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microdiscectomy not sure if its for me

busdriverdavidbbusdriverdavid Posts: 12
edited 06/11/2012 - 8:54 AM in Back Surgery and Neck Surgery
47 year old male, I have a large disc bulge L5 S1. Its been 8 weeks and have had MRI ,PT and 2 nerousurgery consults. Symptoms have gone pretty much unchanged although have a good day here and there. Numbness and weakness left leg from hip to toe. Sitting and laying OK as long as not too long. Standing and walking very difficult and have to use walker or cane, even assisted standing and walking duration is only 10 min before pain forces me back sitting. Seeing very very small improvements (possibly pain Med related), which gives me hope of a recovery without surgery, even though my primary care and both nerousurgines are telling my that with size of bulge and nerve root being crushed surgery is highly recommended microdiscectomy.
Looking for help deciding


  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Bravo on having the two Neurosurgical consults! ...
    My next stop would be a Orthopedic Surgeon who specialises in spinal problems.

    I am a firm believer that we have bone problems that cause nerve issues, not the other way around ..... therefore for me it only make sense to have an ortho fix the boney problems to release the nerve entrapement issues.

    My first surgery was performed by a Neurosurgeon ... 1.5 years later I required an extensive revision by an ortho to clean up the problems not addressed by the neurosurgeon.

    Thats my story and Im sticking to it! .... I will NEVER have surgery by a neurosurgeon again .... unless its brain surgery.

    Best outcomes for you sir,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • The first apt. I had was was with neurosurgion, the second and one doing surgery is an Ortho who specialize in the spine. Know what you mean about neruosurgion. Here is how my apt went with him, I suffered a work related injury and a prestigise Hospital was chosen for the possibility of nerosurgery. Apt was made and new patient packet was sent to my home. Information packet arrived days later first thing I notice was the dry blood on the envelope, now I'm sure this blood could have come from several sources , mailman, sorter, but since I have never received blood on my mail before and this mail came from medical facility? I arrived for my apt. 2 hrs ahead. After checking in with nerosurgery and giving the DVD of my MRI to the staff, I waited for my name to be called. While waiting I hear staff telling the very few patients that they had 2 cancellations and where running ahead of schedule yet 15 min. past my apt. time my name has not been called and am only one left in waiting room, including staff. 30 min. pass and only staff I see are ones carrying food trays from caffiteria quickly into back, one staff member in such a hurry drops her tray on waiting room floor. I only wish that any of your staff was as concerned about me waiting as they where putting food in there mouth. At this point I'm in a great deal of pain from the days travel, 35 min. past my apt. time I am asking anyone who walks by about my apt. they nod but keep walking and never see them again. 55 min, and staff person comes out and I ask what is taking so long and she said they thought I had already been seen? They took me back and was seen by Dr.P.A. , he explains that the DVD of my MRI was blank and that nothing more could be done. I would have to make a new apt. get a new DVD. I contacted by phone and asked if any other way they could get info to Swedish and why disk wasn't checked before giving it to me, UGH radialogy simply reply, " it happens". P.A. although ready to send me on my way that nothing more could be done without this cruital MRI scans wants my to see Dr. and soon joined by Dr, and very quickly he feel surgery is what is needed quicker the better. I ask about injections or the need for MRI and told he saw written report and need to proceed to Xray for potential for an even bigger surgery that may be needed. At this point I'm feeling very overwhelmed, rushed and given all the mistakes, unwilling to have spin surgery ASAP as Dr. Wanted. I have secured a second opinion, so that I can resolve my bulging disc issue L5/S1 as quickly and more importantly as safely as possible.
  • Even if the disk was blank there should of been a mri report that was sent to them even before the appointment. How the hell can they make a blank disk to send with ya to the dr. I am not sure if i agree about ortho is beter then neuro. When its the nerves thats affected from the disc i feel the neuro is beter with nerve issue and protecting the other nerves during surgery. Ortho mainly comes in to play if fusion is needed to fuse the bone. And even during fusion a neuro should be in there along with the the ortho to have safer surgery. I know i had both in the operating room during my fusion and also during my artificial disc replacement.

    Sadly even having a neuro along with ortho did not prevent me geting nerve damage during my 1 st surgery. I would not let them rush me in to surgery if i was you but if the buldge is realy that bad, a partial removal of the disc is not so bad. Most people seem to do prety good with just the partial removal of the disc recovering. Sadly many have issues after fusion because so much stress it puts on the rest of the spine creating many other issues down the road. Good luck
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    What are you doing up so early .... Alex and I can agree to disagree !!! And still remain Friends !!! Right !???

