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Scheduled for Surgery

hartlbbhhartlbb Posts: 28
I am scheduled for a microdisectomy on 1/30. I have done practically everything over the last 14 months to rid my issue. I have a diagnosed extrusion in L5/S1. I also have bulges in L4/L5 and a very small bugle in L3/L4.

Here is my dilemma. My chiro, PT, Physiatrist, 2 neurosurgeons, and one orthopedic surgeon all agree that surgery is the next step. I finally got the nerve to proceed, but I am waining a bit. The last 3 times I got epidural injections (L5/S1) it did practically nothing. But when I did a high dose (50 mg) of prednisone my sciatica symptoms did get better. It has since gone back to the way it was prior to the prednisone.

The issue is that if the epidurals did not work, and they plan to remove the extrusion where they also performed the epidurals, will it do anything? If the prednisone did help (for a short period), are there other places that the MRI might not be seeing that is causing the pain?

I am so confused and not completely sure what to do at this point!



  • also - my sciatica wakes me up at night. Why would laying down make it so much worse?
  • If laying down makes it so much worse ..., and all your doctors suggest surgery then I would think 99% it is the correct next step.
    I wish you a successful surgery.
  • I agree... It seems as though you have tried all conservative methods, now its time for surgery. Good luck and let us know how it goes.

    Especially because you have a disc extrusion. Bulging discs can be healed but once that disc shreds apart and goes into the nerve root and around the spinal cord, there is no healing. That's what happened to my neck. I had 2 large pieces that migrated (didn't show up in MRI either).
    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
  • Thanks to both of you for replying. I guess the one thing I keep going back to is that why would the prednisone help when the epidural (right where the extrusion is) did not.
  • I wish you a speedy recovery,I can say I am pleased with my L5/S1 surgery I had recently,1st couple of weeks are not good but it gets better very quickly.My sciatica also kept me awake at night but has improved since surgery.

    Go steady on the morphine after op it can make you sick and makes people constipated,easier said than done I know but given the chance again I would rather have a bit more pain short term than be sick for days like I was.

    Not sure what surgery you are having but I was in hospital 6 days mine was for spondlolisthesis and fusion.

    I hope you have some help when you come home you will need it for a few weeks at least.

    Good luck

  • Epidurals are hit and miss as to whether they will work for someone or not. Since they are targeted to a specific area, if there's inflammation causing pain just slightly to the side of that, it won't seem effective. Were yours done under fluoroscopy? Oral steroids of course will target the entire body, so it's easy to see how one could work when the other didn't. There's so much that a doc can't see on an MRI. However once they go in to take a look, it's not uncommon to find other issues that didn't show up on your MRI or via fluoroscope.

    Surgery is a personal choice. We can't take steroids forever, so that's not a real viable fix. Have you talked to the surgeon and expressed your questions and concerns?

    Best wishes,

  • I am going under the knife for an L5/S1 discectomy and potential L4/L5 laminectomy on 1/31. I had an ESI two months ago, and it gave me a lot of relief from near crippling sciatica. But I still have tingling in that leg, and the MRI clearly shows a large (16mm) herniation.

    Epidurals don't always work. I have had ones that worked and ones that didn't. But if you are having the symptoms, and you have the MRI showing clear structural problems that match your symptoms, be confident that surgery is probably your best option. That is what I am telling myself - I want to be better and get my life back, and that is worth the short term pain of recovery.

    Good luck!
  • I am new to this forum. I'm up in the middle of the night right now because of my sciatica. I have various things going on in my lumbar spine (some stenois from normal aging, osteoarthritis..probably from aging too...*L*...but it's the S1 nerve root inpingement that is the issue. Hartibb...I am wondering if you are having the surgery and if so I hope it goes well for you. I may be headed for the same thing.

    My sciatica started 6 years ago. My first ESI was successful for a whole year. Then I leaned over to pick up a box when I was moving, and found myself needing another. I had two injections 4 weeks apart. Again...they worked like a miracle for me....for 4 YEARS!!

    In early Dec. however, I put a heavy daypack on my back..helping someone else carry gear. Two days later I was in horrific sciatic pain. I've had two injections and this time they are not working as well. The worst part of the day is at night. Even if I am pain free from medication when I go to bed, I wake up 2 1/2 to 3 hrs. later in pain. I am sitting a little better but the lack of sleep is so difficult. I'm a consultant and have to drive a lot for my work, which is also very difficult.

    Do the injections just stop working after they were once successful? Has anyone else had that experience? I'm trying to stay hopeful but I'm on Day 5 from the second injection and it has given a little relief....better during the day, but still on pain medication. My previous injections were so successful I simply didn't consider that these would not be. Can the injections just take longer to work? I expect to start PT soon as it helped before as well. I'm just not getting the relief I expected. Any others experiece this?

    I joined here to read the experiences of others as I too am fearful of surgery. Hartibb...if you went through with it, I so hope it works and I hope you post your experiences. It's so helpful to have others who understand what you are going through. Take care.
  • All - I went ahead and had the surgery on Monday. I am walking around just fine. My biggest worry is that I still have the sciatic paiin, but the surgeon has informed me that is perfectly normal with this procedure. The incision point is still very sensitive, and I am pretty sore. I am also extremely groggy, walking around in a bit of a fog at this point. I am most concerned about the sciatic pain, thoughts?
  • I really don't know much about the surgery. My understanding has always been that the purpose was to relieve the sciatic pain, so I do hope that this goes away with time for you. Did the surgeon mention anything about that? That relief from the sciatica might take time?

