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Seqestrated disc fragment 2cm - will i need surgery ?

bullroutbbullrout Posts: 13
edited 02/17/2014 - 2:25 PM in Lower Back Pain
Hi Folks,
Great information on this site,

I am a 42 year old Australian male,
I have had a 22 year experience of lower back pain
15 years ago I had evidence of this on an MRI that shows the lowest two discs were desiccated , with a bit of disc bulging
the main area is pain in the lower back and around to hip, this is usually dull pain that prevents me from sitting for long, bending or crouching
I sleep with a tens machine and heat-packs
Occasionally this would flair up, so I would need some bed-rest and painkillers , Often I would be immobile for a few days difficulties in walking /standing / bending for a few weeks
I have attempted to improve core muscles, so my routine involves walking ,pilates and a bit of swimming .
I went to a specialist five years ago and he said because i didn't have sciatica i didnt have a nerve problem (so im confused as to the pain in the hip)

6 weeks ago I had a flair up, after 3-4 days of immobility i was gradually on the mend , only to re-injure myself by over exerting myself, this happened twice
3 weeks ago i woke with pain in my leg and couldn't stand or walk for long, im now taking codine and find that in the morning the pain is worse but still im not standing or walking much, pain is much reduced by lying down

Anyway, latest MRI shows much worse L4/5 bulging and a detached 2 cm disc fragment causing significant compression of thecal sac and right nerve root,

I have only experienced sciatic leg pain for three weeks, I have not had much in the way of numbness.

Im booked in to see a neurosurgeon in two weeks,

I assume that a procedure like a discectomy could be used to get the sequestrated disc part out,
Apparently over time the body can break down this fragment.......but im not enjoying the pain / incapacity im in right now and dont want to do nerve damage,




  • LizLiz Posts: 7,832
    edited 02/14/2014 - 8:10 PM
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  • bullroutbbullrout Posts: 13
    edited 02/17/2014 - 2:27 PM
    just wondering if any body has had surgery to remove a seqestrated disc fragment ?
  • saw the surgeon
    he looked at my leg function , some weakness in big toe evident and also test where you try to stand on your heals
    I think this is consistent with the pressure on my L5 nerve root (right leg)

    next step is a nerve root block injection - waiting to hear from radiologist

    Im not feeling too bad today - mainly have rested but done chores, stretching and a decent walk
    not sure if ill pay for it tomorrow !

    Anyway surgeon said that in the public system I would wait 12 months (NSW, AU) to have discectomy by which time the fragment would have dissolved
    My concern is that I may damage nerves, im not sure how much they recover,
    Im going to try and get a quote for a private discectomy and see if i can borrow money from somewhere,
    Im apprehensive about surgery, but ill see how i fair over the next couple of weeks and hopefully the injection will do something

  • Usually, they will offer treatment options such as injections at first, to see if they resolve the symptoms you are having, and secondly, insurance, and standards of care suggest that the least invasive options be tried first.....
    A discectomy could most likely remove the disc fragment, but just be watchful for worsening symptoms or increased numbness or weakness. Those things could suggest a worsening of the problem.
  • bullroutbbullrout Posts: 13
    edited 03/04/2014 - 5:59 PM
    as of this morning it think i have been experiencing a reduction in sensation in the lower back and groin, im a bit freaked out,
    might see a my GP tomorrow if this persists,
    (also im thinking that maybe i should stop taking codine so i can rule that out as the source of the numbness,)
    I haven't experienced any incontinence,
    but some lack of sensation in toilet activities

    I have been told that the public system will not operate for 12 months unless i have bowel or bladder issues or cannot move my foot at all,

  • thoracic spine painthoracic spine pain Posts: 566
    edited 03/05/2014 - 2:29 AM
    Even if you join Private Insurance you have to wait 12 months as this is a pre-existing condition. I have really good private health cover but I guess you know if you haven't had cover it will be much more expensive. If you PM me the cover I have is now available to everyone and is non profit.

    I must admit as far as my spine is concerned I want to choose my own specialist so that is why I have private health. I think without it the operation will be incredibly expensive, you do need to check the cost especially if you are thinking of borrowing money, and it might be worth having a look at the cost, comparing it to waiting 12 months in the public system or paying private health insurance and waiting for 12 months so you can choose your surgeon and hospital.

    I have been both a private and public patient in Vic, NSW and Qld and the public system used to be as good as private if not better but I guess it depends on which state you are in. In NSW I was an urgent case and ended up in a private ward anyway. Same in Qld when I had my accident. they put me in a private room but had an entourage of training Drs every day. Also some specialists will operate on you in the public system as one did for me - I was in a public hospital - the surgeon always only did private surgery but he was an honourary specialist in the public system and got me in straight away at no cost.

