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Have I waited too long for surgery to be effective?!?!

dvmdtddvmdt Posts: 1
edited 06/11/2012 - 7:40 AM in Back Surgery and Neck Surgery
I'm a 27 year old student with a six month history of left side sciatica. I've tried pain meds, steroids, acupuncture, chiropractics and physical therapy to no avail. About four months into the pain I had an MRI done that showed a disc extrusion at L5-S1 and now two months post MRI I'm going to get a neurosugery consultation. I read up on microdiscectomys on this website and Dr. Ullrich mentioned that surgery later than 3-6 months after symptoms have started may not be effective. Does anyone else agree/disagree? Any helpful information, experiences, or tips are much appreciated as well. Also, does anyone have an idea how much these surgeries normally cost? Thanks!!

David
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Comments

  • Hi David,

    Welcome to Spine Health. You've come to the right place to find answers and to research your condition as well as treatments.

    I've heard that if you have a nerve impingement then that could be permanent depending on how severe the impingement is and how long it's been. I would think 3-6 months is long enough for the damage to be permanent but that's just my opinion.

    There are many of us on here that have been dealing with lower back issues for years and some have had surgery and are feeling better.

    You should definitely get another opinion from another spine specialist before going through with any surgeries. There's always a possibility that the surgery will not ease your pain, however, if they can pinpoint the source of your pain then surgery can most likely help alleviate your pain.

    To answer your other question, it's hard to estimate how much the surgery would be. It all depends on what kind of surgery, what hardware they use, how long you'll be in the hospital etc. This is something you need to discuss with the surgeon. Plus there will be a fee from the anesthetiologist (sp?).

    Best of luck to you on your journey for answers to your questions. You will find that the members on here are very helpful and supportive.
  • David,

    I don't think its ever too late. Nerves can heal if they are not severed. What you must do is research the living heck out of the right surgery for you that will alleviate your pinched nerve. Once the impingement is removed, the nerve will heal but is predicated on how long the impingement was. So I don't think you've waited too long, but the sooner the better for you.

    Maybe Artificial Disc Replacement as opposed to Microdisectormy is the right approach. Because removing the disc only partially will lead to failure later. In 2000, and Intradiscal Electrothermal Carterized (I.D.E.T.) procedure that essentially burned my disc shrinking it and getting rid of bulge. I subsequently replaced disc in 2004.

    I wish you the best of luck in your recovery.

    Jon
  • So I don't think a "rule" 3 to 6 mos makes too much sense to me. I had surgery over a year after my first mri confirming severe herniation and severe stenosis. But I had been suffering from sciatica for about a year before the mri, which means nerve impingement probably started then. By the day after surgery, all of my sciatica/radiculopathy was almost gone. I had a few muscle twitches and such for a few more weeks, but all of my symptoms had resolved by the time I was back at work, 4 weeks post-op.

    What jonbenecke55 said about the microdiscectomy is very true though, and is why I chose fusion over the smaller microdiscectomy. But in my case I had 2 discs that were severely herniated and were causing me back pain as well as the nerve pain.

    Microdiscectomy would really have only been a bandaid surgery since they would have had to remove so much material that I would continue to have problems and would eventually be left with fusion as a my only option. So rather than go through multiple surgeries, and face continued pain, I opted for fusion. It was the best decision I could've made. Already only about 3 mo post-op I feel better than I have in about 3 yrs and have no pain, back or nerve.

    Anyway, my point is that only you can decide what is best for you. Continue doing a lot of research both on possible procedures and on your condition, especially after you've had a chance to discuss it more thoroughly with your NS.

    Oh and I had just turned 30 when I had my surgery in case you worry about being so young.
  • In my case, my L4-L5 disc was compressing my right nerve root for about 9 months.
    During that time, my right calf shrank an inch and a half. I never noticed it until my surgeon pointed it out!
    The numbness took a good 3-4 months to go away. There is no more pain or tingling/burning/pain. Although all the strength is back, I have not done calf raises to build the calf muscle back up again.

    I paid about $26K for the exams, discogram, anesthesia, microdiscectomy, after care and subsequent visits. (that was about 3 years ago)
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I think it's always best to get more opinions.

    My experience:

    Back pain progressed to sciatica and CES over a period of 2.5 years.

    Surgery - 2 level fusion at a cost of about 150,000. I had complications which involved a 2nd surgery and 9 days in the hospital.

