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Microdiscectomy Surgery for L4-5 Herniation...Help Please!

AnonymousUserAAnonymousUser Posts: 49,578
I have a 6 month history of a (R) Herniation...L4-L5 with (R) leg Sciatic pain. I have done all the recommended non-surgical treatments including, Physical Therapy, Chiropractor, Accupuncture, oral steroids and two Lumbar epidural injections. The treatments helped somewhat and I was able to continue working through the Summer.The first epidural injection did nothing. A week after the second injection I had excrutiating pain in my right calf and ankle. I was away from home on vacation and had to return via wheelchair assist at the airport as I was unable to stand or walk for any length of time.

Since my return beginning of Sept. I had another MRI which showed a Fragment compressing on the nerve root. This was not present in June MRI. Was explained to me that the disc ruptured and thus the cause of the fragment and the very painful aftermath. Have seen numerous surgeons...both orthopedic and neuro. who all recommend
surgery... a Microdiscectomy. One surgeon ruled out the use of the Endoscope due to he location of the fragment which he says is in the spinal canal.

Needless to say I can't believe I am in this situation and facing back surgery. I don't seem to have any other option since I'm told if I wait I will increase my chances of having permanent nerve damage. I am within that 6 month window that they say surgery is most successful.I have some weakness in the toes. Although the pain has improved greatly(on Lyrica)I still have some pain in my leg and intermittently in my back which reminds me that it has not gone away.
I am really scared and any reassurance would be helpful. People keeping asking me if there is any way I can avoid the surgery...but it does not seem possible right now. I am not able to work or make any plans for the future.This condition limits my ability to live normally. I just don't believe this will go away on its own...any thoughts?
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13

Comments

  • I had a microdiscectomy last Dec. 07. It does not seem that you do have any options because you do not want permanent nerve damage. It looks like you have done everything right as far as second opinions and third opinions. I understand how scary surgery of the spine can be but try not to worry too much. This surgery is much easier to recover from than a fusion and I have seen many people say that they were pain free as soon as they woke up from surgery. Try and keep that positive thought in your mind and it will help you get through this. We are here to listen, understand and support you and will support you through this entire process. Please take a look at the surgery section at the thread called post op must haves. This will be of great help to you. I was totally unprepared after my surgery and wished that I had found this site sooner. Good luck to you and please keep us posted.
  • Mandirae_ I agree with painintheback. You have approached your situation conservatively and with patience. I was not so patient and opted for L5-S1 discectomy at 10 weeks post injury due to the limitations that the pain was causing on me emotionally and physically. I did PT, dose paks and 2 ESI's before going to surgery which took 1.5 hours and 2 hours of recovery and then home. It is a hard choice but I received 85% pain relief when I woke up. I am now 6 days post-op and each day gets better with some lingering leg/calf/butt pain which will go away soon. Stay positive and know that it WILL get better. Make careful surgeon selections and go with a doc that does spine full time (Ortho or Neuro). Good luck!!

    L5-S1 microdisc 10/09/08
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  • Thank you painintheback and drake for taking the time to respond to my post. I am scheduled to see my last surgeon(neuro) next week. This MD has an excellent reputation in this field of Spinal surgery.Hoping to make a decision after this.
    It has been a process as I'm sure you know...learning as you go along. I have had my questions and concerns since opinions have varied about the type of surgery that would be best.Finding the "right" surgeon and feeling confident/comfortable has been my quest. Although I work in a hospital and consulted surgeons associated with my hospital... I was strongly advised to consult other surgeons associated with NYC Hospitals. I have had to go outside my comfort zone here which has been an added issue...but I realize it is for the best. I was told that the first surgeon that does surgery on my back should be the best. I certainly don't want to end up needing another surgery if I can help it.

