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How did you decide what course of treatment you opted for?

I am at a loss, I've been seeing a physical medicine doctor that specializes in back injuries for the past 12 months. I have shallow herniations at L3-4 and L5-S1 with a more severe one (I forget the term) at L4-5. The one at L4-5 seems to be the problem child, I also have some nerve compromise at that level that has caused foot drop syndrome.

I initially opted for conservative treatment even though somewhat emergency surgery was offered due to a marked weakness in my leg and the foot drop. In the year, I've recovered to the point of resolving the foot drop and regaining nearly all the strength in my leg. I can walk normally again.

I have flare ups that occur about every 8-12 weeks. These typically last 1-4 weeks. They usually come on because I push it too far. The flare up will cause nagging back pain, some sciatic leg pain and a mild numbness in my foot.

My doctor has now said I've most likely reached maximum medical improvement. That my options now are to have surgery or live as I do. Most of the time I'm fine but that's by really be careful with what I do. Plus I reduced my schedule to part time after being out for 5 months. I also avoid all situations that would require me to sit or stand too long, like traveling. I do a lot of what I used to but there's still a lot missing. I would like to work full time and be able to travel again. I'd like to go to a movie without planning laying down decompression time immediately before and after.

I'm just worried surgery will make me worse, especially in the long run. I have a surgical consultation next week for a discectomy but I feel like with the disc above and below already compromised its just set up to fail.

While I'm not ready to accept this is as good as it gets. Being back to 75% is better than where I was a year ago and I don't want to go back either. I feel like it's a no win, so I'm curious what prompted you to have surgery and do you have regrets?


  • I had a discectomy that worked for a while, but then the disc popped again.
    The surgeon is the best in southern UK and has been specialising in lumbar surgery since before I was born.
    My pains wee being caused by a degenerating disc that kept popping, reducing in height and crushing nerves further each time. The best indication for me was fusion with a cage to lift the disc space back up and off of the nerves with rods & screws to hold things in place. Being youngish at 45, the fusion process was not an issue and being a non- smoker meant the fusion was likely to take on 6 week to complete its first 'knit' . I'm 4 weeks post op and all the horrible pains before have now gone. So it was definitely the right decision.
    For me, it was the honesty and caring attitude of the surgeon that helped me decide.

    L5-S1 herniation. Both knee meniscus tear. L4-5 herniation - 2 x nerve block injections. L4-5 discectomy. L1-2 nerve block injection. L4-5 reherniation - TLIF fusion. 2016: L1-2 and L5-S1 retrolistheses and multiple facet joint degeneration.
  • I had a sudden loss of muscle strength in my left quad. I went to my PCP the next day and he discovered I had no patellar reflex. I had an MRI that afternoon. The results the next morning indicated a free fragment herniation at L3-L4. I saw an orthopedic surgeon the next morning and was in surgery two days later. The afternoon of the surgery I had no reflex, but three days later the reflex slowly returned. The surgeon told me that muscle weakness recovers on a one to one basis with how long it's been defective. 6 months of muscle weakness yields six months to recovery AFTER SURGERY.

    I would not hesitate to have a serious discussion about surgery with your doctor.
    L3-L4 Laminectomy micro-discectomy 2008
    ALIF L5-S1 2012
    Facet Joint Ablation L2 to S1 2012
    Facet Joint Ablation. L2 to S1 2015
  • Thank you for the replies. I seen the surgeon and he wants an updated MRI. Mine was almost a year old exactly. He said he believes there will be a change given the time that's passed.

    I would like to get back to where I was. Just so hesitant because I'm pain free a little more than half the time.
  • EBurnsEEBurns Posts: 1
    edited 03/18/2015 - 9:44 PM
    To be honest, I did not have the time or space to think much about the treatment. Because in my case, the pain surfaced randomly and within 2 days it escalated and I had to undergo a surgery. Fortunately for me the pain subsided after that. But I have started to take more care of myself. Once in a year I go for a massage therapy and chiropractic treatment Also I have changed my diet plans and exercise routines.
    I hope your treatment goes well, and remember to follow up with the treatments and exercise regularly after the treatment.
  • dilaurodilauro ConnecticutPosts: 9,856
    They can put everything on the table, so that you are aware of all of your options.

    The pro's and con's of having the surgery or not, how long before surgery is needed, and what conservative treatment are recommended.

    My biggest concern after reading your thread was the fact that you have a compromised nerve root. Depending on the amount of impingement, surgery is generally the viable solution. Nerve damage left untreated can potentially result in long term problems.

    But it seems as though your doctor does not feel the impact to your nerve is not that great at the moment. Personally, I think under these circumstances, I would

    • 1. Ask the doctor why he/she does not feel surgery is required at this time
      2. What can happen if this is left untreated?
      3. Can this get worse?
      4. And of course, for a piece of mind, a second opinion would not be out of the question
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • After combing the internet for two months, I finally stumbled across your post. Thank you!

    My mom had a sudden loss of function, of her left leg, due to nerve impingement at L2-L3. This started Feb. 23rd. She had a microdiscectomy on 4/13. We are three days post-op.

    This is the first bit of hope we've had! She is depressed because she isn't walking without the walker yet. She's very independent and not liking these circumstances.

    Can you please share with us what you did to improve your situation? PT? OT? Etc.?

    Thank you again!!!

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