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2nd Discectomy for L4-L5 or Spinal Fusion???

cathygccathyg Posts: 5
edited 05/17/2013 - 11:53 AM in Back Surgery and Neck Surgery
Hi!
I am a "newbie" to this forum and I am very happy that it is here and available.

I have had a cervical fusion and then a discectomy L4-L5, due to an accident 20 months ago. After returning to work full duty for a few months, I had ruptured the same disc L4-L5 lifting a 100lbs + item at work (we lift this item often w/o any lifts or equipment). Pain is horrific (again) and lost some strength in my left foot/ankle and big toe. After PT, prednisone and painkillers, my Dr is suggesting another discectomy or a fusion with plate and screws and removing the disc.
I was told that once you herniate a disc, it is likely that it will herniate again following a discectomy. I have also heard that the fusion will make the disc above and below more apt to degenerate, but the pain will be alleviated and will never herniate again (bye, bye disc). I need to mention that my job entails moving 'patient like' simulators in and out of beds, turning them, putting them in wheelchairs (one of them is approx 100lbs, taking him out of a wheel chair and into a patient bed - is what cause my disc to herniate again. I love my work and do not want to loose my position, but I don't want to cripple myself and/or live with chronic pain.
Any thoughts, suggestions, concerns - anything is welcome!
Thanks!
CathyG
Cathy G.
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Comments

  • you could try pain management, i deal with the pain myself, but thats because i have a physical job that i also like very much. it pays well, and has excellent benefits.that is why i have put off getting the microdiscectomy, so far.
  • Yes, I have been taking pain killers but they only take the edge off - still am not very mobile and have sciatica down left leg and loss of strength in left ankle/foot/toes.
    I totally agree and understand about your physical job - I LOVED my job, great benefits and very specific. I was a Simulation Specialist for a large organization that has 4 hospitals. We have to lift patient simulators in and out of patient beds and into wheelchairs at times. One simulator is 100lbs, 4 months after my discectomy (injury from a car accident), I was lifting the simulator and ruptured the same disc, pain is unbelievable. Had PT, steriods (which helped for 8 days and pain came back) and multiple pain killers. Still in bad shape.
    Well, I have found out that I lost my position at work, workman's comp case worker told me I will no longer be able to lift and my job description states "requires frequent lifting of up to 125lbs". Very sad, heart broken and upset.
    I haven't even had a chance to recover from surgery.
    Since it is the same disc rupturing, I want the fusion so it never happens again, but my Dr wants to do a revision discectomy AND if it ruptures a third time - fusion is a must. Who wants to risk that??? Going through this is so incredibly painful and restrictive of daily activities....?????
    Cathy G.
  • DNiceDDNice Posts: 1,962
    edited 05/28/2013 - 1:03 PM
    I was in a similar situation. I actually ruptured the disc, I know exactly when it happened and it was excruciating. I ended up in the ER. After many many pain meds and muscle relaxers they got me walking and using the bathroom on my own.

    I had an MD and it failed. I was told revision but then long story short, a "2nd opinion" suggested a fusion would be the way to go. I was very confused. Fusion would "solve" the issue but the risk was there of many other problems. I struggled and ended up getting several opinions (including an e-opinion which I found most valuable from eCleveland clinic).

    I finally found my 'current' neurosurgeon and he said that I had 2 options - (1) wait and do nothing and see if the herniated disc dried out to provide some relief; (2) revision; (3) fusion. He explained the pros/cons to all. He explained why some surgeons leaned one way or the other. At the end of the day, the decision was mine and he wanted me to know all the risks. He said he would wait and if that didn't work revision. His rationale (which was in line with all my homework) was that back surgery is tough and a fusion is final. And a fusion on the lumbar area is really a big deal, more so than cervical fusion. I asked him about the risk of the revision failing and needing a 3rd surgery and the risk of infection, scar tissue, failed back syndrome. He told me that indeed the revision could fail but in my case (and this is important because you have to understand your condition), my spine was VERY stable and that my level above was under stress. He said he recommended the revision because he hoped it would work but he said even if he could buy me 3-5 years, technology advances and maybe I'd be a candidate for ADR or some other procedure that is under research. I knew if the fusion went wrong, I would be mad at myself for not trying the revision.

    That being said, when I woke up from the revision and learned that I barely had any disc left and still didn't regain feeling or see too much reduced pain, I was disappointed. I asked my surgeon if I should have just had him fuse. He said 'nope' and he still felt I'd be pleased with this decision. Sure enough he worked with me for almost 3-6 months post op and I regained strength in my leg (lost my limp) and my pain went down tremendously. About a year after, he recommended a physiatrist which has helped even more with my lower back pain and I'm 3 years post 2nd surgery and glad I never went for the fusion.

    I still have leg numbness and my pain days but have been prescription med free for at least 2 years and in the last year am sleeping, working, and exercising again. I no longer run and am always cautious of lifting heavy items but am no longer fearful of tripping or getting pulled by the dog.

    So, not an easy decision but it is yours. I see your point but I see your doctors' point. It is SO tough to make decisions like this when you are in so much pain and have already faced the initial surgery with lousy results. If you have a spounse/partner/or good friend or family member that can go to a 2nd and/or 3rd opinion with you...it might help.

    I found a doctor that both my husband and I were happy with. We both trusted him which made a difference. I hope to never need this surgeon again but if I do, he made sure that we were making a 'life long' decision together so I know I would go back because I respect how he treated me as an individual and could explain why revision was good for ME - age, life goals, condition, history, etc.

    Good luck
  • Thank you so much for the information. I am under workmans comp and I have an approval for a 2nd opinion and I am trying to make an appointment with highly recommended neurosurgeon and I will be bringing someone to help understand (2nd set of ears is always a good idea). I just want to be somewhat back to normal, this is a living hell. I feel for all those with chronic pain.
    Cathy G.
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