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How to decide about surgery for sciatica?

ajamiesonaajamieson Posts: 65
After 7 weeks of pretty severe sciatic pain (started after a fall from my horse resulting in 4 fractured lumbar vertebrae, spondo, 2 bulging disks, etc) which has not been alleviated by PT and steroids I seriously wonder if I should have surgery. I read about the 2 surgeries and both are elective. Well, I do have a 4 year old daughter, a full time job, a small farm, and was a competitive athlete up til 7 weeks ago. I so much want to get back to my normal self as soon as possible. Also, my husband is getting tired of picking up the slack for me. He also works full time and has a lot to do here on our small farm before and after work. I never thought I'd decide on elective surgery but I swear I hate this so much!!!!! Who wouldn't? What to do...
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Comments

  • I know I've asked you this before, because I was concerned about the fractured vertebrae...but I do not recall the answer. Have you consulted with more than one spinal surgeon? What recommendations have you been given? And what type of surgery are you considering? Are you currently wearing a brace for the fractures?

  • Hi,

    I am wearing a brace for the fractures. I wonder if they have healed though. It's been 7 weeks. I haven't seen an actual surgeon yet. The way my insurance works is that I won't get a referral to a surgeon until after my MRI. I have had 2 doctor's opinions though. Both of them said based on the CAT scan and the pain level I will likely want to go the surgery route but they both need to see the MRI to really say anything of significance.
  • While your post is short, from your description you have been through a pretty major trauma. I would think you would have already have had an MRI and probably would have seen an NS and a spinal ortho if you are considering surgery.

    I was similar to you in the beginning and while I hope I am wrong you should understand that this will take some time to heal in either case, natural or surgical.

    -js
  • I had a CAT scan in the ER but not the MRI. I have Kaiser and I think it takes them a long time before they approve the MRI. I can't see a neuro until after the MRI. It appears to be just the way the insurance works.
  • Who's managing your care right now? This just seems really messed up...as posted above you've been through a major truama, I would have thought an MRI would have been justified a long time ago.

    The decision for surgery is of course, a very personal one. It pretty much comes down to patience and tolerance and if your symptoms get worse. I pretty much threw in the towel today and got an ASAP appointment with my pain management doc today because of progressive numbness that occured this weeekend while I was at work. In the last two weeks, my pain has gotten worse, even with a 2nd epidural steroid injection in the middle of those two weeks. On Saturday, I woke up for work with a loss of sensation in my big toe. Three hours later, I was at work and having some of the worst spasms I have EVER felt...by the time I got home, I lost sensation in my toe, across my foot and up my calf. That was the last straw for me. I knew that the wait and see approach wasn't working for me anymore. I had to leave in the middle of my shift for the 2nd time in 8 days because I coudln't deal with it without my meds. I've been through this already, I just knew it was time. I showed up at my pain mgmt appt ready to state my case and my doc said it before I could...time for a visit to the neurosurgeon. Oh yeah, also got a script for another round of steroids (they're getting to know me too well at my pharmacy lately!!!) to help me get through this.

    Let us know how you're doing...just make sure you don't fall between the cracks! BTW, what kind of meds are you taking?
  • I have seen it posted here many times but is it part of NHS in the UK? I find it really strange this policy especially given the accident you had.

    I know no one is rich here but the money you spend now on an MRI can save you lots of pain and money later. Or I would push them hard about the MRI. The doctor must have some say in all of this.

    -js
  • I agree with all the other comments. I would be really worried that the vertebrae would heal out of alignment or in a way where there is loss of stability with the possibility of nerve compression.

    Since your question pertains to sciatic, there is obviously nerve compression already going on.

    Don't let the term "elective" confuse or influence you in any way. In almost all cases spine surgeries are considered "elective." They are done for pain relief, not to save the life of the patient. If pain is so severe that the patient cannot deal with it, the concept of "elective" seems silly, but that is the way back surgery is classified.

    I really hope you can get a MRI very soon and begin to get some more aggressive treatment.

    Best of luck --
    Gwennie
  • Hi All,

    I am in the US, in Colorado. I have Kaiser Permanente and they set the course of what they do with me. It is frustrating things don't progress faster. At least I finally had the MRI today. I wish I could understand it, I have it on a disk. I hope I hear back from my doctor SOON.

    As for meds, I have a ton but I don't take them very often. I have vicodin, flexerall, percocet, dilauded, nortryptaline. I hate the side effects. Even when I can hardly walk I just hate the pain meds.
  • Yes, it was the same doc. Dilauded was first as it was what I had in the ER. That was followed by vicodin when the dilauded made me very spacey. Vicodin did nothing at all, no change in pain. So, percocet which makes my stomach ache.

  • Can you take an NSAID like Aleve or Motrin? I would at least try to take something like that around the clock as well as the Flexeril to try to take the edge of a little bit.

    Do you have a follow up appointment set with your doc to discuss the results?
  • Now that you have the MRI you are on the right path...get to the doctor today. Any opening ... go and let me him know his diagnosis and plan to recover. Obviously based upon your meds the ER atleast knew this was a major trauma. Now we just got to see what the MRI shows...do not waste time.

    As for Kaiser based upon the few posts here, these are the stories that make me worry about a NHS in the USA and insurance companies and not the doctors deciding what is the course of action based upon statistics...

    -js
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