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Only option discectomy.. input much appreciated

dmarc0462ddmarc0462 Posts: 38
edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
I am 23 years old very active/athletic. I have 3 herniated discs however L4/L5 requires surgery. I had SEVERE leg and buttock pain that has since gone from a 9.9 to a 3 or 4. But numbness and weakness remains (tho improved). I had leg and buttock pain for 2-3 months but the big blast came just over 2 weeks ago. I cant pinpoint the exact time of the injury, but I can assume it was a combo of all activities with weight lifting being the main cause along with lifelong football. I am about to finish college to be a police officer and working out/training martial arts are a big part of my life. I am TERRIFIED I will not be able to do what I want to do in life after this surgery.

Can anyone who is in a similar situation give me some feedback.

A little background on my physical activities are:

1. Weight lifting
2. Running/Plyometrics
3. Wrestling
4. Brazilian Jiu Jitsu
5. Boxing

Again this is probably the first time in my life I've been afraid of anything. So feedback is much appreciated. Thank you


  • Hi & welcome,

    No one can tell you if surgery is right. It's a very personal decision.

    I will find the study they did on people with herniated discs that show very little difference between those that used conservative treatment vs. surgery (microdiscectomy).

    A recent well designed trial called the SPORT trial showed that patients who had surgery for a diskectomy did better than patients who did not have surgery but that there were no long term adverse effects to not having surgery.

    You are young, active, fit. Did just one doctor tell you surgery? Are you able to get at least one other opinion? It's important on surgical decisions to get at least one if not more opinions.

    What have you tried? I would try physical therapy and ask about steroid (oral or shot) or epidural. All much more conservative treatments.

    Now, you asked if you have to give up everything. I would say based on your history, you need to listen to your body even if you do not have surgery. Be smart. Keeping your core strong is key to lumbar stability but overdoing it is not good either.

    Are you numbness and leg weakness symptoms constant or do they vary?

    I can give you some insight if you share some information. I can share my story too if it helps.

    I started out with back issues around your age and while I'm a female, my background of 'very active' is very similar to yours.

    Let us know what you've already tried for treatment.
    You are very wise coming here to do research before jumping into surgery at age 23.

    I'll try to follow your post.

    I'm headed for a microdiscectomy on 2/8 so wrapping up stuff from work but I do try to stop in 1X/day.
  • Once I learned of the anatomy of a lumbar disc, understood how it behaves under different conditions, how surgery would affect it, what happens to it after surgery, and having 2 microdiscectomy surgeries to my L4-L5 and L5-S1 discs, I made adjustments to my life.

    I fear reherniating, because once it has happened, the chances of it happening again go up exponentially.

    I too used to train BJJ and am deathly afraid of a double-leg takedown. If I were to land on my rear, for sure it would pop the disc and then I would have to get the big nasty fusion surgery.

    I can't do a hip throw, or guard pass/lapel choke while standing(squatting) in someone's gaurd.

    As far as weightlifting, I cannot do deadlifts, goodmornings, squats, overhead presses, standing calf raises, or loading plates onto bars.
    Anything that transfers weight from the upper extremeties/body THRU the lower spine to the seat or legs.

    But this is my unique case and each case is different. Many go on to have regular, normal, active lives.

    So, if you can, learn about lumbar discs. Do research on them. Once you have your surgery, go easy. Allow yourself permission to let them recover. You may or may not have to add some precaution to your background thoughts as you go about your activities.

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • You are right about that, I had a herniated disk at L5-S1 and they did a Laminectomy on it didn't really help why 2 years later i'm getting the fusion because the disk is now DDD. But even then I knew my life was going to change. We have a water park here in Atlanta, called White water and they had this one slide, I loved to death called the dragons tail, because you practically get airbourne on it bout 5 times but your coming down on your back and tial bone every time. I will NEVER be able to ride it again, also they said Jogging requires thick running shoes and on a padded track if possible. I did this 3.2 walk and run and fast walked it, tried running on concrete and I could feel it thru my spine thru every step. :( Your life changes, but what I've read and Ive talked to friends of mine that have gotten fusions and they said, some even heard on here snow skied again. If I can get say 75-80% back I would be happy, but there are things you just can't do anymore because the chance of re-injury. But everybody is different. You have to build up your back and stomach muscles after alot of these surgeries or even non-surgeries.

    Why if you get surgery TRY to go the non-surgical route first in every form, Chiro, Yoga, massage, etc..... because at a young age. Unless you cannot stand it, then I would get it done. I'm 40 and have been dealing with it for 8 years now and I have problems sitting at a desk at work for long hours because sitting hurts. Blows people away when I say standing up feels better. Good Luck
  • You probably came close to having the disc heal when your leg pain was receding, and then, once you started feeling a little better, I bet you were in a rush to get back to all those activities that most would say are hard on the spine.

