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FaraFFara Posts: 16
edited 06/11/2012 - 8:40 AM in Back Surgery and Neck Surgery
Has anyone had a discectomy? If so, do you feel that it has improved your situation?

Surgery has been recommended to me by an orthopedic surgeon and a neurosurgeon for my far lateral L4 disc herniation. I do not have much pain at all, just leg weakness and numbness and I am nervous that back pain will arise after the surgery. Anyone experience issues after the surgery?

Any advice or comments are much appreciated!


  • Hi Laura,

    Not being a doctor, I can only give you advice from my experience and those I consulted with. There is a study (I will get the link) on those that had surgery (microdiscectomy) and those that used conservative treatment and there is really no evidence that one is better than the other.

    However, there are other factors that would have a doctor suggesting a microdiscectomy (I am not sure if it's different than a discectomy). If you have already tried physical therapy for 3 months and no improvement, if you have tried other conservative treatments such as anti-inflammatory, steroid, or epidural series to reduce the pressure on the nerve, you might be a candidate.

    The leg weakness and numbness is an indicator that the sciatic nerve is being compressed.

    So...many time when you have both weakness and numbness you have lost 2 of the 3 'nerve' responses (sensory, motor, ?automatic...like bladdar bowel). If the loss is significant, the microdiscectomy can help.

    But you have to understand the risks. I will try to find links I read.

    I had a severe hernation at L5-S1...it was an immediate incident (stretched one morning) that pushed me to surgery. I couldn't get out of bed. After visiting the ER, I was able to get out of bed but the leg pain ...basically went numb accompanied with weakness. I was on a steroid step pack (double dose) in hopes it would shrink the mass just a small amount to give me relief but the numbness was in my buttocks, back thigh, and left heel to littl toe (in addition I have some numbness in my perineum/groin area).

    I opted for the microdiscectomy. The surgery I had was out-patient, in a hospital but expectation is the surgery was 45 mins but total time from start to end was 90 min. Then I would stay in hospital about 5-8 more hour to get antibiotics and ensure I was stable to go home...needed to be able to get out of bed, walk up/down stairs, etc.

    The surgery itself is not terrible. But there is a risk that it fails of about 5-10% nationally (USA). Most fail in the 1st 3 months on the same side and it's b/c more breaks off before you heal or there is a mass that is out of 'sight' that is left behind.

    I'm conservative. I got 3 opinions (+ informal ones form doctors that didn't see me) and I was rather urgent due to loss of feeling in my groin. I had the surgery.

    If you have the surgery - take the recovery VERY seriously. You will feel good right away but do not bend, twist, or lift for 3 months. The key is walking...not long distances but many small increments. This helps scar tissue not form around the nerve.

    From people I spoke to I know
    - a person who is 3 years out and still very pleased (L4)
    - a person who is 10 years out and very please (L4-L5) and only occassionally gets mystery pain in his bad leg but nothing too big.
    - a person who is 2 years out and pleased but it took her a few months to get feeling back in her foot but is not mostly 100%
    - a person who waited a year of having nerve compression...very pleased and last I spoke to him he was a year after surgery and had regained all feeling except some in his foot/heel.

    But just know that it can fail. You can do everything right but it might fail which is why I say if you opt for it, take care of you.

    I am headed in for a revision microdiscectomy. I reherniated in the 1st 3 months. I am not sure if I did anything specific but my husband believes I overdid it on bending (to take laundry out and to pet the dog). I probably did...I was feeling so good, it was a challenge to remind myself NOT to do stuff. I'm very optimistic my next surgery will work b/c I am going to be diligent about recovery.

    I can't really help you decide...because it's a very personal decision. If you are unsure, poke around here more...and get a 3rd opinion. It sounds like you have some time to take your time.

