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Need advice on Lumbar partial discectomy

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:38 AM in Back Surgery and Neck Surgery

I am 30 years old and have a very active life.I play(used to anyways) tennis 3-4 times a week. I am in decent shape and have never had any other issues health wise. The last time I had to go to a doctor was 7-8 years back.

I have had a shooting pain on my left leg/butt since 2009 April. Initially, I thought this was muscle strain and took some Advil and didn't see a doctor. By end of July the pain became unbearable and I went to see a Dr. She told me that it was piriformis strain and gave me a steroid injection into my piriformis muscle. That reduced the pain a little bit for a week or so and the pain was back in full force with in 2 weeks.
By end of September I decided to see another doctor and he gave a dose-pack of methylprednisolone and flexeril and there was no change. By this time I am having trouble sleeping b'cos of the pain.
Finally a week ago an MRI was ordered and I was referred to a neurosurgeon.

This is what My MRI reads : At L5-S1 there is approximately 1.0 x 1.0 x 2.0 cm focus of focally protruded and possibly extruded disc into the ventral aspect of the canal. De-generative change in Lumbar spine is greatest at L5-S1. The protruding material result in moderate to severe stenosis of the canal and effect upon the exiting S1 nerve roots at the level of lateral recesses, left greater than the right.

After seeing the films, the neurosurgeon suggested that I have "Lumbar partial discectomy" as the MRI looked pretty bad. He said if left untreated or if we waste time trying epidural injections and other non-invasive treatment, there is a good chance that I will start having pain in my right leg as well and the chances or irreversible nerve damage due to the bulging disc pinching the nerve is very high. So I have surgery scheduled for 24th of this month with pre-surgery consultation on Monday.All this happened yesterday afternoon.

I am a little scared with the fast development and the surgery part. The pain is excruciating at this point and I can barely sit or stand or sleep even after taking truckloads of advil, flexeril, vicodin and valium.

So here's the questions I have :

1) From the MRI report, how bad does it look compared to some of your experiences. The actual MRi pics that the Dr showed me of the affected disc and a healthy disc had drastic differences.

2) Will this surgery help me with the pain?

3) How good are my chances of having a normal life and what are the chances or re-herniation?

4) Is there any alternatives that I can try at this point without causing major damage to myself

Sorry about dumping all of this on you guys, but I am in a little bit of a panic right now.



  • I'm obviously not a doctor, nor do I play one on TV, but I can tell you what I've learned from my own medical reports and what I've learned by reading here on Spine Health. If it were me, I'd go ahead with the surgery. Your MRI shows that you have disc material protruding onto a nerve and that is precisely what a microdiscectomy helps. So here are my answers to your questions:

    1) your MRI report concerns me beyond your disc that needs fixing because of these words: "De-generative change in the Lumbar Spine is greatest at L5-S1" This would seem to indicate you have other problems in your lumbar spine. Be sure to ask you doctor about them and if there is any reason to believe that degeneration will cause you problems down the road.

    2) yes, this surgery will undoubtedly take the pressure off that nerve and relieve the pain.

    3) see number 1 - if you have further degeneration of your lumbar spine, you do have potential to injure or re-injure yourself again.

    4) because you have waited so long on this, and your nerve has been compressed for so long, I think it would be best (remember I'm not a doctor) to get that disc the heck off your nerve before the damage becomes permanent.

    Please do address the degenerative changes in your spine with the doctor. It may be that physical therapy post surgery in which you learn some body mechanics to move without causing further damage to yourself would be in order. I worry, however, about the Tennis -- obviously it is a sport that requires a lot of twisting and bending, not to mention pounding from running to get the ball. These are the sort of movements that are very damaging to the lumbar spine.

    I wish you all the best.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • It is scary when things move so quickly after months of trying to ignore symptoms, etc., but it sounds like you are on the right track.

    It doesn't really matter how large the protruded area is. The point is that there is disc material that is squishing the nerve root and causing moderate to severe stenosis. The pain that you have been feeling all along in your buttocks and down your leg was probably referred pain caused by the herniated disc.

    It is important to get the nerve decompressed, especially since you have had it awhile. I think you don't want to waste time trying more conservative treatments. If you were just starting out with pain, it would be one thing, but your nerve has already been compressed for many months.

    No one can say whether this will reherniate or not in the future. Your chances will be reduced if you are patient with your healing and do not rush your recovery. Even though you will be eager to get back to your previous level of activity, it is really important to give your spine a good chance to heal. Many people reherniate because they resume strenuous activities too soon. You will have restrictions after surgery and it is important to heed them.

    I would just suggest that you be sure you are satisfied with the qualifications of the neurosurgeon to whom you were referred. The surgeon is the most important aspect of the outcome of your surgery. Be sure of his qualifications and do not just enter into this on faith. Do your homework. I assume you will be able to ask any questions that you may have tomorrow when you meet with the surgeon.

    Good luck. We're hear to answer your questions as they come up!

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  • Thanks to both Linda and Gwennie for the replies.

    I have a pre-surgery consultation with the Dr later this afternoon. I'll ask him about the status of the other discs. I think there was a small bulge in the L4-L5 that I noticed on the MRI, but that didn't seem to be touching the nerve through there.
    I am going ahead with the surgery and as of now, it is scheduled for the morning of 23rd. That would allow me to take a few days off work and just relax after it. I'll update this with more details and questions as they come up.

    This forum is an incredible resource and thanks once again to all the helpful people here.

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