Hello everyone. I have been reading this board for a few days and have now joined. I have a feeling that I will be reading this board for a very long time!!

I will tell ya a little about my back problems first. They started in October 2002. I woke up one morning with back pain and by the end of that day I could hardly walk. I went to the doctors the next day ... he sent me for an MRI and it showed some disk bulging at both L4-L5 and L5-S1. The L5-S1 showed mild impingement on my nerve root. I then (back in 2002) went to a Neurologist. He came in the room and said you are not a candidate for back surgery because it is not that bad and he sent me on my way. Never gave me any reccomendations on what to do. So I left and since then have had lower back pain usually once a month or 1 every two months if I am lucky. It's like clockwork!! It seems for 1-2 weeks out of the month I am living on Motrin.

So ... I have been doing that from 2002 until December 5th 2004. Same thing happened. I had cleaned my whole house the day before. The next morning I woke up and my back hurt pretty bad. By the end of that day I could hardly walk again. So this time I decided to go back to my family doctor. He sent me for another MRI. This is what my results were for this recent MRI:

L4-L5: There is a small central disc protrusion with mild impression on the thecal sac. No spinal stenosis or foraminal stenosis is shown. There is dehydration change of the intervertebral disc.

L5-S1: There is a moderate-sized left central disc protrusion with impingement of the left S1 nerve root. There is dehydration change and decreased height of the intervertebral disc. The neural foramina are patent bilaterally.

The L5-S1 disc protrusion has increased in size since the lumbar spine MRI from October 2002. The small central L4-L5 disc protrusion appears minimally more prominent on today's MRI.


So, he sent me to another Neurologist. I just went this week (January 5th, 2005). Here goes my question to you all. Who here has had this procedure done?

"L5-S1 Hemilaminectomy/Microdiscectomy"?

That is what this Doctor wants to do to me, or I should say the type of surgery he wants to do to me. He said we will leave L4-L5 alone right now and just work on the L5-S1. He said we will work on the L4-L5 with Physical Therapy after my surgery. He seems very nice but I am SCARED TO DEATH of having back surgery!! I mean I am to the point of tears because I am so scared. I have been reading what can happen when you get this surgery and I am terrified. He did even sit there and tell me that if I wanted a 2nd opinion that I could get one and if I decided to have surgery with him to call him back. I have never had a doctor ever say that to me about the 2nd opinion so I was suprised that he suggested it!!

Out of the people here that have had this surgery .... how are you doing now after surgery? Is it really painful after the surgery and for how long, weeks, months? Has this surgery made your leg and butt pain and the tingling in your calf/foot go away? Do you still get the bad back pain after the surgery? About how long after surgery can you bend and twist and be back to normal?

Sorry that my first post was so long. I just wanted to explain my story a little bit first. Any comments and suggestions on this type of surgery will be greatly appreciated!! Also any comments on the surgery and how you are doing afterwards will be greatly appreciated as well!! Thank you :)

Tifferzz

I haven't had this particular procedure done but I wanted to take a minute to welcome you to the board. I am sure others will be along to share their experiences with you.
Do a search using that term and see what you come up with. I have found many really useful sites that way. I would also get that second opinion...it can't hurt.

Good luck to you.

Carol

Thank you Carol for the welcome :)

Yeap, I am doing searching now. I am going back and forth from this board and searching. I am finding stuff basically how the procedure is done. Haven't found anything yet from peoples experiences that have had this done. I am gonna keep lookin!! I was thinking about the 2nd opinion but a friend of mine who works in a rehab hospital referred me to this Neurosurgeon. This doctor had done surgery on my friends, fiances' grandfather, so that is why I am not sure if I want to get a 2nd opinion. Although who knows .... after I hear some experiences on this type of surgery I might LOL.

Tifferzz :)

Tifferzz, on August 16th of last year I had a laminectomy/microdiscectomy at L5,S1. I struggled with pain for about a year before I had the surgery. For me, it has made a huge difference. I still get some leg and butt pain but it is nowhere near what it was before. My back does get a little sore when I sit too long or work it too much. I was unable to sit, bend, twist or lift more than ten pounds for 6 weeks. My surgery was not like most because my disc rupture was difficult to get to.

