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Five years post L4/L5 laminectomy/discectomy, it's back. More surgery?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
Hi there everyone,

I'll keep this as brief as I can.

33 years old. very athletic.

2002 (age 26)-after occasional back problems through high school and college (all sports-related), i suddenly experienced severe pain, then discovered L4-L5 herniation and stenosis.

symptoms: sciatica in the left leg, mostly in glut/calf, making standing for any length of time unbearable and severely limited activity. constantly needed meds (percs, vics, anti-inflammatories) for any active behavior. awful.
2002-2004-various treatments (PT, acupuncture, etc.) that did not work. began getting epidurals. effective duration of each epidural got shorter (9 months, then six months, etc).
2004-began consulting with surgeon (columbia prebyterian in nyc). after a final epidural resulted in no decrease in pain, scheduled surgery.
2004-august - underwent laminectomy/discectomy at columbia presbyterian. immediately following surgery, nothing changed.
2004-october - frustrated with lack of any reduction in pain and by doctor's insistence that everything was fine, got a second opinion with the excellent dr. michael lavyne. following additional MRIs/CT scan and a myelogram, lavyne agreed to operate.
2004-november - got second laminectomy/discectomy. it was successful.
2005-2009 - pain free, with gradual increase in athletic regimen
2009 - july -following workout, feel sciatic pain. immediately stop working out. pain increases.
2009 - get mri - the results:
L4-L5 - severe loss of intervertbral disc heights (assume this is from previous operations)
L4-L5 - 4mm disc bulge, focal tear at T2 weighted sequence. mild/moderate foraminal stenosis, more on left than right. NO extrusion/sequestration.
L5-S1 - 2.5mm disc bulge impressing on thecal sac. mild foraminal stenosis, more on left than right. NO extrusion/sequestration.

So, I guess my question is: is there anything I can do to avoid surgery again? And for those of you who've had multiple ops or you doctors out there, do you think there's any way to avoid fusion/artificial disc replacement given my two previous discectomies?

all advice is welcome!!!!!!!



  • Not sure I have anything informational to say, except that I had an L4/L5 laminectomy/discectomy in 2002 with a resurgence in symptoms since September of last year. I am awaiting another MRI--seeing a new ortho on Friday. I know how that return of pain feels and the dread of spinal surgery.

    It's my understanding that they have made huge strides in fusion surgery in the past few years, so hopefully, if surgery is in your future, it won't be as nasty a recovery as it was the first (or 2nd) time for you. I'm interested to hear what the doc says.

    Good luck!
  • Thanks Mel, I will keep you posted. Fingers crossed! If anyone else has any specific experience, both Mel and I would greatly appreciate it!
  • I don't believe you have had a fusion, right? I think you said you had a lami/discectomy?

    If you can deal with the pain, there is always a chance that you can recover without surgery. It looks like the L4-5 has reherniated, and losing disc height may mean that you have bone rubbing on bone. There is also a smaller herniation at the adjoining level. The report indicates that while there is some foraminal stenosis, it does not indicate that there is spinal nerve compression. So perhaps you will be able to let the discs heal up with conservative treatment and a great deal of patience.

    You may want to get several opinions from fellowship-trained spinal specialists, either orthopedic spinal surgeons or neurosurgeons who devote their practice to back and spine issues.
  • I agree with Gwennie about getting another opinion from a spine specialist. I assume your current diagnosis is based upon an MRI. MRIs do not always show the extent of damage, a neurosurgeon might actually recommend a discogram to find out what nerve root/s are compressed, how large the tear actually is, etc.

    I understand wanting to avoid surgery, but if you have nerve issues, more time waiting could possibly lead t permanent damage. I wish I could have acted , sooner, but it took a discogram to show how bad things really looked. In my personal opinion/experience, I'd make sure to get more than one opinion from surgeons.

    Fusion is no fun, not sure if you qualify for an ADR, but I do believe you need to act and get other professional opinions.

    Please post an update so we know what you decide.
  • hello,
    I too was very athletic and had a laminectomy L4-5-20 years ago-the laminectomy weakens that area of the spine and it is common ,especially since I remained very active,for that same area to re-herniate.I had a fusion in the same place in October2007-with good results.Sure I have rods and screws but I am not getting any younger and wanted a stable spine and to be as pain free as possible.I am not trying to put ego aside and realize that I need to take better care of my back so I don't ever have to go through this again.I have given up the high impact ,high energy sports and lifting{well-still struggling with the lifestyle change}and am trying with the help of this site to learn to be active-and still have good back health.Everyone has different experiences,but i trusted my surgeon,had good success,and glad I did it.It is even commom for us to have several spinal surgeries,as we all seem to have the same adrenalin junkie personalities and push things to the max. Even now I know that the discs above and below my fusion are taking the work of the one removed,so if I don't take care of myself,I could be in trouble again.Good Luck.I have had also had a cervical fusion-i learn the hard way.Hope you don't have to.
  • thank you everyone!

    actually got good news today from my nyc neursurgeon.

    Sorry to hear about your aching back, but this too will pass in time.
    The good news is that the scan shows no evidence of a need for repeat surgery--no extrusion of the disc material.
    The bad news is that you have further degeneration at L5-S1.
    Have your primary doc refer you to a physiatrist/rehab MD to guide further therapy and forget about the possibility of surgery.
    You will get better.

    Now, does anyone have any PT recommendations?
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