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Does it make sense to have surgery now?

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:22 AM in Back Surgery and Neck Surgery
Hello All:

I have a large herniated disc L5-S1. It started in January with severe sciatica. The pain was so excruciating I could barely function. I had to stop working in February because I wasn't able to get through the day. I could not stand more than 5 minutes and couldn't sit at all. I'd been relegated to my bed since Feb up until very recently. I started doing DRX 9000 treatments in April. It was getting me very much better, but the success was limited. Even my chiro said that the machine could not help me any further. He advised that now was the time to seek surgical intervention. This was a huge admission. Chiros typically don't like surgery and this one even more so. He had a family member to actually die from a botched surgery. He'd been telling me for months to do everything I could do avoid surgery.

So I got new MRIs done about two weeks ago. The disc has receded away from the nerve a little, but the herniation is large and it is still touching the sciatic nerve. In the past three weeks I've met with a neurologist twice and met with the neurosurgeon yesterday. They are advising surgery --a microdiscetomy. HERE'S THE KICKER....I NOW FEEL GREAT!! Two weeks ago I made a big leap in my recovery. Each day I've gotten better and better. Today I'm in no pain, I can walk longer distances, can sit normally, and basically function normally. I feel like I can even start working again. The neurosurgeon I met with yesterday explained that the disc has a great likely hood of protruding back into the nerve. I may feel great for weeks but it most likely would happen that the pain will return. He wasn't pushy at all. He was very matter of fact. I'm 33 yrs old. I don't want to keep dealing with going back and forth with pain and disability. Would it make sense to have surgery at this time? I'd appreciate your input. Thanks :)))

Dryden
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Comments

  • If it were me in that situation, I'd wait until I was in so much pain again that I couldn't function before I have any surgery.

    Opening the back up is like opening Pandora's box. I went in for a simple surgery one day and that turned into a nightmare.

    If it ain't broke don't fix it. If it has receeded for now, then leave it alone.

    Those are my thoughts.

    "C"
  • I've been out of work for a year and a half due to sciatica and DDD... It was on and off. They told me chronic pain can do that. Microdiscectomy is a small surgery. Takes maybe an hour and you go home that day. It's worth a try... It can't hurt to take out the disc material that's touching your nerve. If it were a more serious surgery I'd definitely say wait. My sciatica went away for a couple months over the past year and a half, came back strong, went away, came back even worse... If you're not working as of right now, might as well be safe, do it, and then return to work, instead of waiting and having it come back 10 fold and not being able to take the time off.
  • I had my MD in May, and it worked for a little while... But my problem is the disc is totally shot, it's not just a herniation, so over time the pain just came right back. If they can clear up the material that's in the way, and there is enough disc left, it may help you a lot. A friend of mine had it done at 19, and hasn't had any problems since...
  • Thanks for taking the time to comment. Lo, the more I think about it the more I'm inclined to have the micro-D. I've known folks who have done the back and forth with it like you've done. They've had the procedure with no problem. I know that nothing's 100%, but right now having my life back fully is worth the risk. I wish you the best in your upcoming surgery. The wonderful thing is that you're so young. Why, you're still a baby : ) Your body is strong and resilient and I'm sure you will recover nicely. Best to both you and "C".

    Dryden
  • I know, I know. I am still very much a baby. Lol. I am hoping that will work to my advantage!! Hehe.

    I also wish you the best! I have heard many, many success stories from MDs... Mine didn't work but it's because they didn't know it was DDD until they did my MD and saw how dried out and shot the disc was. If it were just the herniation, I'm sure it would have worked wonders. If you have a pinched nerve, over time it can become damaged if it's not released. I heard this from my Neurosurgeon, the P.A., and my physical therapist.