    Whether you have surgery, or elect to try to heal with conservative treatments, you will need to realize that there will be a period of time when you cannot participate in those activities. I'm not saying you can never resume them...just that you will need to lay off for a good long time, while the disc heals completely. Otherwise it is just like a kid picking a scab. The disc will start to heal, maybe almost get there, but then you strain it through too much activity causing pressure on the discs, and you are right back where you started.

    Most spinal surgeons will tell you that one of the biggest problems they have is with patients who have discectomies. Usually they feel so well afterward that it is really hard to convince them to take it easy long enough so that the disc has a chance to heal, and heal well. When the disc heals, in reality it builds up a tough "covering" that is like scar tissue. It is not strong to begin with. It takes months for it to toughen up so that it is strong enough to avoid reherniation. This can be at least three months, more like six if you want to resume really strenuous activities...and then when you do start back, you go slowly and gradually. So it could take 9 months to a year to get back up to speed.

    Otherwise, you go through a procedure, recover a bit, go a couple weeks or months -- reinjure the disc...and you're right back where you started.

    I don't mean to lecture you, or anyone else reading this, but this is a concept that many patients do not take to heart, and they end up in a vicious cycle of reinjury and more attempted recovery. Since you're starting out I wanted you to be aware of this as I can see that your love of athletics could easily get you into trouble!!

    Good luck.

  • Ive have gotten a 2nd opinion and they were both concurring from well recognized orthopedic surgeons. The disc is herniated out and hooked down so there is no chance it will ever go back into place. The MRI was explained well and is clear as day.

    I took an Oral Steroid but the results were little to none. (Though I only finished it last week). Im convinced surgery is the right way to go and so are the doctors. As of right now I walk like a 73 year old man instead of a 23 year old. My hip sticks out and doing daily activities is tough.

    I am willing to change my workouts (cut out all heavy lifting mainly) and be more cautious. However, stopping my training would just destroy me emotionally. I am also willing to wait the 6-12 months before I slowly begin to wrestle or train Jiu Jitsu again or As well as run for the police academy. As long as I will be able to do it again I am ok.

  • Hi there - I am not very good with medical stuff but like you am young - 24. I had surgery on Wed.
    I had all the sorts of things you described and wasl in bits when told I needed surgery. For me thou, I wanted to be able to enjoy my life again as I was so limited with what I could do.
    As far as I know, I will be able to do more after a few months with the help of physio and "back school!!"

    You need to look at the pro's and con's and research.

    Good luck.
  • Ok, so you tried oral steroids. Did they indicate if an epidural would offer any relief? Sometimes the mass just needs to dry out 2mm to come off the nerve.

    As for working out, many of us can appreciate the concern you have. I think Gwennie said it best about needing to understand that there's a time to work out and a time to let your body recover.

    I had a microdiscectomy and felt pretty good by week 2. I think I bent, twisted, and maybe even lifted a little too much. But I didn't exercise aside from walking...so I thought I was following doctors orders.

    Active people can be their own worst enemy. You can work out but you will have to modify and listen to your body. I managed that way for years. I even ran 2 marathons and many other smaller races. Very active.

    I guess my disc was 'spring loaded' and it finally gave last summer. The piece was never going to go back in. The question was...would it dry out enough to come off the nerve to give me relief. I completely understand frustration of an active person not being able to do those things. I was not a very pleasant person for the first 3 months. Now, I'm learning how to get some exercise...walks and keep reminding myself that if I want to get back to working out, I have to get back to letting me focus on the core of what will get me there.

    I had a microdiscectomy in August last year. I assumed in 6 weeks to 3 months, I'd be back to running. I made up my mind I would stop running distances and keep my runs to 5K or less so that I could stay active. But now I am not even thinking about running again. I am thinking about getting better so that I can enjoy life and find alternate workout activities (swimming, biking, hiking, kardio kickboxing (no impact), and travelling).

    I re-herniated. I tell you this because there is that risk. The risk exists for 2 reasons - -> patient bends, twists, lifts too soon and too much or the disc is just inherently bad.

    The risk of reherniation is 5-10%.
    I was that statistic. I don't recall doing too much but when I look back, I am very active and was anxious to 'get back to life' and while I held off on exercising, I did start doing a lot around the house, laundry, driving, etc.

