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Third Microdiscectomy not much disk left

HOTH99HHOTH99 Posts: 12

I recently had my third Microdiscectomy in 26 months at the L5-S1 level to remove a portion of a the disk herniation. Surgeon said he removed almost all of the disk, so that "chances of reherniation are close to zero". Surgeon says remaining disk will wear down and one of three things will happen 1) The vetebre will self fuse, and the problem will then be taken care of 2) the vetebre will be bone on bone, will not self fuse and will cause no pain, 3) the vetebre will be bone on bone, will not self fuse and will cause pain. Scenario 3 could require a surgical fusion. Has anyone else had almost all of their disk removed, but have not had a surgical fusion? The surgeon quoted a 50%/50% chance that the bones will self fuse and if they do not, a 40% that they would cause pain from bone on bone rubbing.


  • First of all, welcome to Spine Health.
    This is a very good place to find information and also lots of friendly people who are experiencing similar problems to you, so understand what you are going through. :-)

    Are you still having pain now from your L5/S1 disc?

    I am not a doctor, but have read a lot of people's experiences and have had a fusion myself.

    I think that it is unusual to have 3 microdiscectomies on the same level. Usually after 2, the next surgery is a fusion. (That is just what I have read.)

    I had a spondylolisthesis which had pushed my disc out of place, and was amost completely gone and was told that I was nearly bone on bone. One surgeon told me that eventually I would self fuse at that level. A different doctor told me that once I was bone on bone I would have a lot of pain from it.
    I had my fusion, with the disc being removed and a cage with bone graft put in, so I didn't find out what would happen.

    There have been people on here who have found once the surgeon went in, that they were bone on bone and some have self fused. One or two have had a difficult surgery because the surgeon has had to untangle the nerves that have been in a mess.

    Your surgeon is in a much better place that us to advise you on your situation and what the outcome may be. Perhaps a second opinion would confirm things.

    I hope that you will let us know how you get on and that a good solution is found, (if one is still needed).

    Do keep asking any questions you have. :D

  • Hi Jellyhall,

    I just had the microdiscectomy 3 weeks ago and had excellent results. The only pain I have no is in the lower back muscles around the incision. Dr. says that should be gone by about week 6.

    I have read about a few people who have had three microdiscectomies including a few professional athletes. Sometimes that third time works for them. I believe my surgeon said three was ok since I reherniated the second time only 3 weeks after the first one. My surgeon said three is the most they will do and then a fusion is considered.

    So I think I am going to take the conservative route and wait to see how this progresses over time. If I do get back pain in the future from bone on bone I will consider a fusion then.

    Has anyone seen stats on how often the vertebre fuse themselves? From what I have seen the data is very scarce.
    Feb 2009 Microdiscectomy L5-S1 (Recovered 100%)
    Mar 2009 Revision of Microdiscectomy L5-S1(Recovered 100%)
    Jul 2010 Revision of Microdiscectomy L5-S1 (Sore lower back muscles around incision)
    No further Sciatica

  • So you are very early on in your recovery. I expect that the pain you are having is from muscles that were disturbed by the surgery.

    I wish you all the best in your recovery and hope that you won't need any more surgeries.
    Do follow all the instructions that you have been given and be patient with your body to allow it to heal well. Let's hope for the best! :D
  • Interesting! I've had two diskectomies at L5-S1, but when I herniated again for the third time at that level (a little over a year ago) they said they couldn't do a third... fusion was my only option.

    I'm glad I opted to wait it out... I'm about 99% pain free now just from PT, stretching, swimming/hiking, and patience. I couldn't walk, sit, stand, or lay down when it first happened, so I kind of consider my current pain-free state a miracle.

    Best of luck to you!

