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L5-S1 reherniation - discectomy vs fusion

I had my L5-S1 discectomy last July & within 8 months I reherniated the same disc again. I'm 35 yrs old & had multiple crashes when I used to race motorcycles. I had couple surgeries on my left leg & the very first time I experienced pain in that leg, I simply tried to endure it thinking it was just pain from my other surgeries. Turns out I had herniated my disc & I had excruciating & radiating pain in throughout my left leg. I endured that for almost 6 months, before I went & saw a doctor.

This time around I went to the doctor the next day :). At first, my surgeon told me that since I was still recovering & that my nerve was under duress for a long time, it'd take some time. But the pain kept getting worse. Couple of weeks ago, my MRI confirmed another herniation. Apparently I fall in to that lucky 5-10% category. Anyhoo, the surgeon suggested another discectomy. Just to be sure, I went and saw another surgeon & he suggested an L5-S1 fusion. His statement - "your disc has proven to be unreliable, I wouldn't wait to find out if it can get worse". He acknowledged that they normally don't do fusion for someone my age, but he strongly recommended a fusion.

Both surgeons had their reasons for a different treatment option. But the decision is apparently mine, which is funny because these surgeons with over 60 years of medical experience between them can't come to the same decision & expect me to make one. I can't even spell the procedures correctly.

I wanted to ask here & see if anyone were in similar situation. And what was the decision they made & how did they reach that conclusion. Thank you.


  • LizLiz Posts: 7,832

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • I am in virtually the same exact situation and I would love to know the answer to this question as well. I don't know if a fusion or discectomy would be advised for me, but those two procedures seem to be the most likely option for me too. For what it's worth, I'm also 35. I hope you find some relief soon and have a successful surgery....whatever that ends up being.
    Left leg radiculopathy/sciatic pain
    L5/S1 microdiscectomy - May 30, 2014
    L5/S1 microdiscectomy - Aug 14, 2014
    L5/S1 TLIF - Sept. 24, 2014
    Left-side screws/rod removed along with bone fragment Dec. 29, 2014
  • I would go with whatever surgery is least invasive, which, in both of your cases, would be the fusion. I just had a Microdiscectomy done this week on L4/L5 and I am praying that I don't reherniate the disk.
    microdiscectomy 7-2014
  • I had a fusion on the L5/S1 last Sept, and 10 months later I am still in major pain, it did not take care of the pain at all. I never had a discectomy and I can't tell you the best route, but just know that whatever you choose, it may not be forever or cure the pain.
    I had an ALIF fusion, where they go through the stomach and replace the disc and use cadaver bone. The fusion has almost fused completely, and I did 4 months of aqua therapy, but the pain I endure is just like before the surgery. It is a fairly long recovery, I spent 5 days in the hospital, and then 2 weeks in bed, walking as often as possible.
    I am going to get another MRI this week to see if I too have another herniated disc causing this pain.
    I hope you can make an informed decision and that you experience full relief.
  • Fusions are serious procedures and the post op pain is horrendous and it takes a long time to heal. That said, the choice is yours. In my case, I enthusiastically chased down every single less-invasive treatment BEFORE reluctantly going with the fusion. I am 34 and have two young children and the recovery took a village. Good luck
    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
  • SarahLindeauSarahLindeau Posts: 767
    edited 07/19/2014 - 6:25 PM
    One more comment: I made it a priority to know the metrics/outcomes for my chosen surgeon. Such as- of the patients who seek your services, what percentage do you agree to operate on? What is the average outcome for similar fusions in my sex and age group? Will you continue to see me as a patient after surgery or will you discharge me from your care after post op? Etc
    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
  • Owie_999OOwie_999 Posts: 176
    edited 07/19/2014 - 7:09 PM
    I'm 37 and had a microdiscectomy at L5S1 in Jan this year. I re-herniated 3 weeks later and had repeat surgery in March. Unfortunately I've re-herniated again and am now booked for a fusion in 3 weeks. My neuro gave me the option of another microdiscectomy but felt that it would likely happen again. He said that in general they (neuros) try 2 discetomies, them recommend a fusion. The decision to go for a fusion wasn't made lightly. In the end I figured if it was likely to happen again it was another block of 6-8 weeks of recovery. As it stands he's told me recovery will take 3 months(I've allowed 6months at a minimum). The other main factor was family. We like to travel each year for 4-6 weeks over winter to remote areas & I didn't want to re-herniate in the middle of nowhere. I'm also the primary carer of a disabled child so I need to get on top of things to continue her care.

    Microdiscectomy L5/S1 Jan 2014
    Microdiscectomy L5S1 March 2014
    L5S1 fusion planned for August 2014
    Microdiscectomy L5S1 January 2014
    Microdiscectomy L5S1 March 2014
    Fusion L5S1 11th August 2014
  • Thank you all very much for the input, I really appreciate it.

