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So, can I consider my second surgery a failure?

TneitzelTTneitzel Posts: 39
edited 06/11/2012 - 8:57 AM in Back Surgery and Neck Surgery
OK. So I have posted on here before, I am 22 years old and this past April I had a Microdisckecotmy at the L5 S1 level under false pretense that it would make me feel better and that I would be able to go back to work in six weeks? A month and a day later I was back on the same surgeons table being cut open a second time due to disc fragments on the right side and a bone spur? on the left. That was May 21. It has been almost four and a half months. I do feel a little better but not good by any means. In August I found out that I have a small 3mm re current disc herniation and my L5 S1 disc is now degenerative. I do active core/trunk strengthening every day and PT once or twice a week. So the Question I have to ask which I am in dispute with my parents about is - Was my second surgery a failure? I do believe it was, If it wasn't then I wouldn't have a re current disc herniation and a degenerative disc. Basically the only thing the surgery fixed was the CONSTANT right/hip pain. For that I had to compromise for constant back lumbar pain, 1-4 hours a day of mid thoracic pain, and at least one flair up of leg pain a day. I refuse to give the surgeon the benefit of the doubt and say that he did a successful surgery, if he had, I would feel better and be off heavy narcotics. What do you guys think?


  • My 2-cents worth.
    Don't put your surgery in pass or fail bucket.
    The surgery is quite complex.

    I know this isn't what you wanted to hear.

    My situation is similar to yours (except I was 40).
    I needed the first surgery - large herniation from a ruptured disc (yes, ruptured...the instant it happened, I never felt such pain). I lost feeling in my left buttocks, groin, back thigh, and foot to outer toe. I also lost significant strength, ankle reflex and had constant leg pain.

    First surgery - FAIL!
    It took a heck of a time convincing my surgeon of this. I think the word "fail" makes it seem like the surgeon did a lousy job. Not necessarily true.

    My surgeon was good. There are a few reasons the surgery fails
    1 - The issue is micro surgeries do leave the surgeon with obstructed view in some ways. So one of the risks is that they can miss a piece.
    2 - Another reason the surgery fails is because another piece just breaks free before the body heals.
    3 - the disc is inherently bad. So no matter what, it will just continue to have pieces break free.

    Now, my surgeon was good but when I knew things weren't as "gratifying" as he kept implying they would be, I grew frustrated that he wouldn't admit something was still wrong. But by the 10-week post op (had a 6-week post op where we tried a prednisone), he sent me for the MRI.

    So, on to 2nd surgery...new surgeon. Oustanding surgeon.

    I had the surgery and like you, it took about 4.5 months to be able to say I was getting relief. I almost regretted the 2nd surgery and wished I had gone for a fusion.

    But, like you, I finally realized I did get some relief. I was reminded that MicroD's are good at relieving leg pain and not necessarily back pain.

    I'm over a year out of surgery 2.
    It took 6 months for me to get strength back in my leg and lose the limp. I still have all the numbness and back pain but it's manageable.

    So, what do I think?
    1 - microdiscectomies are big surgery despite their names. There is nothing micro about them other than the incision.
    2 - Microdiscectomies work but I think the statistics of success are much lower than 90%. I just can't prove it.
    3 - Lumbar back issues are tough. You cannot compare them to cervical issues. The lower back carries a good portion of the bodies load
    4 - if you aren't happy with your surgeon, move on. I moved on after the 1st surgery. The surgeon was good but I felt he didn't listen to me. My new surgeon is great...he listens, he told me the plan to treat my back, not just for the surgery at hand but if the surgery didn't work. He always tells me my options to keep my meds to a minimum.
    5 - Have you seen a pain management doctor? There are meds that can help with the pain that may not be as addictive as others
    6 - Did it fail? Maybe. If they didn't operate, would it be better? Not sure. Was it the surgeon's fault? Probably not. Do you have other options? I believe yes...there are so many specialists it's just a matter of finding one you connect with that isn't so quick to want to put you under the knife again.

