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Not Sure if I need a microdiscectomy surgery.

Jul10JJul10 Posts: 4
Hello everyone,

I want to thank you in advance for reading my post. I am 26 y/o and have two herniated discs, L4-L5 and L5-S1. One is worse (L4-L5) than the other one according to my last MRI exam done on May 2014. I should also mention that I had a previous lower back surgery when I was 15-16 years old, but I don't remember where was the root of this problem but the outcome was immediate relief and pain free after the surgery

This is what the last exam reported:

L4-L5: There is a broad-based disc bulge and left paracentral disc protrusion/extrusion which appears worse than what was seen on the previous study. This measures 1.3 x 1.1 x 0.8 cm and results in severe central canal narrowing, left lateral recess effacement and abutment of the traversing neutral elements. Mild bilateral neural foramina narrowing is also present.
L5-S1: Broad-based disc bulge is present with posterior disc protrusion. Overall this appears improved compared to prior. There is mild central canal narrowing and mild bilateral neural foramina narrowing.
Impression: Lower back spine degenerative disc disease changes. Specifically at L4-L5 there is left paracentral disc protrusion/extrusion resulting in severe central canal narrowing and effacement of left lateral narrowing which overall appears to be improved since previous

I would like to hear your opinions on similar cases that you may have experienced. I have an upcoming surgery on Nov. 21 but I am not sure if I am taking the right decision. I know I have the last word on this microdiscectomy surgery, but perhaps some of you may have been in a similar situation and would like to share your experience with me.

I been on dealing with this situation since late 2011, I don't remember how it happen but as the days went by I was diagnosed with sciatica on my right leg. The next year 2012, I still continued through the pain, I had 3 epidural shots but that did not help me. I also try chiropractic and the only thing it did was short term relief. The pain was slowly going away, but there were days that sciatica flare up again and I was back to ibuprofen (400-600 mg). I was still doing a sport that I love (bodybuilding) and able to continue with this hobby even until today.
2013- I was still able to manage the pain, although there were a couple of time where I just needed to take time off from the gym in order to not aggravate the pain. I learned a lot of exercises that helped me in keeping my core strong and exercises that keep the pain away from my lower back and leg.
2014 - The beginning of the year everything was going great until I noticed I lost flexibility on my left leg now. I remember doing deadlifts and other exercises that I went over my limit because I was not experiencing sciatica pain. I was back to the same situation now but with sciatica on my left leg. I decided to have an MRI done (the one reported above) and those were the results. I took 3 weeks off from the gym and doing mobility and stretching to relief the pain, it worked. I managed to get back quickly than before and less pain. Nonetheless, I decided to pay a visit to my neurosurgeon and hear what he had to say about my situation, he was surprised on how I improved my L5-S1 disk but at the same time that it got worse on the L3-L4 disc.
2014- (5 months ago) I decided to get try sport physical therapy for a couple of months and learn new ways to improve my condition. It worked somewhat well, I tried different techniques like the decompress table (this did not help me much) and the needle stimulation which I got some relief from that. I stopped going because I had to travel overseas for 7 weeks. I was still with not pain, while I was out in a different country I was not lifting weights but I did a lot of walking and still pain free. There were some days that my back was stiff and aching but not pain on my leg. Sciatica was never present during this trip even when I had to be standing for more than 6 hours in a concert, there was not pain. I came back to the states and four weeks after I had to move to a different apartment. Here was another test to see my back conditions, I moved heavy objects from place to place and still not pain whatsoever. I was almost very careful to use proper form when lifting these heavy objects. Right now I am still going to the gym, working out at a proper intensity but I am not doing any squats or deadlifting exercises. My pain level is 1/10 and my flexibility has been getter better. I am in a situation where I don't feel comfortable having this surgery because of how my back been doing so far. However, I am scared that this may just be for a moment and expect the worse such as more nerve damage. Can any of you give me some advice or share your similar expereinces. Thank you once again.
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1

