Hello, In January of this year I had hemilaminotomy, microdisectomy, and a foraminotomy on l5/s1. I had the surgery for a far lateral herniation. Because of the acute angle of the herniation and the fact that I have spinal stenosis, I was having constant sciatica. I also have mild annular disc bulging and advanced facet osteoarthritis in l2/l3 and l3/l4.
The surgeon said that the disc had solidified and was completely obscuring the nerve, which was extremely irritated. So he removes the solidified section and created more room to the point that he says he could get a blunt instrument all the way around the nerve. I had very modest relief from this surgery but as time went by the nerve pain came back. I also started experiencing sciatica down both legs where as before it was just the left one. So the surgeon ordered a new MRI.
The MRI showed that the nerve is still pinched by the disc and is not likely to get better without another surgery. (I have been doing physical therapy for the last two months with zero improvement). So the Doc says I can have another microdisectomy or I can have a fusion. Apparently the angle of the herniation and the location of the pinched nerve make the microdisectomy difficult as he has to go through the facet joint and risks creating a Pars defect, where as the fusion, it wouldn't matter. My fear is I'm 22 and I have DDD on other levels albeit not nearly as bad as l5/s1. Will the first fusion start a chain reaction up my spine over the coming years? However I'm currently taking time off work and didn't expect the need for additional surgeries so I'm running out of time and money and I'm afraid doing a second microdisectomy may have the same result as the first and then I will need a third surgery, which will be almost impossible.
Am I just delaying the inevitable? Will the fusion be the only way to eliminate both sciatica and back pain? If any one has had similar complications I would really appreciate hearing your experiences or if there are any doctors out there I could use some advice. Thank you.