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24y with a huge herniated disc (MRI images)

JamesthJJamesth Posts: 5
edited 10/10/2014 - 8:19 AM in New Member Introductions
Hi there.
6 months ago I found out that I have a herniated disc L4/L5 and a disc protrusion. 2 months ago i had a terrible crisis, never felt so much pain in my entire life, had to rest in bed for almost 3 weeks. For the first time, I had sciatica pain with numbness and deficit.
The MRI revealed that the L4/L5 disc escalated to a huge herniated disc.
Here is the image of the MRI: http://imgur.com/IdWYcrw

Right now, my toe is a bit weak, and sometimes I feel a pain in my leg. I am not in pain anymore, but I don't feel safe to do anything.

I've seen 3 great surgeons. All of them said that the MRI suggests a surgery case. 2 of them would do an arthrodesis and one would do a microdiscectomy. 2 of them want to do it now, and one suggested me to wait, because I am not in pain, and the deficit is ONLY in my left toe.

I don't know what to do. So many decisions to make. Should I wait? If I do wait, could I have permanent damages? Should I go for the microdiscectomy or the arthrodesis? I am so young, and I don't want to make a decision that could impact the rest of my life negatively.

I am not looking for a solution here. I just want to know the opinion of fellows who have been to a similar situation.


  • No one is qualified to advise you about waiting for surgery or not, or what type of surgery to have.
    Since you have seen three surgeons, is there one that you feel the most confidence in? One who took the time to explain the MRI findings to you and explained the risks of waiting or not waiting for surgery?
    When there is nerve involvement , there is a risk to postponing surgery, but how much risk in your individual case, no one here can say.
    The surgical approach is determined by the doctor, as well as the type of surgery. I would ask each surgeon why they are recommending a particular approach and type of surgery and what would happen if it failed.

  • The two doctors that advised me to do the surgery now said that as the deficit in my toe did not go away after 9 weeks, they think I should do the surgery now, to avoid permanent damages in the nerve.
    One of them said that he would have to do an arthrodesis because of the size of the herniation.
    The other one said he would do a discectomy because I am too young, and if I did the arthrodesis now i would have to do another surgery in a few years. This one is a very known and experienced surgeon.
    Both are orthopedist.

    The other one is a neurosurgeon, and said that although my MRI indicates a huge herniation, I am not in severe pain, and the deficit is only in my toe, and it's not guaranteed that i will recover from it. And considering my age, he advised me to wait and go see him again in a month. He said that a discectomy could worsen the pain in my back, because the disc is very thin already, and my spine would get "loose".
  • is danger to the spinal canal nerves.......a condition called Cauda Equina Syndrome.
    While you may not have what are considered hugely significant problems at the moment, a herniation that is already sizable can cause problems if for some reason you were to get injured further or the herniation to worsen.
    As for the fusion over the discectomy, I can see the points made by all three surgeons.. and the reasons for their decisions based on their suggestions and explanations.
    If the neuro feels that a discectomy would thin an already compromised disc, but would worsen your back pain, then to me, that seems to be not an option worth considering.....what he means by loose is anyone's guess, but I am assuming he means that it would change the alignment a bit because of the loss of disc space height...
    It might be worth seeing another neurosurgeon, and taking all four opinions and seeing if there are two who agree.....
  • Thanks for the information!!
    The thing is that I am in good conditions right now, but I am afraid of permanent damages.
    I keep asking myself if it is possible to live with a herniation that big without surgery.

    One thing that my neurosurgeon said and I agree is that if I can "postpone" the surgery for a time, I should do so. He said that as my case is a difficult one, I should not do the surgery now. If anything goes wrong I will always blame myself for taking the wrong decision. It makes sense.

    I think i will wait... It is not an easy decision though, cause it is difficult to live knowing that any movement could make things get really bad, and that waiting could result in permanent damage.
  • This was my herniation. I know what you must be going through.

    Consider all of your options as best you can. I know surgical outcomes all differ and surgeon's certainly while they do their best.. they cannot guarantee anything to do with nerves. I would ask the surgeon's what to watch for and keep note of any symptoms and any changes that would suggest a worsening herniation such as new numbness or loss of function or pain. Ask them how soon you could get in should you decide the surgical route... And ask them what they would advise their sister or brother to do. I had a disectomy and Im 39 years young and while I wouldn't say it was my best time spent this past summer I can say I've done all I can and am now recovering so that's good news. Physio helps and keeping positive and setting very real goals witj respect to what I can do now.
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