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  • it is good that you are able to have a third opinion and i hope you find a resolution soon.

    based on the above posts, im going to be devils advocate here,

    there are specific indications for the various types of lumbar surgeries.

    in the case of microdiscectomy the primary indication is change in bowel and bladder habits, progressive muscle weakness, leg pain, sensory loss due to lumbar disc prolapse compressing the nerve root as evidenced on mri and backed up by clinical findings (muscle weakness; loss of reflexes; change in sensation). the surgeon trims the disc thereby decompressing the nerve root. microdiscectomies are not indicated for primary low back pain and are commonly known to increase back pain

    in the case of fusion, they are indicated for discogenic pain and/or instability of the spinal segment (among other things) causing radiculopathy (not relieved by micro-d) and/or lower back pain.

    as much as one would love to have just a micro-d, if it will not address the primary complaint then it is not indicated. so if you are seeking help from a spinal surgeon for your leg problems due to nerve root compression then a micro-d is indiciated but if you are seeking help for your low back pain of discogenic origin then micro-d is not indicated. it sucks, but only fusion surgery will address lower back pain or discogenic origin that is sufficiently severe to severely limit functional tasks and quality of life depite greater than 6 months of aggressive conservative therapy.

    i hope you find a consensus and a positive outcome. please dont be afraid to ask the hard questions,

  • I am very pleased to hear that you can get a 3rd opinion.

    It sounds as if you havn't yet had PT and facet joint blocks which I really would concider before having a fusion.

    Really a fusion is the last resort after you have tried everything else. It is not a quick fix as there is nothing quick about the recovery.

    Blessings Sara
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  • gina,

    i'm sure you are a little over whelmed by the responses and the decisions you have before you. i thought i'd forward a link to the burton report which is very informative about some of the procedures and concerns that i have been trying to raise with you.


    i highly recommend giving this a read. definitely follow the third link about spinal stenosis.

    again, i wish you all the best.

  • Rachel,

    I disagree with your assessment that only a fusion will relieve lower back. There are other procedures less invasive that can provide relief and still leave stability in your back. There is the Discectomy, Laminectomy, Foramintomy to name a few. There is also a regimen of PT combined with steroid injections. I'm sure you mean well, but your post seems to indicate that there are only 2 options for someone suffering from back pain which can't be further from the truth.

    People need to identify a Doctor who is willing to try numerous types of treatments and lay out a treatment plan before they just go and open you up.

  • you are right there are alot of conservative measures to try and alleviate lower back pain and in most circumstances lower back pain is either self limiting or it gets better with conservative care (only a very small percentage of lower back pain sufferers ever go on to need surgery). but in the case of lower back pain that severely affects quality of life despite greater than 6 months of aggressive conservative care that can be attributed to a specific anatomical source through a combination of clinical picture and diagnostic imaging, then surgery may become a very valid option. the key here is identifying the source of the symptoms (this is not easy when it comes to lowr back pain)and undergoing aggressive conservative care. if a source can be identified and aggressive conservative care has not alleviated the problem then the proposed surgery has to address the source of the problem.

    gina, if you have not already, when you attend your next appointment with the surgeon ask them to explain to you what they believe is the source of the symptoms and how the proposed surgery will address that source (get them to explain to you what leads them to that conclusion so that you clearly understand why they are making the suggestion they are). then you may want to ask them if there are any other less invasive options that may produce a positive result (PT, injections..., im not sure if youve been there done that?)

    as an aside, if surgery could only relieve either the back pain or the leg problem which would it be? make it clear to the surgeon that this is the primary reason you are here, but that the other exists.

    good luck with your next appointment
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