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Back to the drawing board

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.



  • This is exactly my fear. My doctors recommend a fusion art C5/6 and I work in a law office. I have seen a chain reaction and it scares me to death. Why I have been fighting off the fusion.
  • I know ADR is more common for the neck, have you given that any thought?
  • i had a microdisectomy back in 2010. I was one of those lucky enough to reherniate the disc a whopping week after the surgery. didn't realize it immeadiately, but 4 months later was back in for the 2nd microdisectomy. i had asked my surgeon about the fusion then, and he said i had plenty of disc material left, and the microdisectomy was an faster recovery. Plus the chance of herniating for a 3rd time was still low.

    well, i had the surgery, and 4 months post-op, when the pain levels never really changed, a new MRI showed i had herniated the disc for the 3rd time. i was able to go another year and a half before i couldn't take the pain anymore, and had the fusion done.

    honestly, if i had my choice, i would have done the fusion for the 2nd surgery, if only to avoid the 3rd one. I don't think the 2nd microdisectomy helped me at all, esp. since i had herniated the disc again so quickly. And to this day, i have no idea how it herniated that 3rd time.

    but by the same token, i still have a lot of back pain, its better than pre-fusion, but its not good. And i know for a fact i will have to have the level above fused at some point because it was in lousy shape before i went through the surgeries. but neither of my surgeons wanted to touch it, since it was still functional at the time.

    sorry, i can't say it worked and its wonderful. i would still say though i wish i had the fusion done on the 2nd surgery. just because it woud have saved me from having yet another one.

    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • Hi, sorry you are not doing well.
    I ruptured my L5/S1 disc and lost feeling in butt, groin, back thigh, and heel to outer toes. I had an MD and didn't really feel a difference 2-weeks post op. Well, long story short, re-herniated or they left some disc behind or more came out after they flipped me over. I had the revision surgery about 5 months after the first. I did a lot of research and realized that neither MicroD or Fusion would guarantee me no back pain. Lots of risks with lumbar fusions (more so than cervical) and less success stories. I decided that while I would be annoyed if nothing changed after the revision, I knew I would be even more upset with myself if things went wrong with the fusion and I didn't at least try to Microdiscectomy revision.

    I did the revision and didn't feel too different after but my doctor was extremely strict on the rules after surgery and I learned a lot from the initial surgery. (I switched doctors too and went with a neurosurgeon). It took about 3 months post 2nd surgery for me to be able to acknowledge I was seeing improvement and then at 6 months I stopped limping and my pain was manageable. I got 2 years out and realized I was no longer having leg pain but was having severe lower back pain at night. I spend 4 months with a physiatrist and was amazed at how body mechanic play into recovery.

    I'm 3 years+ out from 2nd surgery and I am happy.
    Am I 100% like I was before surgery? No but that would be unrealistic considering how bad I was. I have learned to tune out low pain and have my life back. I still worry that some day I will need the fusion but I'm hopeful that with each year that passes, technology will advance and give me other options OR that fusions will be more proven for the lower back.

    Good luck.
  • idk53iidk53 Posts: 21
    edited 04/23/2013 - 6:28 AM
    Thank you for the advice, it is much appreciated.
    I will most likely do a revision and hope for the best I suppose.
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