  • My Dr. said that in theory they could do four microdiscectomies, however it becomes kinda pointless after three. This is coming from a top surgeon at one of the best orthapedic hospitals in Boston. I can't wait to start stretching and exercising. Dr. says I have to wait 6 weeks from date of surgery to start PT.
  • Hi,

    I had two discectomies and still had a lot of unresolved pain. I obtained a few medical opinions and the consensus was that I was feeling disk pain and that a fusion would take care of it. So, I am now 6 months after a fusion and still have the same pain...

    I can't say that I'm the most knowledgeable person on the subject, but I have never heard of bone on bone being a good situation nor being a pain free scenario. Something about that is counterintuitive and based upon the apparent difficulty in getting a spinal fusion to take even after using special hormones, bone grafts, and bone growth stimulators, it seems like an unlikely scenario that two vertebrae will just somehow fuse on their own. I have had other arthritic surgeries and I think I can safely say that MY bone-on-bone situations in my feet, my hands, and now in my back have caused the bones to become enlarged and extremely painful. The bones did not fuse, they just became increasingly irritated. There's probably a medical term for it -- is it simply called arthritis?

    Have you obtained a second opinion? I like your notion of being conservative. I wish I was more conservative after my first discectomy in terms of activity to protect my L5-S1 disk. I should have done more to rebuild my core strength to protect that disk from further herniation. Alas, I did reherniate it even though my doctor cleared me to do any activity that I wanted to. It didn't take much to reherniate the disk -- riding my bike on a steep hill.

    Anyhow, I sincerely hope you remain pain free!!

    Take Care,

  • Hi there,

    I've had 2 microdiscectomies on L5-S1.
    I was told if I herniate again, my options are "wait" and hope I get better with time or go with the fusion.

    That being said, I can see why your doctor wanted to try the 3rd MicroD. Why? B/c if you reherniated within 3 weeks, perhaps it was not a reherniation but really a piece left behind. I also reherniated within the 1st 2-3 weeks. No one would say if it was rehernation or if the other piece was there and maybe just out of site.

    Ok, now that I've said that, after my 2nd microdiscectomy, the surgeon told me that I didn't have much disc left. He said there is a chance over time the bones will fuse on their own b/c of how little disc I have left.

    I really hope the 3rd time is a charm for you!
    If not, I know bones can fuse on their own naturally over time...

    I'll try to follow your posts b/c I'm interested to hear how you are doing.
  • Thanks for the comments. I am almost a month post 3rd microdiscectomy and have no pain EXCEPT when I sit down on a low chair (such as a deck chair or sit on steps). When I sit I can feel a little pain radiate down the leg. After a minute or two it passes. I am assuming this is because I have not started stretching or PT yet. As for the bone on bone, the surgeon's belief is that if there is no pain, leave it alone. I was pain free after my two previous microdiscectomies so the Dr. figured he would take more disk out and let time be the judge. If I was pain free for a significant amount of time -great. If it became a painful bone on bone situation they would do a fusion. But they wanted to give me a chance at possibly being pain free without the fusion. As for the 3rd microdiscectomy, the surgeon told me he would do a third because my reherniation was only 3 weeks after the first surgey and caused by missing a step on a staircase and landing hard. Because this was an accident he basically said it "didn't count".
  • Thanks for keeping us updated.
    For someone like me, I'm very interested in this.

    As I said, I had 2 microD on L5-S1.
    I got no relief from the first and suspected something was wrong by week 2 but the surgeon wanted to wait 3 months b/c it's hard to see.

    Long story short - from the MRI, they knew the re-herniation was very early on b/c of how the scar tissue was. At the 2nd microD, the surgeon confirmed that it had to have happened very early on b/c it was surrounded with scar tissue....

    Anyhow, my surgeon said I don't have much disc left to lose so even if I lose a bit more...he won't fuse unless my symptoms get worse. He's very much like your surgeon in that he wants to give me a chance at being pain free without the fusion because he said once we do that, there's no going back.