    I'm headed for the revision (same surgery, a little riskier) and I know the chances of success go from 90-95% to 80%. Even on the revision, I took a month to research it and met with 6 doctors (neuro and orthospine) from varying hospitals. I didn't tell them the diagnosis I got. Amazing the information I found. I was fortunate and on co-pay so it ws worth the co-pays.

    I would talk to one more doctor and ask them what non-surgical options you have (even if they tell you that you need surgery). I would also talk to them about why these surgeries fail. They will tell you most don't.

    Also, there are some great articles/studies about this.

    On the positive side, I know a person who had 3 epidurals and he is 2 years pain free and still running. I know 5 people who had the microdiscectomies and are pleased with the results. Results do vary...but I know people that are 2, 4, 10 years out and have had success. I do not, however, know if they revised their activities to avoid reinjury.

    I will check back. It is really great you are here learning and doing your homework before proceeding.
  • Thank you for your input. My doctors mentioned the same stat about re-herniation etc. I was given the option for epidurals but I opted against it because they said in my case they will not work. That disc will always be where it is. I have come to grips with the fact that surgery is probably my only option. I figured epidurals would only deliberate and the oral steroids were much less invasive so just try that first.

    I am going back to the surgeon on Tuesday to talk to him AGAIN.
  • wow, you definitely are doing all the right things to make the decision.

    I just wanted to warn you about possible re-herniation. I am so conservative when it comes to surgery and that works for me. I just didn't want to be in the situation I was in.

    I didn't try the epidural. The reason I didn't is b/c I had a single 'event' (stretched in bed and felt a pop) that landed me in the ER. I lost significant feeling in perineum (groin), left buttocks, left back thigh, left heel to outer toe and loss of ankle reflex. They were very concerned that the situation was going to escalate to impact bladdar/bowel. My pain/numbness/weakness was constant and still is. If I had intermittent, I would have tried the epidural b/c as I understand it, it just needs to shrink/dry out the disc material a small amount to get off the nerve.

    I had an orthospine person do the 1st surgery. For this 2nd one I'm switching to Neurosurgeon for 2 reasons (1) I have significant scar tissue around the nerve and (2) my original doctor who I loved, is not in network.

    I already told work I will not be online for 2 weeks (I can work remote from bed but work is stress and stress is unhealthy for recovery. I have also told work that I will be remote for the entire 6 weeks.

    I have help coming. Not because I need it but because I'm thick headed and will bend to get dishes out of the dishwasher without even thinking. I have a 'gripper' for picking up things like socks but I really want people watching me making sure I do not do anything foolish.

    Let me know how your next appointment goes.
  • wow sounds like yours is a bit worse than mine. I lost feeling and had weakness but never lost reflex in my ankle or knee. I still can not walk on my heel though. Thank you again and I will report back after my app.

    Still more stories (hopefully of a successful recovery haha) are encouraged
  • I do know success stories.
    But you are young so wanted to ask what options you've tried any symptoms so that I could suggest some questions for you to ask your doctor.

    It does sound like you are already doing that.

    But just to give you confidence - I know of at least 5 success stories (2 females, 3 males) and of the 5, 3 of them are 3 years plus post op and still pleased!

    I tell you the pitfalls because if you go for surgery you sound very anxious to get back into your normal routine. Take the first 6 weeks to 3 months very seriously on recovery. This is one situation where pushing yourself too fast will backfire.

    Sounds as if you are just doing some final checks before opting for surgery.

    The surgery itself isn't bad at all. Out-patient. It took 90 mins begin to end (45 mins of actual operating time). I was walking 3 hours after the surgery and was home in 24 hours. After the 1st 4 days I was in good shape from an incision pain perspective. By the end of the first week I came off pain meds and was only using muscle relaxer every other day. Ice and walking were my friends.

    Now that it seems you may go for the surgery, I just wanted to share the positives. I gave you enough to consider on to go for surgery or not.

    If you do go for it, the actual procedure was the 1st surgery I ever had and I can tell you it was not bad at all.

    p.s. remember, folks on here are the ones in your shoes with problems. Many folks do fine and never make it here. 90% success rate! Just remember that.
  • This input is VERY helpful. I will be patient with recovery. I have a lot of nagging family members/girlfriend to make sure I do dont anything to strenuous. My main question is can I go back to college classes 1 night a week for 3 hours at a time. College is how I have health insurance and I dont want to have to withdraw. I'd like to get the surgery during Spring Break instead of waiting it out til summer. That is one of my questions for the Dr.
  • Saw my orthopedic surgeon again. He basically said do nothing for 6 weeks after surgery and no strenuous activities for 3 months. Also that it is a common procedure and it has a high percentage rate of recovery. I'm going to speak with the neurosurgeon friday so I'll get his take on it too.
  • Hi there,

    What he telling you is right.
    I just don't know if people fully understand what that means. But yes, that's what I tried to say above.

