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Had the appointment with an Ortho

I recently had an appointment with an orthopedic surgeon and upon review of my MRI, as well as all the non-surgical options I've tried, he is recomending surgery. I have a bulging disc in L5-S1 as well as DDD from L2-L4. I also have spinal stenosis with the narrowest part being (you guessed it) L5-S1. The surgeries he is recommending is a hemilaminotomy, microdisectomy, and a foraminotomy. Has any one had any similar surgeries? What was your experience?


  • have you tried physical therapy? i would recommend getting a 2nd opinion. not because i am disagreeing with the doc. just that i want you to be sure that is indeed the treatment. good luck.
  • a microdiscectomy and foraminotomy and got near immediate relief. It didn't last long, however. I ended up having a fusion a year later. Hopefully, the addition of the hemilaminotomy will make your back more stable.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I have done physical therapy, chiropractic and had a set of epidural injections and various other treatments.

    How bad was your bulging disc? The doc tells me mine isn't too bad, it probably wouldn't affect me much, if i dint have such bad stenosis right there. I'm hoping this gives the surgery a greater chance for success?
  • I would make sure you get 2nd and 3rd opinions from Board Certified Orthopedic Surgeons or BC Neurosurgeons who do not know the first surgeon.

    A laminectomy is usually for spinal stenosis so I'm not sure why all the other ones are needed if you don't even have an actual herniation and the bulging disc is not that bad.

    Again..if two other Board Certified Drs. recommend the exact same thing and that there aren't any other types of non surgical treatments that can be done...then you can feel confident in moving forward.

    But because this is not an emergency...it's crucial to take time to get more opinions before having any surgery like this.
  • idk53iidk53 Posts: 21
    edited 10/02/2012 - 9:39 PM
    I've been doing research on him EDITED and apparently he is a very good surgeon, as well as the medical group he is with has an excellent reputation. His specialty is spinal surgery, specifically spinal reconstruction.

    Of the three surgeries, they all sound very similar. Does anyone have any clarification on the specifics of each surgery?

    Post edited to remove name of medical professional and or facility. by The Spine-Health Moderator Team

  • That's great that he is well trained and well respected...but that should not keep you from getting 2nd and 3rd opinions. And most all great Drs. actually want you to do this. You can certainly choose him to do the surgery in the end...but I would never have any major surgery without making absolutely sure that it's the best choice..

    The different surgeries are as follows:

    The first one is actually called a Hemilamectomy...It is surgery to help alleviate the symptoms of an impinged or irritated nerve root in the spine. During this procedure, surgeons remove part of a vertebra called a lamina. This removal of bone creates create more space in the spinal canal and is meant to release nerve tissue from pressure.

    The second one is where there are at least two different surgical approaches for opening up the foramina – the forminotomy and the foraminectomy. While the goal of a foraminotomy is to remove as little tissue as possible and thus protect the structural strength of the spine, a foraminectomy involves a large amount of bone and tissue removal.

    Then, once in there...they go and do the Microdisectomy. This is a minimally invasive technique that allow access to the herniated disc fragment with a minimal amount of muscle and soft tissue disruption. The inflamed nerve is identified and, utilizing microsurgical technique, the extruded fragment of disc is dissected free and removed, releasing the compressed nerve. The incision is typically closed with one to two absorbable sutures and dressed with a band-aid sized dressing.
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