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Not sure if I should get microdiscetomy

smittysssmittys Posts: 4
I was in a car accident over a year and a half ago and have been suffering from severe lower back pain. I have been going through numerous diagnostics to pin point the reason for the pain and after 1 1/2 years the doctors finally figured out it was a herniated bulging discs. I have gone to several spine surgeons one told me to get pregnant and if that didn't help then he wanted to fuse my spine. Can we say "Quack Doctor!"
Another surgeon wanted me to get the fusion surgery asap and the third doctor wanted to try microdiscetomy first. I would like to go with the last doctors choice but everything I have read about the people who had gotten this procedure complained more of leg pain and numbness rather than lower back pain. I have no leg pain or numbness just incredible back pain in my lower back. Does any one have any suggestions? I'm afraid to be wasting time with this surgery and it not working and then I will have to get my spine fused anyway. Has anyone gotten this procedure that DID NOT have any leg pain or numbness????? Has it helped? Very desperate for answers.
I was pregnant at the time of the car accident and lost my baby 2 weeks after the accident. My husband and I have been waiting to find out what is wrong with my back and how to fix it for over 1 1/2 years. We are desperate to get pregnant and I'm am just so sick and tired of waiting to see if something will work or not. I just want someone to say this is whats wrong, this is what will fix it, and this is how long it will take for you to recover. I need to get my life back on track before I loose my mind.


  • Hi and welcome.
    I think you are asking yourself all the right questions and doing the right research. Remember, you don't have to stop at 3 opinions.

    I say this because I ruptured my disc (true herniation). I couldn't get out of bed..excruciating back pain radiating down my leg. A trip to the ER, IV meds, and an MRI showed a massive herniation. Wherever I hurt went numb. So I fit the information you found...leg pain, leg numbness, and loss of strength in my leg. Severe compressed L5-S1.

    So, what level is the problem at? Do the doctors say why they think microdiscectomy will work? It can work for many patients but I agree you don't want to jump in too soon.

    Have you tried epidural injections to get the inflammation down?

    I don't have an answer but I would definitely listen to yourself on the fusion. It's a big decision and permanent. I've read that there's an 80% 'satisfaction' rate. I will recommend a fellow-ship trained Orthospine or Neurosurgeon.

    I had 3 opinions before having my 1st surgery and I was considered urgent (they thought the nerve compresion may impact my bladdar/bowel). It failed. Before my 2nd surgery I had varying opinions (revision microdiscectomy or fusion). I met 7 doctors and 1 remote opinion...to help me feel confident.

    I think I would seek additional opinions.
    Ask the current surgeon recommending MicroDiscectomy why he thinks it will work? If there are any non-surgical treatment options? I think others might be able to recommend some other procedures to ask about or research.

    (I will send you a PM on an idea)
  • While I can not diagnose your problem I can tell you what various surgeons said to me. I have problems with my lumbar spine, which you can see in my sig. This is a very condensed version of what happened.

    After years of treatments, my physiatrist had the surgeons at her office evaluate my case and they refused to see me because they felt a micro-d would not get rid of my back pain - and they would not consider a fusion on a person my age. On her advice I tried to get another opinion. I went to a doctor at one of the top hospitals in Boston and he asked me which pain I would rather be rid of - back or leg. (I DO have leg and foot pain/numbness but it is nowhere near as bad as my back pain.) I told him that I could live with just the leg pain if I needed to but the back pain was just too much. He then proceeded to tell me that while he could try to do a micro-d, he did not think I would be satisfied. He said that it would not be likely to help my back pain and would essentially waste my time.

    My point is that, if I were you, I would get a second opinion. Make sure you are very clear with the doctor that the back pain is the real problem. If another doctor confirms that you should try a micro-d first, then you might want to consider it. It never hurts to ask questions.
  • Since I was pregnant at the time of the accident they couldn't do any real diagnostics for my back. After I lost my baby I had an Mri, Bone Scan, 5 epidural injections,Radio-Frequency Ablation, and finally a discogram (which I would not wish on my worst enemy). This all took place over a period of 1 1/2 years. I also suffered a shoulder injury from the accident so I had multiple surgeries on my shoulder at the same time.
    The discogram came back positive and is focused on L1-2.
    All three doctors pretty much leaned toward fusing the spine but the last doctor is one who likes to try smaller, less invasive procedures 1st. Which, honestly I like. BUT, I don't want to waste my time with a procedure that is meant to help more with leg pain than back pain.
    The other reason I felt comfortable with the 3rd opinion is because it is given by a surgeon that my pain management doctor highly recommends and I LOVE my pain management doctor. He seems to be the only doctor who truly wanted to help me find out where my pain was coming from and has been very supportive over the past year and a half.
    So, so far I have had 3 opinions in which all doctors said fusion surgery was my best option but they all wanted me to try something less invasive first (like PT,getting pregnant, or microdiscetomy) Haha, the pregnant thing still makes me laugh.
    The other thing that got me was that he wanted me to do 4 weeks of PT first which I just can't seem to understand. At least it gives me some time to think about the procedure.
  • Remember, while you can stop taking a medication, stop a manual or physical activity treatment approach, etc., you cannot reverse a surgery. If your pain is becoming increasingly frequent, more intolerable, your function progressively worse, and you have tried all reasonable options, then surgery is a consideration. If you cannot answer "yes" to most of the above, maybe you have not adequately worked your conservative treatments.
  • definitely try the microD first. Always go with the most conservative first as the major surgery could always be tried later IF the microD does not work.

    If you go straight for the fusion there is a good chance that it will not be successful and that type of surgery can not be reversed.

    When in doubt always go as conservative as possible. It may be well worth it in the end.

