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Failed micro dissection/failed PT - what is next?

TWHladyinLVTTWHladyinLV Posts: 47
Hi Everyone,

it's been since July 8 since I've been to work, they wouldn't let me work modified duty. All my leave is gone so I lost my job. I'm still technically employed - just waiting for a medical separation.
I just now started PT last week (had to change doctors), amd the treatments were going OK till they started some leg exercises and put me on a recumbent bike for 5 minutes. an hour after I got home my pain meds started wearing off and holy !!!!!!! %$$#@%$^&*( anyway - you get the picture. My new Orth o doc looked at my MRI's and said the last MD did a rape job on my supposedly "micro" dissection??? He said I had a laminectomy from what he saw, but the nerves are still being impinged to a worse degree than before my surgery.
I did back injections before my last surgery in 09 but they helped little, so I opted for the Micro. Am I looking at a fusion now? My pain level jumped from a 5 to a 9 after the PT, so my doc said to quit the PT.
I really didn't expect to keep my job this go 'round. I tried to get an accomodation for a low work seat and a high stool to be able to not have to bend so much, but my boss told me if I turned in the ADA request I'd get canned for sure, so I dropped it. I feel like I can get a job, but need to get my back in shape first then think about what I will be able to handle. This all started with a WC neck and back injury in 06. I may try to re-open my case and see what happens. My neckhas been giving me issues with complete numbness from my elbows down, hand and finger drop, streaks of lightning pain, etc., so something is going on there too. Then the rediculopathy is terrible in the left leg. I have to wear a brace for foot drop and my hip, knee and ankle feel wobbly all the time. I did have the brain MRI and no lesions were found, so I don't think I have MS, but I'm going to see a specialist just in case.

Just wondering if anyone else has had this re-curring injury and ended up having the fusion??

Thanks bunches!


  • Hi, I can relate to failed Microdiscectomy (L5S1).
    I am surprised one surgeon would comment on another surgeon's work. My surgery never really gave me relief....I didn't know if I was just expecting faster recovery or if I was a failed case.

    I gave my surgeon the 6-weeks recovery and then he put me on prednisone hoping it was surgical inflammation. At week 10, I begged him for another MRI and sure enough, I had another large herniation at the same level.

    No one could definitively say if he left a piece behind or if I reherniated. I guess with the micro surgeries, the challenge is 'visibility' for the surgeon.

    Anyhow, I spent a month researching my options and meeting with various surgeons. I knew now I had to find a surgeon I trusted and could build a long term relationship with (if needed).

    I was told revision MicroD by some doctors and fusion by others. Fusion was scary to me based on what I read for lumbar. I was not convinced.

    I opted to try the revision MicroDiscectomy.
    So far, I'm pleased. I was VERY careful on recovery. My surgeon didn't want me driving for 6 weeks and wanted me to avoid even being in a car for that time too. I have very little disc left so I may naturally fuse even if I lose a little more.

    I still have no feeling in my back thigh/foot but my strength has come back. I do have chronic pain but it is managed with exercise, tylenol, and advil.

    I'm not sure if it will last but I'm about 10 months post op of my 2nd surgery and while the weather plays a role in my day to day pain, I am generally doing well and feel I've made a good decision.

    Fusion is always in the back of my mind as I suspect one day I may need to face that surgery but for now, I feel I've bought time for myself and for technology to advance.

    There are folks here who had this happen and opted for fusion. I'm sure they'll give their insights.

    There are questions you can ask your doctor
    - What is the success rate of fusion? Can he define success? (my understanding is it is same or better but never that anyone gets back to 100% better)
    - What is the recovery time? Best case vs. worst case scenario?
    - What if this doesn't work? how will he approach your case?
    - How does s/he approach the recovery?
    - What other options do you have if you don't want a fusion? Why not revision microdiscectomy?
    - What risks does the surgery pose?
    - What future impacts might you have? i.e. domino effect?

    Also, if you are in the US, I strongly encourage you to get a few opinions. Oddly of the 7 opinions (8 if you count a remote opinion from Cleveland Clinic), the recommendation was split 50/50 on revision vs. fusion. It helped me be confident that fusion was not right for me since 50% said, go for revision.

