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Surgery Cancelled - am I crazy?

signavyssignavy Posts: 63
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
Greetings all,

I will try my best to keep this short. Had my PREOP last week for L5/S1 TLIF due to spondylolesthesis (grade 1 according to surgeon/grade 2 according to radiologist) and disc herniation and bulge at L5. The surgeon stopped in after the PREOP staff asked a bunch of questions to discuss my MRI results and talk about my pain levels - which I said were btwn 2 and 4. My surgeon said that my spondy was stable, he believed my disc had probably degenerated to the point where it has hardened over and shouldn't degenerate further and that he didn't feel I had any permanent nerve damage. He then went on to say that he didn't think it would be UNREASONABLE to give my back a little more time and PT to get better. After asking a few more questions I headed back over to the PT section to schedule aqua therapy and graston. He did say that he had no problem putting me back on the schedule if the PT didn't deliver meaningful results.

I am now wondering if this was the correct decision - I keep second guessing myself as I continue to read some posts. There is some nerve compression because I do get painful spasms on occassion as well as some tingling and numbness. I am obviously not qualified to second guess the surgeon's comments, but I have read postings where people were told to give it more time and the nerves were compressed for too long so they have permanant damage. My injury is almost a year old and I wonder - isn't that enough time? Anyone out there have a similiar experience and get better? Anyone told to wait it out a little longer and now regret the outcome of surgury?

I appreciate your time and wish everyone that is recovering from surgery or dealing pain all the best.



  • dilaurodilauro ConnecticutPosts: 9,833
    I would just discuss this over and over with your doctor to have them explain to you WHY your do not need surgery right now.
    If you have trust and confidence in this doctor, then go with it, if NOT, it might be a good time to search for another opinion
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Hi Mike,
    Well that is quit a delima? I guess the one thing is have you had a emg study on your legs and what did it show? Although they are not perfect, they can help as a tool. Although I am one from the cervical side and have permanent damage, not by choice but rather by the process. My thoughts are can you manage the pain and how much can it be reduced with some meds or is that how you are keeping it so low. If you are using meds try going off of them and see what levels of pain you still have.

    I am sure you are aware that there is no guarantees with surgery. Did you ask the surgeon by waiting what you could be jeopardizing as far as future and permanent damage. Most of them will give you some odds. It is like the same odds they give you that surgery is a success. Success not meaning rather you fuse but rather it takes the pain away. Obviously you have researched the surgery and understand what it is. Maybe you can talk to the therapist and see how many they have seen in your situation and the outcome. Did the surgeon give you any signs to be cautious about and you should call them if it happens?

    Don't beat yourself up emotionally to much with the second guessing. Surgery as these are such a huge decision. You can always change your mind if therapy doesn't help and go for the surgery and if the pain begins to increase. Hopefully it all works out and you have made the best decision for you and your individual situation. Keep us posted on how the therapy goes.
  • I have come down off the meds (was taking mobic - stopped completely / was taking valium - stopped completely / still taking Neurontin / take Motrin ocassionally / take tramadol ocassionally. My pain levels were less when on the Mobic and Valium, but I was nervous about their long term use. I try to avoid the meds as much as possible - not sure that is the best decision as I clearly have more energy when I am not in pain.

    The surgeon said I risk nothing by waiting - but I read about people who say their doctors attribute nerve damage to the nerve being compressed for so long. I do trust this surgeon - he is an ortho and is not pushing me towards surgery - unlike the Neuro I saw who said after 6 months of failed conservative treatment to have surgery. At 39 I like to think I have a ton of good life to live, but if this is the best I can expect it's depressing. I guess another 1 to 3 months of PT will at least put me in better physical shape and I can further evaluate where I am at.

    How are you perm nerve damage caused - during the surgery or waiting to have it?

    Thanks for the replies. Atb, Mike
  • I can imagine how confused you are feeling right now and you're probably not sure where to go from here. I'm no doctor but I can say that MRI's don't pick up all the damage. When my surgeon opened my back up he saw a lot of debris from my arthritic facet joints, and this was a surprise to him. In other words, there is no telling what is going on until you have surgery.

    I hope your surgeon is right about you having no risk of permanent nerve damage. Seems like he's evaluated you all year long and hasn't seen any neurological deficits I'm guessing. From what you say about your pain being in the lower ranges then it possibly be true that maybe you can afford more time. Remember that once your back is operated on, there's no going back and no guarantees of getting better.

    I do agree with Ron to seek another opinion, maybe a third too. This way you'll be feeling more confident about what you choose to do. Think about how this affects you every day: are you in constant pain even if taking narcotics, does the pain wake you up at night, can you stand sitting down or walking, do you spend the majority of your time in bed or a recliner, do you put off taking a shower or slacked off on grooming because of the pain, do you avoid stores that don't have scooters, wheelchairs or someplace to rest, and is driving or being a passenger in a car very uncomfortable? If you ask yourself these questions and answer yes to a lot of them, then you should talk to your doctor and see what he thinks. In other words surgery is best if your quality of life is intolerable and you have failed all conservative treatments.

    Please keep in mind that I'm speaking solely from my experience and I'm not a medical professional. I hope things work out for you soon, and take care
  • I personally would avoid surgery until you absolutely have to have it. There is no going back.

    I think giving your body every opportunity to heal itself is a safe bet.

    When I said 'go' on the surgery I was at the point that life in a wheelchair would have been better than what I was dealing with. Luckily it did not come to that. I am, however, left with some possibly permanent nerve damage, but it's from the surgery, NOT the waiting. All the nerve issues that I had BEFORE surgery are gone. Now I just have NEW problems.

    I am glad to know that I can sneeze now without practically collapsing in a heap of pain. I am glad that now I can trust my bladder.

    I am not very happy to have to deal with daily charley horses due to nerve damage in my formerly okay right leg.

    Back surgery seems to be a lot like a high stakes game of chance - you have to make sure that if you play the game you are willing to pay the price.

    ...just my humble opinion coming from a "post-op'ey"
  • Meydey/saltz,

    Thanks for your replies - confused is definitely how I feel. I trust the surgeon as he has always been very straight forward with me with regard to surgical expectations and he has always told me to avoid him as long as possible. The thing I am most hung up on is the spondylolisthesis - I know it wont heal itself and while the surgeon says it is low grade (1), stable, and probably not what is causing my symptoms I am finding it hard to believe only the disc herniation and bulge is causing nerve compression. My surgeon hasn't said the slippage is compressing any part of the nerve, but then again I didn't ask. Any thoughts on the spondy causing or not causing symptoms.

    Sent you both a PM. Thanks again for the replies. Wishing you both pain free living. All the best, Mike
  • Spondy is not anything I know about - but stable, at least that sounds good.

    I do wonder why he thinks that it's not causing your symptoms - that's like him saying that he doesn't think surgery will cure any pain, just fix the spondy.

    But, you should also know that MRI's do not always show the problems.

    I highly recommend requesting a Discogram. My NS would have done surgery on only one disc (the one that looked the worst on the MRI) and not done surgery on the second disc - the one that the discogram proved was the most painful for me.

    It's not a fun test. It hurts. But they have to make it hurt to find out which disc is the culprit. It certainly put my mind at rest over whether or not to have surgery. Ask your dr.

    Best of luck and let us know...
  • For what it's worth, most ortho's look at a spine from almost a completely "structural" point of view, whereas neurosurgeons look at it with regards to how it is effecting the nervous system.

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