    As long as you understand this, you will be in good shape. What I never realized is how much I drop things and need to pick them up...or twist, lift grocery bags that might be a bit much.

    Let us know how the NS visit goes.
    The success rate is somewhere between 90-95%
  • just got back from the neurosurgeon. He says this is the best disc to herniate because it has the best chance to get better without surgery. The fact that I have regained a good amount of strength makes him think the herniated jelly could be dissolved by my body. So he wants another MRI

    HOWEVER, he said my petellar reflexes are hyperactive and that worries him. So he is having me get a full brain and spine MRI. So now I'm a nervous wreck thinking I have a brain tumor. UGGHH this sucks
  • Hi there,

    I'm so glad you are gathering more information. I wouldn't worry about a brain tumor. I think they want to look at the entire spine because problems at the base of the brain/spine can cause issues too.

    The "jelly" can re-absorb. I actually thought it was that it 'dries out' but either way, yes, it's possible that if the herniated piece is small, that it will dry out just enough to take pressure off the never.

    It's why I waited for a bit before opting for revision. I didn't get worse in 3 months, just never got better. The doctor thought there was hope that it could dry out. For me, the mass was big so it was a long shot.

    For you it seems like an option because your symptoms seems to be improving.

    Again, keep me posted. I may not respond fast as I'm headed in on 2/8 for my revision but I am interested in your story because each doctor has a different perspective.

    ...it sounds like you are gathering all the right information before making a final decision.
  • dMarc...

    I was just thinking of you and know you had some big tests coming up. I hope you were able to get all the extra tests scheduled and you are ok.

    Again, just thinking of you and hoping you are ok.
  • Hey Dnice.. thanks for the concern. I recently got my 2nd MRI (full spine this time). I go back to the neurosurgeon friday. I saw my films and they are not any different looking than the 1st. Though I'm obviously not a doctor..it looks like theres a big balloon coming out of the disc area :/
  • big balloon...sounds like my MRI.
    Well, hopefully the follow up appointment can confirm the right course of treatment.

    I'm no expert MRI reader either but have been 3 for 3 so far on mine. I'm learning how to read them better each time the doctor explains them.

    Wishing you the best!
  • Well I finally got back the NS today. My 2nd MRI shows no change in the herniated disc. He would like to operate asap. From everything Ive come across is that this surgery has a excellent success rate so its up to me and make sure I rehab the proper way. He said it should take about 2 months for the hole in the disc to scar up.

    As for the hyperactive reflexes I had.. he said its because I'm in very good physical condition.

    ANYONE with stories of being very athletic and returning to all their previous activities I'd love to hear your store.

    I hope I can eventually wrestle, train and box again. I'll just have to strengthen my core because my other 2 discs are deteriorating as well :/
  • hi,

    Sorry to hear the disc didn't re-absorb/dry out.
    Again, they really don't think the epidural is worth a try?

    I ask b/c I wish I tried it (but was told in my case, I had a piece that broke off that was so large the epidural would take more than 1 and not likely work but if I pushed, they would have tried). I only didn't b/c I had immediate significant loss of feeling in my buttocks, back thigh, foot, and perineum (groin) so they were worried about other nerves being impacted (like bladdar, bowel).

    If you go for the surgery, please read all the other posts. I wish someone would have smacked me in the face and said "LISTEN!!! YOu will feel better after surgery but your body needs 3-6 months to fully scar over properly so don't overdo it"

    I didn't think slight bending to take laundry out of the dryer was an issue...it was.

    Take the 3 month recovery extremely seriously. Even if your doctor clears you for golf or running at week 6...wait until month 3. Ask for PT to learn how to keep your core strong.

    Recovery is the toughest part of this surgery b/c you will feel better and think pushing through will help heal faster...which is not true.

    Good luck. I think this doctor was your 2nd opinion. As for ASAP...well, you have to decide. I heard that but still spend 3 weeks meeting various doctors just to be sure of my decision (not just on surgery but on surgeons).
  • i think that you are wanting too much from this operation my friend ..i too was a very fit person and used the gym 4 times a week and swam every day .now after 2 operations {laminectioy l4/l5 and discectomy S1 l5.} i am in pain ALL THE TIME and unable to even stand for more than a few minutes .as for sports ..forget it same goes for sex./shopping and anything normal people take for granted ,,i do hope that you have a better outcome than me and even if you do PLEASE REMEMBER your back will never be as strong and you will injure it if you try to be superman .if you can get good pain relief from your op...and i sure hope that you do...then treat your back with extra care because if you hurt yourself it may never heal and you will end up like me ...in constant pain/unable to work ...and you dont want that ..do you
  • Straker - your information is good.
    I was trying to find a way to say the same thing.
    The surgery is not a cure all.

