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Second Surgery

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:25 AM in Back Surgery and Neck Surgery
In August of 07 I hurt my back at work by moving a stuck pallet. L4-L5 and L5-S1 are ruptured and there are a few that are bulging above those. I went to a surgeon who said I needed a two level fusion. After that, I went to another that thought he could do a lumbar laminectomy and micro discectomy on one disc and nothing to the others. I had that surgery on L5-S1 in July of 08. I slowly got better for a few months until around this past November when I started having severe pain. It's now to the point where I'm in severe pain most of the time and am in some type of pain all the time. The pain is worse now than it's ever been. I'm going to get an MRI tomorrow morning to see what's going on. My doctor thinks it's one of three things. 1. Scar tissue. 2. L5-S1 is ruptured again and needs to be re-operated. 3. L4-L5 is worse and needs to be operated on.

He said the worst would be scar tissue since there's nothing really that can be done about it. I just wanted to get anyones thoughts. Can a second surgery just like the first be done on the second? Can the same surgery be redone one the same disc? Might I need a fusion now? Would a disc replacement come in to play? So many questions. I will also ask my doctor's opinion but sometimes doctors prefer one thing and try to get everyone to do just that. I don't think mine is like that but I still want opinions.



  • I wish I could give you advise, but unfortunately I can't. But I know some people on this forum had second surgeries, so maybe they will offer you their wisdom. I just wanted to wish you the best, hopefully the MRI will shed some lights on your problem. I also wanted to ask you, do you have a good feeling about your surgeon? Even if you do, if at all possible, it is always a good idea to get a second opinion.

    Good luck, and keep us posted.

  • I agree about getting a second opinion. I live in DC and hear great things about my surgeon all the time. He was my second opinion the first time around. I'm sure I'll get a second opinion this second time around as well. I'm in such severe pain now that I can't wait to find out about the results of the MRI.
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  • i had back surgery feb 2007..i had a herniated ruptured bulging disc pinching a nerve.L4/L5 AREA.i recovered from that surgery but by the time they did the surgery most of the disc was ruptured..i recovered from that i did heal however a few months later i started having pain again..i go numb,my legs cramp, i sit down too long my back hurts,stand in one spot too long my legs cramp.i get this burning feeling in my right foot.i had a second mri done.more disc protrusion between the L4 TO L5 area..i go to work in pain..everyday..so, i know how everyone here feels when it comes to back pain..i just had nerve testing done today.i find out the results next week.ill let u all know how it goes
  • Have you had anyone discuss a Spinal Cord Stimulator for your condition? Are you taking any meds for nerve pain?

  • I'm interested to see if anyone answers your questions. I asked similar ?'s earlier in the week and still have many of the same ?'s.

    I have had L5/S1 laminectomy/discectomy and found out yesterday that it is reherniated but in a different location than before. My surgeon said that sometimes, but not often, this happens. He said that it is most common in young moms and construction workers.

    I had an epidural this morning. If you try this route, be prepared that it could be quite different than epis you had before surgery. I wasn't expecting that. They had to do it with dye that I'm allergic to, so it was a slight hassle. If the epi doesn't work by Friday, my dr. wants me in for surgery next week.

    One more thing that I didn't know. With a 2nd lam/discectomy, he said that he would suck out all of the jelly stuff from the disc. He didn't go into more detail because I was in SO much pain that I couldn't handle talking about it.

    Enough rambling....sorry. I just hope I helped and answered your questions in some way. I'm so sorry you are going through this and hope you are feeling much better soon. Best of luck and God bless!
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  • I got an MRI last week and brought it to my pain management doctor. He told me that I need to get in to my surgeon immediately. He said that I should tell them that I need to get in no later than this week due to a complication from surgery. Just my luck, my surgeon is out of town for the next 2 1/2 weeks and is booked for month. They said if my PM doc calls that maybe they can get me in 2 1/2 weeks when he gets back. I told this to my doc and he suggested that I get someone else to look at them. After that he said that he thinks I should get epidural shots again. I told him that I don't really want to do that. I had three last year and they didn't help at all and in fact I think they made me a bit worse. I'm in so much pain right now that I couldn't put off surgery for shots and I know I'm going to need surgery. I'm having 10 out of 10 pain on and off and a minimum of 7 or 8. Here's what the MRI says. Maybe someone can translate it for me. L1-L4 are bulging.

    There is a diffuse disc bulge and broad base central disc herniation that extends .1 cm beyond the endplate margin. There is mild crowding of the exiting L4 and descending left L5 nerve root. There is no spinal stenosis.