    Accepting I need surgery has been the first step. The next is now deciding on the surgeon. That is where I am at now. Can you share how you came to decide on your surgeon...Orthopedic vs Neurosurgeon, recommended by MD or someone who had surgery, etc. might be helpful. Thanks for your kind words and support. Much appreciated. It really helps to talk to others who have had the same experience and to others who have had the surgery and are recovering. Hope you both continue to feel good and continue with you recovery.
  • I suffered from a L5-S1 herniation for 10 months (and during a pregnancy) before I finally gave up and had surgery. I was scheduled for a micro-d, but when the surgeon got in there, I needed a laminectomy, too. I, like you, tried EVERYTHING. I was determined to NOT have surgery. I have to say, however, that it was worth it. If I had it to do over again, I would have done it sooner. I am still dealing with nerve pain and am on neurontin. I've read and heard that I may suffer from the nerve pain (burning, tingling, 'swooshes' of cold) in my leg and foot for as long as the nerve was impinged. As far as I can remember, this happened last August when I was pregnant. So I am 6 months post op and getting more and more pleased with the results everday. I wouldn't wait if I were you! But demand PT after your surgery. My surgeon didn't order it and I didn't start that until 3 months post op and I truly believe that would have hastened my recovery. Good luck!!!!!!
  • If it makes you feel any better in my experience painwise. Having the microdiscectomy hurts way less then the pain I have had from my disc herniating. I think others will agree with me here on this. The first microdiscectomy I had I only took 1 perocet every 3 hours at the hospital the night of my surgery.

    The second microdiscectomy my surgeon had me on a morphine pump which I think was overkill. I don't think I needed such a strong pain med. I took it though it was nice to be pain free and also in control of my own pain medication while in the hospital by being able to push the morphine pump when I needed it. The max is once every 10 minutes I think it was. I did not need it that often though.
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  • Hey there. To answer your question, for 14 years I was a corporate VP for a company that manufactures spine implants, therefore I have been in surgeries with the best (and worst) spine surgeons. A Ortho did my microdisc but because I knew him and knew he specializes in these and is well know, I had a advantage. I would recommend either, but make SURE they only do spine. It's like commercial flying- you don't want to fly on a plane with a pilot that only flies part time. Do your homework and check references - patient successes and even ask for some patient referrals to call. Also, lean to a surgeon that wants to exhaust all conservative therapies before surgery. The ones that want to cut immediately usually are too aggressive.
    Good Luck.
  • mandirae said:
    I have a 6 month history of a (R) Herniation...L4-L5 with (R) leg Sciatic pain. I have done all the recommended non-surgical treatments including, Physical Therapy, Chiropractor, Accupuncture, oral steroids and two Lumbar epidural injections. The treatments helped somewhat and I was able to continue working through the Summer.The first epidural injection did nothing. A week after the second injection I had excrutiating pain in my right calf and ankle. I was away from home on vacation and had to return via wheelchair assist at the airport as I was unable to stand or walk for any length of time.

    Since my return beginning of Sept. I had another MRI which showed a Fragment compressing on the nerve root. This was not present in June MRI. Was explained to me that the disc ruptured and thus the cause of the fragment and the very painful aftermath. Have seen numerous surgeons...both orthopedic and neuro. who all recommend
    surgery... a Microdiscectomy. One surgeon ruled out the use of the Endoscope due to he location of the fragment which he says is in the spinal canal.

    Needless to say I can't believe I am in this situation and facing back surgery. I don't seem to have any other option since I'm told if I wait I will increase my chances of having permanent nerve damage. I am within that 6 month window that they say surgery is most successful.I have some weakness in the toes. Although the pain has improved greatly(on Lyrica)I still have some pain in my leg and intermittently in my back which reminds me that it has not gone away.
    I am really scared and any reassurance would be helpful. People keeping asking me if there is any way I can avoid the surgery...but it does not seem possible right now. I am not able to work or make any plans for the future.This condition limits my ability to live normally. I just don't believe this will go away on its own...any thoughts?

