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Please provide opinions/feedback.

I'll summarize my story and I hope for some feedback from those in a similar situation. I've had 4 lumbar surgeries, 1 mircrodisc and 3 laminectomies mostly because of sciatica and herniations. I am 3 weeks post op on my last one and have some severe sciatica when I walk, every step I take sets my leg on fire. I just saw my surgeon today and he told me in so many words that there was nothing else he could do for me. He said I more than likely have permanent nerve damage and I should give it 6 months and if nothing improves that a SCS is my last option. I feel pretty helpless at this point since he told me there is no treatments left. I have several issues still, after surgery he told me that I would need a fusion in the future but he wasn't sure that this was the right time. I'm about to turn 39 and he's brought up my age many times as if I am too young for anything as invasive as a fusion at my age. I don't know if I should talk to another surgeon or if I should start pain management. I've done every treatment I've heard of, from the surgeries, injections, RFA, pool therapy, physical therapy and several medications. I asked about follow on PT for this surgery and he told me it wouldn't help. Has anyone else come to this point in their treatment where there is nothing left? I'm open to any suggestions that anyone has.......Thanks

Microdiscectomy/Laminectomy/Foraminalectoy L4/L5/S1 Oct 2009, Mar 2012
Laminectomy L4/L5/S1 Dec 2009, Oct 2012, Dec 2012
Microdiscectomy and Synovial Cyst removal Feb 2013
St Jude Spinal Cord Stimulator implanted January 2014



  • Shell2ySShell2y Posts: 80
    edited 01/08/2013 - 10:40 PM
    Hi. Sorry you are in such a rotten position. My view for what it's worth is do both - get a second surgical opinion but also hunt down the best multi focus pain management centre you can - one that includes physiotherapy, counselling, pharmacological advice and whatever else they can offer. A fusion may help you and may be the right thing, but there seems no way I think from what you have explained as your background that you will ever be totally free of pain (sorry to be blunt but sometimes I think "beating around the bush" doesn't help anyone) so you really should explore trying to perfect as much as you can how you cope with pain. It may well be that in addition to your anatomical challenges that you also have a chronic pain syndrome that also means your pain receptors and nervous system is on hyperdrive and keeps drilling into your brain just how much pain you are in. I know that this is at least partly my problem at the moment. So a pain management centre will focus on addressing this while a surgeon may have another view on how to handle the actual anatomical issues. Best of luck.

  • Thank you for the reply, I'm really not interested at any more surgeries unless it has a higher rate of success. During my last appointment prior to surgery they were reading my myleogram and noticed that the sciatic nerve didn't absorb any contrast and at that time he told me it was likely because that nerve was damaged/dead so I knew ahead of time that the probability of a successful surgery was low. However because of my job, military, I had to give it a shot, I'm just under 3 years from a military retirement so I needed to try every option to extend my service so I don't lose out on a substantial amount of retirement monies. At this point trying to control the pain I think is the best bet. On another subject has anyone ever tried and had success with acupuncture?
    Microdiscectomy/Laminectomy/Foraminalectoy L4/L5/S1 Oct 2009, Mar 2012
    Laminectomy L4/L5/S1 Dec 2009, Oct 2012, Dec 2012
    Microdiscectomy and Synovial Cyst removal Feb 2013
    St Jude Spinal Cord Stimulator implanted January 2014

  • Shawn, hi and welcome.

    I'd like to help you on your issue but the info you gave is too superficial for me to comment except in general terms and point you to. Info sources. The devil is in the detail.

    I have had a failed microdiscectomy with hemilectomy, nerve damage, drop foot, leg muscle atrophy, subsequent fusion and are recovering well. It's been very slow but progress is in the right direction.

    It is generally not expected to still have pain whilst walking after a MD. Check out;

    Nerve damage can often be quantified by an EMG study (see the articles on this website).

    Lumbar nerves can often regenerate (it's painful though). The nerve damage can be permanent and the chances of this generally increase with the time and amount the nerve is compressed.
    See http://www.spine-health.com/ask-a-doctor/chronic-pain/healing-chronic-pain-and-nerve-damage-after-surgery for more info.

