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Pushed to Surgery (l4/l5 herniation)?

digiteckddigiteck Posts: 2
edited 01/12/2014 - 8:46 AM in Back Surgery and Neck Surgery
(Apologies if this is the wrong forum section)
Almost 4 weeks ago, I experienced shooting pain down my leg. I got an MRI and an orthopedic told me I have a large l4/l5 disc herniation, i am candidate for surgery, and take a medrol pak before a follow up.
Shortly after, I got a 2nd opinion from another orthopedic and he recommended conservative treatment (PT), a 2nd medrol pak, and told me i'm a candidate for surgery.

Followed up with first orthodpedic and he told me my herniation is large, I will, at some point, get this surgery and to schedule it ASAP. 5 days since this follow up (less than 1 month since onset):
-PT seems to be helping
-Foot drop has recovered significantly (not 100%, but getting there).
-NO pain down my leg at all.
-Mild aches (not painful, just annoying) in either my hip, lower back, or upper back at certain parts of the day.

Is it possible that a large herniation could 'heal' without the need for surgery? I'm going to get a third opinion tomorrow, however it seems to me that there is no dire need for surgery at this point. Any thoughts?


  • LizLiz Posts: 7,832
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    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Sometimes the inflammation and swelling from the initial trauma subside just enough to stop generating pain. However, the herniation is still there. Other times, macrophages "eat" or dissolve the herniated nucleus material if in fact it is outside of the disc.
    Then, the next time you push it back out again, you will be in pain again. The other worry is permanent nerve damage. If that herniation is allowed to stay on the nerve, there is a real possibility of permanent effects.

    Are you also utilizing ice/cold packs?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Yes, the body can sometimes re-absorb part of a herniated disc. It doesn't "put the toothpaste back in the tube," but it can relieve symptoms for a while. The disc is still most likely weakened from your initial herniation, and my guess is that at sometime in the future, you will have additional problems with that disc, as it has been damaged, and is now irregular.

    That said, it appears that you are feeling better and you can delay surgery for now, so that is awesome! I would continue the PT for now, as it's necessary to have exhausted your conservative therapy options in order to be approved for surgery (if you are in the US, that is). Insurance companies here in the US will demand that you have a record of trying conservative treatment in order to be pre-approved for the surgery.

    Hope this helps!
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • thanks for the replies so far. very helpful.

    ice/cold packs for the mild aches works perfectly; thanks for the suggestion.

    I got a 3rd opinion from a neurosurgeon today and he echoed similar to the replies to this thread. He gave me a list of things not to do, continue PT, and told me to check in. Otherwise, no surgery for now since I am progressing - unless progress reverses.
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