I can understand your fears. You hear so many horror stories about back surgery but it sounds like you may have a good doctor. If he is not rushing you into surgery, that is a good sign. The decision to have surgery is yours, not his. Ask as many people who have had surgery by him to get an idea if he is good or not.

I am a 38 year old male who is pretty active. I was very worried this would slow me down but I am doing very well. I have been snowboarding twice and cross country skiing twice this year with no problems. Educate yourself as much as you can and ask alot of questions. Then you can make the decision whether surgery is for you or not.

I am sorry you are having problems but this is a great place for info and support. There are some really great people out there that have had similar experiences. Good luck and let me know if you have any specific questions.

Alan

Carol

You are right to be cautious. I had hemilaminectomy microdiscectomy performed by a neurosurgeon to correct a herniated disk and nerve imingement at the L5, S1. I am 8 weeks out of surgery and my life has been severely affected. Prior to surgery, I had bad sciatic pain in my leg but full muscle function. After surgery (which was repeated the following day), I had a deficit of muscle strength in my left small toes - this is related to the calf muscle and results in a noticeable limp. Several weeks after surgery and I developed pain, swelling and numbness in left calf and left foot, at night this is compounded with burning, stinging and tingling sensation on the side of my left foot. My experience is that this type of surgery is extremely invasive and risky. My advice would be to avoid this surgery at all cost and not to have it performed unless you are in a emergency situation (i.e. impairment of muscle functions). I have heard of endoscopic surgery to correct lumbar herniated disks - I would explore that option before submitting to microsurgery (which, as far as I can tell, means that the incision is not at long as normal surgery - it is still full blown invasive surgery).

Wow, ok! Thank you AlSmith. The type of procedure that you had done Al, what is that? The "laminectomy" part? I am glad that your surgery has helped you Al :) Also, thank you for comments and suggestions. Trust me, I am taking everything in. I am looking into everything that everyone tells me!!

Hi Stan3, thank you for your reply!! I am sorry that your experience with this type of surgery hasn't gone well. That's why I am scared. Actually my Dad just sent me an E-Mail and told me about the "Endoscopic Discectomy". I haven't seen or read anything about that type of surgery till now. I think that is a better approach. I am now researching to see if anyone in Pennsylvania does that type of surgery. I think even if I had to travel to get that type of surgery done.... I think now I am leaning towards that type of surgery over the "Hemilaminectomy Microdiscectomy".

Has anyone here had the "Endoscopic Discectomy" if so, how has it been for you? Thank you all for your replies!! They are greatly apreciated and well read from me!! :)

I had what is called a far lateral herniation. This means that my disc ruptured out the side of the disc space vs a more contained herniation. In most microdiscectomies, the surgeon only has to pull the muscles aside. My surgeon tried this approach but was unable to reach the rupture so he had to cut through the muscle in the left side of my spine and dialate the incision with what is called the metrx system. The surgery took alot longer than most and because of the cut in the muscle, my recovery took longer than I anticipated. The lamanectomy part was where the surgeon cut down the opening where my nerve exited the vertibrae to reduce pressure on the nerve.

As a point of clarification, micro means the surgeon used a microscope to visualize the surgery area. This enables the surgeon to see what he is doing better. When a discectomy fails, it is often because the surgeon did not get all the disc material that needed to be removed. For this reason, I am a little skeptical of the endoscopic discecomies. If you chose this approach, make sure you chose a very reputable surgeon that has alot of experience. Less invasive does not always mean better.

Stan, I am sorry to see you have had such a bad experience. You may want to ask your surgeon about Neurontin or something else for your nerve pain. I developed alot of burning in my foot post surgery and the Neurontin takes it about 98% away. Good luck and I hope you are able to get some improvement soon.

