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Would like opinions and shared experience of herniation shortly after discectomy

For several years, I have had sciatica in my right leg and last October, I developed major cramping and numbness in my leg from something that wasn't too strenuous.  I couldn't go more than 10 or 20 yards before I would have to crouch down to get the cramping to stop.  After a few days it got to the point where walking ten feet to the bathroom was an almost impossible task and the safe position of crouching down was no longer there.  

I went to an ER now and some quack told me to rub some Caspicin oil on my leg.  No x-ray or nothing, so all this did was delay things.  I then got into my GP and she got me into PT, a prescription for hydrocodone and muscle relaxer, had an MRI scheduled, and a referral to two specialists.  I saw both specialists (a neurosurgeon and a orthopedic surgeon) on a Monday and both recommended surgery at first sight.  It was a "massive" herniation.  At this point I could stand upright for only a minute or so if I was on pain killer.

One other thing of note was the doctors and the physical therapist all indicated that I was a great candidate for surgery.  All the other discs looked great as well as the structure of the spine.  

I had surgery two days later on a Wednesday.  It went great as well as the recovery.  But the doctor said that this herniation was over the top of a lot of chronic material and a lot of material came out.  In addition there were some radial fragments they could not get to.  Instead of a 15%-20% chance of re-occurrence, I was over 50% and that too much material had come out that another discectomy would not be an option in the future.  Also the nerve may have been the worst inflammation he had seen.  

I was up walking around right after surgery and the unbearable cramping stopped immediately.  I had lost a lot of strength because of the nerve and I was walking with a limp and would fall from trying to stand on my right toes.  After 2 months, I was able to push up onto my toes one time and after 7 months I can now push up and down about 15 times. So I have seen some progress in strength but it is no where near as strong as my left leg.   I haven't had any setbacks or occurrences, but the numbness in my thigh and foot have not gone away and I get a lot of pain in the calf area.  I do feel stress on my lower back if I lay on my stomach and laying on my right side causes pain in my leg and it has been this way since surgery.  It is hard to get quality sleep from turning into positions that create stress.

At my 6 month appointment, we decided to get another MRI with contrast, which I had today.  I was expecting some scar tissue to explain things, but there is an obvious and substantial herniation inflaming the nerve and very little material left between the discs.  I have no idea when this occurred as I was a great patient in recovery, there were no instances of note, and the pain and numbness today have been there since post surgery.  But since the pain is exponentially better than pre-surgery, I just thought it was part of the healing process.

If anyone has a similar experience, I would love to hear it and what your next course of action was as well as how it worked out for you.  This time I am not in dire pain and would like to get more educated on what to expect with different options.  But at the same time, I know I have placed massive pressure on this nerve and while it was released somewhat 7 months ago, there is still pressure on it.
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Comments

  • chase9401cchase9401 Amarillo, TexasPosts: 7
    I did meet with my neurosurgeon yesterday and he wants to do a TLIF fusion


  • SavageSavage United StatesPosts: 7,385
    Hello.....
    While you are waiting for members with shared experiences to respond, you may find it useful to use the search, upper right on page, and typing in your concerns, you may be led to current or older discussions.
    You may also be led to the medical side of this site with articles and videos. Very informative!
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

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  • smartens162smartens162 Manitoba, CanadaPosts: 431
    A very familiar story.  I ruptured at L5-S1 March 2014, discectomy surgery December 2014.  The recovery was going well, although the pain was not gone immediately.  I was able to resume most activities and exercise and doctors, physiotherapists and surgeon all were impressed with my progress.  But about 6 months into recovery I started feeling alot of tightness and stress in my lower back.  No nerve pain, really.  PT said there was scar tissue giving me grief, but we were managing it; I went to see him about once a month when I needed some relief.  Then at almost a year post-op came that familiar crippling back spasm that rendered me to my bed unable to walk barely to the bathroom and back.  An MRI one month later (here in Canada, MRI has a serious wait list) confirmed re-herniation.  There is a wait list for surgical consults too.  It's been almost 8 months for me now.  I did consult with spine specialists in Germany, who I had consulted last time around too.  The same recommendation from them this time, a disc replacement at their facility costing me $50000 Cdn.  I opted for the least invasive option recommended to me at the time, the discectomy, done in a nearby city by a top-ranked neurosurgeon, cost covered by Medicare.  I had also consulted with an orthopedic surgeon at that time, who recommended a fusion.  My GUESS is that I will get the same recommendations across the board.  But it seems to me that discectomies are rarely a permanent fix, and I really want to get back to living life instead of this vicious cycle.  If it weren't for the cost, I'm pretty sure I'd go for the disc replacement.  An interesting note from my recent consult over the disc replacement: the disc material is pretty hard to get at with surgery through the back, unless they remove some of the bones surrounding.  With an anterior artificial disc replacement, they remove all of the disc material through the front, nothing in the way.  I'm not sure if this has been helpful for you, but it's my experience thus far.  I too am very thankful that I do not have nearly the level of nerve pain that I did prior to my surgery.  But I do feel like it's coming eventually, if I don't do something soon.  Just gotta keep waiting for consults for now..
  • chase9401cchase9401 Amarillo, TexasPosts: 7
    Thanks for sharing.  That wait list is terrible.  They already penciled me in for a surgery spot this Wednesday if I want it.

