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Can a microdiscectomy work?

vermithraxvvermithrax Posts: 21
edited 06/11/2012 - 7:53 AM in Back Surgery and Neck Surgery
I have a herniated L4-L5 disc with really nasty sciatica all down my left leg, with tingling. Been this way for a year and it just got much worse for no real reason.

Going to get another MRI and go to my Neurosurgeon soon. Pretty sure he will recommend Endoscopic Microdiscectomy or just regular discectomy.

I have read countless papers on discectomy results and browsed every forum I could find to see what is the normal outcome of this surgery. The results frighten the heck out of me.

It seems that microdiscectomy is just a prelude to fusion most of the time. I will do anything to avoid fusion if at all possible.

Has anyone here had a good outcome from their discectomy surgery? I'm in sooo much pain, and I am out of options.
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Comments

  • will it work ?? a lot depends on the consultant and then on you ..follow what you are told and you should be ok for many years BUT many people find that as the years roll on revision surgey is required so prepare your self .a good repair will last about ten years befor you get and epidural fibrosis {scar tissue } causing you and problems ..if you can get by without going under the knife then in my opinion i would .spinal surgery is big and not to undertaken lightly and unlike any other surgey backs tend to give us pain even after the operation scar has faded
    good luck with what ever you decide .
    tony
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • vermithrax said:

    It seems that microdiscectomy is just a prelude to fusion most of the time. I will do anything to avoid fusion if at all possible.
    Right on both counts. Partly removing a disc to get it to reduce the herniation is a delay tactic. And yes to avoid fusion as that is the last step. BTDT on both counts.

    Your hope is that someone comes up with a better answer than fusion before your disc finishes wearing out.
  • Can it work? Yes.
    But like others say, it depends on several factors
    - your surgeon
    - you
    - your condition

    I know people that have had it work for 11-12 years. Then when it 'failed', they had the revision. Other people when it fails, fusion.

    But keep in mind, technology is always advancing. So even if it is a 'stall' tactic, it can be a good one to try. Just think, they now do minimally invasive fusions. Granted, still a big surgery but with a smaller incision. The material used to fuse is better, there is special nerve monitoring now that can help with recovery. There are different approaches (front, back, side). There is artificial disc which in the USA might become a more viable option in a few years.

    Also, fusions are permanent and they have their issues too, especially in the lumbar region. They are not a sure thing either but now you have passed the point of no return.

    Lots to think about.

    There is a lot to think about with microdiscectomy vs. open discectomy. Typically MD's fail b/c line of sight for the surgeon is a bit obstructed but if the piece is small, they can be very successful.

    It's really a matter of weighing your options and deciding what risks you can 'live with' if they actually happen.

    Remember, back surgery is optional. Are you sure you can't try ESI injection or steroids to help reduce the inflammation? Is the pain constant or intermittent?

    Any back surgery is a big decision...so take your time and get other medical opinions. Remember, doctors are human and each has a different philosophy on how to approach the back. For me, conservative was better. No matter what people said to me, I wasn't convinced fusion was the way to go b/c I had other options and if they failed, I knew I could always opt for the fusion. If I opted for the fusion and still had problems, I knew I would have regrets thinking...darn, should have tried something else first. But it's personal and your situation may be different than mine.
  • Success is very subjective.
    Understand what success means vs. what 'failure' means.

    Success may not be 100% better or it might be 90% better but your lifestyle has to change. Heck, I didn't mind giving up running and some of the lifting around the house to get back improvement and avoid fusion.

    When I saw success for lumbar fusions was only around 75-85% (can't recall the number) and that success included "somewhat better", "better", "Signficantly better"...I didn't want to risk it for just somewhat better when I could get that same effect from microD.

    Anyhow...just want to give you some food for thought to help you formulate questions.

    You are already off to a good start with your initial post.
  • I had this procedure done 6 years ago on S1-L5. Unfortunately it failed (but only because another piece of my disc evidently slipped into the same space that the original fragment was removed from), so I had it done again one month later.

    From then on, I tried all conservative treatments, for example: I tried different pain meds, numerous facet joint injections, epidurals, radio frequency ablation, TENs, physiotherapy, pain management, I bought MBT shoes, swimming, joined a gym etc. etc. The upshot was that nothing really gave me much pain relief so, last year, I had a 2 level fusion.

    Having said all this - I know of people who have had microdiscectomies and in the same amount of time as me, have NOT needed any further treatment. So it obviously DOES work for many people.

    You need to make sure you follow any restrictions your surgeon gives you (such as being careful when bending, lifting or twisting - it's so important). Have 100 per cent faith in your surgeon and, if not, obtain a second/third opinion if you are not sure. Be pro-active in helping yourself to improve your core strength by doing exercises that will build up the muscles that surround your back.

    Unless it's a medical necessity, I wouldn't advise anyone to have a fusion before trying all the other options first, because it might be that something far less invasive will work first time.

    And as others have said, if ever you do need further surgery in the future, new technology by then may hopefully give you more options and therefore a better outcome.
    SUE
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • Both of mine were successful. They were endoscopic.
    However, I know I have ticking time bombs for lumbar discs.

    When I herniated a disc the first time, Pro Disc and Maverick ADRs were the latest thing. Here it is 4 years later, and both the Pro Disc and Maverick are obsolete.

    At this point, I am symptom-free, but if something happens, I now have the option of a newer, better technology in the Spinal Kinetics M6.

    Like you, I was once out of options and had to get the surgery; I was freaked out and scared. In my research, I ran the gamut from "homeopathic fragrances to relieve back pain" to massive 360* fusions.
    Lucky for me, I found a fantastic surgeon with a fantastic minimally invasive technique. Today, I am pain-free and very happy.

    Every case is different and your mileage may vary.
    -----------------------------
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Most that i know have had great results with just the partial removal of the disc. Most are back to work and i think them knowing they can face fusion if they reherniate it makes them more aware to not over do it and do proper core excercises to prevent future surgery. With all the right factors i think a lot of them avoid further surgery. Of course it dont work for every patient. Good luck
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • My husband had a discectomy 21 years ago and is still doing well. If he overdoes it or drives long distances his toes start to go numb and he may get pain down his leg. That's when he backs off and concentrates on his exercises.

    Best of luck.

    KarenD
    KarenD
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
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