Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

What to Expect on 2nd Microdiscectomy

Three months ago I had my first one at L4/L5 to relieve sciatic type pain/numbness/tingliness down my left leg and into my foot. It was a success and the surgery wasn't that bad pain or recovery wise.

Two to three weeks into my PT, I began to experience pain in my right buttock and back of my right leg. We (myself, the physical therapist and surgeon) thought it might just be inflamation from doing the PT exercises and so we watched it. After 6 weeks of PT, it wasn't going away. I was prescribed oral steriods and they didn't have much of an effect. We did an MRI and it indicated new herniated discs at the L3/L4 and L4/L5 positions.

The surgeon suggested either more PT incorporating traction or another surgery. I commented that I thought PT caused the new herniations and that when I do my exercises, it makes the pain feel worse. He then suggested surgery. I'm opting for surgery again which may be a cavalier attitude toward it, but I don't have high hopes for PT since I did everything by the book with PT the first time and followed all directives and came out with new herniations.

So my question, the surgeon will be going through the old incision site and expanding it upward about two inches to get to the L3/L4 herniation and he will be removing the pulpus (not sure on the spelling but it is the interior jelly part) of both discs and leaving the anulous to support my back. I had questions about that if it would be enough to support my back and he said it would since I'm not overweight and fairly athletic and eat right. Should I expect this surgery to be about the same on the pain and recovery scale? Will going back into the same site be more painful? In general, will recovery time be about the same? I know everyone is different so there may not be a general consensus, but to hear others' experiences would be helpful.


  • I don't think they remove all of the nucleus material, only the extruded parts of it and some from the center to make some room.

    Have you had or are you planning to have a discogram?

    What kind of incision do you have now?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • He stated that it would be removed in its entirety and that there would be nothing left there to herniate in the future. I have not asked for a discogram and truthfully didn't know what one was until you mentioned it and looked it up. (I wonder if a neurosurgeon and an orthopaedist approach these things differently? I'm seeing a neurosurgeon that was highly recommended).
    I don't know if there are certain types of incisions, but I can describe it. It's about a 4 inch vertical incision in the small of my back at my waistline. It was closed with staples and I had a drain for a couple of days. It's nice and straight with no jagged edges. He said he would extend it up a couple of inches.
  • PaulPPaul Posts: 730
    edited 07/09/2012 - 3:23 PM
    Remove the disc in its entirety or remove JUST the pulposus?

    Hmmm... I've heard of removing the entire disc for the purpose of a fusion or an ADR and I've heard of removing just the herniated pulposus, but not surgery to specifically remove the pulposus in its entirety while leaving the annulus.

    I've heard of discs showing as normal on an MRI but were found to be "empty" when the surgeon went into them.

    I've also heard of nucleus replacements.

    I'd be interested to know what they say. I've always wanted to know if too much nucleus material can leave the disc.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • He said he would be removing the herniated pulposus and then cleaning out the rest of it. I then asked, "So there will be nothing in there?". He said yes and that because I am young, healthy, not-overweight and not prone to become overweight that the anulous is sufficient to support those vertebrae. He said if I did have weight issues, then we would be having a totally different coversation.

    I'm still wondering if I should expect more surgery pain or about the same.
  • Kwilson400KKwilson400 Posts: 42
    edited 07/15/2012 - 2:33 PM
    I had repeat discectomy/ lamenectomy. Keep us posted and good luck.
    June 2011 L5-S1 Lamenectomy/Discectomy
    Dec. 2011 Repeat L5-S1 Lamenectomy/Discectomy
    June 2012 New tear L5-S1 w/ Perm. Sciatic Nerve Damage
    Currently- restrictions (including no work duties) for a min. of 3 months to allow disc time to heal
  • They'll remove all the remaining jelly from the donut to prevent reherniating.
  • something about this worries me. i had 3 lumbar surgeries at l5-s1. microdisectomy with hemilaminectomy the first 2 times. then the fusion. now when i got to the point of the fusion, yes the disc was herniated for the 3rd time, but my main problem wasn't the sciatica like it had been, it was pure non stop low back pain. i was told it was because the disc had collapsed and i was basically bone on bone. now if your doc takes out everything inside the disc, isn't that what you would be heading toward?

    i do know my doc said its a 50/50 chance of getting pain from bone on bone. but i'd be worried about that as a possibility.

    have you had a second opinion about this surgery yet? i'd want to make sure that you're not setting yourself up for a fusion down the road. (and my surgeries were all within 2 years... 6/10, 10/10 and 2 weeks ago.)
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • BkinsBBkins Posts: 364
    edited 07/13/2012 - 3:16 AM
    Just some general comments. The first is reference the PT you had. Was the PTist specialized in spines or just a normal PT. The difference between the two are huge and there are not that many spine PT's. I have to go 25 miles each way to get to mine. I have had 5 back surgeries and didn't find her until after the 3rd surgery. She had me doing completely different exercises then the first 3 had me doing and I could tell my core was getting stronger after 3-4 weeks. It may be putting the horse before the cart at this point but they are out there. I found mine through another Dr. Didn't like the Dr. at all but sure did like the PT.

    Just me, and nothing for nothing, I'd be gettting at least another opinion. You can always make a course change before you start down the trail but its almost impossible to make changes once your there. Never heard of just sucking out the centers and leaving the rest. Seemss to me to leave the discs open for further collaspse at some point down the road. Has the surgeon said what keeps the discs from getting worse down the road? I know you mentioned that your active and not over weight. Just curious as there is always the next step when it comes to spines.

    Good luck in whatever you chose to have done.
Sign In or Register to comment.