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Info and Advice

kitkat0928kkitkat0928 Posts: 5
edited 06/11/2012 - 8:31 AM in Back Surgery and Neck Surgery
My name is Kathy and I am new here. I am looking for information and opinions. I have been scouring the forums and am so grateful to read about other people's experiences and advice.
I had a discectomy at L5-S1 approximately 6 years ago.
I had a decent period of relief, post surgery. I had some bouts of sciatica and muscle spasms, but really nothing unmanageable-without any meds.
About 3 years after my surgery, I picked up my then 3 year old, who was about 45 lbs. I felt something pull in my back and my sciatica and back pain started again. An MRI showed a bulging disc at the site of my previous discectomy. A neurosurgeon in the same practice where I had been treated previously diagnosed degenerative disc disease but advised that I wasn't a surgical candidate at that time and referred me to pain management Dr. I spent 2 years under the treatment of a pain management Dr. I tried various injections, nerve ablation, the trial for a spinal cord stimulator. I got no relief with any of the injections and got a month or so worth of relief from the nerve ablation. The SCS was moderately successful but I didn't have the permanent implant because shortly after my trial, I was laid off and no longer had insurance. When I lost my insurance, I changed back to just seeing my primary care Dr. He was treating me with Zanaflex, Ultram, and an anti-inflammtory in three month cycles.....much more affordable than seeing the pain mgmt Dr, as I was paying for everything out of pocket. That worked for about a year or so with no real issues. So, I've muddled through the past 3 or so years, between the pain management Dr and my primary care Dr.
That is, until about 3 weeks ago. I noticed it starting kind of slowly....the pain just increasing more and more. The Ultram wasn't working like it once had and I assumed I was just getting tolerant of the medication. It wasn't long before I figured out that something else was wrong. I went back to my primary care Dr, who gave me a shot of steriods and a short term prescription for Lortab. That same night, I ended up in the ER because the pain was so bad. They administered Toradol and Valium. It didn't offer relief as much as it just relaxed me enough to rest.
I went to a new pain mgmt Dr, who sent me for another MRI since it had been almost 3 years since my last one. He also referred me back to my neurosurgeon...he really feels like he's out of options to treat me. He would be willing to go through with another trial for the SCS, but the worst pain right now isn't nerve pain/sciatica...it's the acute pain in my lower back. It's his opinion that the SCS really wouldn't help much, at this point.
The MRI reflects the previously operated on disc still bulging-more than it was 3 years ago, but not herniated. There is much less disc space between L5-S1 than there should be. The neurosurgeon who did the discectomy thinks that spinal fusion is the next best course of action. He isn't sure if the disc is causing the pain or if there's scar tissue but, in his opinion, it's clear that that part of my back is unstable. Frankly, I'm fine with that. *Something has got to help. I am at the point I can't do anything. I am out of work because I can't sit, walk, or stand for more than about 10 minutes at a time...and when I attempt to, it's excruciating. I am currently taking Lortab 10 mg every 4 hours, Celebrex 200 mg once daily, and 4 mg Zanaflex 3 times daily. The Lortab lasts about 3 hours before I can hardly stand the pain.
My neurosurgeon says that he isn't comfortable doing the fusion himself. He told me that he doesn't really do many of them...and while it's in his opinion the fusion will provide the relief I need, he just doesn't feel comfortable enough to do the surgery. He referred me to another neurosurgeon in the practice that does many more of the fusions and told me that he would get me an appointment ASAP. I called after not hearing anything for a week....and the soonest appointment that they could get me was over a month away.
At this point, if the neurosurgeon who did the discectomy wouldn't perform the spinal fusion himself, I'm wondering if it's even worth waiting the nearly four weeks to see the other Dr in the practice. Should I attempt to get in to see an orthopedic surgeon instead? Should I be looking at other options, rather than the fusion? I can't seem to find any good alternative.
I'm just so frustrated. I can't do anything, I am in a lot of pain AND medicated. Any advice, thoughts, opinions are all appreciated....



  • My back Dr is an ortho but he only does spines. He is a spine specialist.

    Good luck to you.