    L5-S1 (the disc I had surgery on in July 08)
    There is a diffuse disc bulge and broad base right paracentral/subarticular disc herniation that extends into the right foramina filling the right lateral recess. It is filled with disc material seen on axial image 17 of series 5. The disc extends .3 cm beyond the endplate margin. There is severe crowding of the exiting right L5 and descending right S1 nerve root.

    After the administration of contrast media, there is right lateral recess soft tissue enhancement that crowds the exiting right L5 and descending S1 nerve root.

    1. There is a right paracentral/subarticular and foraminal disc herniation with granulation material. This results in severe crowding of the exiting and descending nerve root on the right. There is no body spinal stenosis, however.

    2. There is a broad based central disc herniation at L4-S1.

    My doctor gave it to me and said "this is what's causing the pain you're having". He was busy and I just stopped in to pick up the report. I need more info. What should I expect. I believe/hope I can fix this with surgery but would like opinions and to know what type of surgery I may expect.

  • I am not a radiologist or surgeon, but I agree with your PM doc, see a surgeon. I'd guess you're having severe right leg pain by your report. Besides the herniations, sounds like disc material is leaking out which is quite irritating to nerve roots. Granulation material means scar tissue. Sounds like the radiologist thinks that the amount of space in your spinal canal created by your bones is fine, it's the bad discs and scar tissue that are causing problems. Once again, just what I think he's trying to say.

    It's one of the more impressive reports I've seen-they usually don't use words like "severe" unless they mean it. Also note that MRI's do not always show the extent of herniations or tears in discs, so there may be even more than what the report states.

    If it were me, I'd make an appointment with another doctor that you trust and can get you in sooner. Kind of disappointing that your PM doc is not helping expedite this. Then I'd also call up your surgeon's office. Make sure his nurse has a copy of your MRI and ask her just to show it to him and I bet he'll get you in quicker. Since he's your treating doc it might even be considered malpractice if he saw the MRI and DIDN'T see you. I'd have appointments with 2 surgeons so you can have 2 opinions, very important.

    As for what surgery? If I knew, I'd be making a lot more money than I am. You had a previous opinion of fusion, maybe that's what you're looking at now???? Don't know but I do know you need to be seen soon.
  • I finally got my PM doc to call the surgeon and he was able to set up an appointment with the surgeon for me on Jan 7.

    I really want to know what's wrong with me that's causing all this pain and what may need to be done to fix it. I'd love to hear some opinions. I know that's all you can give but I'd love to hear some different views. Don't worry, I won't hold you to anything.
  • Speculate on treatment? I'm not a doc, keep that in mind. I gave you my interpretation of the MRI report.

    You've got an difficult situation as I see it. You've already been told you need fused from L4-S1 at an earlier appointment, right? Well, this report states that you also have bulging discs from L1-L4 also. Many people have non-symptomatic bulging discs. They never even know it until they have an MRI for something else and it's seen. However, whenever you have a fusion, you have a "golden window" of about 10 years until the stress of the fusion makes the disc above(and below if not fused to S1) go bad. If you already have discs above a possible fusion site that have issues, presents a bit of a problem. Will they go bad quicker if you have the lower level fused? Will the doc say heck with it, fuse it all? Don't know a whole lot about disc replacements but I doubt you're a candidate becuz I think you have too many levels involved, but maybe some of the spineys with disc replacements can weigh in on what their docs told them.

    Have you had a discogram before? That might help decide how many levels generate pain and need to be worked on. It's not a pleasant test but many neurosurgeons consider it the gold standard to isolate bad discs and nerve root compression. It helps specifically identify which areas are the pain generators.

    In my lowly spiney opinion, I don't know what a surgeon would do because of the multiple problems. What I do know is that you need to be seen and it is SO IMPORTANT to have more than one opinion. I cannot stress enough that you need to schedule an appointment with someone else to help you make a better informed decision. You may love your current surgeon, but you only have one spine and you HAVE to make sure you feel good about your treatment plan. Please get more than one surgical opinion and do it soon.

    Keep posting your updates so we know what the docs say and how you're doing, I'm really curious about you.

  • So I finally saw my surgeon yesterday. It takes a while to get in to see him but it's always worth it. He's the best in the area.

    He said that L5-S1 is totally blown out again and he needs to operate pretty soon. He set it up today for the 29th of January. I was pretty excited when he told me the news since I knew I'd soon have some relief. As soon as they called today with the date I got overwhelming anxiety. I know it'll be the same procedure as last time but I'm still very nervous. Wish me luck.
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