    Keep me posted. I may add you to my buddy list.
  • I just had my 6 week follow up with the surgeon. I am pretty much pain free at this point. I am starting physical therapy next week. My surgeon said at this point I can go back to unrestricted activities (however at only 6 weeks out I am going to wait another 6 to go to unrestricted). I am feeling really good and just keeping my fingers crossed. Although I have almost no disk there is no lower back pain. Surgeon says to exercise the core and stay healthy in order to minimize any chance of lower back pain from tha lack of disk space.
  • Good news for you! Sounds like things are going as planned. I'm with you on being smart about the lifted restrictions.

    I'm 6 months post op of 2nd microD and am doing generally well. I can't say I'm where I want to be but not going backward.

    I realize as I increase activity I'm sore and I'm just learning how to distinguish 'muscle sore' from over doing it. My abs are strong but I'm still working to get my back extensors (? on the muscles) strong as I can feel strain when I'm tired.

    Anyhow, best wishes. If you remember, I'd love to know how you are doing at the 3 months mark.

  • Please keep in mind that when they remove a section of disk, they do nothing to ensure the integrity of the remaining disk. Thus, you are more susceptible to another herniation (if I recall your history correctly). This was my case. I had a perfect discectomy and I felt like a million bucks! When they say "no restrictions", my advice is do not take that literally. I think they mean "within reason".
    If you reinjure yourself, you are likely to go down the slippery slope of more surgery and probably a fusion. I only say this because I wish I could rewind the clock and prevent my injury after I was told "no restrictions". I was just riding my bike.

    I'm so glad your pain is under control. I wish you a lifetime of no pain!

    Best wishes,
  • i had most of my disk removed at one level in my lower spine a while ago and over time the two vertebrae fused themselves together. it does happen.
  • Hi Everyone,

    I am now at the 2 month mark post surgery and I am doing remarkable well. I have no pain at all and I just started PT. I also started at the gym, doing eliptical. My physical therapist was expecting me to be in bad shape since this was my 3rd micro but I was able to do all the exercises with relative ease. Also, I am walking about 2-3 miles a day, everyday. Hoping the vertebre at L5-S1 are busy self fusing...keeping my fingers crossed that I have no reoccurrances.
  • Great to hear you're doing so well 2 months after surgery. Best wishes for a complete recovery. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi Reformed1,

    My husband is having a herniated L5/S1. He was undergoing physiotherapy for the last 4 weeks but still the pain exists. We now did the MRI, which conformed that his L5/S1 is in a bad shape. Doctor referred to a spine surgeon and also suggested he might have to go for a discetomy.
    I read in your post that after your first discetmy, riding a bike got your disc reherniated! Biking/ swimming, I thought was the exercises allowed to build strength after such a procedure.
    could you please let me know if they really do bad to the disc?
  • Yes, there are many exercises that can help rebuild core strength. The key, in my opinion, is to get professional guidance through a physical therapist or a doctor. I was also suggesting that things should be done in moderation. My doctor told me that I cleared to do "anything that I want to do". Well, riding my bike on steep hills caused me to exert so much force on my lower back that my disk reherniated. If I had stuck to riding on level trails, I would be in a better place today.

    Again, I can't advise as to what's appropriate for your husband, but my experience suggests that if you push yourself too hard too fast, you can definitely do damage.

    Best wishes,
  • I have basically bone on bone at 2 levels- one self-fused, one not. The unfused one definitely causes more pain than the fused one (the fused one causes pain for different reasons), but the unfused one still doesn't cause as much pain as a big herniation. It just makes grinding sounds and is a very deep aching pain.

    Does that help?

