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mico disectomy questions

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:25 AM in Back Surgery and Neck Surgery
I have a L5-S1 herniation for more than 1 year. Normally, my lumbar has a pain level of about 1 out of 10. If I lift more than about 30 lbs the pain increases. Hopping up and down also increases the pain. However, I don't have leg pain or shooting pain, though there's some dull pain inside the abdomen.

I have seen two doctors, one specilized in sports injury; another specialized in back surgery. Both told me I don't need surgery. But my back has decreased my quality of life. For example, traveling is a problem because luggages weighs 40 lbs apiece so moving them around is a struggle. I can't jog or hike down hill because both involve bouncing movement which aggravates my back.

The only thing I was given to do is physical therapy or back exercises. This keep me in the condition I mentioned above. If I don't do them, then it gets worse.

I read about people having micro disectomy and then are able to lift heavy weights. I'm having surgery envy.

If you have micro disectomy, what was your pain condition before and after the surgery? Is it necessary to have shooting pain in the legs before surgeon would operate?


  • Ouchy, let me first say WELCOME TO SPINE HEALTH! The people here are wonderful. I am relatively new -- been coming here since right after my Microdisectomy on Sept. 5 of this year. The following is my opinion, so take it with a grain of salt. I know others will provide additional viewpoints, but here is what I think the answers to your questions are.

    In my humble opinion, please do not have the surgery unless you have horrible pain or numbness in your legs or loss of bladder function. If the docs didn't recommend the surgery to you, don't do it.

    I am a little over 3 months post-op, and I still have numbness in my foot. Other than that, I am relatively pain free. What that means is that I still have weird twinges of pain in my back, butt, and legs, and each one brings with it the fear that I have reherniated my back. So far I haven't done so, but according to my physical therapist, it could happen at any time if I am not careful.

    Life after a MicroD involves a major lifestyle change. They cut the protruding disk off, leaving the remaining disk without any protection. After three months the scar tissue has formed a single bond that is easily broken. As time passes, more scar tissue will develop to either strengthen the bond or to grow into the nerve again to where I am back at square one with sciatica pain that may need surgery.

    I cannot bend over at the waist (I have to lift my leg behind me to ensure I bend at the hips). I will always have to avoid bending at the waist. I cannot run at all until it's been 6 months from my surgery date. Then I will still have to be careful. I will never be able to do things like climb a tree and install Christmas lights and then jump out of the tree as I have done in previous years. My weak back will not be able to tolerate it. According to my physical therapist and neurosurgeon, I will never be able to pick up more than 25 pounds again. Right now, I am still at the 8 pound limit. I don't know who can lift heavy weights safely after having a MicroD. I would not even try it.

    In the event I do reherniate my back, I will either have to have another microD or have a fusion (which takes months and months to heal). I am not looking forward to either one. A MicroD does not put you back 100% in my opinion. I look at it as a shortgap to prevent having the fusion. I have to accept the fact that I have a weak back now and will always have to be careful.

    So bottom line is, do anything you can first before you have the MicroD. If you have bladder problems or numbness in your legs, get to your doctor quick. Otherwise, I would try to stick it out a little while longer and be thankful you can still run and jump at all. After the surgery you will not be in a better position than you are right now (other than some less pain). You will live constantly thinking about your back and how to protect it. You will not be able to lift heavy stuff. At least this is what I understand to be true.

    If I had any choice in the world besides the MicroD, I would have avoided having the surgery. But in my case, I had no choice as the disk was protruding 1 CM into the nerve. I hope this helps!


  • Good afternoon,

    I agree with Hayie to a certain extent. If you are registering only a 1 in pain level, most likely a micro will not help improve your quality of life. If you have been to 2 surgeons, I'm assuming you have had an MRI, and they both say no then I would find a sports trainer who specializes in lower back injuries. Not being able to lift more than 40lbs sounds a little weird to me, but everyone is different in the world.

