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Torn between ESI or surgery

MeeshaMMeesha Posts: 55
I'd almost made up my mind to have surgery... was going to make the call yesterday or today. Well yesterday, someone I know was very against surgery, and said I should have decompression, and today, finally the pain clinic called -I was referred to them over a month ago. And now I have a consult with the pain clinic for an injection in less than 2 weeks.
Not sure if an ESI is the way to go, since if it doesn't really work, that's wasted time when I could have had surgery. My surgeon says if I leave surgery too long, he won't even do it since it won't be as helpful.
Also just had a 2nd MRI yesterday, so have to wait till he looks at that too.
I will have to do more research, but I'm so tired of reading and researching now.. it all starts to make me a bit nauseous after awhile.
discectomy in June 2010 - success! No sciatic pain, just some remaining numbness in foot. And I get charlie horses a lot.


  • if your surgeon is a good one and he/she can do a microdiscectomy then you should be ok .just make sure that you find a top surgeon and when you have had your surgery .take is easy dont over do it or you will be back on the table remember its only a repair you will never be a strong as you were before thing got bad in your back ..and yes there is a chance that you will need more surgery as the years roll on its normally about 10 years following the first surgery ..i would not waste time on epidurals .you may find that S1 will go later in life good luck
  • I say you should try at least one injection and see how it feels. What if you could avoid surgery all together? I always believe in trying all conservative measures first before surgery, unless paralysis is a issue. With both surgery and the ESI there are risk, but the risk of surgery far out weight the ESI in my opinion. I have had the injection and honestly it was rather easy. My leg went numb and was a nice break from the pain. I actually took advantage of my driver and went to the grocery store following the injection, although that is not what I was told to do. I was told to go home and rest, but the break in pain felt nice. I have seen plenty of members come on the board and use conservative treatment and are back out living normal everyday busy lives. Anyway good luck and keep us posted.
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  • Not sure of your situation to know if ESI is an option but if I could have tried it, I would have.

    The reason I didn't? I had a severe disc herniation at L5-S1. Lost a large piece (forget the size) and immediately lost strength, had foot drop, and lost feeling in perineum, buttocks, back thigh, and left heel to outer toe.

    They did try steroid (double Medrol pack) but that did nothing. They did that to buy time for me until I could find a surgeon. My surgeon would have tried Epidural if I wanted but due to loss of feeling in the groin, they were very doubtful it would do anything.

    What are your symptoms? How long have you had them? I only ask b/c I'm surprised your surgeon said he won't try Microdiscectomy after the ESI. I can understand if you wait 6-months without doing anything but you are going to try an ESI in 2-weeks. You'll know pretty quickly if it works. If it does, great. IF not...as soon as it stops working you can always opt for surgery.

    Of course I don't know your situation but I do know 3 people who had ESI's that worked. They needed 2-3 series but they are now 2+ years fine.

    If you go for the Microdiscectomy, ask your surgeon about how he approaches recovery, what signs he looks for in regards to 'rehernation', etc. I agree with Straker in that you have to be very careful after MicroD for 6 weeks to 3 months. You'll feel better quite quickly but I would be careful on driving, bending, twisting, lifting. It's not necessarily anything we do to reherniate but the body hasn't healed so you don't want to risk anything.

    I ended up having MicroD that didn't work. I had a revision 3 months ago and it seems to have worked, though I've not recovered feeling in my leg, my leg pain is somewhat lower (not gone) and my back pain is gone. I don't know if I reherniated or if another 2nd piece was free that was out of site. But MicroD's do come with risk of reherniation.

    You just have to be confident that your surgeon isn't talking you into surgery. Be sure it's you that is comfortable with it. If you have doubt, you may want to get another opinion on the surgery vs. ESI. Again 2-3 weeks probably won't hurt in the grand scheme of things but I'm not a doctor.
  • Time seems to be the concern.
    There are studies done on that. I have to find them but if I recall, the window is typically 3-4 months of conservative treatment, then operate but even up to 6 months is generally ok.

    They have no idea when the nerve will completely shut down after being compressed. In reality, it depends on several factors such as how long it was compressed, how severe the compression is, how hard the nerve may have been 'hit' by disc material or other bone on bone, etc. The nervous system is s tough one to gauge.

    The MicroDiscectomy surgery itself isn't terrible. It's a small incision and out-patient (though I stayed overnight both times which was a blessing). They will teach you how to log roll out of bed, climb stair, etc. There can be complications but for the most part, the surgery itself was not terribly painful. It is back surgery and even though it's minimally invasive, it is back surgery.

    I wish you well in your decision. It's a double edge sword with these back issues...I know how frustrated you must feel right now.
  • I personally would try the ESI first, unless there was danger of permanent nerve damage by waiting. I've decided that I'm going to get the full series of 3 injections myself and see how it goes.

    The first one seemed to help, and I've been excersizing a bit to try to build up my core in the mean time.

    Surgery scares me, because it weakens the disc further. I fear that if I get Micro D, it will only be a matter of time till I need a fusion or another more invasive surgery.

    I know your pain is worse than mine, so I don't blame you at all for wanting to get out of it. Maybe get a second opinion from another doctor? I went to two so far, and they both had very different opinions as to what I needed to do.
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  • Thanks for all your comments -they were really helpful. I've decided to go for surgery- -it's scheduled for about a month from now. I have more realistic expectations now -I know the pain may not be 100% gone, but I think I'll be better off at least. These forums are really helpful for know what to do during recovery.
    discectomy in June 2010 - success! No sciatic pain, just some remaining numbness in foot. And I get charlie horses a lot.
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