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Disc repair/re herniation

kyadog115kkyadog115 Posts: 266
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
HI all...
I havent bee here in a long time but can someone help answere this please? In April 09 I had a herniated L5. I had a discetomey on it with an S-1 Nerve root decompression. After the surgery, I was ok, but the back still sorta bothered me. Anyway, Jan 12,2010 .I fell veryhard and slammed my back on icy steps here at my apt. I was taken to hosp, they took x-rays but didnt find anything. To make a long story :shorter" My ortho finally ordered an MRI, It shows a herniated L-5 impinging on The S1 nerve root.
My question is.....wouldn't that have shown up on the initial x-rays?Could the ER doctor have missed it? Also,when one has the discetomey,isnt that supposed to "fix" the herniation? I believe this traumatic fall caused this herniation but i'm not cedrtain if it was ever really corrected to begin with. However,after the discectomey i did complain to the neuro who did the surgery and he did do another MRI and i recall him saying everything was ok..wouls u all suspect the fall caused this herniation?


  • Welcome back. It has been quite some time since I've seen you posting. I hope that means that you have been doing okay, at least up until that nasty fall.

    X-rays are good to check for any bone problems, whereas MRIs look at the soft tissue. I do not think a simple xray would pick up a herniation, which is why it wasn't found until your mri was read. With your previous surgery, was it a microdiscectomy? Did they fuse anything together? My guess from what you are stating is that they trimmed off the piece of the disc that was herniated but left the rest of it in place. Otherwise you would have a fusion with bone graft material and no disc remaining. Could this impingement be treated with an ESI? That is where most doctors like to start, along with physical therapy to strengthen your back.

    I hope that explains things. Sorry for your continued struggles.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • HI Cindy,
    Thanks for the reply. Things have been ok, pain meds KINDA keep me comfortable.To answer, yes, it was a microdiscetomey...nothing fused.Wouldn't u assume at this stage that they'd(Dr's) would recommend fusion?
    It was discussed before the micr'd but i opted for less substantial procedure.Would u think the fall caused this? Other than that, I have not and do not lift anything heavy anymore..
    Thanks,,hope u r well...
  • Sorry about your pain.And yes a fall could cause it.

  • As Cindy says the Xrays can't pick up soft tissue that well which is why drs generally order an MRI if they suspect disc involvement.

    It is very likely that your fall caused a new herniation on the same disc. The discectomy only removes that part of the disc that is bulging out. If there is still a lot of nucleus material left it is possible for this to be squeezed out through the scar tissue of the discectomy or even a different tear. Particularly now that you have reherniated that disc, it will be weaker. I know that it is possible to redo the discectomy, but the success rates are lower so you do need to discuss this with your surgeon.

    For my own part over a 3 year period I had herniated the L4/L5 and L5/S1 discs to varying degrees of severity by lifting my 2 year old, taking a dog for a walk, falling on ice and after a sickness bug. The last 2 were within 8 months of each other and I hadn't recovered from the microsdisectomy I'd had for the first disc when the second disc went. By this stage I had had enough of the pain and disability so I opted for a 2 level fusion.

    Only you can know how much you can take before resorting to fusion. It is not a surgery to be taken lightly so I would discuss all the options with your surgeon
  • Thanks for that reply. I cant take much more of this pain. I cant stand lond without having to lean forward somewhat. I cant walk any distance without the use of a cane and even then the pain is excruciating. I really think at this point i need to undergo fusion. In 2-08, I had a 3 level ACDF(c3-6) w/hardware,,plate, 8 screws......now my back again, my depression is horrible....I'm only 51 yrs old.i have severe DDD. Please say a prayer for me, i'm gunna need it i think

  • Hi there,

    Sorry for your recent troubles. Paul is right. X-ray isn't always the best indication of issues with the nerve compression.

    If you did re-herniate, there will be 2-schools of thought. Fusion or revision microdiscectomy.

    I just had a revision. I did a lot of research and found there are doctors on both sides of the fence. Some say try the revision because it's less invasive than a fusion and still has an 80% success rate on the 2nd pass. Others say, it "only" has an 80% success rate and if you have little disc they may tell you the disc my 'choke' the nerve if you herniate a 3rd time. On the flip side, fusion will permanently "fix" the issue at the site but it will put stress on the disc above/below. In addition, Fusion has about a 80% 'satisfaction' rate.

    So....see what the doctors say.

    The discectomy doesn't 'fix' the disc, it fixes the herniation. It removes the piece (her herniation) that came out and is compressing the nerve. The remaining disc can have another piece break off (i.e. reherniation) and come out of the spinal column. From the sounds of it...your surgery fixed the issue. I know people who have had it work for 10 years.

    Hopefully it's not too bad and maybe they can try an epidural injection or oral steroid. Otherwise, I hope that a revision Micro D is an option.
  • Hi Paul,

    As always you remain in my thoughts and prayers. I'm so sorry to hear of your fall and increase in pain. That's exactly what I did about 3-4 months after my ALIF and may have been how the screws broke. Either way I would've eventually ended up in pain if that's not what caused it cuz I did not fuse.

    I've also read and been told by my new neurosurgeon that an xray will not show the disc herniation. My husband has 2 herniations in the same cervical disc C6/C7. I took him to ER and they did ctscan and I took him to walkin clinic 1-2wks before that and they did xrays. None of these showed the disc herniation. It really wasn't obvious until they did the MRI.

    Good luck with everything and I will keep you in my prayers. Please keeps us posted.

    Your spiney friend,
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