    I personally had a laminectomy and discectomy on l4/l5 and l5/s1, in July of this year (2008) after having back problems for 8 years. I went from a condition like yours, to have occasional flare ups, to in May of this year having lost complete feeling in my right leg. 5 months later, I personally can lift well over 100lbs if needed, I go to the gym 4-6 times per week to lift, ride a bike, etc... I do have problems with stiffness, though I can bend over at the waist without too many problems. Sit-ups are a bit rough, but 5 months is still very early for back surgery.

    Only you can decide ultimately, but it sounds like it would be best to find a sports fitness specialist and continue building of your core muscles.

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  • Have you gone for an MRI?
    An MRI with contrast is helpful.
    Keep in mind that it may not show what is actually going on, or shows something completely different from what was suspected.

    Your case kinda sounds like mine 15 years ago.
    I "toughed it out" and the nerve was irritated constantly.
    The bodies natural response is to send out chemicals to tighten the muscles in an effort to firm up the area and prevent further injury.
    Over time, the muscles "squeezed" the hydration out of the discs and eventually lead to disc dessication. Once they dry out, they never recover. (there is ongoing medical research in this field however).

    Keep an eye on neural signal impingement.
    My right leg shrank over a 9 month period of time because the disc was putting pressure on the nerve.

    Keep researching endoscopic disc decompressions.
    There is a technique available that is not as traumatic as normal microdiscectomies.

    To answer your question, my L4-L5 case was 80% back pain, with some leg pain. 9 on a 1-10 scale.
    My L5-S1 case was 99% back pain with very little leg pain. 10 on a 1- 10 scale.
    So yes, they will operate.

    For now, my L4-L5 is doing great.
    My L5-S1 is causing me problems however.
    It is not letting me lead a normal life and I know I will have to limit my activities as long as I have these discs.

    Many patients go on to lead normal, unlimited, productive, happy, pain-free lives.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • H Ouchy,

    I had a microdiscectomy/laminectomy last year for a herniation at L4-S1 and severe DDD at L5-S1. I didn't find know the extent of my problems until the following year. After this surgery, I woke up with severe pain in both my back and my leg. I stayed 3 days at the hospital and it was recommended that I go on to the rehab ward. I decided to go home instead and have home health care come out to my house. While trying to recover, I had so many problems and had a ct/myelogram and 2 post op ESI's. PT wasn't very helpful either. Three months later I was released by the surgeon and was sent to pain mgt. A few months later I found out that I still had nerve impingement on L5-S1, retrolisthesis, benign hemangioma. To sum it all up, the surgery didn't help me.
    I went on to have a TLIF/Laminectomy, and they also found facet arthropathy. I didn't even know I had problems with that. All I knew was I couldn't sit, stand, or walk without pain. I'm going on 7 months post op now and I face a daily struggle with chronic pain and take multiple medications. This is my experience so far. If you're having pain ranging on 1 out of ten, it seems to be manageable with conservative measures, as long as there isn't any nerve involvement. Surgery is not a cure all and your chances are 50/50. If you do go on to having it, I hope nothing but the best for you. Take care
  • January 10,2008. I started out with a 11 milimeter herniation (that is huge) :jawdrop: . My situation is a little different from yours since your herniation is smaller. But I will share my story. :)

    The docs wanted to do a fusion, but preferred the front approach. I was over weight and because of that the risks were too high to come in from the front. :( Initially they told me (because of the magnitude of the herniation, and what it was doing to my nerves) that I needed to lose weight as quickly as possible. :O Two days later, I got a call from them saying they were going to go ahead and do a diskectomy because I couldn't afford to wait until I lost the weight because of what the herniation was doing to my nerve. :SS I was told the diskectomy might actually be enough and I may not need the fusion at all. =D>

    I had surgery on a Thursday, and by Monday I was off all meds. That Saturday I was walking around a new home complex for well over an hour, and no pain. =D>

    At the end of February I noticed that the "familiar" back pain was coming back, and getting worse. Went back to the doc in March. He did a x-ray, and told me that now my disk had completely collapsed, and fusion was the only option. :''(

    Sorry for the long saga. :D My point is my diskectomy only helped me for a short time. But that's just me. Although surgery is surgery, diskectomys are usually minimunaly invasive, and often help a lot of people.

