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iSpine Discuss New injections in the Main forums forums; Greetings from Bonn. After a horrible couple of months, I've come to the BetaKlinik on my own... just to ...

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Old 07-21-2011, 01:34 AM
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Default New injections

Greetings from Bonn.

After a horrible couple of months, I've come to the BetaKlinik on my own... just to deal with my case.

I'll post more details later. We redid some of the costovertebral joint injections today. Results seem good, but it's tough to tell. I was hoping for the same clear indications I had before, but the ablations I had in January may have muted the injection response. Just what we need, less clarity!

Wish me luck!

Mark
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
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Founder: www.iSpine.org
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Old 07-21-2011, 04:57 AM
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Default the best

Wishing you this kind of outcome w/whatever you try diagnostically and/or therapeutically. Keep us posted as time or energy permits.

BTW..didn't do the condo in SD. Nondisclosure issue. Still looking!
take care~ Maria
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Old 07-21-2011, 06:42 AM
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Mark,
I wish you the best outcome possible with whatever treatment you have. Glad you are spending 100% of the time on yourself.
judy
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2007 ACDF 4-7
2008 hip , knee scope, hip replacement
2009 thoracic T-5 thru T-11fusion
2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear
2010 lung surgery
2010 T2-L2 kyphosis correction
2010 Kyphoplasty T-3, T-4
2011 Cervical osteotomy ,revision C4-T5
2011 Foot surgery
2011 Revision fusion T7 thru L4/laminectomy
2012 Hammertoe correction left foot
2012 Revision fusion T-12 thru L5
2012 Revision fusion L4-L5
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Old 07-21-2011, 02:50 PM
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Default Guten Morgen

Hi Mark,
Sometimes you have to take care of yourself... and just yourself.
I hope eveything goes well. Safe travels home and God bless. -Cheryl
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female age 45, height 5"6", 145 lbds, non smoker, conservative treatments failed, (7/2007) C4/5/6 peek disc replacements,plate & screws failed fusion,
(9/2008) revision with bone replace plate and screws, (10/2009) C3/4 stand alone peek cage, (12/2010) facet joint injections C3-7, (1/2011) rhizotomy C6/7 failed, Trouble swallowing
most recent mri (7/2011) shows ajacent level issues: right neural foraminal narrowing C2/3, posterior bulge indents thecal sac at C6/7/T1 no mass effect on cord.
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Old 07-21-2011, 06:44 PM
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Dealing with a confirmed diagnosis is difficult enough. Unknown- as a woman-crying comes to mind. Sending you lucky vibes from the SFV.

Have you seen Dr. Baumbach?

A belated HB.

Dale
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3 level Prodisc adr S1-L3, Oct 12, 2005
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Severe nerve damage in left leg, still working on it
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Old 07-24-2011, 03:39 AM
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Good Luck, Mark. I hope you find some answers and pain relief.
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1995 & 2005 L4/5 Discectomy (no disc left)
3/2010 4 Level ACDF C3-7
5/2010 Thoracic Laminectomy
2 Ruptured Thoracic Discs (T7/8, T9/10)
DDD
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Old 07-24-2011, 11:39 PM
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Here is a quick log of my diagnostic injections / ablations here at the BetaKlinik:

December: My first costovertebral joint injections. Single panel of 6 injections. Dramatic immediate success, followed by several days of feeling better than in years. Undone by difficult travel home about 4 or 5 days later.

February, targeted injections at same joints…. One at a time, wait an hour between. 2 absolutely positive… provocative value like discogram. That’s my pain, that’s where I feel it. All others negative. Based on great results, we ablated those 2 joints. No benefit from ablations.

July. Wednesay, 4 injections. Dramatic positive result. I’m confused because it lasts longer than local should and before steroid should have kicked in. I was good all day into the wee hours of the morning. Backslide the next day, so about 16-24 hours good? This is explained 2 days later by Dr. Reul. He did not use typical local, but used a long-lasting local.

I’m very glad that I did not know. I would have blamed placebo effect had I known.

Friday, Dr. Reul does 5 more injections. 4 at the 2 levels above Wendesday injections, plus 1 repeat at the likely offending joint. Note that these injections split the 2 culprits from February. Wednesday did the lower one… Friday did the upper one (and the lower single one – left side only.)

Friday afternoon, clear positive. Friday evening, it seemed to wear off. Possibilities:

1. Reul used medium length local?
2. Effect would have been longer, but checking out of hotel, dropping off friend and bags at train station, throwing around my own bags and making my way to another location caused earlier setback.
3. Maybe my brain thinks of medium local and caused expected result. This is all so confusing.