    Let me know if you have any other questions.
  • Hi Dnice,
    Thank you for your comments!
    I was kind of shocked that he would make that comment on the other MDs work too. Then the other day I was talking to another person whom I met who had several back surguries (wounded vet), and when I told him my surgeons name he said, " the butcher?". I never had a bad experience with the doctor until the last injury. While I never made it sound like I blamed him in any way for the surgery not accomplishing what it was supposed to, he just got on the MS thing and my treatment went to zero from there. I felt I had no choice but to change MDs. All my MRIs have come out negative for MS, but my PCP still wants me to keep my appointment to see the Neuro in Dec.
    I met another lady yesterday who has had the fusion after the failed micro D and she is very happy with her results.
    I am wondering that if you want to be able to return to recreation that can be strenuous
    if it is better to have the fusion? My back has never felt stable since having the micro almost 2 years ago. I like to be outdoors and love to hike and go camping. I feel claustrophobic being stuck around the house. I have practically lived on a horse since I was 5 and I feel I am too young to give up doing what I love. If I have to have a fusion to get that then I will.
    But you have given me some good points to bring up at my next ortho appt.
    On top of all this I am scheduled to have foot surgery in late Jan. I am going
    to have a whole joint in my foot replaced. I have been putting that off for several years now and it's getting to the point I can't walk further than half a block. So I have the foot drop on the left side and crippled foot on the right! . I am way too young for this!
    I have already lost my job so what's the hurry? I think that's what I did wrong with the micro D, I went back to work too soon when I knew I was't really ready. I wanted to save my job. Now I realize that that was probably the wrong choice.
  • Just to follow up, remember everyone's experience with surgery is varied. It's good to see from experiences here, what the possible results might be.

    I hear ya about being too young and wanting to get back to more strenous recreation. I can't speak to if one surgery is better than the other.

    Regardless, both options will require you to keep your core muscles strong and always think twice before bending, twisting, or lifting.

    If it helps, I herniated at age 40. I am (was) an avid runner, hiker, biker, (not much of a camper but it came with the territory). After my 1st microD, I had planned to get back to 'light' running...in the 5-10K range races. When it failed, I realized running is now at the bottom of my list...will only run if someone is chasing me.

    But, I gave that up so I can keep hiking and swimming, and doing my cardio and light weights.

    I don't know if fusion would have allowed me to run or would have removed my worry over strenous hikes.

    I do hike...maybe not as strenous as I used to or for as long but I do hike and I take my dog. I always carry a cell phone and tell my husband where I"m going in case I have an accident. I tend to stick to 'easy' hikes (rail trails, open space, etc) if my husband is out fishing but if he's home or if I can get a friend to go, I will give medium hikes a try.

    I think your life goals are very important to your decision. I also think you have a very good point about 'having time' right now to do your research, pick the right surgeon, make a decision that feels right for you so that regardless...you have no regrets.

    As for going back to work too early...not sure you can beat yourself up over that. I was doing that intially but then realized, I wasn't told otherwise to worry so I underestimated that 'minimally invasive surgery' is still major surgery for back. I pushed myself when I started feeling better but with backs it's different.

    The good news is you have the benefit of experience on your side. I pop on about 2-3 times a week just to offer support. I hope that's encouragement that things can get better. They may not put you 100% back to where you were but you be be active again.
  • I appreciate your comments.

    It helps to be able to talk to others who have been there-done that.

    I used to run too, then started race-walking when I couldn't run anymore. Then started hiking. Now can't get around the grocery store! 

    I have never had a weight problem till after my back surgery they found some Thyroid nodules and I was eventually diagnosed with Hypothyroidism. I'm way heavier than I have ever been and barely eat anything. I know I could do better if I could walk. It's just the foot things.

    Really the foot surgery freaks me out more than back surgery does! I guess because my sister has had 5 foot surgeries that went from bad to worse, and she can barely get around.

    I guess I can still sit a horse, which is very good core exercise. But not much cardio. I do get exercise washing and grooming my 2 horses. It's like washing and waxing 2 SUV's . But still can't loose weight.  bummer. I'm sure my horses wouldn't like hauling my fat ___ around anyway. My husband wants me to sell them but I wouldnt do it unless I couldn't take care of them any more.

    I guess there is a foot surgery forum somewhere on the web. I should get on there!

    Then there is the feeling of being cheated out of your life. In my case I was fine, but got injured by someone elses carelessness at work. The person who did it is so terribly sorry and I told the person to not feel bad for me. I would feel bad too if I was the one who had done it.

    I have an appointment with an attorney next week to see if there is anything I can do to get my job back.
  • Hugs to you. It does suck and that I can appreciate. You seem to have a good attitude toward what happened and I agree...you keep the horses until you can't care for them...you obviously enjoy them.

    Let us know how it goes with the Neurosurgeon. Oh, bring someone with you to the appointment. I was so overwhelmed at the first 3 appointments (my own doctor, and 2 other opinions) that I finally took my husband to the next 4 because we both had to be happy with the surgeon & his recommendation. And, it helped my husband understand what was involved in the surgery. He was able to prepare to help better after the surgery.
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