    Some private funds don't cover you for everything and you have to copay quite a lot of money, like $15 for an asprin. PM me if you want to know who my provider is, as they used only to be open to certain people but have now open to everyone.

    Sandi private health insurance is very different in Australia to the US. They don't make you do any conservative treatments at all before an operation if the Dr recommends it. It is only about $800 a year and they have no say in the meds you take. They can recommend certain Drs and hospitals but there is no compulsion.

    If you go as a public patient everything is free including hospital medications, operations and all tests and MRI's/bone scans and any medicine dispensed at the hospital. The govt has a free list of medications and co-pays here if your meds are on the free list they don't cost very much. I was shocked at how expensive medications are in the US.

    Private Health care funds don't cover medications, and if a Dr says you need an operation private health will cover it. It is the Drs decision - they don't question the Dr's judgement.

    Here the Drs are the ones who make the decisions about medications and operations and treatments, not Private Health Care providers or pharmacists. Our system is so different and sometimes it is much less expensive as a public patient as you pay absolutely no costs and stay in hospital for as long as the Drs deem necessary. Some private covers do incur costs if they don't cover some things in a private hospital. Also public hospitals have private wards as well but as a private patient I was with all the public patients and as a public patient I was with all the private patients.

    You get no better treatment if you are private - you can just use a private hospital and choose your own specialist. Also the waiting time is not as long if you pay privately.
  • sandisandi Posts: 6,343
    edited 03/07/2014 - 10:57 AM
    thanks Sandi
    as of this morning it think i have been experiencing a reduction in sensation in the lower back and groin, im a bit freaked out,
    might see a my GP tomorrow if this persists,
    (also im thinking that maybe i should stop taking codine so i can rule that out as the source of the numbness,)
    I haven't experienced any incontinence,
    but some lack of sensation in toilet activities

    I have been told that the public system will not operate for 12 months unless i have bowel or bladder issues or cannot move my foot at all,

    Those symptoms are worrying, and you would wise to at least be checked out to make sure that both a surgeon and your regular doctor are aware that you are having these symptoms....loosing sensation or changes in sensation and ability to empty or hold in , urine or feces is a big problem, one that you can NOT afford to take lightly or take a wait and see approach with.
    You do not want to wind up with permanent damage to either bodily function........you may not get it back .
  • Sandi and 'thoratic spine pain'- thanks for your comments
    update -
    since the next day after my last post I had much reduced symptoms (of saddle anesthesia)
    the GP said that it is unlikely that more disc material will further herniate because disc is not longer under pressure due to tear

    currently I am not sure if I have any / or a mild degree of sensation loss in this area

    with my right leg it is easy to judge whether it is a bit numb because i have a normal leg to compare it to, not so with the groin area, so im not sure how much I am feeling / not feeling.

    So i may be having some CES symptoms but definitely not a rapid onset of them

    This makes me very keen to get the material out surgically - but it will have to be private microdiscectomy
    not sure how much $$$$$ are involved

    So im seeing the surgeon next tuesday,

    all the best

  • update
    My symptoms seem to be slowly getting better,
    no further signs of CES, less leg numbness / pain,
    right hip still painful, had been taking codine

    Ive seen the surgeon again, he gave me a quote for a discectomy for about 10k
    coincidentally this is exactly 10k more than i have !!!!

    last wednesday I had a 'nerve root block ' have had reduced pain , able to stop taking the codine
    but i still am taking it easy because i can feel that there is still underlying issues and i dont want to do more damage,
    the radiologist who did the injection said that some of the material on the initial MRI could have been blood from torn posterior longitudinal ligament, In his opinion the next time i have an MRI it might look a bit better,

    so if pain situation continues to improve and MRI shows reduced pressure, and i have no sign of the CES i might be able to get away without the surgery

    so MRI in two weeks , see the surgeon in 3,
    I guess there is a possibility they will want to do another injection.......

    all the best
  • 2nd mri shows a big reduction in material (but still large extrusion)

    i have much less noticeable leg problems

    steroid injection was very effective for 2 weeks, still possible some residual effect, which may be diminishing

    I have back pain / hip pain , but can do stuff

    only taking paracetamol

    have option of another injection if necessary

    am trying to do stretching / walking daily , aqua 5 days a week

    so looks like i have avoided surgery for now,

    the radiologist who may report on 2nd mri didnt really comment on 1st mri , i thought report would make comparison,

    but surgeon said there was a 60% reduction in material (this is over 2 months )
    so it is interesting how quick this has happened

    Hopefully no more blow outs anytime soon ........
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