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Possible L5-S1 surgery, looking for feedback

impact1400iimpact1400 Posts: 1
edited 01/13/2016 - 8:07 PM in Back Surgery and Neck Surgery
Hello everyone,

I'm a 27 year old male who is exploring possible L5-S1 discectomy, and I'm hoping to get your feedback. Quick overview: I was dealing with stiffness/discomfort/some spasming from August 2014 to October 2015. In November 2015 a sneeze caused severe pain, intense sciatica, burning, and some tingling from lumbar down the right leg. Here's a quick version of my timeline:

August 2014 - "minor" car accident; was rear-ended at a fairly low speed; no significant injuries at first but then lots of stiffness, some muscle spams and pain around tailbone and SI joint, but NO sciatica or other nerve issues

Oct. and Nov. 2014 - first round of Physical Therapy (bad therapists, I think); no relief

January 2015 - first MRI shows the following: a) loss of disc height at L3-4, L4-5, and L5-S1, b) 9mm herniation at L5-S1 and severe central canal stenosis, c) bilateral neural foraminal stenosis, and d) mild 2.5mm herniations at L3-4 and L4-5.

April 2015 through Oct 2015 - more physical therapy; was feeling great (almost "fine") in the summer, and then symptoms returned in September

November 2015 - I sneezed twice and felt the most intense pain ever from the middle of my back through my foot; for the next two days practically unable to walk or sit down due to severe sciatica and some numbness; received trigger point muscle injection in back (not epidural) and felt better within a few weeks; also started talking 600mg of Gabapentin (nerve blocker) daily; resumed daily life and desk job but still had moderate radiating pain near butt and down leg

December 2015 - second MRI, which is different from the one 9 months ago; does not mention severe L5-S1 stenosis; however, it says extensive very large herniation L5-S1 12mm anteroposteriorly with large free fragment of disc projecting 2cm over upper margin of S1 level causing significant compression of dural sac and compression of right S1 root; it also says mild central stenosis at L3-4 and L4-5 secondary to bulging discs; no foraminal stenosis on the study

In mid-December 2015, orthopedic spine surgeon essentially said to let my symptoms dictate whether or not I wanted to have a discectomy at L5-S1. He said it's not "dangerous" to avoid surgery right now, and if I could tolerate the discomfort with pain medicine and other treatments then I could choose to do that. His only caution was that the nerve may not recover fully if I choose to have the surgery way down the line. He also doesn't think there's a need to operate on anything at L3-4 or L4-5.

Late December/early January I took a two week trip to Europe. Was able to walk around all day as a tourist and felt okay as long as I took Advil regularly. (As a reminder, I have been on 600mg of Gabapentin daily since early November). I think all that walking and exercise was good because my life is very sedentary -- office job, driving in car, etc.

So now in mid-January I'm a little confused, as I do feel "better" but not "normal." Haven't taken any Advil or Tylenol in a number of days, just the Gabapentin. Can anyone who has had a similar experience shed some light? I realize I am young and maybe my body is reacting differently, but I'm surprised that the flare up in November only lasted a few weeks and since then things have been moderate to mild. Has the Gabapentin really masked things that much? Everyone who sees my MRI wonders why I'm not in the severe condition I was in back in November.

Any input would be much appreciated. Also, I have an image from my recent MRI that shows the problem at L5-S1. Please let me know if it would be helpful to post. Thanks!!

No one on the Spine-Health patient forums is medically qualified to provide any advice or recommendations on any diagnostic test. However, the following key words can always be applied.

  • MILD Treated with conservative measures such as Physical Therapy and mild medications. Many times these situations can be cleared up and the condition can be resolved.
    MODERATE Some more treatments may be needed, ie Spinal Injections, Ultra sound and stronger medications. Always a possibility of more aggressive treatment if the conservative measures don't help
    SEVERE Need for stronger medications. The requirement for surgery may be necessary



  • LizLiz Posts: 7,832
    Please take the time to read this post and refer to it when you have questions

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    Liz -Spine-health Moderator

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • Doctor said i need fusion L5-S1 asap. Because of injury at 25 now 43. Disc is degenerated and vertibre are not holding up.well and the pain is unbearable. I am so sorry what you arw going through. How.does anyone know if the surgery and surgeon is best choice. I am going to keep looking around let you know what i find and let me know if you decide what to do.
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