Saturday was amazingly good. I went to a family party with a dear friend in the Netherlands. I sit all afternoon without squirming. It feels strange to smile a natural smile instead of forcing one out through the constant tight jaw grimace that I have 24/7.

Sunday, back to slightly better than normal. I still get mid-thoracic pain when typing. I’m pacing when talking. Not sitting still for too long. Again, better than normal, but NOTHING like yesterday.

One thing to note. I was hoping for extreme positive result from the 2 positive joints that were ablated in February. This is not realistic… they’ve been ablated, so the response is muted.

I’m encouraged by the clear positive result, but still question that it might be the cumulative value of multiple injections. (If they injected steroid in my hip, it would help my back.) Still, I can’t ignore the predictable course of the longer lasting local, that I DID NOT KNOW ABOUT. So, this is good news.

However, this does not point a clear path to a solution. I would like to redo ablations at the two positive joints from Feb, but with more aggressive application of energy. Dr. Reul was conservative then, so he did not risk giving me the permanent wrap around band of numbness that is possible with more aggressive ablations. I think I’d like to risk it.

I meet with them in the morning and could probably redo the ablations then. They have that kind of flexibility here. They own all the equipment and I’m treating with the doctor who runs the clinic…. It would just take a few minutes. However, I fly home a couple of hours later. I don’t think I want to risk getting on a plane 3 hours after the nerve ablation… sounds like too great a potential for having a problem on the flight home. I’ll wait till next time. Or, I’ll do what Dr. Reul recommends. I trust him.

This log will be used as the basis for our discussion early tomorrow morning. Wish me luck.

Mark
__________________
1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
President: Global Patient Network, Inc.
Founder: www.iSpine.org
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Old 07-25-2011, 12:05 AM
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the best of luck Mark, I'll be thinking about you
judy
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2007 ACDF 4-7
2008 hip , knee scope, hip replacement
2009 thoracic T-5 thru T-11fusion
2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear
2010 lung surgery
2010 T2-L2 kyphosis correction
2010 Kyphoplasty T-3, T-4
2011 Cervical osteotomy ,revision C4-T5
2011 Foot surgery
2011 Revision fusion T7 thru L4/laminectomy
2012 Hammertoe correction left foot
2012 Revision fusion T-12 thru L5
2012 Revision fusion L4-L5
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Old 07-28-2011, 10:18 PM
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Posts: 113
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oh Mark i didnt see this thread till now...i hope this injections will bring some relief for you...finger crossed.
i cant wait for a autumn to came to betaklinik,its realy hard to live normal with so much amount of pain 24/7...
i hope we will both have some benefits from them
P.S. i will need you before my trip. tnx again )))
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Old 08-01-2011, 06:21 AM
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I met with Dr. Gasser and Dr. Reul on Monday morning before I flew home. I leave here with a new motivation to find the PT regimen that I can do without causing flare-ups and try to improve the situation.

I will also try to get the crooked atlas/axis situation corrected. (not sure yet, how this will go??)

If things don't improve over the next few months, I'll come back and start doing more ablations to correspond with the successful injections. I'd elect to do the 2 previously positive costovertebral joints more agressively. Then, if necessary, spread out to the other joints indicated by the successful injections.

I'm reluctant to do large panels of ablations like we frequently do here. I don't believe that there is any entry to the spine that is such low risk that we can start wholesale nuking of so many joints. But, if things don't improve, I'll give it a try.

I'll post more as I learn it.

Mark
__________________
1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
President: Global Patient Network, Inc.
Founder: www.iSpine.org
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Old 08-01-2011, 08:46 AM
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Location: Orange County, CA
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Looks kinda scary to me. I have never had ablations. This is my first time hearing of them. I did look them up to educate myself. Seems they work pretty well or at least that what the website I was on says.
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Had a 360 lumbar fusion in May 2008 with cages, screws, hardware. It didn't fuse and one of the screws are loose. Also have a tear at L4 but they say it isn't touching the nerve. Have a bulging disc at T6 which causes middle back pain. I'm not even gonna mess with T6.
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Old 08-01-2011, 06:01 PM
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Mark,

Is there a specific reason you will not have whatever procedures done here as opposed to going back for them? Just wondering -

D
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3 level Prodisc adr S1-L3, Oct 12, 2005
Dr. B in Bogen, Germany
Severe nerve damage in left leg, still working on it
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