    The complications damaged my nerves. I only had 24-48 hours of hemorhaging and possible BMP reaction where the nerves were being pressed on. Those nerves have not come back after almost 18 mo.

    2.5 years of sciatica and CES were gone post-op. That nerve damage was not permanent.

    So who knows at this point. Its got to be something about what exactly is happening inside there. The only difference that I can point to is that the 2.5 years was pain and flashes of agony. The 1-2 days was complete and total block-of-wood numbness that slowly spread from just a patch on my leg to the whole outside half of my leg and was moving from my small toes to the big toe.
  • I herniated my disc (where a fragment separated and was sitting on my left sciatic nerve) and was told 3-4 months the would try conservative treatment and if no improvement operate (in most cases).

    In my case, I had severe compression (lost feeling in a good portion of leg back leg and weakness) so conservative treatment was less of an option.

    I have been told that no one really knows on the nerve. They are fairly certain at 10 months of severe compression that the nerve will not fully recover. They also told me even after a few months I might not get full recovery but they don't know. The nervous system is strange and unpredictable.

    I'm headed for revision microdiscectomy (have a 2nd herniation on the same nerve) and am hopeful for relief of my left buttocks/back of thigh..

    Get another opinion. But I don't think it's too late.

    Surgery cost depends on what your insurance coverage is/isn't.
  • SpineAZSpineAZ WiscPosts: 1,084
    I have seen so many people that have surgery 1-3 years after initial pain and they do get improvement. That's not to say it will work for everyone but if the true cut off was 3-6 months I think surgeons would go out of business and those of us in pain would remain in pain.

    I will say that the "sooner the better" when nerves are involved. I waited a bit too long with my neck and have some slight residual numbness in two fingers (not major but always there). And that was 3 years after the pain started.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Welcome to Spine Health. Please note that members on the forums are patients sharing their personal experiences and opinions. None of which can replace the professional opinion of a qualified physician. You may wind up more confused than informed on different procedures, because for everyone who has had a bad outcome, there are those who have had the same procedure with a good outcome.

    Time lines given even by the professionals, are simply educated guesses based on their professional experience and knowledge. It does not mean that it is written in stone for each and every person who suffers from a disc herniation and nerve impingement.

    The key is to be evaluated by a qualified and experienced medical professional in person. Listen to what is said and if possible seek out another opinion by another qualified medical professional.

    Don't let an article you've read hasten you into making a decision that you may regret later. Use it to educate yourself to formulate questions for your own doc. Use it to educate yourself to the benefit of seeking help sooner rather than later.

    "C"
  • My cost for a 2 level diskectomy was about 35,000 and I didn't say over night. That included all the doctors and hospital fee.

    For my 3 level cervical fusion it was 75,000 for operation, surgeons, hospital fees and few days in hospital.

    My c3 laminectomy was 30,000 not including diagnostic testing before hand. I am closer to 50,000 on that one because I had a MRI, CT myelogram, EMG & epidural injections & xrays.
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • I am considering lumbar fusion with rods/screws - my MRIs from 4 yrs ago & of this August show spinal stenosis at L3 level, multilevel degenerative changes with severe scoliosis - grade 1 anterior subluxation L4-5, with a pseudo disc. I want more info on surgery if anyone has had similar operation. I've had p.t., chiropractic, pain meds, etc., ongoing for about 8 yrs. Have pain, numbness in right foot and leg, I'm 58, female, had a spinal fusion for scoliosis down to the lumbar area at age 15 with part of my rib fused along spine, the curve and deformity of ribs has become bad again after having children, but I'm told that it's too late for the scoliosis to be helped. Any advice or info would be appreciated. Thanks.
  • SpineAZSpineAZ WiscPosts: 1,084
    David:

    Are you covered by health insurance? If so the end cost would in large part be dependent on the health insurance policy under which you are covered. Every plan is different in terms of annual deductible, co-pay amounts, co-insurance amounts, and out-of-pocket maximums. If you are covered be sure to get a copy of your 2010 health insurance plan to have for reference.

    For someone with premier insurance the out of pocket cost could be $1000 or less. For someone with a high deductible health plan it could be in excess of $5000. It just varies so much from plan to plan.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Hi I was due to have fusion surgery but since having nerve conductive study and a EMG and a mri I have now been told I can only have a discectomy! Pls help
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