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Update : microdiscetomy being scheduled anyone had it done?

AnonymousUserAAnonymousUser Posts: 49,322
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
OK...First of all....Let me introduce myself..I am David, from Wilmington NC. 38 year old male, in good health (or at least thats what I thought). I have never even spent a day in the hospital, and now for the last 3 months I have been suffering with my back and left hip/leg shin pain. and a slight case of foot drop to go along with this. Though honestly, my back doesnt really hurt compared to my leg/and hip. I have seen a chiropractor off and on over the last couple of years as I have had a tendency to injure my back but has always seemed to heal in a few weeks or less. This time is different. I cant really recall doing anything that brought this on, but has increased in intensity (pain) to the point that im really having a hard time at work. I guess I would just like some opinions and perhaps some folks to share thier experiences with me. I also want to post the result of my CT and see if anyone can really intrepet it for me. I heard the Dr. interpertation. I guess im looking for the laymans version. So here goes!

Exam: Ct of the lumbar spine without contrast
History: Left sided leg pain and foot drop
Technique: Thin section helical scanning of the lumbar spine is performed and sagittal and coronal reformatted data sets are produced.
Findings: The vertebral heights and alingment are maintained. Bone mineralization is withing normal limits.

At T12-L1 the central canal and neural foramina are widely patent.

At L1-2 minimal facet hypertrophy is present. The central canal and neural formina remain patent.

At L2-3 some facet and ligamentous in buckling is present. The neural formina remain patent.

At L3-4 A small disk buldge is present. In addition, there is facet hypertrophy and ligamentous in buckling. No formal stenosis is present.

At L4-5 A large ventral epidural defect is present within the central and left paracentral location. This has mass-effect upon the thecal sac and is consistant with a disk protrusion. On the sagittal imaging, there is AP extension of the disk material up to 9 mm. Along with some facet hypertrophy, this contributes to moderate narrowing of the left neural foramen. The right neural foramen remains patent.

At L5-S1 a disk osteophyte complex is present along with facet hypertrophy. There is osteophytic narrowing of the bilateral neural foramina to a moderate degree.

1. large disk protrusion to the left of the midline at L4-5 probably accounting for the patients unilateral symptoms.

2. Osteophytic narrowing of the bilateral neural foramina at L5-s1

Its my feeling that the L4-5 buldge is the major cause of my leg pain and numbness. Im not sure how big a 9 mm buldge is, but somehow reads like the goodyear blimp is pressing on the nerve that goes to my leg. If you have any impressions or perhaps just a kind word. It would be appreciated more than you will ever know. Thanks I hope to hear from you soon.



  • No comment on CT, but it seems like you are on the right track. Foot drop is nothing to mess around with and I am glad you have your films and a surgical appointment.

    Good luck to you, like I said, you seem like you're on the right track!

  • Thank you, I sure hope so!
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  • Your conclusion is pretty accurate, although 9mm is far from the goodyear blimp! It is not so much the size of the bulge as it is where it is positioned and to what extent it is compressing the nerve. In your case, the bulge is affecting the central canal, which means you are likely to have some pain in both legs, or it might switch back and forth between legs.

    In addition to the bulging disc there are some bony overgrowths that are taking up some space in the foramen one level below the bulging disc. The foramen is supposed to be an opening through which the spinal nerves exit the spinal canal and proceed to bundle together and join the sciatic nerve, which branches into both legs. When there is stenosis (osteophytes in your case) of the foramen, the "space" is overgrown, making it difficult for the nerve to pass through freely. In your case, this is occurring at the L5-S1 level. For most people this is the dermatome that runs in a band across the butt, down a swath of the thigh, calf and into the foot, affecting the outside of the foot and little toes.

    Your first course of action would be to make an appointment with a fellowship trained spinal specialist who can make an accurate diagnosis and discuss a course of treatment with you. The usual action is take follow a course of conservative treatment first to see if you can heal without needing surgery. You will probably be given epidural steroid injections to help with the inflammation, so that you can pursue a series of physical therapy treatments. Surgery is always considered as a last resort when you have run out of other options!

    The important thing is that you make every attempt to "baby" your back while you try to let it heal. Avoid any activity that involves bending, twisting or lifting more than about 10 pounds. Avoid bouncy car rides, long distance travel and try not to sit too long at a time. Get up and stretch, walk around, and better yet, lie down on the floor to give those discs a chance to unload for 10 minutes at a time.

    If the rupture is the main cause of your pain, it is possible for the disc to heal...but it takes a great deal of patience as it is a VERY slow process. Most people give up and have surgery because they cannot deal with the pain any longer.

    Hope this casual info helps you a bit. I'm happy to answer any questions you may have, if I can.

    xx Gwennie
  • Thank you for you post Gwennie. I am slowly realizing that, taking it easy is the route to go. This all really started with a pain in my hip, and slowly over several weeks progressed to pain in my lower legs. Then I got a cold and during a bout of coughing in the kitchen, my back poped (felt like lightning) I went down on my knees and hurt in my back for several days. Since that time, I have had numbness in my lower leg, the foot drop, and at times unbearable pain in my left shin ( I have never been stabbed, but can imagine that must be what it feels like)I am not able to quit working as, well, like most people, I just cant afford to. I have been seeing a Chiropractor for several years off and on, and went to see him as well as my family Doctor. I have not really had any relief in the last month of adjustments and sought the CT scan. I have an appointment on Wed the 25th to get a more specialized opinion and hope to find some relief there. Im not sure where this path will take me but feel that its at least a step in the right direction. Thanks so much for your help David
  • I went to the orthopedic doctor yesterday and he looked over my Ct and gave me a thurough exam and came pretty quickly to the conclusion that I would need this procedure (microdiscetomy) mostly because of the foot drop issue I am having (I have lost about 50% of the strength in my left foot). I am curious as if any of you folks have had this procedure?, what was your outcome?, recovery time?, complications and such? Any thing you can add will be greately appreciated. This will be performed at L4-5 in my back. Thanks for all your help
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  • the pain is not that bad. 1-2 weeks is the most of the pain. take it easy for 3-4 weeks and you will b ok
  • I had a microdiscectomy at L5/S1 (one level below yours) about a month ago, after suffering from hip, thigh, leg, and foot pain for over 6 months. The advice I'm about to give is based only on my limited experience.

