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Stressed after 2 failed microdiscectomy/ What's next in my future?

i_hate_sciaticaii_hate_sciatica Posts: 5
edited 04/09/2015 - 8:03 PM in Back Surgery and Neck Surgery
Hi All,

I am new here. I wanted to post my situation and to hear from others who have similar stories. I just had my third MRI today and came home to plug in my CD to find out once again I have re herniated after my second microdiscectomy/laminectomy on my L5S1.

Here is my history:
8/2014 -large herniation/horrible sciatica pain
9/2014- Surgery 1/micro/lamin/ surgery went great-re herniated within 4 week post op
2/2015- Surgery 2/ surgery went great/ pain came back at 2 week post op
4/2015- MRI reveals a slight re herniation/pain in calf/foot

So, this is where I am. Completely horrified and disappointed. My follow up is in another week and half with my surgeon. This was supposed to be a re check after surgery though will turn into something more serious now. I know I've read a lot of info stating that most spine surgeons usually will not do a Third Microdiscectomy.

My fear is maybe fusion will be in the topic....but honestly, it is such a small part of fragment poking out in my nerve canal (because I'm running out of disk space) that I'm not even sure what to consider. So many questions I have. I have heard that even a level 1 fusion could cause other disks above to collapse and cause further problems down the road.

Should I take a conservative approach? Would fusion be a good idea? Is it worth it?

I look forward to hearing from you all with similar experiences.

Thanks so much!



  • LizLiz Posts: 7,832
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    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • my situation as well there seems to be very many different "terms" used to describe the surgery on has endured. I was told I was having a microdisectomy , however as I got further in after surgery, due to pain 2 weeks after left side minimal but increased on right, I learned I had a laminectomy as well as the microdisectomy, which I researched on my own because I had the rarest of disk herniation which is an extrusion. Jelly ballons up pushes out and breaks off and lodges into the nerve. I did not have any instrumentation just the disk fragment removed from the nerve. I too felt great first 2 weeks followed drs instruction to T even had a family member come stay with me...What brought me to Dr. was all left sided leg pain from an injury, shoveling snow and fell, never had any back pain. But MRI confirmed the disk extrusion. I too started having pain about 2 weeks after surgery. Left sided and now right sided my surgeon did a post surgical MRI. Came back with scar tissue but doesnt look to be right sided and report said possible re herniation but from disk dr didn't feel he saw anything to suggest re herniation.
    I unfortunately am 12 months post op from my surgery call it what you will no instrumentation and two failed post surgical epidurals one severe, a "wet tap" no patch just bed rest recovered in 5 days...I had toradol, I had steroid packs ..I've had land PT water PT, traction, have had 9 mris , one radioactive bone scan, which had an uptake at T 7???whats that???? I had full arthritic lyme, blood work, xrays, a nerve test which I question because I had been on valium at the time of the test then I read later in an article you should not take a sedative drug with this test????and aside fromLast MRI read granulation l4 l5, scar tissue and some neuroforaminal encroachment?

    But all still left sided nothing to explain---- severe right sided pain----- back is a dull ache,now because its had surgery I'm sure I have soft tissue swelling below incision site but I've described its like sitting on a rock on the right buttock for hours and my tail bone is so predominant now my pain doesn't go down the back of leg like most sciatic sufferers... mine goes around hip increase of where your hip sits and travels over top of leg into inner thigh feels like a vice on the nerve sometimes into the lower extremity. Sometimes numbess and leg weak ness hardest to get up in the am.. Ive been diagnosed since surgery with SI joint, femoral nerve dysfunction, periformis, I don't think many doctors diagnose this, but every time they try something to help these conditions they just cause more pain...including PT...So now neuro surgeon is suggesting what ever you call disk removal and instrumentation and fusion and clean up scar tissue, I am going to bring to his attention on Monday when we discuss that I did read on another thread that someone had particles from their laminectomy that did not show up on the MRI which is what I feel may be happening in my case maybe something so untraceable by test that they can only see once going in ?? is rubbing against this scar tissue, has itself wedged into a nerve and because my activity brings on pain maybe its freaking out my peripheral nerve system???

