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scoliosis vs surgery vs leg length inequality

NickRNNickR Posts: 8
edited 06/11/2012 - 8:55 AM in Chronic Pain

have a problem and would like to ask for opinions. sorry for the length of the post. feel free to comment.

had an accident back in 2008 (fall from height) which most probably caused the left paracentral 6mm disc herniation i have in l4l5. since 2008 i had a lot of sciatic pain in the left leg, which slowly progressed from left buttock pain, to behind knee pain, to toe pain and tingling and numbness.

did try various exercises and techniques with no result for almost a year and a half. i reached the point where i could walk with some pain, could not sit at all, was consuming mild pain killers which could cover the pain 100%. one physio insisted that my accident had nothing to do with it (but perhaps, contributing to it), that the real problem is postural, and the real reason i am in pain is that i have scoliosis and leg length inequality. thus, i tried schroth exercises with him for approx 2 weeks (in order to "straighten" the spine and "decompress the disc hernia"), which resulted in an absolute disaster: my body responded with severe sciatic scoliosis that lasted for 3 months (!!): i could not walk at all, stand for more than 2-3 mins, i could hardly go to toilet... something like this:


i was near a phychological deadend, almost ready to proceed to surgery (although i had no muscle problems or other neuro signs and many doctors told me i could delay it). however, i told myself i am going to try one last physio (great fame etc). he gave me some simple exercises to do every 2 hours, which i did and still do, and voila, suddenly i started improving. everyday getting better and better, no pain meds at all, sleep with no pain at all, shower like a human being, pins needles burning gone completely, scoliosis improving day by day etc. however, i cannot sit at all, and my standing time increases but very slowly every 3-4 days.

my problem however is the following:

i had the following (even ***before*** the "scroth" .. botch but i believe not before the accident):

a) pelvis rotation
b) leg length inequality (left leg seems to be longer, i am almost sure i didn't have this before the accident)

now, we have 3 scenarios:

a) surgeons tell me to go for it, go for the surgery. it will take the pain away. i am considered to be young for microdiskectomy (30yrs old) and young people tend to heal better and faster. after the surgery, the body itself will find the proper healthy posture again as time goes by.

b) half physios+chiropractors tell me that the leg inequality is the reason of the scoliosis which causes increased pressure on the l4l5 disc. the increased pressure on the disc caused the herniation, which eventually came in contact with the nerve which, as a last result, increased the rotation of the lower spine and the scoliosis because of the pain. so, the real goal would be to treat leq inequality and reduce the rotation of the lower spine and the pelvis with exercises. that would decompress the hernia and eventually the body will absorb it.

c) other half tell me that the injury caused the disc herniation which came in contact with the sciatic nerve, which caused long term inflamation and pain, which caused the rotation of the lower spine as a reflex to that pain, which caused the pelvis rotation which, as a last result, caused the leg inequality. so, i should treat the disc herniation, either by removing it via surgery, or by trying mckenzie and such and hoping it will be absorbed. herniation will either get worse or be completelly absorbed within 3-4 years.

so, how am i supposed to i know who of them are right ? :o should i treat hernia or leg inequality?

obviously i tried to "correct" the curve in my spine via schroth, but that was clearly a mistake (3 months not walking is a good sign those exercises were the wrong way to go). however, there are too many different exercises to try.

at the same time, i am afraid that surgery may not fix the pelvis position, if all pt failed to do anything before the surgery, how can i hope that they will succeed in it after the surgery? but, if pelvis does not find its proper position, reherniation or other spine problems in the future are almost certain since i know i do not move properly as i did before.

what would you think i should do? :o do all of the above make sense?

(thanks to anyone reading all of this!)


  • Two ?s for you....what type of surgeon did you see and did you have an MRI or other tests done?

    Has anyone tried a wedge in your shoe to correct the leg length problem? That is how mine is dealt with.

    I also found water therapy to be the best for back problems. You don't want to go the surgery route unless you absolutely have to. A spine center may try steroid injections as well. Get all the conservative therapy first.

    Best wishes,

  • Thank you for the fast reply.

    Disc herniation was confirmed via MRI. Have done 3 MRIS during the last 2 years, and MRIs show that the disc herniation is very slowing getting worse.