    ***Be comfortable with your surgeon. You may have an orthopedic or neurosurgeon, just make sure they have a good reputation, and most of all that you like/trust whoever it is.

    I was originally diagnosed with a hip problem by my family doctor and was sent to an orthopedic surgeon who discovered that it was my back, not my hip. The orthopedist was awful. He came highly recommended, but during the 4 months he was "treating" me with conservative, non-surgical methods, I really felt like he didn't care a bit about what I was going through and didn't seem at all interested in helping me. I was a number, not a person. When it became clear that surgery would be necessary, I was thankfully referred to a neurosurgeon. The neurosurgeon was also highly recommended, but as soon as I met him, I felt like I could trust him. I felt like I would be safe on his operating table, and I was. Surgery is scary enough without having to worry about whether or not your surgeon really cares about getting you out of the OR intact, and in better shape than you were when you got in there.

    ***Complications are always possible. Surgery is always a risk.

    My procedure went very well. All the pain in my hip/leg/foot was gone immediately. My back hurt from the procedure, but I would take that pain over my leg pain any day. It got better every day. By the third day I no longer needed my pain medication and was able to relieve the incision pain with just a couple of advil each day.

    ***Recovery is a slow process which will require a lot of patience on your part. Your nerves have been compressed for months, they won't heal in a few days.

    I felt so good after the surgery that I wanted to do everything I had been unable to do for the six months prior. I tried to take it easy, but I went too far on a couple of occasions and suffered for it the next day.

    ***Problems can occur even if everything goes very well, but don't let that prevent you from having the procedure if it is recommended.

    At about 3 weeks all my pain came back, for no apparent reason. The current hope is that it is a nasty flare up, the nerve is "angry" and needs to calm down. My surgeon put me on prednisone for a week to help quiet things down, and ordered an MRI to be sure it's not a re-herniation. The results will either indicate that more surgery is necessary, or that it is just a flare up and I have to "wait it out."

    ***Everyone is different, every case is different. There is a wide variety of things that you will read about in these forums that may or may not happen with your procedure.

    Even though my pain is back, I would have that surgery again in a heartbeat. The relief I felt during the first few weeks was indescribable. I felt like I finally had my life back. If a second or even a third surgery will give me even half the relief I had then I'm absolutely going to do it. I trust my surgeon, and that makes all the difference.

    Good luck, I hope everything goes well for you.

  • Foot drop is one of three reasons that surgery is a priority. It is important, if your doctor has told you that surgery is needed, to do it sooner rather than later. This will minimize the chances of permanent nerve damage.

    As back surgeries go, this one is a fairly simple procedure. The important thing is to follow your doctor's directions and to not overdo afterwards. I just had surgery a month ago and my doctor told me the biggest problem he has with this type of surgery is trying to keep the patient in line! After months of being in lots of pain, most people feel terrific and are eager to do all the things they haven't felt like doing while in pain. Of course, the result is pushing the limit and running the risk of reherniation. What most surgeons want you to do is rest and walk...at least for the first couple weeks. Of course you will want to avoid any activity that involves bending or twisting and you should avoid lifting anything over about ten pounds until you have recovered. Walking is the BEST exercise. It is important to do it from the time after surgery you are requested to. Walking will stretch out the nerve that has been compressed and it will help keep the development of scar tissue to a minimum.

    You should do just fine!

    Take care.

  • I met the surgeon last wed and I agree completely about feeling comfortable with him. Its a large orthopedic practice. Dr. Miller is a well respected surgeon there and I did feel about as comfortable with him as I could given the situation. I think if I didnt have the foot drop issues he might have been willing to spend a little more time using less invasive treatements. But because foot drop can become permenant, I could feel a sense of urgency in what he was telling me about having the surgery. However, somehow he made the surgery seem like it was something he could do in his sleep, he was completely confident in his abilities without comming across as arrogant. Having said that, it only relieved my anxiety somewhat, as it is MY back he will be working on. I have an MRI scheduled for monday so that they can get the best images they can (the CT was done without contrast and didnt give a very well defined picture). I had a BB in my ear since childhood and that prevented me from getting the MRI done in the first place. I had it removed yesterday, and they can now do the MRI. So hopefully, things this week will go well and I can get this taken care of. I have made an observation in all of this that I would like to share. Though the pain in my leg is at times off the scale, I mean I have never hurt like this before. I know what to expect from it. It just hurts. The mental aspects of having this kind of problem are quite significant as well. Thoughts of having the surgery, how successfull will it be, not being able to work, finances, bills, all those other little things the surgery or the Dr. doesnt have anything to do with can be quite worrisome too. It has been important for me to keep it all in perspective, and look at this as a part of getting better. Just some of the things we have to do to get back on the right track. One part of this has been discovering this web-site and finding out im not alone in my troubles, and being greatfull for the opinions and kindness people have given me here. Thank you all so much
  • Hi Trainman, And Welcome to SpineHealth
    I'm glad you found this site. and I'm sure you will find some good answers or ideas.
    I'm more of a neck person, but know a little about foot drop and alot about leg weakness. so if I can ever come in handy you know where you can find me. good luck and once again I'm glad you found spinehealth.I have gotten lots of help from the board and I'm sure you will to....Patsy
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