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Unsure If I Should Go Forward with Surgery

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:40 AM in Back Surgery and Neck Surgery
I herniated my L4-L5 disc in February 2009 from moving some furniture. My symptoms were pain from my lower-left back all the way down my left leg to the top of my foot (moving around depending on the position I was in), as well as left foot drop. The pain was pretty bad, but I'm not a particularly active person and found little issue with the foot drop.

I saw a neurosurgeon but decided to go a more conservative route and entered physical therapy. Within a couple of months, all of my symptoms were gone. The pain went away first, followed by the foot drop.

In the middle of November 2009, I re-injured my back (though I can't figure out what caused it like before). The symptoms were roughly the same, except that the pain was far worse. I still had the left foot drop, but it also tingled most of the time. My updated MRI showed the same herniation, though there was a slightly farther protrusion this time (1.4 cm rather than 1.2 cm). I saw a neurosurgeon at the beginning of December but, due to the holidays, was unable to schedule a surgery (microdiscectomy) until the first week of January.

After about 3-4 weeks of mostly laying down and pain meds, my pain is now gone. I still have left foot drop (though I think it's less drastic) and touch still doesn't feel normal---still tingly---but the major symptom, pain, is gone.

I'm considering speaking to the neurosurgeon about my options at this point now that my worst symptom (pain) is completely gone and, if earlier in the year is any indication, my other symptoms will be gone soon too.

I'm a bit worried that the neurosurgeon will suggest cutting still because he's a neurosurgeon. I'm young (29) and not in terrible shape, but I've never had surgery before, and I'm concerned about the risks of surgery when weighed against the fact that I seem to be getting better on my own. On the other hand, this is a recurrence, and further recurrences that keep me from school/work for a month wouldn't be good.

What do people generally suggest in these situations? Thanks in advance for any help!


  • mike-I go in for my second spinal fusion next week-L4-L5.2 years ago I had L3-4.I also have the leg pain,and with the first,foot drop. I could probably do ok if I sat most of the time,but I can't live like that! I know surgery can be scary,but please think about fixing the problem,not putting a temporary bandaid on it! I am not a medical professional,but having been through this twice I urge you to think before you cancel.Send me a PM if you want to talk!
  • I would think about how the pain has affected your life. Are you hurting badly and/or consistently despite taking all your meds, doing PT, resting, etc?

    Is it hard for you to get around? Does it hurt to walk and drive, and does the pain increase? Does sitting down aggravate the pain and do you also have a hard time as a passenger in a car? Do you get debilitating nerve pains and/or muscle spasms?

    Have you given up most activities due to the pain and all you want to do is lay in bed so that the pain is more bearable? Is rolling over in bed or even taking a shower like the biggest chore in the world?

    If you answer yes to most questions then I'm safe to say that the pain has seriously impacted your life. I based those questions solely on my experience with my lumbar disc herniations and sciatica, and all the pain, problems, and difficulties that went along with this.

    When I finally was offered surgery, I based my decision on how the pain devastated my quality of life. My answer was...YES!
  • What happens is, the disc has something go wrong with the outer covering called the annulus. Kinda like a tire except the air is crabmeat-like tissue called "nucleus".
    A tear or breach in the covering allows the nucleus material to squeeze out. If it's on the nerve side of the spine, you will feel it. If it's on the other side, you probably won't.

    Scar tissue will close up the tear if the material retracts itself back into the disc or completley breaks off and floats away.
    However, scar tissue is weaker than the outer covering. So, while it will close up the tear, it won't take much to open it back up again.

    There is a newer idea of using suture material in an "X" pattern over the tear to help shore it up.
    The "X"-close by Annulex.
    Seems interesting, but I don't know if the invasive approach is worse than the problem.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • SpineAZSpineAZ WiscPosts: 1,084
    You can certainly talk with the NS and perhaps get a second opinion from another NS and/or orthopedic spine surgery.