    Gosh, I wish I had more for you. I know your frustration but I'm almost twice your age. I hate feeling like I'm 70 at my age. I know it's got to be doubly frustrating in your 20's.

    I know others will offer some input.
  • Tneitzel said:
    Was my second surgery a failure? I do believe it was, If it wasn't then I wouldn't have a re current disc herniation and a degenerative disc.
    Did you do something to make it reherniate again?
    Even if you did, it's not the surgery's fault.

    Degeneration is not surgery's fault. That can happen to anyone anywhere anytime.

    It sounds like you are cruisin' for a fusin'.

    *my 2 microdiscectomies worked great.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • paul, I couldnt agree with you less. No I did not fall and that did not cause the re herniation. Your one of the lucky few... Also for the record my surgeon actually told me that yes, the disc degeneration was from the disc being cut into twice. I do not appreciate your comment what so ever, and the "crusin for a fusin" joke.....come on man are you 15? If your going to say stuff like that then get off the site! This site is meant for people to encourage others and give helpful advice having been thru similar situations, not tell them that they are facing the most invasive, horrible spine surgery there is. In my case, having a fusion this young would be the worst possible option because I would be looking at one every 4-5 years from then on. Fusion should be the last resort, once you have exhausted every other option, In my case I will do EVERYTHING in my power to get better before I get fused. However thanks Dnice I appreciate your input and not making jokes like some immature people... yes I did see another surgeon and he recommended a fusion and gave me a 60% success rate... and yes, after the first surgery I had disc fragments and a bone spur, I was under the impression that it would not get better without another surgery and at that point I was not ready for a "fusin". Yes I do see a pain management doctor, it helps a bit I am currently on Nurontin 600mg, 50mcg Fentanyl patch, and 4-6 10 mg hydrocodone a day. At this point I will stick with the core strengthening and give it some more time, In a year if I do not feel better I will most likely do and ADR before a "fusin". Thanks for your helpful comment DNice.
  • Or, you could man up a bit and have thicker skin.
    Some dude on the internet got you flustered? C'mon, man.
    I think we're all adults here and we can speak bluntly.

    I have been on this site for about 5 years including the old site, giving encouragement and words of advice.
    I've seen TONS of members come and go.

    Look, I am sympathetic to your case and not out to cause you or anyone any grief. If you saw an MRI of my lumbar discs, you would see that my lumbar discs are trash, and probably worse than yours.

    I know fusions are serious business. I probably will end up needing several. L1 thru S1! I am not looking forward to having my entire lumbar spine fused.

    But you have to know, that your discs are not going to be the same anymore but you have to go on with life as best and as happy as you can.

    You will get better, and you will be pain-free, but you will always have to be conscious about protecting your discs from now on. Ease up a bit on strenuous activities that hammer those discs. You still have an entire lifetime ahead of you. Protect and preserve them as much as you can. I'm not saying baby them and live in a bubble, but just be easier on them.

    A word about ADRs. Some wonderful advancements have been made in the last 2 years. To be a candidate, your facet joints have to be good. When the disc is degenerative, the facets wear faster. I was > < this close to going to Germany to get some installed, but my facets had deteriorated too much thanx to the bad pathology of the my discs.

    I wish I could get something like the M6. Have you seen those? They are neat! They seem to be the latest and greatest right now.
    But hopefully, you won't need it or anything!
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Paul said:
    Did you do something to make it reherniate again?
    Even if you did, it's not the surgery's fault.

    Degeneration is not surgery's fault. That can happen to anyone anywhere anytime.

    It sounds like you are cruisin' for a fusin'.
    Tossing Paul's quote here... I don't see what the heck got you so upset? Your symptoms, "reherniation" is a valid comment/question - a good surgeon would think that too! DDD is a function of age of said disk, and degeneration; again, not a surgical cause. His comment of "crusin' for a fusin' (to me) is just another member saying that sadly, your next intervention may be a fusion.

    Paul has been on here a looonnnnggg time, and I have yet to see him joke at someone on a serious issue. His post was not a slap. Sorry Paul, had to be said... :) Hummm....

