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Seeking advice - possible 3rd surgery

edited 06/11/2012 - 8:41 AM in Back Surgery and Neck Surgery
Hi everyone.

I'm wondering if anyone out there has had a similar experience and maybe some words of wisdom - as i'm feeling like i'm hitting a wall.

I've had long term back problems since I was a kid, mostly L4/5. In february 2009 I underwent a laminectomy/discectomy at L4/5 and S1. Seemed to be recovering well, but then re-herniated in July/August and had a 2nd Discectomy surgery in August 2009 for "massive herniation" of L4/5. I've had residual nerve pain radiating down my right leg since, has ultimately gotten a bit better (meaning not constant) but it's still there. Have also had major issues with tendons (hard as rocks), which never seem to get better, no matter how many anti-inflammatories I've taken or how much massage I got.

MRI in October showed that S1 was prolapsed or bulging a bit, but not too big an issue because of past surgeries.

I've gone to PT, but then was stopped by the therapist as she felt it was doing more harm than good. Now scheduled for another CAT scan this weekend and Nerve root block next week at the L5 (which i'm scared of doing). Right foot has gone cold in past week - and as from yesterday, i can barely stand up due to back pain/tightness. When I move, I have excruciating pain in lower back (almost feels like i have a vise on my spine) and then quick bolts of pain down my legs (both). Pain is so bad today that it's making me nauseous.

Have talked to dock about 360 degree fusion of L4/5 and S1 (ALIF/PLIF) but he seems to be pushing me towards the nerve root blocks every 6 months. I'm having trouble with this, because I'm not at a point where I want to consider pain management as my route for the rest of my life.

Anyone with similar experiences/surgeries? I'm thinking I want to push for the ALIF/PLIF in the next few months, but that will also be my 3rd major surgery in about 1 year. I'm just at my wits end and am starting to question everything.

Any help/advice, etc.. is greatly appreciated.


  • I reherniated L4/5 4 times and L5 S1 twice. My surgeon wanted to do a 4th discectomy(he doesn't do lumbar fusions). The discectomies hadn't worked so far, I didn't believe a 4th one would help either. MRI showed both discs had collapsed and were pinching 3 nerves. I got 3 more opinions, one said pain management and 2 said fusion. Before fusion I dragged my leg around with a cane for years. I was losing the ability to walk. Since fusion I only need my cane occaisionally (I'm disabled due to permanent nerve damage). Fusion was a success for me as I have regained alot of my mobility back. Fusion isn't for everyone, for me it was the only choice. You can never get too many opinions!!! Good luck to you in your search for answers, take care. Never give up.

    Faith M
  • There seems to be an assumption that the nerve block will "work" and that it will provide sufficient pain relief. But it does not address the problem that the nerve is being badly compressed and is not likely to have an opportunity to decompress unless you have surgery. This strikes me as an unhealthy fix that is just covering up the problem rather than addressing it.

    I would suggest you find another fellowship-trained spine surgeon and have another set of eyes look objectively at your issues. Perhaps more than one new opinion would be a good idea just to see if there is a consensus on the best way to resolve your issues.

    I cannot comment on how many surgeries in a year are too many. That's something you can ask the new doctors when you meet with them!

    Good luck.

  • Is it possible the surgeon is using the nerve blocks as a diagnostic tool? I just underwent a series of nerve blocks they weren't meant for any lasting pain relief just a diagnostic tool. The nerve blocks typically only last a week or so for me, not sure how long they are lasting for you though.

    Just for peace of mind I would be getting a second opinion, as it seems you have some doubts in this surgeon. It is always a good idea when talking about surgery to get a second opinion, to be on the safe side. Hope it all works out keep us posted.
  • Hi JJ--just my 2 cents (see my signature below) re: 3 spine surgeries in a year..well, I did it & I survived..end result was the fusion, after the other 2, w/ PT & over 10 injections/nerve blocks etc in the interim...
    My NS finally suggested the fusion to help relieve the leg pain (same as you describe) & it did help that but I have permanent r.leg nerve damage (other stuff contributes)& still have chronic back pain--but I am fused & do feel stronger in that L4/5 area.
    You have to think of your quality of life, how much pain you're in, what you can endure ( I couldn't have taken it much longer, altho the fusion is a bear...) & what you'll have to live with when it's all over.
    Don't expect perfection---spine fusion surgery is "salvage" surgery & there are no guarantees, & it does more to stabilize things than actually give much pain relief, I've found.
    It sounds like you have some nerve-root compression & the fusion (which usually includes a decompression) could help that aspect & help reduce the electical pain in your leg ( I still have some, but not nearly as bad) As Gwennie says, your current treatment seems to be covering up the basic problem, not really addressing a long-term "fix".
    Get another or more opinions--but in the end, you must make that decision, based on your current misery & the gamble that things wiil be better, in some areas, after the fusion.
    3 spinals in a year is very hard on your body--so if you do go that route, plan on a long & patient recovery, factor that into the mix as well. I took me over a year to start to feel better, to get my energy back & to adjust to the "new me" & grieve the losses, etc. Give things time to settle down, prepare mentally for it & think positively. We can & do survive these things & go on to an albeit "different" yet productive life.
    PM stuff works for some--but it's a short-term thing, I found. When things got unendurable, my NS suggested the fusion & for me, it helped a lot.
    Good luck --keep us posted. I totally know what you're going thru. You are NOT alone here!
  • Another view about the benefits of nerve block injections...

    It is possible that the medication (steroid) injected will calm the swelling and inflammation, thus allowing the bulging disc to move back into place. At least that is what my doctors told me. Doctors ALWAYS try epidural steroid injections that target the nerve before doing surgery. If one can get relief with this, it is far better than doing surgery.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
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