    Have seen 3 neurosurgeons (all with great fame, 2 of them do not get anything out of this because they are in public hospitals etc) and 2 Orthos/Spine specialized.

    neuro 1: recommends me to go for the surgery 100% and that my profile has a very high success rate (no neurological signs, clinical matches MRI, herniation is one of the most common cases etc). Tells me I will be even able to return to sports, provided that I listen to everything he tells me for the next 6-8 months after surgery. He also claims herniation is big, and that kind of herniation is very rarely absorbed. However, absorption is not impossible and since I do not have neurological signs it is my choice to go for the surgery or not. He also claims pelvis rotation and scoliosis will go away within 6 months post op for sure. They are the result and not the cause of the herniation.

    neuro 2: as 1, although he says it may take years for the herniation to be absorbed, and that most probably it will only get worse. Still it is my choice, but he is more in favor of the op and he thinks that delaying the op is as risky as the op itself because it is only a matter of time before real nerve damage starts taking place.

    neuro 3: same as neuro 1 regarding success rates. However he recommends I never returns to sports ever and I never ever sit for more than 3-4 hours (without break) for the rest of my life.

    Ortho 1: tells me I fit the profile (3 months bed is enough) but since I do not have neurological signs (reflexes ok, strength ok) it is only up to me. He recommends I do not go under knife, and he claims that pelvis rotation may not be corrected via the surgery and that nobody can guarantee it. He tells me he can promise that leg pain will go away if I follow the proper post-op plan, but he cannot promise me (but he estimates it will happen) that the sciatic scoliosis will go away and that the vertebrae will return into normal position. That is a risk I have to take.

    Ortho 2: tells me my only salvation is the surgery, that I should do it right now, and that disc herniation is the real cause of this mess.

    I do not write about the PTs/chiro because all of them are strongly against any kind of spine surgery. Chiros claim the problem can be solved 100%. PTs claim it may or it may not. But since I am improving, even slightly, I have to wait.

    However, each PT gives me a different theory about of how I should proceed and what is wrong with me. Some say pelvis rotation, some leg inequality, some birth scoliosis. And frankly I am afraid of them, because up to now, many of them have made me worse.

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  • Damn, i wrote a second huge message :)


    Hmm, what do you mean by "water therapy"?

    How was your leg inequality diagnosed?

    Are there any objective exams for that?
  • A PT found the leg length problem just by measuring my legs. Said that could have given me back pain/hip pain.

    Water therapy, also known as aqua therapy, is done in a warm pool. My favorite thing was to "hang" down in the deep end, kind of like having traction.

  • I recently found out that my short leg problem could be the root of my spine issues and chronic pain in my shoulders, upper back, neck and headaches. The only way you can be sure if it's your leg is to have an x-ray so they can measure the length.

    I still have to talk with the RN at my NS's office on Monday, but the RN mentioned that I might need a full body scan as well. Not really sure what that is for. Personally, I would hold off on the surgery until you get some confirmation on whether you have a leg length issue.
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
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  • Hm,


    I see that you had 2 fusions in just on year back in '08.

    Did you have an accident?

    How did your problems start?
  • Re the neck fusion - ski and car accidents, arthritis. Re my back I had spondylolisthesis. My neck is pretty good, but my back will never be the same :(
  • @Lili_Inu:

    A difference in leg length chances completely the way we walk. That i can say that for sure, because I do feel the difference and I do know that my new movement patterns caused changes up to my upper spine too - even before i developed sciatic scoliosis. I have no pain up there, but I am cautious because I do know things have changed there too. I'd agree that leg difference affects the spine 100% and most certainly not in a good way.

    Most of the orthos I have met, however, are only interested in the yes/no answer regarding surgery. None of them has been interested in leg length differences, pelvis alignment, healthy movement patterns. So i guess I have to find one good ortho.

    It is possible to have a full body x-ray standing?

    I guess that way would be the only one via which I would be able to measure both leg length difference and possible pelvic tilt or rotation objectively.

    After that, I would be able to choose better whom to trust.
  • :(

    Re the neck fusion - ski and car accidents, arthritis. Re my back I had spondylolisthesis. My neck is pretty good, but my back will never be the same :(
    Maybe not the same, but I wish you find the path to make it strong and completely painless.
  • I live in New Jersey just outside of NYC where my NS is located. According to the RN at his office, I have to go into NYC to have the scan done because she believes that there are no facilities equipped to do this type of scan in NJ.

    I would find a doctor who recommends investigating the leg length issue first before suggesting surgery. Good luck!
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
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