    I had help for maybe 2 to 3 days after my MD, and then I was fine! I'm sure you'll be back to work in no time, and hopefully with a lot less pain :) One suggestion, though.. You may want to request a couple days worth of muscle relaxers afterwards. Sometimes the nerves go a little haywire from being moved or touched from the surgery... I didn't ask til later on, after I spent the second day in bed crying my eyes out. Soon as I got the muscle relaxers, it totally went away. Keep us updated on how you're doing and what you decide to do :)
  • Exactly the same thing happened to me before my microD. I was feeling great and I was having rhizotomy done 1 x a year that were doing a great job at controlling the pain. My doc said that the MicroD might make it so that I would not have to do the yearly rhizotomy so I went for it. BIG MISTAKE! I am in much worse pain now then I ever was preop and the microD was in Dec 07. Do not have surgery until there are no other options and you can not tolerate the pain any longer. Who knows how long it will take to start effecting the nerves again? Did you know that after microD or fusion it puts more strain on the discs above and below and makes it more likely that you would be dealing with another herniation? This is all just my opinion. I am not in the medical field or by no means an expert. Good luck and keep us posted with what you decide.
  • You obviously have had your own experience, so I can't say you're wrong. You know your body and what you feel... But micro D doesn't put any extra strain on the surrounding discs, because it's only removing the material that has been protruding... If you have a discectomy and they remove a good portion of it, maybe, but then you'd eventually need a fusion, most likely. If you're just having them clean up the spilled material, then it shouldn't make things worse unless there was a mistake through the surgery! MicroD is a small surgery... Doesn't really alter much at all if it's strictly a microD. I know sometimes they combine them with some other techniques, but if she's got a pinched nerve, it may do more damage to leave it compressed. Once your nerve is damaged, there won't be all that much you can do. I would hate to see that happen to someone :( I do think that fusion is something that should definitely be a last resort... No doubt about that. My doctor said after 10 years, the surrounding discs on average degenerate about 33 percent... Yikes. Sounds like I'm gonna be looking at a few more surgeries in the future! Oh goody. Lol.

    I'm sorry yours turned out terrible :( It's tough when something that is supposed to fix your situation makes you feel worse. That's gotta be disheartening and quite a bit disappointing.
  • I'm going in Tuesday for a Micro D for herniation on L4-5. It's been an ongoing problem for 11 years and wished i'd gotten this done sooner. Additionally, a herniation won't cure itself....you may mask the problem for a while but ultimately it's still there and in my case, the L3-4 and L5/S1 are already showing some good signs of bulging.
  • I've been on both sides of the fence and really if you are feeling OK now, then why not wait and enjoy it while you can. When and if it gets worse, then things can be done but while the going is good I'd keep it going.

    Blessings Sara
  • No matter what you decide for yourself I wish you the best.

    Good Luck,
    Christina :)
  • I will keep you posted. :)))
  • dryden,

    more important than the pain or lack there of in your decision to have a microD is your neural function. if you have muscle weakness, loss of reflexes, change in bowel/bladder function, and/or numbness in a dermatomal pattern then it is likely your nerve root is being compressed. but if you do not have these signs / symptoms then it is inaccurate to say the nerve is still being compressed, as a compressed nerve causes neural signs. one thing about the human body is it is excellent at cleaning up after itself (well maybe discs and nerves to some extent may be the exception). most disc prolapses despite size do not require surgery as during the healing stage the disc resporbs / dehydrates getting smaller, therefore no longer causing the mechanical compression of the nerve root (which is what a microD proposes to fix).

    in saying this, microD'S on the whole are incredibly succesful surgeries and often get good results. when they dont get good results it is often due to inherent instability that is made worse by removing some of the disc or poor correlation of signs / symptoms to the offending level

    my opinion, whether is counts for anything, is if you dont need the surgery dont have it. you should not have spinal surgery in case something may happen, you have it because something is happening (mri that correlates with signs/symptoms)...

    only you can decide if surgery is right and you need to use the experience of your medical team. do they agree? do you trust them?

    good luck,

    rachel
  • You made a very good point regarding neural function. My most recent EMG test plus reflex test conducted by the neurologist shows that nerve is still being impinged. The MRI confirms it. My medical team does agree and I trust them. I am having the surgery. I will be sure to update this post. Thanks for your response :)))
  • good luck with the surgery.
  • The same thing is happening to me. I was in pain for 9 weeks. Finally got a MRI and saw a neurologist. I have a herniated disc L4/5. I am scheduled to have a laminectomy and diectomy on Sept 9th. I have had back pain on and off again for 20 years. I am 47. But all manageable and never sciatica like this. I had to stop work and could not sit at all. Now all of a sudden I am improving. Surgery one week away and I am second quessing myself. It was easy to say surgery when I was in pain.