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • i have suffered for 15 years with back pain due to having an OPEN discectomy that was done by a consultant ..not up to the job ..so i then need revision surgey 10 year later and since that i have been in hell with back ache and not being able to sleep and i am now waiting for ALIF fusion .i am registered disabled and life is hard .please think long and very hard before you have ANY surgey .brenda makes some good points .so think on and make sure that you dont make any mistakes .surgey is not always the answer take care

    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
  • Have you had an EMG/nerve test yet? I would be concerned about the weakness and numbness in your legs and your Primary Dr. can order this test. I would also ask the Surgeon not just the PA if you wait for surgery is there a possibility or nerve damage waiting for surgery.

    I have not had surgery from a L5-S1 herniated disc and annular tear that is now healed but leaving Degenerative discs causing pain and sciatica in it's place. After not being able to walk far without a cane and resting and pain and numb foot and leg for over 3 years I don't know if I may have done surgery if offered but would like a second opinion for surgery and need to know if sciatica and nerve issues would be permanent waiting.

    Usually they do injections in your spine an epidural to see if that gives you some relief. Best wishes for your decision. 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
  • I know that its only been 8 weeks since my injury but condition is not improving and can not go through life like this so I am being very aggressive with my treatments. Microdiscectomy is less invasive and fear that the longer this nerve root is compressed the longer it will take to recover if ever.
    Take good care,
  • Hey there,

    First off, both Orthopedic Spine surgeon and Neurosurgeon are qualified to work on your back. Just look for fellow-ship trained. And, for the record, neurosurgeon's actually study longer. They cover what the Ortho-spine doctor does and then some. Picking one over the other is a personal choice. I had my first MD done by an orthospine but when it failed, I decided since I had scar tissue around the nerve, I was better off with a neurosurgeon who would take extra care on the re-do. Unlike Brenda, I could easily say I would never have a back surgery by an orthospine doctor again. So at the end of the day, you need to make sure you are confident with the surgeon. I know good ortho's and good neuro's. I also know bad ones of each. And bad is 'my opinion'. Why? Because all face medical decisions differently. I love my neurosurgeon and the 2nd surgery was far more successful than the first, recovery was easier, and his overall approach was better.

    That being said, as long as you have a couple of opinions from doctors that do not work for the same practice, you can have some confidence that they aren't just 'agreeing' with each other b/c the work together.

    The decision on back surgery is personal and 100% up to you.

    A few things I would ask your doctor is:
    - what if I do nothing? Can I try ESI or some other sort of injection? What else can I try? What would you recommend if this were your spouse or child?
    - What is I opt for this surgery and it fails? Then what? If he said, let's worry about that when we face it...I would ask again. What happens, though if it fails? What if I feel worse 2 weeks later? 6 weeks later or 2 year later? It's important. My first doctor said the odds of it failing were so low and in my case, the surgery would give me significant relief. So much so that at week 6 he was still saying it even though I was on more pain meds than before surgery. I practically had to beg him for another MRI. He had me try prednisone for 10 days before he would agree to the MRI.

    So, make sure the doctor you are seeing is treating you for the long haul. Why? Because lower back issues don't just go away.

    I am better but by no means 100%. Like other's said...just do your homework. When you exhaust all conservative options and still see your world closing in on your, and when you find a surgeon that makes sure you understand the risks and how s/he'll respond to them....you will know when surgery is the right decision.

    Good luck
  • busdriverdavid said:
    even though my primary care and both nerousurgines are telling my that with
    size of bulge and nerve root being crushed
    See the part in bold. That is your key issue. The disc is one thing and is part of the root cause. The nerve being crushed is the beginning of permanent damage. This is why you are being told to surgery is highly recommended. This would be my major concern and fear. If the disc is shot it is shot. If it's repairable then great let them repair it. Avoid nerve damage as much as you can.

    As for the neurosurgeon vs orthopedic surgeon. That's an old debate that had some value 10 years ago. Back surgeries are so common these days both surgeons are doing many of them. To say neuros are only for nerves and orthos are only for bones is meaningless today. Get 2 surgeons opinions like you did. If they both concur then decide which one you want to have cutting into you and supporting you after the surgery.

    \good luck
  • There are different versions of microdiscectomies. Some involve more cutting and even sawing than others. Can you describe what the surgeon proposes to do as far as cutting?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
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