  • Hi everyone, its great to hear other peoples experiences.
    I am having a second discectomy on my L5S1 shortly after reherniating 5 months after my first and am really concerned about my future in sports. I am an avid surfer among other things but was wondering how anyone has recovered and returned to such things??
  • Hi hoth, I have almost all disk material removed as well . Can u please tell how you are getting on with your recovery. Did the bones fuse for you ? You reply would be really appreciated as I am worried sick of fusion ?
  • Just want to update anyone who is interested on my progress. My last post was July 2010. In November 2010 I started noticing that whenever I was laying down my muscles would tighten. Even if I layed down on the ground for 5 mins I would be stiff. In the morning my back is stiff and I have to stretch for a few minutes to get loose. I tried running again but it aggrivated by lower back muscles. I go to the gym and do core exercices but nothing seems to relieve the lightness and mild pain when I get up from a laying position. I can do yardwork, but after bending down and back up for a couple hours the muscles at the side and back of my hips begin to hurt. Going to my primary care Dr. in a week to see if he has any suggestions.
  • Thanks for taking the time to come back for an update and for finding your original post. Is everything else good aside from this new pain?
  • waltfwwaltf Austin, TXPosts: 18
    Hi, well I am going for my third microdiscectomy at the same level (L4/L5 Far Lateral) next week.
    My first microdiscectomy was on 11/28/2011 and then my second was on 12/1/2011 (re-herniated 1.5 days post surgery). Have had continued left leg pain, so after an MRI showing additional disc material pressing on L4 descending nerve, am going for number three in 1/29/2012 - so three microdiscectomies at the same site in 2 months! Oh, I also had an L5/S1 microdiscectomy at the same time as the first L4/L5 microdiscectomy - that one is fine.
  • Had my third microD on December 29. Re-herniated two weeks later. Have fusion scheduled for Feb 7. Lucky me!!!
  • waltfwwaltf Austin, TXPosts: 18
    edited 02/07/2013 - 11:47 AM
    waltf said:
    Hi, well I am going for my third microdiscectomy at the same level (L4/L5 Far Lateral) next week.
    My first microdiscectomy was on 11/28/2011 and then my second was on 12/1/2011 (re-herniated 1.5 days post surgery). Have had continued left leg pain, so after an MRI showing additional disc material pressing on L4 descending nerve, am going for number three in 1/29/2012 - so three microdiscectomies at the same site in 2 months! Oh, I also had an L5/S1 microdiscectomy at the same time as the first L4/L5 microdiscectomy - that one is fine.
    Well, haven't been to this site for a while. Thought I'd do an update to my previous post. The above surgery (3rd microdiscectomy in ~2 month period) went well, except that a few weeks after I re-herniated my L4/L5 disc. This time we waited until July (7/18/2012) and did a fusion at L4/L5 with interbody cage and pedicle srews / rods.

    Technically the fusion was a success (cannot herniate a disc that is not there), but as far as pain I am worse then when I started. I currently take 32mg/day of Exalgo (time release Hydromorphone, i.e. Dilaudid) with another 8 to 16mg (typically) of fast-acting (normal) Hydromorphone as needed.