  • Hi. I don't envy your position. I can relate. Before I had that first lumbar laminectomy in 1995 I was pretty much in agony--couldn't stand up for more than 2 minutes at a time. Definitly I needed surgery. I live near Detroit, and the hospital where I had the surgery done had a neurology and spinal surgery department. My doctor was a neurosurgeon who specialized in the spine. I felt confident in his expertise. I guess my best advice to you is to get in to see a great neurosurgeon who has done many fusions, etc.

    I am scheduled for a discogram to see if discs are causing my continued pain. Usually these tests are prescribed prior to any kind of surgery, and I have had two fairly recent lumbar fusions (2007 and 2008). Have you had a discogram yet?

    I feel like I am not helping as much as I wish I could. I know how desperate you are right now. I just think you need some good, good opinions from really good doctors. And as for seeking an alternate route, just from my own experiences I found that in the end, I needed surgery. But I did try chiropractors, medial branch blocks, drugs, p.t., first.

    Good luck with your decision, and I hope you find your answer soon so you can get on that road to recovery.
  • Thank you for your reply. I haven't had a discogram but didn't have one prior to my discectomy, either. From what I've read thus far, it seems that there's split opinions regarding the necessity of a discogram.
    I certainly wouldn't refuse one at this point, since I just want to do whatever it will take to be able to function again. But it hasn't been suggested by the neuro, nor was it ever suggested by my pain mgmt Dr either.
    I have tried chiropractors, PT, medications, injections, etc...so I can't help but think I'm at the end of the road for treatment other than sugery, now. I just want to be able to have some function to do normal things, like drive, go to the store, etc.
    I have made an appointment with an orthopedic surgeon that specializes in spinal surgery. I was able to get an appointment for this Friday. So, I will be gathering all of my records from the various doctors this week for that second opinion.
    Thank you so much for your thoughts and well wishes!!!

  • I just had a microdiscectomy (L4/L5) to relieve sciatic pain in the left calf and back pain. 24 hours after the procedure, I still have calf pain and pins and needles in my big toe. It is normal for the sciatic pain to persist a while? Everyone I know that has had the procedure has had immediate relief, so I got concerned.

    Thanks for any words of experience others can offer.
  • Sorry you've been having a hard time and it's frustrating not knowing what to do after all you've been through. Did you get a new insurance plan yet? I guess you must have if you're contemplating surgery :)

    I've had an orthopedic surgeon and neurosurgeon operate on my back and there wasn't a big difference to me. I do prefer a neurosurgeon now because of my nerve damage on one leg, and I like his personality better.

    After I had a microdiscectomy, I reherniated L4-5 and it also showed retrolisthesis. L4-5 and L5-S1 has severe DDD and the nerve was being compressed again. My NS did a 2 level fusion on me later on, and I eventually fused all the way but unfortunately I'm left with chronic pain, scar tissue, and permanent nerve damage and weakness. I did try an SCS trial last year but suffered complications, and I didn't find it to relieve my pain either. I have more back pain than leg pain at a 60/40 ratio.

    Yes, it's hard to make a big decision about having a fusion. I took a chance on it because my pain was constant and severe and I was hoping it would take some of it away. I was told I'd either get better, stay the same, or get worse. I did not want to go on living the way I was.

    Now, a year later I'm back to square one- I spend my time laying down because I can't sit, stand, or walk for too long. I hurt all the time, even rolling over in bed hurts. Sorry for writing a novel.

    My advice is to research all you can about your options, esp. the fusion. Know what you'll be getting into, find out the REAL recovery time, and be prepared to handle post surgical pain. Ask if the surgeon will use a PCA machine post op. In some people it takes more than 12 weeks to recover. It can go on for 6 months or more. A nerve can take up to 2 years to completely heal. Meanwhile you have to deal with some limitations, PT, residual pain, and boredom.

    I'm just talking from my experience and hope it helps you out. Take care :H
  • How are your discs above 5-1?

    In your post, you mention your doc is unsure where the pain is coming from. Discogram!

    Where are you located?

    Can you schedule consults with other spine surgeons in the same area?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
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