Comments

  • smartens162smartens162 Manitoba, CanadaPosts: 449
    edited 11/10/2014 - 6:40 PM
    - L5-S1 ruptured disc since March 2014...what are the professionals saying about your surgery? If it was me, and there was slow but steady improvement, less pain, regaining strength, I think I would hold off on the surgery, unless some professional (surgeon, physiotherapist, etc.) is saying there is a greater problem ahead for you by not doing the surgery now. I should be getting a discectomy surgery hopefully before the year is up. My life is really on hold due to pain, so I'm very ready for surgical intervention.
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  • RunnerHKTRRunnerHKT Posts: 230
    edited 11/11/2014 - 5:56 AM
    ANd this probably sounds strange. you really need to listen to your physician. And you probably need to see a second or even a third opinion. When I ruptured my disc I immediately went to one surgeon who is touted to be the "best" in the area. after that I went to a second surgeon who is also very good. Both stated that from my film I needed surgery, but given the way I am handling the pain etc, I may be able to delay or actually heal on my own. Since both opinions were the same I felt I was making a good choice to delay surgery. I can not lift anything at this time, at all, nor can I actually walk any distance without crippling pain, but I do note improvements daily. (And I am getting an Epidural SPace Injection today which hopefully will fix the walking.) None of us on a forum can tell you if you need surgery or not. But I do recommended seeking out 2-3 opinions from people in your area who are highly qualified. Once you've discussed the issue with 2-3 qualified people you will probably hve a plan to manage your injury with confidence.
  • Hi guys, thank you for your replies. This morning I had a phone conversation with my neurosurgeon's nurse to order a new MRI exam for me and see my lower back current state. I told her that I have not experience pain in the last 5 months but that every now and then my lower back flare up and it would feel stiff. She told me that I should not do the surgery if there wasn't any leg pain. I asked her if she could get me an MRI order and she sounded as if I was requesting for too much. She said that money would be wasted in doing the exam if I don't have any pain which sounded rude to me. I told her I just want to make sure I going to take the right decision. She made the order and I have now a new MRI exam for this coming Monday. Regarding asking other doctors opinions, I actually did during this past summer. I checked with another neurosurgeon and his opinion was that if I do the surgery, the results were going to be positive. He said that they will cut the bulging part of the disc and free the sciatica nerve. Overall, the decision is mine and it is a difficult one to make. I know I can manage the pain but at the same time I am worried that any wrong movement or lifting could damage the nerves. I will keep you guys updated with my situation.
  • So if I follow, you have physical findings that can be corrected surgically, but no significant pain at this time? No sciatica? My own personal opinion is that if you haven't got both (a fixable structural anomaly PLUS pain), you should wait. It's a huge surgery with inherent risks that I wouldn't take if you are not in pain.

    You didn't say where you are located, but here in the U.S., insurance has to pre approve most spinal surgeries. If your record from your doc says you're not in pain, you may not be approved because the insurance company will see it as an unnecessary surgery.

    Just my two cents.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
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  • SarahLindeau said:
    So if I follow, you have physical findings that can be corrected surgically, but no significant pain at this time? No sciatica? My own personal opinion is that if you haven't got both (a fixable structural anomaly PLUS pain), you should wait. It's a huge surgery with inherent risks that I wouldn't take if you are not in pain.

    You didn't say where you are located, but here in the U.S., insurance has to pre approve most spinal surgeries. If your record from your doc says you're not in pain, you may not be approved because the insurance company will see it as an unnecessary surgery.

    Just my two cents.
    Hi Sarah, thank you for sharing your opinion with me. Yes, at the moment I don't feel pain, but my last MRI (6 months ago) showed that L4-L5 disc got worse compared to my last exam. So far, there is a high percentage that I will no do this surgery because the pain is gone. What worries me is that later on this could get worse by simple bad lift movement or something related to it. I have learned to manage the pain which I am confident to do if this happen again, however I don't want to cause anymore nerve damage by prolonging this surgery. It is clear that time will only tell how far can I go without surgery. It looks like I have already answered my own question, hehe.
    I apologize for my poor grammar structure. English is not my first language.
  • When you get your new MRI you'll have a better idea of how things have changed & what compression (if any) is still going on. It could completely heal with time. Once you have a weakness it's always best to keep posture, proper lifting techniques, restrictions etc in mind. In my opinion having surgery won't change that. Best case scenario is always natural healing. I've got my fingers crossed for you.
    Osteoarthritis & DDD.
  • Thanks for your reply. If your concern is nerve damage, definitely talk with your doctor about what the prognosis is. In my very layman opinion, I wouldn't risk surgery unless there is a great reason to do it. It's incredibly painful and it has the potential to make things worse. It's always a risk. Some people here are content to manage their issues non-surgically and are doing very well. Some people have bulging or ruptured discs and just don't have pain. It's all very case specific and you should weigh the pros and cons together with a qualified and respected surgeon.

    Just curious- where are you from?
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • Hi,

    Below is what you are concerned about:
    "However, I am scared that this may just be for a moment and expect the worse such as more nerve damage."
    Why are you expecting the worst if you are feeling better?

    Here are my questions:
    Is you are in less pain than before isn't it logical to think you have improved?
    If you are in less pain, isn't it logical to think that your disc is not hitting any nerves?
    Why are concerned about nerve pain?

    Look, you may have been worse at the beginning of 2014, but then you went for physio and IT SOUNDS LIKE PHYSIO WORKED!! Thank- your lucky stars and just be careful from now on!!!

    I hope that helped,
    Angry30
  • Greg1978GGreg1978 Posts: 28
    edited 11/20/2014 - 6:34 PM
    Well if your not getting the pains down your leg or weird feeling in your foot maybe the nerves arnt being pinch anymore. I use to be huge into bbing before my Sciatica started up and now lately every week I get different symptoms. The buzzing down my leg down to my foot I felt a few weeks ago turned into a horribley bad pain in my glute to now this week it's a burning feeling in the front of my calve. I think what ever is leaking in my disk is causing different pains what I'm saying is things change especially if you're still bodybuilding I work 8-10 hours of construction so things are always changing and moving around .Good luck and reading your story is aspiring for me I use to workout 5-6 days a week it all depended if I was bulking or cutting but regardless it was my life my day wasn't over unless I got in a workout now I'm just a loss sole. I am schedule to get a shot next month I'm praying that gives me some relief so then I can be proactive and try to get this better
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