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • alright paul, just got a little offended with your little joke or whatever you want to call it because the way I like to see it I'm not "crusin for a fusin" I want to think positive and that the core/trunk strengthening will work and I wont have to get a fusion... as for being thin skinned, what ever I can take BS but what you said didnt sit right with me. I like to think that I'm not going to have to get a fusion at this point. That sucks about your discs man, from what ive gathered from my mri's is that just my L5 S1 disc is garbage. I have heard from multiple surgeons that if I were to have a fusion being this young, it would not be good and I would be looking at one every 4-5 years...Doesnt sound like something I want to do. It is proven that fusions work better on middle ages=d adults (in their 40's) Im glad that your Micro D's worked, I wish mine did. I guess I just took your comment wrong like you were trying to make it seem like I did something wrong and ha ha mine worked and yours didn't and that I am bound for a fusion, sorry. I now know you didnt mean that. Your second comment was much more helpful Appreciate it. I dont wanna get off on the wrong foot with anyone on here I think this site is a great idea and has been quite helpful for me in my situation. It just sucks man...Being 22 years old, used to be very active, worked construction, biked, ran, fished ALL the time, played football and soccer. Now I cannot do any of those things my level of activity literally went from an 8 or 9 to a 2 or 3. Im sure you know how it feels too. Thanks for responding I don't think your a jerk. Good luck
  • Ok cool, thanx and sorry about the dust up earlier.

    Have you looked into getting a discogram or some more testing?
    I feel like there is a cause for the pain and it just needs to be pinpointed so that it can be addressed. There is this newer imaging technology called neurography. It can provide a very detailed image of nerves that is unmatched by any MRI or CT scanner no matter what Tesla it is.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • My doctor said not to get a discogram at this point due to the shredding and cutting that has been done to the disc. He said once they inject the dye and needle, the pain could be horrendous if not worst. I am just in way too much pain for that to happen right now. He said in a year or so it would be a safe time to get one, once everything has (hopefully) healed. Thanks for your input and sorry for getting off on the wrong foot, It was just a misunderstanding. Peace
  • I have heard that Discograms (or maybe it was mylograms) are controversial for the reasons you state.
  • At the age of 12, I was told if I ever gained a lot of weight I would have severe back problems. At 32, got pregnant and of course gained 30 lbs from the pregnancy. In my 7th month of pregnancy got terrible sciatic pain and endured it for 2 1/2 years. At age 34 I had laminectomy and fusions on L4-L-5S-1, and guess what? After a few rough months of recovery was pain free for 24 years. A little over a year ago, started having pain again and went to 6 different neuroscience and ortho surgeons and in July had my 2nd back surgery. Had ALIF and posterior rods, screws and bolts. At 8 weeks did not need any pain meds and now I am 9 weeks after surgery and am feeling so good and know that I will be 100% after fully fused. I truly believe that getting 24 years of success after major 2 level fusion is pretty terrific. Knee and hip replacements are typically good for about 15 years. If I can get another good 20-25 years from this surgery, I will consider myself very lucky. Don't be freaked out if you do need more extensive surgery than anticipated. I am thrilled I could have the surgery because I already can see that I am getting my life back and I plan on living it to the fullest. I like to work ( not so hard) and I like to play hard! So, do your research, interview lots of doctors and go with your gut feeling. Sometimes the easier procedure is not always the best long term. I would rather have a couple of crappymonths post-op and feel great for a long time rather than an easier procedure where I would be looking at repeat surgeries every 5 years, but, that's just my opinion. Good luck with whatevr you decide.
  • 60% is on the lower side, when I went through the lit before my op (fusion and adr) it was more like 70% for the fusion.

    You're right to be doing everything to avoid it.

    The things is... you have pain. i wouldn't really be taking anyones opinion on that except your own. If you're here after it's been however many months or years or whatever with severe back pain, that's when you start looking at the fusion or adr cos you can't work etc.

