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L4-L5 central protrosion / annular tear, need a solution

jdevrienjjdevrien Posts: 9
edited 11/03/2015 - 5:48 PM in Back Surgery and Neck Surgery
First of all, I am new to the site and it looks like this is a good community with lots of usesful advice. I'm 29 and have been dealing with significant back pain since i was 25 when i injured my back while detailing cars. (lots of repetitive bending and twisting with a buffer and being 6'4" didnt help). I'm getting to be desperate for a solution, as all my hobbies have been on a shelf for some time now and while i have had numerous periods of successful healing, overall im on a downward trend. A year ago my MRI showed an annular tear at L4-L5 and this year it shows a paracentral protrusion (about 4-5mm, my own measurement on the images). The surgeon also noted evidence of nuclear fluid being present around and outside of the joint where it shouldn't be. My pain is 95% in the back/disc but can escalate to sciatica (by doing simple activities that would never hurt a normal person). My surgeon who has done a number of successful surgeries for friends/family gave me 3 choices: 1) do nothing 10-20% chance of success 2) microdiscectomy/laminectomy 3) fusion ... but he felt strongly i shouldnt go the fusion route. I chose to do nothing and hope for the best continuing conservative treatment but so far im still miserable. My surgeon is confident that microdiscectomy would be successful for me, but admits the risk is if it fails ill need a fusion. The reading I am doing indicates there is not a high success rate for a microdiscectomy of a small protrusion like mine and aren't effective for back pain pain (rather radicular pain). I did challenge him on this but he stuck with his opinion. My situation is far from an emergency, but not being able to do projects and enjoy my hobbies is killing me... and today i even turned down a job opportunity Ive been hoping for because of this, so i need to get this dealt with ASAP. 4.5 years is enough, my life is passing me by.

filling out the recommended form....

- When did this first start?

4.5 years ago at age 25, currently 29

- Was it the result of an accident or trauma? No. I worked too hard at my side job detailing cars.
- Are there others in your family with similar medication conditions? No.
- What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc) 3 surgeons, 3 pain management doctors , 1 OMM doc

. Which doctor did you start with? Primary Care Physician
. Who are you currently seeing? Orthopedic Surgeon

- What Conservative treatments have you had? Which ones?

. Physical Therapy --- 3 tours
. Ultrasound / Tens unit -- ultrasound
. Spinal Injections - 3-4 series of treatments
. Acupuncture - Never tried
. Massage Therapy - yes

- What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc) MRI

. Summarize the results, please do not post all details, we cannot analyze them
L4-L5 central protrusion (4-5mm), history of annular tear, evidence of leaking fluid.
. How many different tests have you had over the years? Similar results?
3 MRIs, 1 CT scan, numerous Xrays

- What medications are you currently using? (details, dosage, frequency, etc) None, pain killers make my situation worse

- Has surgery been discussed as an option? (If so, what kind) Yes. Laminectomy/Microdiscectomy and Fusion (Fusion not recommended).
- Is there any nerve pain/damage associated? I would say it is less than 10% of my pain, but it can quickly progress to nerve pain. I do have some mild weakness in my right leg/foot but doesnt affect my ability to function.
- What is your doctor’s action plan for treating you?

Do nothing(continue PT) or microdiscectomy.



  • SavageSavage United StatesPosts: 5,476
    Welcome to Spine-Health
    Please click on link for helpful information!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • Any advice? The annular tear seems to be my bigger part of my problem, its very rare i have sciatica. Im at a point right now where i can feel the disc re-tearing on a regular basis. I am trying to walk and rest enough daily to pull out of it. Everything i read says this isnt a surgical situation and a microdiscectomy is not a good solution for this. but I really want to get back to a normal life soon. Part of me has faith i can heal it naturally the other half wonders if im just kicking the can down the road. Would really like to hear from someone thats been through something similar.

    I'd also like to hear from people that have had fusions at a young age. Everyone has been telling me NOT to get a fusion because I will need repeat surgerys down the road. Is that necessarily true? If i play it smart and take care of myself is it possible to avoid additional surgeries after a single level fusion?
  • jdevrienjjdevrien Posts: 9
    edited 11/18/2015 - 4:46 PM
    Still struggling with this. A good nights rest always does me well and i feel good in the morning. But by end of the day that progress is undone. Im using my back brace to get through the day. When i tried going without it st my desk job yesterday the weight of my body compressing the disc was enough to make it act up. Today i wore the brace all day and feel like i am depending on it now. I just find it so hard to ask for a fusion when i am not in extreme pain and can walk around fine. But as stated ive already turned down a job opportunity, ive lost interest in dating, and my hobbies are non existent. Also im very wary of any distance travel, which luckily work hasnt asked me to do lately. Im still at a point i can get by but i think the day that my hand is forced to do something isnt far down the road.

    Again, surgeon wants to do a microdisectomy but i have a hard time believing this disc will ever heal.
  • SavageSavage United StatesPosts: 5,476
    It may benefit you to use the search on this site, upper right on page.
    Type in your concerns an you may be led to current posts, or older posts, articles and or videos.
    You may want to jump into thread that is covering any of your issues, as you read about other people's experiences.

    You may want to double check with doctor if brace is okay and for how long a periods of time.
    I'd also explain the relief you get from it.

    It can be a lonely situation when we must put all our energies into taking care of our bodies screaming pain.
    There is also a post entititled....The Blend.
    It has ideas to treat the pain from different directions.
    You can tweak it for your own interests and personality, and it's really a good read.
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • Thanks Savage.

    Figured id check in here again. Per my doctors instructions i have been working daily on strengthening my core. Not quite the 8 or 6 pack he wants, but im getting there. I have made an agreement with myself to not worry about my future for right now and just let it ride. My pain has been changing.. For a while it seemed like forward progress. There has been less discogenic "ache" now that i am stronger. Im not regularly depending on my back brace anymore . However, my disc still seems to be very unstable when attempting light to moderate activities. It seems that 90% of motions i make throughout the day are manageable, but there are particular movements that downright nuke the thing. Sometimes im lucky and can stop the motion in time, othertimes the smallest movement hits it like a gunshot and i nearly jump out of my shoes. Tonight doing the dishes (standing straight) and having my arms out in front of me for a few minutes was enough to cause significant pain. As miserable as that sounds, the bulge/tear causing this will subside in a couple days like it always seems to and ill feel fine until the next one strikes. For now, i am just writing in my journal and not caring about making a decision. I think the answer will present itself one way or another soon. The most challenging thing is having a business idea i want to pursue and having to restrain myself!
  • jdevrienjjdevrien Posts: 9
    edited 01/29/2016 - 12:02 AM
    Bumping this up again. Im pretty much at the point i believe i need to try some kind of surgery. Day to day living is no problem for me. im not in extreme pain but i still have zero stamina for physical activities other than my therapy exercises. Im not participating in any of my hobbies and overall neglecting the maintenance of my home (my 60 year old father does all the handyman work now). Its not how i want to live and im more afraid of doing nothing with my life than physical pain at this point.

    Any thoughts on microdiscectomy or fusion for an annular tear? I feel like the discectomy is worth a shot, but im also concerned its not going to hold up to what i need it to do and it will end up being more time wasted. And if it does heal correctly im concerned there will still be nerves in the disc causing pain. I know fusions dont bode well over time but at this point 5 years of good function sounds better than zero.

    Please, do think that by adding a comment to your thread is going to get any quicker responses. Let things take their natural course. People will respond when they have things to say

    Liz, Spine-health Moderator
  • jericho163jjericho163 Posts: 44
    edited 01/28/2016 - 4:41 PM
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