    That's exactly what I need relief from....sciatica.
  • He indicated that the nerve iflamation could be bad for a couple of weeks, that it was quite common. My biggest concern is that is hurting when I lay down, which is the exact same thing I had prior to the surgery.
  • to the other side. Sorry to hear that you are still having sciatica pain. The nerves can take some time to settle down after surgery.

    Depending how long your nerve was impinged and just the irritation of the discectomy itself cause the nerve to be angry.

    Hope that things settle down for you soon and that you have a great recovery
    >:D< Karen
    >:D< >:-D< : Karen
    L3-S1 herniation and bulges, stenosis, mod facet,ddd,impinged nerves,coccydinia
    discectomy/lami July 2011-unsuccessful
    adr L5-S1 Feb 2012
  • thanks, I look forward to it settling down. It was inflamed for quite some time (from Nov 2010 - Jan 2011), so I guess I should not expect it to be 180 degrees better already. He did indicate that the pressure on the nerve was worse than what was shown in the mri.

    The biggest concern I have is that what is flaring it up (laying in bed + sitting) are the exact ways it flared up before.
  • another update, I haven't taken any pain drugs (including ibruprofen) since Thursday night. My sciatica is pretty bad. I have a follow up for them to look @ my incision on tue, but I am getting the feeling that the surgery did not work, although I guess I am probably judging too early. I would expect for the symptoms not to flare up under the same circumstances (in the morning after sleeping). Uhg!
  • Sorry to hear you still have sciatic pain I too have pain after my surgery although mine has been relieved a little,I told my surgeon when I went for my review and he said to come in for a nerve root block,this I had and it went well for a few days then it started to return,I have not been to see him since as I want to see how I am in a week or so,he did say to me it could be a year or more for nerves to sort themselves out after being compressed so it looks like it's a waiting game.

    My sciatica was also worse when laying down and sitting including muscle spasms it doesn't make much sense.

    Do you get a cold leg like icy cold?my leg and foot feels like it is freezing.

    Hope yours gets better soon Des

  • Yes, I get that cold feeling, although it's my foot, not my whole leg. I am more worried that I have reherniated the disc, is there anyway to know other than mri?
  • I had a Laminectomy/discectomy on 11/10/11 the moment I woke up and walked my sciatic pain was all gone. I do however get very slight discomforts but maybe a 1 in the pain scale and it doesn't happen often.

    My friend had a MicroD and she said she thought she did the worst thing by having surgery since she had pain 4 wks after the procedure but after that she said it was much better.

    Sorry that it hasn't been better and hopefully it's just too early in the recovery. Best wishes to you!
  • I had a Laminectomy/discectomy on 11/10/11 the moment I woke up and walked my sciatic pain was all gone. I do however get very slight discomforts but maybe a 1 in the pain scale and it doesn't happen often.

    My friend had a MicroD and she said she thought she did the worst thing by having surgery since she had pain 4 wks after the procedure but after that she said it was much better.

    Sorry that it hasn't been better and hopefully it's just too early in the recovery. Best wishes to you!
  • thanks for the reply, so what you are telling me is that everyone is different, and it's too early to know. I appreciate the support and responses very much. I just wish I had some sort of improvement, if nothing else, it's worse right now :(
  • Hi hartibb It is early days so far for you after surgery although you still seem to be in a lot of pain,if it were me I would go back to my specialist and ask their advice,my surgery was different to you and helped a lot with my lower back pain,my nephew had the disc trimmed in his back and he was out running after 1 month,it could be more needs to be done for you and another MRI may confirm this.Or it's just a case of waiting for the nerves to calm down if they have been compressed like mine which affect my leg and foot.

    When you had the microdisectomy did they treat just one level ie L5/S1 or all levels you mentioned in your first post?it may be the other levels above L5 are causing you pain, Just a thought

    If only we all had the answers.

    Good luck.

  • All an update on my condition. It was officially two weeks yesterday since my surgery. The pain has calmed some, but is definitely a little worse still than when I went in for surgery. I saw my nuerosurgeon last week and he indicated that it would take 4-6 weeks for the nerve to calm down. As of right now the pain (especially in the morning) is pretty bad. I am hoping that in the next couple of weeks I start seeing relief, but if I had to grade the results of the surgery (right now) it would be an F.

    Des - it was only an L5/S1 micro. I have bulges at other levels, but no extrusions.

    To make things worse, my neck has been killing me the last few days. I think it's because I was propping my head up on my pillow while laying down and watching TV during my first couple of weeks of recovery. I am seeing my chiro today for a neck adjustment. On top of that I just got a cold, when it rains it pours!
  • Update, 3 weeks post surgery, no real relief. I have changed from ibprofun to naproxin and it really helps. My neck has been killing me also (sucks) but don't think that it is related. I have my first PT appt this Wed.

    I go back on 3/8 for a follow up with my neurosurgeon, hopefully I am seeing some relief by then. Has anyone felt that naproxin makes them a bit drowsy?
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