    Hello, Im Tom... And you have just met the man with the worst pain and had the most surgeries on low back. I wont spen all my time listing all the surgeries, lets just say I have had atleast dozen of them. I guess the position your in, you have to decide if first you can live with the pain, and the consideration of permanant damage, ok having said that along with everyone else... you have to ask if it is going to gaurantee you the relief you seek and then you have ask if you are committed to having a new life style. because as a professional I can say for sure "Once a bad back always a bad back" that my dear is gauranteed. Now, Im trying to de3cide the same thing now but having to take a much more radical approach such as a FUSION, i had all the other surgeries and afraid its next.
  • I am now sheduled for my L4-L5 Microdiscectomy on Nov. 4th. I am trying to mentally prepare for the surgery and maintain a positive attitude. I still have my concerns and trying not to be too scared. My pain level has improved, but I do have my good days when the pain is more controlled and other days when I have to take more pain medication. The Lyrica definitely dulls the pain in my leg. I am using the last MD I saw...a well repected and recommended Neurosurgeon. I hope the pain after surgery will be managable. I will be staying overnight at the hospital. I am beginning to lay out items, i.e. easy to put on clothes for discharge home. My husband will be staying with me first day home, but hoping I will be able to manage on my own after that. I was told I can't drive for 2-3weeks. I was surprised since I had heard from others 1 week. I will see the Surgeon 3 weeks after surgery for F/U. Was told No Physical Therapy or going back to work before then. He explained the surgery to me(which I had heard several time prior) which included removing some bone to access the spinal canal where the fragment is said to be. For those of you who have had a Microdiscectomy was this true for you? Any helpful information to help me prepare would be greatly appreciated!! I still can't beieve I'm going to have back surgery!
  • You sound a lot like I did before my surgery. :) In my case, the back pain hit me completely out of the blue, but it was so bad that I had no choice but to have the microdisectomy. The shock itself that I actually needed back surgery was huge for me. I can assure you, though, that the surgery is minor compared to what you have been through. If you are like me, you will wake up from surgery in 99 percent less pain and have to remind yourself in the weeks afterwards that you just had surgery and need to be careful.

    My NS told me I could drive in a week, but it actually hurt my back so I waited until two weeks was up. In my case, I think it was the shock of it all that had me back at work the second week after surgery. I just wanted my life back to "normal" as quick as possible. I was in a weird kind of denial or something, and it took awhile for me to wrap my mind around the fact I needed back surgery and had back surgery. The best advice I can give you is don't feel rushed to get back into your life as fast as I did. Lie back and relax, do everything your doctor tells you, and you will be just fine. Walking is the first thing they will have you do after surgery, and they will recommend you walk 45 minutes a day (break it up into 15 minute walks around your house to start with). It will really help get your strength back. No bending or lifting, especially until you get back for your follow up visit to your doctor.

    Like you, I was worried this would drastically change my life. I can honestly say my life is back to normal except for the fact I have to be careful not to bend at the waist (they'll tell you how to do this) or lift things that are heavy. I have to stop and remind myself, because the pain isn't there (except for some numbness in my foot the doctor says will take awhile to go away). Hopefully, your life will be back to normal in a few weeks, and you can plan for the future.

    I was surprised (and I think you will be too) at how the surgery itself was not as bad as I expected. The hospital experience is always a bit scary, especially if you haven't been in the hospital in awhile, but the surgery isn't.

    You might visit the "Back and Neck Surgery" posts on this forum, too, and you'll see a lot of other people going through the same thing you are. Be sure to also read the "Good News" posts to see all the success stories. For me, the fear of the unknown was the worst part. But that's what this board is here for, to answer your questions and give you plenty of support. Please update us on how you are doing and be sure to visit the "Back surgery and Neck surgery" section -- there's a great list of Post Op Must-Haves to get for when you come home from the hospital.

    Hugs,
    Haylie
  • Hi Mandirar, just wishing you all the best for your op.Like you will be i had this surgery back in July,the 17th. It was the best thing that happend to me i woke from the op with no pain what so ever.It's been a slow process getting fit again but the benefits of the op far out weigh the pain and agony i was in before.Don't be afraid of the op you should be looking forward to it as you will be getting your pain free life back.Wishing you all the best ,Chris.

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