    Even the people I know who are very happy with their microdiscectomies...had to revise their activity. They were all highly active like me (and you). They had to adjust. They are still active and fit but could not do all the things they used to b/c they realized they couldn't risk more damage and permanent/continual pain. They still have some residual pain.

    On a side note...thank you for your honesty, especially on the topic of sex even being something that you can't take for granted.

    I do have good days but I can't take a good day for granted that the next one will be good too.
  • Let me be honest guys. I have almost no pain anymore. My only problem is the weakness and numbness. I guess the only thing that is on my side is that I am young and very inshape (though i have lost 10 pounds since my injury and my abs are a thing of the past).

    The way im looking at this is its relieving the pressure off this nerve so I can eventually get 100% use of my foot back. My entire life depends on being physically fit and I refuse to let this injury inhibit me. I greatly appreciate everyone's advice and concern and I hope all of your issues are resolved as well.

    Straker - I am very sorry to hear how bad your pain is. If standing for more than a few minutes hurts and you can't have sex then I'd try everything else I could.

    DNICE - Anti inflammatory procedures will not work because this disc has no chance of receding or absorbing because it is not fragmented. So it just needs to be removed and let the hole scar up.

    I threw my MRI on facebook for people to see.. hopefully raise awareness for smart lifting.

  • SpineAZSpineAZ WiscPosts: 1,084
    Even without pain your symptoms are enough to necessitate surgery as soon as possible or the damage can become permanent. If the weakness and numbness becomes permanent you won't have the ability to be active at all, especially with what sounds like foot drop.

    I think what you may have to do is find different ways to remain physically active. After you recover see a personal trainer (preferably one who has dealt with a lot of post-injury training) and tell him/her you are aiming for activities to keep you as active as possible but that do not strain the cervical neck area at all (or very little) and that your goal is overall physical fitness for life while retaining spinal integrity.

    I was never very very active but after all my spine and knee work I've just worked out ways to stay active (lots of hiking and walking). I invested in a "running" capacity treadmill (even though I can't run) because I wanted the best padding I could get to reduce overall body strain.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • DMarc...I re-read the earlier posts in this thread and recalled your hernation is like mine which is why the epidural won't work.

    Please stick around and let us know how the surgery goes. I am optimistic for you! You have the right mind set and right attitude and all our advice is just to help you not overdo it too quickly. You should be quite successful as long as you take the first 3-6 months very seriously and then use motn 6-12 carefully.

    Do you have a surgery date yet?
    I initially went in for surgery for same reason - i had significant loss of strength and feeling in my leg. They key is to get the nerve uncompressed and then walk (on flat surfaces) during the 1st 6 weeks of recovery to help scar tissue not tether back onto the nerve. But flat surfaces and it's best to walk in shorter more frequent increments than 1 long walk/day.

    I hope you get immediate relief from numbness and/or leg pain/weakness.

    Come back and let us know when the date is and how you are doing recovery wise. I'm excited for you to get some relief!!!
  • Saw your MRI....looks all too familiar.
    Not to be competitive but mine looks even worse than that. So, the positive is that it seems your compression is still at a point where you can get some good relief.

    I'm wishing you the best.

    It stinks! I know how frustrated you must be especially since you are are doing everything to stay fit.

    Good luck
  • Dmarc...I am also 23 and I just had L4/L5 microdiscectomy on Thursday. I had been in and out of PT 4-5 times and it always seemed to get better. This past aggravation though, I couldn't even roll over to get out of bed. I was fully informed of the procedure and the lifestyle changes I would have to make in order for this surgery to be a success, but at such a young age, I knew I had to accept that because I don't want to constantly have the pain I was feeling. People say I made the decision to have surgery too quickly, but seeing my MRI (which looks like yours) and having DDD in a few of my discs I feel I did the right thing. My surgeon said in a few months I will be able to go back to my yoga practice, and hopefully find more ways to stay healthy. Its frustrating at times, but don't let it get you down, I believe outlook and attitude are really important in the recovery process and it seems you have a good one so far!

    Keep posting to let us know how it goes!
  • Thanks Jen.. I will most definitely change my lifting regiments. No more explosive power lifting or heavy weights. As long as I can go back to training martial arts I'll be happy. And I plan on doing that in good time of course. I'm setting this up for next thursday so I'll keep everyone posted.

    Again my pain is almost non existent. If it stays that way after surgery I'll be in good shape.
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