    Oh, as for back pain after surgery?
    You will have some during the recovery but it's more muscle fatigue than pack pain. To this day, my main complaint is really leg pain with minimal nerve pain in my back. The pain in my back I experienced was more due to stress from the surgery but that was my experience.
  • Thanks you so much for your response! I just had a 3rd opinion today and he recommended back surgery as well. I have been to a neurologist, neurosurgeon, and orthopedic surgeon who have all said surgery .The second orthopedic surgeon I went to said to hold off and see if I get better. It has been 4 weeks since I last saw him and I have not had any improvement. So that's 3 for surgery and 1 to wait. The dr. today said if I am on the fence about the surgery to get an EMG and see what the reults are and that may help me with my decision. I know that the success rate of this surgery is very high and it is minimally invassive but I am still very fearful.

    Parts of my leg have been numb for over 2 months and although the leg weakness has improved, it is still not 100% and I was told that the longer I wait, the more damage I can be doing to the nerve. Is this true?

    Did you go to an orthopedic or neurosurgeon for the procedure?
  • Hi again,

    Nerve damage is an unknown. Unfortunately the nervous system is a tricky part of the body and can surprise you...I was told think of it as a 'electrical circuit' that can short circuit.

    Every doctor I've met has said they cannot tell when permanent damage occurs. Most of my doctors said that someone in your situation they would treat for 2-3 months conservatively but if not improvement, they like to operate by month 4 to give the nerve a chance to wake up. I also heard that 10 months of compression means permanent nerve damage. I've also heard that you never know. For me, they are still hopeful I will get feeling in my leg/buttocks back but have told me not to get my hopes up on the foot (which is fine).

    Just don't expect to get feeling back right away. From what I heard...it took most people I referenced at least 2 months to start getting feeling back.

    I wanted to try epidural. The only reason I didn't try that is b/c of the numbness in the groin...they were worried about my bladdar/bowel nerves being impacted.

    There is a thread stickied about Ortho vs. neuro.
    I had an OrthoSpine team do the inital surgery and would highly recommend the doctor 'team' I used. I'm having a NS do the 2nd surgery only b/c knowing I have scar tissue built up around the nerve, I'm more comfortable with a NS (and unfortunately my original doctors are not in network so it just worked out that it was the right time to switch doctors).

    It really depends on the area but either can do it.
    To the NS...it's like reading or chewing gum...it's something they do as a part of their training all the time. An orthoSpine specialist will generally train for I think 5 months extra for this (but don't quote me b/c I have to look up the article).

    If I had to do it again, I would have chose my same surgeon group for the inital MicroD...I trusted them, they listened to me, they worked out of the hospital where my Primary Care physician had access to so if I was concerned he knew them and vice-versa. They are highly reputable and treated me well and took me seriously when I told them I wasn't doing well.

    I'm switching to an NS only b/c I had to find a new doctor in network since my insurance was lousy and I felt that if I was going to switch, I'd try to find an NS...it wasn't easy. Many NS in my area were veyr aggressive for fusion vs. revision. I finally found a NS that is more conservative text book in his approach which is good for me personally.

    Let me go look through my notes to see what I can find on the choice of doctors.
  • I've had two "micro" discectomies.
    There are different ways to get a disc off the nerves. One of those ways is a discectomy. Further, there are different versions of discectomies!

    You can have very radical, very invasive surgeries, very minimalistic, and in between.
    There are trade-offs.

    For the version I chose, it definitely improved my stuation. A nuero did it, with an ortho assisting.
    I still have some residual discomfort with my L5-S1, but nowhere near what it was before.
    My L4-L5 problem was completely resolved.
    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 I waited to long but after reading posts on hear & pain went to groin area and leg went numb I was ready
    After surg The first 3 months all was pretty well I do have back pain and feels like a brick in there an some times elect shocking in leg mostly when driving doc say its nerve waking up
    I would still do surg definitely sooner even if this is as good as it gets
    I’m 6 month post op now from reading hear look like some recover with no leftovers in as soon as 3to 6 weeks to 2 years and some go for redoes there are a lot of strong people on hear so keep us posted it kind of helps keep my head strait reading about the people on hear
    a nero-serg did mine l5 s1
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