    Do you have muscle weakness, muscle atrophy (shrinking), inability to walk on heels or toes, foot flopping when walking? Can you describe your pain in more detail?

    A general comment is that back pain is not often fixed with surgery, but to fail to stop sciatic pain at all by surgery is unusual and disturbing. One should seek a few additional surgeons diagnosis to identify the pain generator and opinions on future actions and risk of additional nerve damage. Often 3 MD's are viewed as max number per disc then fusion. Not much point having a retirement package if you can't walk anymore to enjoy it.

    If you want to provide details, would be happy provide more detailed comment where appropriate.
  • Thanks Dave,

    The only reason I was so vague was because I was wondering if anyone had been given up on by their surgeon, but the more feedback the better. I've always thought my surgeon to be quite odd. For example this surgery was very painful compared with the others and it started in the recovery room and lasted throughout the night. I had severe leg weakness the first night in the hospital which has improved but is no where near what can be called acceptable. In addition to that I had 3 doses of what the nurses called a potent antibiotic injected into my IV, they said it was normal after surgery but I hadn't had it ever before so I'm wondering if the weren't concerned about infection for something that had happened in particular.

    Anyway when I put weight on my left foot, I do use the ball of my foot as opposed to the heel because it does lessen the pain, I get my sciatic pain that I've always had x2. The pain is can be so intense that my leg will give out and I will vocalize the pain which is very uncommon for me. The pain is hot, stabbing and shoots from my lower left back through my hip, intensifies on the outer side of my knee, clear down to my foot. I also have tingling in my toes if I elevate my foot, or my hips move to far forward, like when you arch your back. I've had these problems for going on 4 years, every year it gets worse. I just don't think I'm willing to do another surgery that is identical to the others expecting a different outcome.

    Also like I said previously due to the way that the nerve doesn't show up on my MRI's/myleogram that doc said he was under the impression that it was pretty damaged/possibly dead, which I doubt because I do have feeling and pain so my guess is that it's definitely not dead. For the life of me I can't understand a doctor that uses age as a factor for performing surgery that could be beneficial. L4/L5 I have very little disc left and it's pretty much bone on bone, he told me earlier that I would be needing a 2 level fusion with hardware in the future. I'm like many others on here, I'm not a doc but have done house of reading and research, and I know that my sciatica could be caused by the vertebrae sitting on top of one another.

    Anyway Dave there's my story if you need more information please ask.

    Microdiscectomy/Laminectomy/Foraminalectoy L4/L5/S1 Oct 2009, Mar 2012
    Laminectomy L4/L5/S1 Dec 2009, Oct 2012, Dec 2012
    Microdiscectomy and Synovial Cyst removal Feb 2013
    St Jude Spinal Cord Stimulator implanted January 2014

  • DaveFusionDDaveFusion Posts: 476
    edited 01/10/2013 - 7:16 PM

    Discuss the pain with your current surgeon and see if he makes sense. ask what is causing the pain. he should be able to explain because he saw what's in there. ask for pain relief. Ask if nerve damage has occurred. Ask if EMG study would be useful in quantifying damage. Ask what are the future risk of nerve damage. Try to get referral for a EMG study.

    Get second and third opinions. You may be able to find a better surgeon. Get new MRI plus a EMG study. And fresh eyes to look at this. Find out if nerve has and is still being damaged. It definitely sounds like its being pinched somewhere. Find out what are the risks of continuing without further surgery. Get relief from the pain so you can build / maintain core strength. Research neurography, maybe useful diagnostic scan. It's a scan specifically for showing nerves to identify where, how nerves are pinched. Have you researched Piriformis syndrome? This is sometimes missed by doctors. Use search at top of page.

    IV antibiotics is standard when hardware is inserted. Maybe there was some infection inside from previous surgery? Something to ask him about.

    If I hadn't of had the high risk of further nerve damage, I wouldn't have had the fusion. Would have kept on pain relief and PT.

    There is still a possibility that the verve irritation may settle down. Try to be positive and give it some time. But don't be in pain. And get the referrals started. Discuss other surgeons with him.

    Take care.
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