    Foot drop and loss of sensation is actually more of a reason to have surgery then pain is. Foot drop and loss of sensation is indicative of severe nerve impingement and/or damage. Anytime there is nerve damage you don't want to wait too long before having it fixed. But I understand wanting to gauge if you are improving in all aspects as well. Maybe an evaluation by a physical therapist where they can objectively measure your foot drop and sensation/numbness. Then return to them in another 2-4 weeks to be re-evaluated. If you've shown improvement at that time then it's possible you will heal further on your own. But if they find no improvement and/or see a decline it will help you in making the surgery decision.

    I have a great Orthopedic Spine Surgeon in Phoenix if you come up here for treatment (I assume you are in Tucson given your user name). I had another orthopedic spine surgeon who did my neck surgeries (and did them well) but he brushed me off when I came in a year later with severe back pain and crying in pain. I found another Orthopedic Spine Surgeon who really listens and did all kinds of tests to decide if I needed surgery and what approach to use.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Get a second opinion...especially since this will be your second surgery. No harm, no foul!

  • I am also young (34) but I am going for three artificial discs rather than an fusion. I think your situation is now only going to get worse, unfortunately. I have been in your shoes, where I think things are healed up. I also had surgery 19 years ago to L4-L5 and the stuff Stryker talked about with the annulus, I now have all 3 discs with tears in all 3 of the annuluses. So.....talke to more doctors, talk about ADR (Artificial Disc Replacement because we have to live to live to be 90, at least and not be in pain. Foot drop is a big deal, just because it's not painful doesn't mean it's not a huge issue- especially long term. I get tingling and numbness and my Neurosurgeon told me that if I wait too long I could loose bowel and bladder function. We are too young to be dealing with this for the next 60 years. Get it taken care of now when you are young and get rebound back quicker. Get into the BEST doctors in your area, ask for referrals from your current doctor or other people you know. I am going to Germany for my surgery and I am paying cash $64,000. to go to who I think is the best doctor in the world. This is your spine you are talking about. We spend that kind of money on cars and boats, etc. Why not on our spines- if you can't walk then how can you enjoy the rest of life? I had a baby 17 months ago and that made my symptoms so much worse. I've tried physical therapy for 18 years, accupuncture, traction/decompression, spinal injects, microdiscetomy don't waste your time. Get better now, surgery is scary but not walking and loosing bladder control sounds worse. Private message me also and I can try and help. Get educated more on your situation so you know the pros and cons.
  • Thanks for all the comments guys.

    I decided to go through with the surgery, on Monday, and left the hospital on Tuesday morning. I've just got some pain at the incision site right now, it hurts to move from laying down to sitting up and I get some muscle spasming there, but no complications. Unfortunately, my leg function hasn't returned yet, so I'm anxious for that to come back.

    Looks like I had nothing to be scared of. The anesthesia didn't even affect me that much---I ate three full meals the day of the surgery and didn't even fall asleep until bed time. :)
  • I'm glad to hear things turned out well...

    I'm relatively young as well, I'm only 32.

    I'm heading for my 2nd discectomy at L4-L5 on the 26th (I had to make the choice of 3 level fusion or repeat) after two years of pretty much being problem free. I was even considering not going through with this surgery as my 2nd epidural and a second round of oral steroids had helped me immensely with my pain November '09. However, while doing something routine (read: 'adult relations' LOL) this past week I've done something to p*ss off my back all over again.

    As mentioned before, its not so much the pain but the other neurological symptoms that have really kept me from cancelling...my foot and left leg are still numb despite having well controlled pain. The return of the pain has only reinforced that I'm making the right decision.

    Just keep in mind that your nerves have been 'smooshed' for a while and it will take time to regain strength & sensation. As the next couple of weeks pass, it may even feel worse as those nerves 'wake up'. Are you scheduled for physical therapy?

    Keep us posted on your progress!

  • No PT has been scheduled yet, but I'm meeting with the neurosurgeon again next week and we'll discuss my options then.

    Good luck with yours!
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