    Last visit to my Pain Mgmt. Dr. he gave me literature on Spinal Cord Stimulation (SCS), I will discuss this option with him in more detail at my next appointment (beginning of March, 2013).
  • So far its been a Success Story - It has been 3 years since my 3rd Microdiscectomy. I have doing core exercises about twice a week for the past 3 years and have even started running again. I am up to 2 miles a couple of times a week. I am 40 years old now and I recently beat a group of 34 year olds in the 40 yard dash. The only time I get any soreness is I do more than 5 hours of yardwork or perform activities that require over an hour of repetitive bending over. I have been careful about lifting anything heavy. The most I will lift is 50 pounds. I really dont have any limitations anymore. It has been a blessing to feel this good after three surgeries. I knock on wood every day that it continues. So for anyone that has had failed microdiscectomies, there is hope.
  • HOTH99HHOTH99 Posts: 12
    edited 12/31/2013 - 6:59 AM
    In my last post I was doing excellent, however a month ago I started experiencing sciatic symptions out of the blue.
    I did not hurt my back this time, the pain just slowly returned. I am trying NSAIDS and exercise but it does not seem to be working. Going for an MRI in two days, but I know it is going to show another L5-S1 disk herniation. My surgeon told me that another herniation would be very unlikely since he removed almost of the disk in my last surgery. I guess he was wrong. I am most likely facing another surgery since my herniated disks no longer heal by themselves. I am going to push for another microdisectomy since I had 3 years of full relief last time. More to come after my MRI results are in.
  • Hello I wonder if anyone could offer opinion/advice?
    I prolapsed my bottom 2 discs L5 S1 significantly in May 2013, I had a spinal nerve block which worked a treat but have been spending past 7 months living precariously .... Sadly I have had further problems pre Xmas and now am told that MRI from last week shows L5 S1 prolapsed again but worse this time! Disc above is intact but completely black (no water) but surgeon doesn't seem concerned about that.
    Have been told I have three options 1. Wait it out (not an option when in this much pain) 2. Another spinal nerve block which "could" offer another 6 months relief but no long term solution. 3. Microdiscectomy... Taking away 2/3rds of disc....
    I have read lots of posts on here saying they needed 2-3 of these procedures which is off putting?
    The pain is so bad at the moment and I can't imagine this lasting much longer.... What's the recovery time after surgery?
    Thank you
  • Hi,
    I'm new to the forum, this is my first post. I had an L5/S1 microDiscectomy and Laminectomy on Oct 2nd, 2013. I had four very large and very far lateral disc fragments removed which have been causing me awful pain for several years now. I did PT, got the epidural injections and nothing seemed to help. So coming to grips with having back surgery at 32 yrs old was not an easy decision for me, but I had no other choice. The pain was so intense I even had to medically resign from my career, which I was in the heights of at the time. I did not want to go under the knife but looking at the promising outcomes and somewhat short recovery times of the surgery I bit the bullet and had it done. Well...pfft so much for that, after 3 long, painful months I began to truly realize that I hit a wall of some sort, my recovery just halted and the pain was becoming worse, esc sciatica pain. So much so I went to the ER because my leg pain was just unbearable. Well I got in, got a new MRI and the disc re-herniated:( I am so pissed, I did everything I could (no bending, lifting, twisting) for 3 months and now I'm pretty much back to square one. The pain is just as bad as it was pre-op, the only good thing is I do have much more strength in my right leg than before the surgery. But that's it. I still have to take just as a many pain meds (OxyIR 20mg and Soma) as I did before. I feel like it was such a letdown, and now the only thing left to do in order to get any relief is another surgery. It's sort of depressing because I feel like months to years on end are just wasting away, painfully. My career involves lifting, carrying, pushing and sitting or standing for long periods of time. There's really no way around it. I just pray one day I can return to what I have my degree in and have spent all my life pursuing. It's just frustrating as I'm sure ALL of you know. All of us just want to get better, and from reading on here it seems relief comes sooner for some than for others.
    For those of you considering surgery, it's a very difficult decision to come to I know. My advise is to be sure you have tried all other measures such as PT, acupuncture, corticosteroid epidurals, medication, and meditation. I say should all those not prevail in providing any or very minimal relief of the pain, then seek out a good, highly regarded ortho or neuro and see what your surgical options are. But remember that the big black bold lettering on your surgical consent form that says"May lead to other complications such as future spinal surgeries" is the one complication that you hear the most about.
    For those of you going thru what I am, or waiting in pain for your body to heal, I say make everything and anything in your life as easy on you as you possibly can. Meaning I'm single, so I have know one to go shopping for food. I can't lift cat litter and bags of groceries..so I signed up to have my groceries delivered. The same with my laundry. I got a temporary handicap permit so I don't have to worry about parking so far with my leg pain and weakness. Make things work to your advantage if you can, that's how I'm getting by.
    Well I look forward to everyone's stories on here and I wish you all a great new year and a speedy and healthy recovery for us all:)
    Spinal stenosis, recurrent disc herniation, DDD, microDiscectomy/Laminectomy on 10/2/13
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