    I've gone through and read quite a bit on the site and old posts and there are still a few questions that I have.

    1) I'm not in very much pain at all.  It is more of a nuisance with the numbness and I lose some sleep and will get pain in my foot if I lay on my right side (lay on left and it goes away).   But it's not going away and the nerve is not going to heal without surgery.  Is it worth it?

    2) What is the difference in recovery of the two surgeries?  I know exactly what the discectomy was like and wonder how much different the fusion will be.  (to me the discectomy surgery and post op was a breeze, but the long time not being able to do much was difficult.)

    3) I never got better than where I am today and then had a set back.  While the initial surgery made a large improvement, I never regained feeling and never not had the issues I have today.  I haven't seen any posts where anyone went back for revisions like that, but the fact that the nerve never got relief may explain things and give some hope that it can be healed.


  • smartens162smartens162 Manitoba, CanadaPosts: 431
    with the research I've done since 2014, I know that the recovery from fusion is quite a bit more intense than a discectomy.  Some fusions require hospitalization for a couple of days, whereas discectomy is generally done as an outpatient procedure, which you already know.  If you thought taking it easy after discectomy was difficult, the timetable for fusion is definitely extended.  I think the whole no BLT rule is alot more involved with fusion as well.  For me personally, I don't want to waste time and energy with another discectomy if I'm eventually gonna need a fusion anyway, but it's a bigger commitment.  If I cannot find a way to do the Germany disc replacement financially-speaking, I think I would choose fusion in hopes of a more stable back to live the rest of my life with.  I know some who choose multiple discectomies to delay fusion, because of the commitment of time that a a fusion recovery takes; can't afford to take that much time off from work, or just the timing is bad due to projects, waiting for children to be a little older and less dependent, etc.  Do due diligence and find out what your best option.
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  • chase9401cchase9401 Amarillo, TexasPosts: 7
    Well, I'm sitting in the waiting room right now about to head in for TLIF fusion surgery.  The timing is good now and better to not mess around with it.  I feel pretty good right now and am not in pain, but know it won't get better on its own and I'm only one wrong move away from a major problem.

    Did a bunch of yard work and swam with the kids yesterday.  Last chance to throw them around for a while.


  • smartens162smartens162 Manitoba, CanadaPosts: 431
    praying for you today!  There's something about just taking a big step that is empowering and terrifying at the same time, but praying you have peace today and in the days to come.  Keep us in the loop as you recover!
  • Good luck Chase!! Check in soon!
  • chase9401cchase9401 Amarillo, TexasPosts: 7
    Thanks for the encouragement.  I will try to update going forward so others that are looking At this  surgery can get some reference.   

    ive been out for 3 hours and feeling good and am in God spirits.  Surgery took about 3.5 hours.  There  is a bit of pain now, but completely managable with meds. I had a hard time sitting up  to eat.  Most of the problem is the gown holding me in place while the bed moves. 

    I am am starving but only got eased in with a baked potato and soup..  I think I could scarf  down a steak if they gave it to me.  Think it is a good sign that my main worry now is food.
  • chase9401cchase9401 Amarillo, TexasPosts: 7
    After the first night things are great.  Got up for about an hour and a half this morning and walked around with a cup of coffee.  Probably pushed it a bit too much as company kept coming when I was ready to lay back down so that was a bit long on my feet .  Got up to the bathroom and back on my own without too much pain.  Meds right now are two hydrocodone every 4 hours.

    So far recovery hasn't been a huge difference from the discectomy.  I have a little more pain but not much.  Some of that also came on from being up too long.  I also have a back brace for when I get up, so have more support.  This time I also have a drain on the wound.  I had a catheter through the night as I was drinking massive amounts of water.  Now it's hard to pee.

    so far, so good.  I can go home tomorrow (2 days) if i want and the wound drains.  But I think I want to stay another day.
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