    I fully realize that fusion is going to be a real pain in terms of recovery. But I probably will rather endure that if it guarantees pain relief long term. I have been on pain medication for the past 4-5 yrs for one reason or the other & I'm tired of it.

    But, when I ask any doctor, they tell me that relief from surgery (fusion or discectomy) is never guaranteed. That makes it essentially random, weighted random but random nonetheless. Well, I'm first going to try epidural & see if that in anyway alleviates at least some pain. If it does, I might even postpone my decision.

    Did you all try anything else before opting for fusion?
  • I have no additional input, but the people with kids - wow, I can't even imaging how guys did it. I don't have kids but I can't even pretend to understand how tough it probably was, especially if they were young. In that sense, I guess I'm a little lucky.
  • SarahLindeauSarahLindeau Posts: 767
    edited 07/20/2014 - 7:12 AM
    Yes, I have a two year old and a five year old (who was 4 at the time of my fusion). I had already delayed the fusion for a year while I tried other treatments. Doing this gave me peace of mind that I really did try every last option, and time so that my 1 year old daughter would be 2. It was still a very rough 6 months after surgery. Not being able to pick up your children or do any meaningful work around the house was hard.

    While you're waiting to be scheduled for the fusion, see if hydrotherapy or low intensity PT helps you. That's what I did, up until November before my fusion in December. Even if it didn't relieve my pain, it got me in great shape for a long and lazy recovery. I was really strong, physically, going into my recovery and I think that has helped me in the long run.
    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
  • Owie_999OOwie_999 Posts: 176
    edited 07/20/2014 - 6:15 PM
    I definately understand wanting to get off pain killers. Getting a headache is a nightmare, I have to think about what medication I took last.

    Before deciding on surgery (only 3 weeks til my fusion) I tried the epidural injection, steroids, lyrica, clinical Pilates, physio, swimming & walking. After both discectomies & once I had the all clear from my surgeon I resumed walking, clinical Pilates, swimming & a hydrotherapy program from my physio. Walking wasn't as easy as I'd hoped as I was told to walk on flat even surfaces & we live in a hilly area.

    Microdiscectomy L5S1 January 2014
    Microdiscectomy L5S1 March 2014
    Fusion L5S1 11th August 2014
  • I also had a discectomy, then a couple years later it reherniated and then some. By that time, I couldn't put any weight on my leg. So a fusion was needed.

    But it is (or can be, I should say) a lot longer than 3 to 6 month recovery. I was in pain for over a year, and although I am back to all my old activities, I am still and will most likely always be on, some pain meds.
  • PiccolinaPPiccolina Posts: 6
    edited 08/10/2014 - 6:11 AM
    I, too, need to decide whether or not to have a fusion. My laminectomy was done in 2001 after a full 12 months of constant excruciating nerve pain and an inability to walk upright. In addition, I was pregnant for 6-7 of those months and could not take real drugs. I fear that horrible experience is behind my desire to fuse right away now that I have herniated another disc. But, only one out of three docs I consulted made it seem as if it should be done right away. The other two seemed open to me trying conservative messures first. I am now leaning toward continuing with yoga, my inversion table, and physicsl therapy with dry needling and a portable TENS unit. I am a teacher going back to school soon so I don't even want to consider surgery until late May/early June at the earliest. I hope I can get through this year, sigh.
    L4-5 and L5-S1 laminectomy 2001
    now bulge @ L3-4, spondylolisthesis grade 1 @ L4-L5, new herniation @ L5-S1
  • lisamhllisamh Posts: 11
    edited 08/11/2014 - 9:35 AM
    Hi all
    Just wanted to offer my story into the mix I am 36 years old and 8mths on from the recovery of my 3rd microdisectomy on the same disc l5s1 .
    First op done august 2013
    Re herniated 3 weeks later 2nd op Sept 2013
    Doing great back at work then re herniated again Dec 2013 3rd microdisectomy this disc did not want to behave.
    Yes you are reading this right 3 microdisectomys in 5 mths it was tough and can say the recovery was a little more difficult each time but here I am now 8 mths on I've been back at work 6mths I work full time I am a nurse at the hospital so on my feet all day but can honestly say really glad we tried again my neurosurgeon was great and explained everything to me including the fusion but felt I was just to young to go down The fusion route I am doing great started yoga recently and swim and ride my bike so all in a success this was the right thing for me hope this helps good luck with making your decision .
  • smartens162smartens162 Manitoba, CanadaPosts: 361
    I am so glad to hear this, lisamh! I mean not what you've had to go through, but that there is life after repeat discectomies! I am scheduled for my first (hopefully only) discectomy in a few weeks, also declining another surgeon's recommendation to do the fusion. I am 45 this year, also too young, I believe ;)
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