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23 and Getting a Discectomy?!

vitale232vvitale232 Posts: 43
edited 06/11/2012 - 8:54 AM in Back Surgery and Neck Surgery
Hey guys! First off this is an amazing site with a wealth of information, so thanks to all of the contributors!

I might as well go through my story to give folks a good idea of what's going on.

As stated in the title, I'm only 23 years old. In hind sight, I've had bouts of lower back pain on and off for maybe five years. I've always been somewhat "reckless" in dealing with pain and generally continued about my normal way of life letting things slowly resolve themselves. I'm a very active individual and love participating in things like mountain biking, multi-day backpacking trips, swimming, etc.

Upon graduating college I began working conservation jobs. I started at the Grand Canyon National Park in May of 2010 working with the vegetation program. I was essentially a landscaper. Right around that time I started feeling a nagging pain in my lower back that was pretty persistent. It felt like it could be a nerve thing, but it never started to radiate out of my lower back. It was never at an unmanagable level as I was able to fully participate in the activities I love. I continued working there until December.

In February I started working on the Pacific Crest Trail. This position was more similar to construction work with lots of heavy rock work and use of hand tools all day 10 days at a time.

Somewhere towards the end of February my pain started to migrate away from the spine towards my hip. This should have been a sign, but I continued working hoping things would resolve as they always had. In early March I found myself with debilitating radiculopathy down my left leg.

I started seeking chiropractic care along with Physical Therapy. Once we were able to get the muscles to calm down, the chiropractor realized it was potentially a disc issue and sent me for an MRI. The MRI revealed an 8mm protrusion on L4-L5 and possible bilateral pars defects of L5. The pars defects were confirmed by a CT scan 2 weeks ago.

Since the injury I've been religiously doing PT exercies. I'm in very good shape and my core is the strongest it's ever been.

I've had 2 cortisone shots. One was a standard interlaminar ESI and three weeks later I had a Transforaminal injection on L4-L5. Both provided about 10% relief for 1 day.

I'm 3.5 months out and have no significant progress. I'm completely frustrated with the injury and feel like I'm missing out on my "glory years". I just want the pain to be at a more manageable level so I can start living my life as fully as I was. With all of the positive literature out there for microdiscectomies, I've made the decision to go forth and get the procedure done. I've found a neurosurgeon with whom I am extremely comfortable. He's very down to earth and spent 50 minutes going over my MRI with me and another 50 minutes going over my CT scan.

When I called to schedule the surgery yesterday I referred to it as a microdiscectomy. The secretary said that he does not perform microdiscectomies. This has me somewhat concerned. Am I looking at more of the traditional "open discectomy"? What does this do to the healing process? From what I understand there would be more muscle damage. All of the research that has made me comfortable with this procedure was for a microdiscectomy.

The procedure was described as ~1.5 inch incision where my doctor will be using glasses similar to a jewelers glasses. He said I'll have a post op appointment 2 weeks out and start PT. About 6-8 weeks out we'll meet again and "see where we stand". Maybe I'm being overly optimistic, but I was thinking he meant potentially be cleared or potentially continue PT.

If anyone out there can answer my questions or offer words of advice/encouragement I would surely appreciate it. I'll be sure to chronicle my recovery since I feel I'm a more unusual case due to my age.

Thanks for reading!


  • That sure sounds like an "open" version of "something". They can access and see the disc under "direct" vision, which means with his own eyes.

    Damage will be a window cut into the lamina in the vertebrate (which will fill with detrimental scar tissue), cut ligaments and cut muscles.

    Maybe he needs to do it like that to address the pars issue?

    The damaged disc leaks irritating chemicals to the surrounding nerves. This process is the body's way of tensing the surround muscles in an effort to immobilize the local affected area.

    It's just my opinion, but I feel like a damaged disc can be in a person with the strongest core in the world, but it's still going to be a damaged disc.

    How many spine surgeons did you consult with? You need several professional opinions. Don't go into surgery if you feel rushed or if you have any doubts! This is serious business, this spine surgery stuff.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • I would definitely seek a few opinions....maybe an orthopaedic surgeon and a neurosurgeon as well (im partial to neuros, but to each his/her own). And yes, don't be pressured, its your body. I was 27 at the onset of my problems---saga continues 13 years later!

    Good luck,
  • Thanks for the replies.

    The more I read, the harder it is to decide the difference between a microdiscectomy and a discectomy. The procedure described by my surgeon seems to be similar to a microdiscectomy as described on spine-health.com

    As far as other opinions go, I've had multiple practitioners tell me a discectomy was a good route. The chiropractor that sent me for the original MRI said that I should talk to a surgeon after seeing my MRI report. He no longer wanted to treat me.

    I visited with an orthopedic surgeon. He works in the same practice as my current neurosurgeon and basically acts as the "gate-keeper" for the practice. He insisted that if I were his son he'd send me in for the surgery. When asked about ESI's he said that all I had to lose was time, but in all likelihood I'd be back in their office 2 weeks later.

    I scheduled an appointment with the neurosurgeon a week later. He spent 50 minutes going over the MRI and talking with me. He basically said that my two surgical options would be either a fusion or a microdiscectomy. The fusion would address the disc issue I have at L5-S1 (only slightly symptomatic), the L4-L5 herniation, and the pars defects. He then went on to say that he would highly recommend trying the ESI's, and I was lucky enough to get in with a pain management clinic that afternoon.

    About a week later I was able to declare that the shot did not help. The neuro sent me for a CT scan and I came in to see the results. He spent another hour with me and offered the same surgical results. I quickly ruled out the fusion as it's a much more dramatic procedure than I need at this stage. He concurred. He then spent the next 30 minutes presenting peer reviewed studies, personal experiences, and general expertise. He left the decision completely in the hands of my family, but had an underlying tone suggesting I should try another ESI.

    So, I made an appointment with the pain management clinic. When talking with the doctor, he suggested that if this shot failed as well surgery was a good next step. He also gave a tremendous vote of confidence for the surgeon I am seeing.

    A week later it was apparent the shot wasn't helping. I called to schedule the surgery and this is where my confusion set in. The secretary was a bit of a grouch and got nasty with me when I said microdiscectomy. Apparently my doctor hasn't been doing that procedure for the past 11 years unless he started within the last week.

    I'm really comfortable with my doctor. He makes me completely at ease and really knows his stuff. Perhaps I'm just experiencing the normal second guessing that comes with a decision like this? When I called the procedure a microdiscectomy in front of the doctor he did not correct me. Man I'm confused.
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