    Has anyone had something going on but drs really could "see" until they were in?

    Unexplained pain on opposite side since surgery? Brought on by activity or sitting but NOT DOWN BACK OF LEG over the top to inner thigh????

    My next step which freaks me out is surgery, and I just want my quality of life I can deal with a few flare ups but this is 12 months of constant...and answers or similarities please post...desperate....THANK YOU
    This can't be happening
  • FritzcrackerzFFritzcrackerz Posts: 246
    edited 04/12/2015 - 11:28 AM
    Fusion has its risks but, when you get to the point where you have reherniated after conservative treatment and discectomy surgery, the benefits far outweigh the risk.

    My surgeon told me that a discectomy is like trying to repair a flat tyre by cutting off the flap of tyre wall that is sticking out. The air will forever be trying to escape as the hole will remain.

    Have a look at the TLIF fusion video on this site. It explains how the disc space is lifted back up off the nerves, any scar tissue from previous discectomy is removed, then the vertebrae are fused in place with a cage full of bone graft and screws and rods to stabilise while the bones fuse.

    Some people have massive herniations with no symptoms at all, whilst others have a slight bulge and experience agony. This is because we are all made and wired differently. The good surgeon will rely on the clinical assessment of the patient and listen to their reported pain, then imaging should show where the problem is to confirm their diagnosis. Poor ones just rely on imaging and ignore the patient.

    The headline figures are that 70% of fusion patients see a marked improvement of their symptoms and 5% get worse. My surgeon said that the 5% is made up of people with other pre-existing conditions, massively obese or heavy smokers. He also stated that, once the vertebrae have fused, the condition can't deteriorate again, unless you break it.

    As for adjacent disc failure, you will have to make lifestyle adjustments to reduce the risk. Learn to lift properly without twisting, improve your posture, lose some weight, that sort of thing. Accepting the fact that no spinal surgery is ever going to restore your back to pristine condition.

    As you will see from my signature, I've gone from conservative treatment to discectomy to fusion. The fusion was 7 weeks ago. My sciatic pain and CES symptoms are gone and I'm grateful to my surgeon for giving me back my future.

    The decision is yours. It's a personal risk assessment, informed by your surgeon, a second opinion if you're not sure and whatever info you can glean from sites like this. If you feel the benefits outweigh the risks...

    Hope that helped,

    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.
  • Steve (Fitzcrackerz's) answer was spot on. Like both of you, I've had repeated herniations of the same level, causing severe pain and massive disruption of lifestyle. I tried everything recommended, both conservative and more conservative surgery, but in the end, the only thing that stopped the reherniating was a fusion with instrumentation. It wasn't a fun surgery, but it did fix the structural problem. That was almost 7 months ago and I had one other revision surgery about 4 months ago because I've had extenuating circumstances with some lingering nerve damage, but I don't regret the fusion. I don't have to wait and wonder when the next shoe is going to drop.

    That being said, it is a long tough recovery and definitely not a surgery to be taken lightly. Do your research and interview surgeons. Know what to expect and you might find that it isn't as bad as you are dreading (I was so very nervous before my fusion, where I hadn't been with my other surgeries.) If there are any more specific questions, I know lots of people here are happy to help with any info they have! Good luck!
    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
  • Thank you all for the great info! I will do my research on the TLIF fusion . I see my surgeon next week to discuss options! I'm also wondering if there is a non invasive way to perform this type of surgery as I ran into a guy who does medical sales for spine surgeons and he gave me a highly recommended neurosurgeon in my area who performs it. He said something along the lines of where they make 2 holes in the lower back... Not the typical larger incisions.

    I will post what my spine surgeon suggested ... Thanks again in advance for taking the time to respond!
  • There is definitely a non-invasive fusion...that's what my TLIF was. To give you an idea of the size of incision/scars that I have, I have three identical one-and-a-half to two-inch straight incisions across my very low back. For me, the surgical pain was never as bad as I thought it would be. I had two microdiscectomies through the same incision and then two new incisions for the fusion, one on either side of my spine. I think people would be very surprised how small the incisions turned out to be.
    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
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