    Good luck.
  • has any of these docs suggested trying a discogram? That would be a great way to find out if the disc is in fact causing the pain before doing any surgery at all.
  • J.J. Grey-Actually I just had a discogram done (see previous) entries and thats how they pin pointed what was wrong and decided on surgery. I'm just wondering why they would want me to try PT when I had already tried that about a year ago with no improvement?
    Douglas 34- the doctors actually said I have pretty much tried every type of conservative method out there with no improvement. We thought the epidural in the facet helped because I was pain free for about 1 week but when they did the Radio-Frequency Ablation on that area and I had no improvement they realized it was not the answer and we had to try something else.
    I just did my 1st day of PT and the odd thing was the movements she put me through did not cause any pain until today. I can hardly move because my back hurts so much.
    That is one of my main complaints. If I do not do ANYTHING for days I'm ok but as soon as I start moving the back fires up. The best my back felt was when I had the flu and was in bed for a week straight. But I was such an active person before the accident and I have a 5 1/2 year old boy so staying in bed is not an option LOL.
    By the way, I really appreciate everyone's input.
  • SmittyS - just from what I've heard from others. It sometimes takes up to 3 epidurals to get relief. I know someone that got an epidural that gave him 2 weeks of relief. He got a 2nd one that gave him 2 months. He opted for a 3rd try and he's on 2 years of relief combined with various PT exercises.

    If you are out of options, genuinely, I would consider the microdiscectomy. But talk to the surgeon about his/her approach to recovery, return to work, PT, etc. Ask what happens if it fails. Ask what happens if down the road you need a fusion, what's his/her approach to it?

    I only recommend this b/c once you opt for surgery (even though it's a micro surgery), there is a risk that you will need a surgeon who's approach aligns with your needs. I switched surgeon's for my revision micro D. Why? A few reasons but mostly b/c my original one was out-of-network and clearly I needed a surgeon that could support me longer term. Even though he was very conservative (even questioning the need for the revision...he hoped the disc the hernited would dry out and give me relief), we discussed all the 'what if's' because he wanted me to know what could happen. He then wanted me to know how he'd approach possible future decisions and how he conducts fusions. Why? Because he wanted to build a trusting relationship with me before agreeing to operate. I feel taking the time to pick a surgeon you trust, that you feel answers your questions, is willing to spend time with you is important. My current surgeon (the new Neurosurgeon) never told me how great I'd feel. He told me what he hoped I would feel but when I got out of surgery he always wants to know exactly what pains I'm having so he can make sure I'm healing. He's genuinely vested in making sure I am a success.

    Good luck. PM me if you have any questions.
  • Hi Smittys,

    From what I understand, the pain generator could be "discogenic" pain which is what happens when the disc is damaged and more nerve endings grow inside the disc (innervated). Bodies response to get us to stop using that joint, I guess. The other possible culprit could be your facet joints that are forced to readjust to the loss in disc height.

    Fusion is designed to remove the innervated "bad" disc and restore disc height and properly situate the facets.

    In my unmedical but personal opinion, more often then not, a micro-d just puts off the inevitable if the disc is pretty damaged. We are like horses in such a way that lumbar injuries are weight bearing and they are difficult to heal on their own (lack of blood supply, age, etc).

    Good luck,

  • Thank you for all the advice. I have gone to 2 PT sessions so far and my back has not gotten any better. I know I need to give it more time but I do not have high hopes.
    I am going to go ahead with the microdiscectomy in 4 weeks. I'm still going to give PT a chance but I'm going to go ahead and schedule the procedure and cross my fingers that it will "fix" me and I won't have to go through a fusion surgery.
  • Smittys, I would trade my L4/5 bad disc for your L1/2 anyday. Not minimizing your pain or anything, all I'm saying is L1/2 is probably the best Lumbar disc to have an issue with and fuse successfully. I would think the highest one would have less acute angle pressure on it as opposed to the last two lumbar discs.

    GL, I think you'll be much better a year from now no matter which surgery you decide on. :)

  • I'm a firm believer in seeing things in black and white, the power of putting pen to paper when heart and mind are uncertain as to which way to proceed. My head can mislead my heart and vice versa, but when I see it written down in front of me, there's no mistaking what the answer or course of action should be.

    Please remember that spine surgery, ANY spine surgery is not a "magic cure" and can be the opening of Pandora's Box. Proceeding forward with something just because it's called "minimally invasive micro-discetomy", doesn't necessarily equate to it meaning "minimal risk associated".

    It's always good to find someone you trust, to help you in evaluating your condition and surgical and non-surgical risks. This can be a life altering decision and shouldn't be made without experienced knowledgeable skilled guidance.

    We are just other spine patients who have had good and bad experiences. All of our injuries no matter how similar, are so individually unique that we really can't compare them.

    I wish you the best,

  • Correct me if I'm wrong...I thought microD was to treat sciatica and nerve impingement MORE than lower back pain. It sounds like Smitty's leg pain is minor compared to her back pain.
  • The problem with micro-d's is thatin order to "decompress" the nerves, the disc is made weaker OR is already weakened by the extrusion. I can attest to this, personally. The theory is great, "let's get whatever is pressing on the nerve roots OFF of them", but is the area stabilized enough to allow for weight bearing/daily function? All too often, the disc just herniates again because the disc wall was made weaker via surgery. I'm very observant of the signatures/history of members on this board and I challenge you to look at those lines and see how many of them have had a micro-d which was followed by a fusion at that same segment. I guess to each their own and each case is different, but unfortunately, it seems as thoughmicro-d is just a precursor to eventual fusion or ADR. Living on eggshells, worried about hurting your back again is NO fun at all. I'm not giving advice one way or another, but I cannot ignore the developments of what I have seen on this message board and from others that I know of.

    GL in whatever you choose.

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