    I would really think about this decision though. If your herniation is small, then you may be able to manage it with PT, who knows. You will know in your gut what the right decision is.

    This is solely my opinion, I am not in the medical field or anything. Every situation is different.

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  • I see, surgery doesn't always work.

    That's probably why the doctors are reluctant to operate on minor pain.

    Thanks for the feedback. I no longer have surgery envy.

  • I had a radical one almost 1 year ago. My leg pain is better but my back pain is worse. This is just my opinion but I would wailt until it got much worse before considering surgery. There are no guarantees. Might make it better but it might make it worse. Is it worth the risk? Also, microD weakens that disc and makes it more likely to rupture and places more stress on the discs above to carry the load. If I would have known 1 year ago what I know now, I would not have had surgery. I was able to manage pretty well having rhizotomys done yearly. My doc told me that the microD and laser surgery could make it so that I could stop with the rhizotomys. It did not. 2 weeks after surgery I was in such pain that I had a 5 level rhizotomy (nerve burn). I am not trying to be a naysayer because lots of folks have success but you must decide if it is worth the risk to you. Good luck on making that decision.
  • Dan, what is your secret to being able to bend at the waist and lift so much? What restrictions do you have, and how long do you have them? My physical therapist made it sound like I will always have a weak back and have to be careful. I admire all you can do, especially at just 5 months post op! You are an inspiration.


  • Hi Ouchy,

    I have a herniated disk at L4-L5 with pressure being on my L5 nerve root. Basically I have servere sciatica, on a scale of 1-10 of pain I was 12. I cried all the time, I finally went to see my Dr. who sent me to Pain management but before I could make that appointment I went to the emergency room and was kept in the hospital for 4 days. I had a MRI and the neurosurgeon said I could have surgery but I should try a epidural shot of steriods. I did that and it didn't do anything, it took just the edge off so I could at least sleep. I was taking hydromorphone (type of morphine) and a muscle relaxer, advil, and tylenol. After the epi didn't seem to work I was beside my self so I called the same neuro that saw me in the hospital and now he tells me it's not urgent so he set a date of January 15 of 2009 to get just a appointment with him, not even the actual surgery. So now I was really in trouble I couldn't find any neuro or ortho docs to see me before mid January. I finally decided to try spinal decompression(traction) at a local Chiropracter. I'm on my 5th treatment and I am feeling alot less pain. I 'm going tomarrow for a second epidural. Hoping it will help even more. I would try anything before surgery. The epidural would probably help you the most. They can give up to three in a year. Most people do really well with them. I think I was just in so much pain it didn't work the first time. I was bed ridden for 5 weeks prior to starting the epi and decompression. But this is just my opinion and whats been working for me. I'm still trying to work towards being pain free. Good luck.
  • I had a MicroD at L4/L5 almost a year ago and I would rate it as a complete success. It has returned me to a pain free life and as long as I am diligent doing stretches (I found pilates to be especially helpful) it doesn't cause me any problems. I have to do a fair amount of lifing, I have 2 toddlers with a combined weight of about 25kg (not sure how much in Lbs but somewhat over 50?) and I can carry them both at the same time if I need to, without it causing any pain.

    Having said all that I don't think I would encourage you to have surgery, as pre-op I would rate my day time pain as a 7 and my night time pain as a 9. I was in agony with nerve pain in my leg and with a less severe ache in my lower back. The op fixed the nerve pain and the back pain has lessened away to nothing over time.

    I hope your condition self-resolves in time. Feel free to ask any more questions if things change.

    Good luck

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