resolved pain temporarily, it does predict the possibility of funicular pain. I had pain all over my body caused by spinal cord compression from a collapsed C5/C6 with bone spurs in the central canal. I did not have stenosis in the foramen or spinal cord compression anywhere else. I walked with a limp, had trouble emptying my bladder, and was losing the coordination in my arms. I do believe the surgery will help you but not knowing if there is any permanent damage to the spinal cord, I don't know if you will still have pain after your surgery. There will be pain of course from the surgical path. When I woke up from surgery, all my preexisting pain was gone. I only had pain from the incision. Now you see how spine surgeons miss this. They were afraid to touch me; afraid of a poor result from their surgery that could lower their personal statistics of success because they could not link my symptoms to the imaging. My walking also returned to normal and I regained strength in my legs. Like you, I did also have pain in both feet and when driving and having to push the pedals, it would get worse.

Here is the medical literature that changed the course of my journey to spine surgery.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3111492/

Did you g to Mayo? I am scheduled to drive down on the 21st of this month at 10pm for new MRI and meet with a neurosurgeon the next morning at 8:15 am They looked at the MRI from 4 months ago but did not like the quality. I am thinking about calling them to see if thye can also do the cervical area

I had fusion L2-S1. Emergency. No back pain. Nerve pain especially at night. Then it went beyond excruciating nerve pain to no pain but weakness. Difficulty walking. I had no clue something was wrong with my back of all things. I arrived at the ER on a Friday in lousy shape. The neurosurgeon performed surgery first thing Monday. No dainty sissy shopping for the perfect doctor. Elective surgery. Nope. The neurosurgeon and his staff were fantastic. So 10 pedicle screws. This winter my right foot began feeling cold. Pain from my buttock to my foot
I went back to the same neurosurgeon. Two pedicle screws showed lucency and there was bone spur squishing the nerve. But this time I was much stronger. Elective but not quite. Those nerves were compressed. And it went well. He rechecked the torque on every screw. And inserted a new spacer plus two long long pedicle screws into my sacrum. He pushed me to get my bone density checked. I see an endocrinologist who is a female Indian version of Columbo. I wouldn't call it failed back surgery. The neurosurgeon studied the structure of my back. Considered my age 67, female.and while active I'm thin. Sometimes you just get lucky. Funny because I found some hospital papers from ten years ago. I sustained a subdural hematoma. He was listed as the responsible neurosurgeon had I required brain surgery. I didn't. But it's easy to forget that neurosurgeons do some very important work.
But I never had back pain
The second time I understood more about our nerves.

Does new drug called journavx help with sciatica?

Does not work. If you put it into AI and ask if it helps with sciatica. AI will tell it does not work on sciatica. In test they got the same results as a placebo