    Every year my back gets worse. I have tried PT and chiro. and exercise. I get better and build my strength and feel good! But I just can't seem to get my back right.
  • Dryden, hope all goes well. I had a MicroD in mid-May, and it has helped me a lot. My symptoms included considerable leg pain and foot numbness/pain. Prior to surgery, epidural steriod shots and PT had helped somewhat, but I never did get to being "normal".

    When I had a relapse, I opted for surgery and have not regreted it.

    At the 3.5 month mark, I've been seeing weekly improvement. Still not 100% (nerves take a long time to heal, and mine had been impacted for a long time)but for me it was the right decision. I still have foot numbness, but the leg pain is virtually all gone.

    Keep us informed.


  • Surgery is a few weeks away. I will keep you posted : )


    Dryden
  • Gardener, it sounds like you've done due diligence in going the conservative route. I pray that this surgery will get your back right. I'm still feeling pretty good. But my concern is if I don't have this disc surgically taken care of my sciatic nerve will become permanently damaged because of being impinged for so long. Also, I don't want to dance with the sciatic bear ever again! BTW, Sept. 9th is a very auspicious date. It's my birthday : ) I wish you a very speedy recovery and a full return to life.
  • Hi Dryden,

    I had my preop. appt. today. I quess I am really going to do it. I like what you said about doing the dance. I have to agree. I will let you know after your birthday what I think about surgery.
  • I finally did it!! I think entertaining the endless list of "what ifs" before surgery is far worse than the surgery. So far so good. I'm up and walking around and am on minimal pain meds. I take them as needed and not the 3x per day as perscribed. Today I took them only once. I have some pain and stiffness in the back of my right thigh. The neurosurgeon warned me ahead of time about this. He says it's because the nerve starts to swell 2-3 days after surgery. But even when not taking the meds the pain is no where near the pain I had even 2 months ago. Currently I do not regret the surgery. Right before the surgery my pain level was about 1-2. My pain is about the same level but in a different place. I'm relieved when I think that I my be pain free in the future and able to resume my normal activities. That is worth the trade off of having a little more pain right now. I'll keep you posted.
  • Hi Dryden, welcome to the other side. So glad you are doing well. Your story is kinda like mine. I was dying with agonizing pain for months, but by the time the surgery came around I was doing much better. I had fusion myself and decided to go for it as my spine was unstable and so knew it was only a matter of time before it would get worse again. Been dealing with this for so many years prior and limping for past 2 years at intervals with flare ups. So anyway hurray for us being brave and getting it over with so we can be on our way to a permanent recovery. Remember to take it easy, no over-doing as you will pay later, follow the docs instructions, and yes walk, walk, walk. Take care, Sue
  • Dryden

    Gardener here. I had my L4-L5 laminectomy discectomy on Sept. 9th. My worst day was the third after surgery. I am glad the surgery is behind me. I am three weeks post surgery and have been getting better every day untill about three days ago. I seem to have stalled and am still experiencing sciatica. So a little dissapointed because I thought or heared of people going back to work after three weeks. My NS office says just keep taking it easy and it will work out.

    So I guess I am saying that it takes time and keep going and be upbeat.
  • Cali-Sue, I love that bible verse in your signature. I need to remind myself of that everyday when the fear monster starts to rear its ugly head.

    Gardener, I've been wondering how you're doing. I'm glad to see that you also made it to the other side. The common denominator in almost all of the micro-d threads is it does take time. Sometimes complete relief immediately, sometimes up to two years. We'll get there little by little. I still have some sciatica as well in its old familiar patterns. The surgeon also advised this will happen as well. He told me he often gets calls from patients who are still a few weeks post op but still have some sciatica pain. They fear they may have reherniated. He says not to worry. It does take time for many of us.

    Blessings,

    Dryden
  • So glad you noticed my favorite verse. I say it often, it gives me great comfort. I also say "by his stripes I am healed". The bible says to SAY, SAY, SAY! Claim it, own it, believe it, and it will happen :) Sue
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