    I was 29 when I had mine done. It's a bear of an operation to recover from but it's still an option.

    As for my back mri looks worse than yours... please. If you are pain free or pain controlled it doesn't matter what it looks like. Discogenic pain cannot be imaged properly, they're not even sure what causes it. It's amazing how poorly people seem to understand that the disease is pain, and you're either in it or you're not. Pain around the region of disability is indication.

    Good luck mate, you've got the right attitude, wanting to avoid the bloody thing.
  • rascal, that really sucks Im sorry about that but it is hopeful news for me if worst case scenario I do have to get fusion that there is a good chance I will be pain free and can get my life back. Hooch, thanks for the kind words.
  • There are no guarantees. MidcroDs are an option that are always worth trying, at least once, sometimes twice. The gist of it is if you take a little material and reduce the pressure. It could heal up. 2nd try is usually to correct something missed or a re-herniation.

    Paul's questions were fair. You could have a simple fall or bad twist shortly after surgery and poof, re-herniate. Some it just doesn't take. I wouldn't get hung up arguing with your parents on the "failure" or "blame". It's really pointless.

    Now what has value here is you get your parents to understand that you tried twice with a MIS solution. It didn't take. No need to argue further or label it. It didn't work, period.

    So what do you do now. If it were me, regardless of age. After 2 MicroDs on the same level without success. I'd seriously consider the fusion. Either that or you need do PM and try and keep it under control with drugs. If you can wait it out longer then a better artificial disc solution maybe coming. Most of the ADR solutions today have poor failure rates. Yeah I said fail.

    Right now there are some implants that are not permanent, but will give stability and proper disc height. That'll help your spine sit correctly and possibly reduce nerve pain. Find a surgeon who has several options. At your age I would want some solution that is more flexible than a conventional fusion.

    Instead of arguing with your parents. Try getting them more involved. Get you and them educated about spinal issues so you can have some discussions. Get them behind you.
  • Z06, I think you misunderstood what I was talking about with my folks. Its not really like we are arguing, more just talking about it, and your right, It does not matter at this point. All that matters is that it is done and has already happened, and now I have to deal with consequences. I've definatley accepted it more since I made this post. Indeed Micro D's are usually the first thing you try surgically for a herniated disc but Ive heard from more than a few people that they are not as easy as they sound. In my case the only thing the surgery did fix was my CONSTANT agonizing crippling right leg/hip pain. I don't doubt that micro d's work to fix leg pain, but in most cases they leave the patient with more back problems than they had before like in my case. As for the disc degeneration, the surgeon and my PM doctor both said indeed that it was caused by the surgery when he cut into the disc twice. I honestly don't even want to say that fusion is my next option, My next option is core strengthening, PT, and time. Obviously surgeries don't work for me so I have more faith in conservative methods now. As for those implant/spacer things, What are they called?? Is there a certain operation with a name where they do them? Any info on those would be much appreciated. Also I have had my Fentanyl patch does increased and this has help quite a bit as far as waking up so sore in the morning and it had helped with some breakthru pain so I have found myself being able to take fewer oxycodones or vicodin.
  • Another thing to add to the equation... as I was in those shoes thanks to crashing a helicopter a month before I turned 22... "Young and springy".. Yeah, I know, not medical terms, but I think you know where I am going here.

    When I crashed, I was told by the FAA and the NTSB (not that they are medical experts mind you...but have see tons of aviation accidents) I shouldn't have made it from that crash, never mind walked away!!! Okay...I sprained and strained the hell out of my spine from the base of my skull to my tail bone. Except for one level, I am now losing them almost 30 years later.

    I would vote for trying to see if you can still work with conservative treatments (manipulations, massage, exercise, shots etc.) before looking down "fusion street"...

    Does getting a fusion mean more surgery? Not necessarily. A friend of mine was fused almost 20 years ago, and is still doing great, me on the other hand, I stink..heheh my spine didn't read the books! Listen to your body and what you "feel" internally. You will know when certain routes need to be taken. :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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