Leg pain from damaged L-4

[mikejh0730]

My doctor is recommending the trial stimulator, and work comp is also wanting me to do the trial before we decide where to go from here.
I guess I could give you a little background on me. I wrecked an ATV last August. I landed on my back and the ATV rolled on top of me and the handle bar jabbed me in the stomach. I fractured my L-3 and have a herniated disc at S-1. The fracture healed, with the exception that it is enlarged in the area of the fracture. The problem has been the dibilitating leg pain. I have had 3 epidural steroids, which gave me relief for a month or so, a nerve root block, which put me in more pain, and I tried different meds. I have gone through all the tests. Multiple MRI's, XRay, CT Scans, and a CT Myleogram. The Doctor said that it doesn't appear that the nerve is being affected by anything pushing on it. He came up with the conclusion that when I wrecked I stretched the nerve root, or the fracture broke off and damaged the nerve, then went back into place.
We have a ranch and that is our livelyhood. It is a very physical job at times, and I spend a lot of hours driving or on machinery.
I need to know some details about the dorsal column stimulator. I have read that you have to turn it off when your driving or on machinery. Is this right? If so it wouldn't be very practical for me. I spend 14 hours a day on machinery during the summer.
Also if anyone would have some advice for me about what to do next. I have been considering a second opinion from a bigger hospital like John Hopkins or the Mayo Clinic. Any help would be greatly appreciated. Thanks, Mike

[Mark56]

Hey Mike-

I have a dural space inserted Spinal Cord Stimulator, haing not heard of a Dorsal Column Stimulator, and mine is of Boston Scientific manufacture. It has been a life rejuvenator for me, as I have been able to resume practice of law full time, and never turn it off, even when driving. Fine print in any stim company product written by their lawyers will warn against such use, but then there is the practicality of common sense.

If one wants to be able to return to work and do so in your field of endeavor, a permanent install would be the only way to give it a real go. The trial of the stim is fragile, and merely inserted percutaneously and taped to your back in as secure a way as possible- riding a four wheeler would not be in the agenda for a Trial opportunity, but doing more careful things with the focus whether the stim handles the pain management for you is the goal.

Who manufactures your proposed unit?

Caring,
Mark56

[Rrae]

Welcome to the forum!

So sorry to hear of your accident.....I cringed. My twin 17 yr olds have atv's, so of course a mom will worry. I'm going to read your post to them if you don't mind.

On the positive side! You do sound like a prime candidate for the SCS aka Dorsal column stim. Mark is correct in stating the main reason they add the no driving/machinery warning is simply to cover their rears. Use your own judgement on this. To some, the stimulation is distracting enuf that they turn off while driving. Working machinery is different - you aren't on a highway potentially putting yourself or someone else at risk. Some people claim they do get surges when changing positions, even just looking down will cause your leads to stretch a bit and you'll feel a stronger sensation. This is the thing to be aware of. I would hate to see you cutting sheet metal or something and ...... well you know.

SCS usually has good results for lower limb pain. I too have bilateral leg pain, but mine isn't due to an accident. Peripheral neuropathy, radiculopathy and CRPS are conditions that respond well, although CRPS is known to spread in some patients, so extra caution should be taken when making the decision.

Getting a 2nd opinion couldn't be a smarter choice. You certainly don't want someone doing this who's just out of med school.

It's great to have you here Mike! Stick around and let us know how this unfolds for you.

Rae

[drtim12760]

I have had a similar situation. I had a hip replacement that went bad and my femur was shattered. I have 12 screws and wire holding my femur together. In the process the surgeon over stretched and ripped my sciatic nerve from the muscle. This caused excruciating leg pain and resulted in an order for 5 L4 nerve root blocks. I responded positively (pain became tolerable) after 3 treatments so the last 2 were cancelled. That calmed my leg down enough to become functional.It was suggested by the neurosurgeon who attempted to repair the damage done by the orthopedist, that I have a neuro-stimulator but I opted out of that.
I also saw an activator chiropractor for regular adjustment of the lumbar area and that helped tremendously.
I don't know where you are but I would suggest you go to the *** and find an advanced proficiency rated Dr. before you allow the stimulator implant.

Good Luck

[Dr. Smith]

Mike,

I posted a reply in the Spinal Disorders & Back Pain forum (from that subject's POV) - written/posted before reading this thread.

Doc