Alan

Before I had my hemilaminectomy/discectomy performed in Houston on Nov. 11th as microsurgery by a neruosurgeon, I explored 2 other options to correct severe sciatic pain resulting from a rupture of the disk at the L5, S1 (sciatic pain left leg, buttock to knee joint accompanied by numbness on bottom of left foot). Second option was normal surgergy performed by an orthopedic surgeon in Doha, Qatar (where I live) and the third was to have endoscopic surgery performed in London by a spine specialist.

Unfortunately for me, I let my decision be swayed by timing (vacation time) and health insurance coverage (I lobbied by UK based insurance company very hard to get them to agree to cover the procedure in Houston). I was so focused on economic factors that I lost sight of the important factors -i.e. risk of procedure. If you have time, my recommendation would be to explore the endoscopic option.

Regards, Stan

1st off, I would like to Welcome you to the Boards! :wave:
I'm 6 months post op hemilaminectomy/microdiscectomy for levels L4-5, L5-S1. I too was scared out of my mind prior to surgery, so I understand your concern. You should go for other opiones (sp?). Surgery should be your VERY last resort! You should try all conservative means of treatment before you go under the knife, such as pt for starters.
Unfortunately, for me, my surgery was a failure, but I DO NOT regret my decision to have the surgery. It was one out of two options offered to me after all conservative treatment failed. I opted for the smaller of the two surgerys, and for me, it did not work as planned. I not only had herniations, but I also have ddd (degenerative disc disease) - so when he shaved off the herniations it made the "jelly like" material that hold the discs apart even less. I am now contimplating a two level fusion....which I wonder if I should have opted for in the beginning...
At any rate, just because I had a failed surgery does not mean that you will! I've a very good friend who had the same surgery in 99' and she's feeling WONDERFUL! My suggestion to you would be #1 see another Dr. #2 see an neuroSURGEON if possible one who specializes in the spine #3 look at all conservative means of treatment before surgery. I wish you luck, and please ask all the questions you want!
~M~

Hi Stan and mlachowicz and thanks for the welcome M :) Ugghh, yeah so far my surgery is scheduled for March 10th. I have been looking everywhere for another Neurosurgeon that does the Endoscopic Discectomy. I found one in New York (I live in Pennsylvania) and I was definitely willing to travel there ...but I got bad news from them, they do not accept my health insurance which is a HMO :rolleyes: So, as of right now I am scheduled for the L5-S1 Hemilaminectomy Microdiscectomy in March unless I can find someone else. I have searched and searched the web for the Endoscopic procedure around my area and haven't had any luck. I am definitely willing to travel a few hours if I find one.

As of last week .... I had such BAD, BAD butt and leg pain from last Sunday to last Thursday. I was pretty much in bed for those 5 days. I laid with the heating pad (moist heat) but it was really bad. It was hard to even lay on my sides. Then last Tuesday ... I went numb. I am still numb on my left butt cheek, my left back of my thigh, the left side of my groin area and the left side of my foot (on my left foot). The good news is that I am not in pain right now. As of Friday ... the pain went away but I am still numb which I can deal with right now. Anything is better than that pain I had last week!! Does anyone know what it means when you are still numb, but not in pain? These are the first days I have not been in pain since December 5, 2004!! I am wondering if my disc is still pinching my nerve root? :confused: Or if is stopped pinching now and that's why I am not in pain? I dunno. I just finished oral steriods again on Saturday .... so I am wondering if that is why I am not in pain right now. Maybe it took the inflamation down? I have no idea. This numbness is still weird though!! I am trying to get used to it. Well I guess I will go do some more searching for another Neurosurgeon who does the Endoscopic procedure. Wish me luck!! Thanks everyone for your replies!! :)

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have you attemped any physical therpy? your are probably still numb because the herniation is on the nerve.
good luck
~M~

Thank you for your post Quietcook! I am taking everyones advice here and I am going to get a second opinion. A few people here in my area have suggested that I go to this Orthopedic Surgeon. They said he is really good. So, I called them a little bit ago .... but they need my family doctor to call them to set up the appointment. The bad thing is ... this Orthopedic Surgeon does not have any appointments open until April. WOW!! And my surgey with the Neurosurgeon is scheduled for March 10th. Uggghh!! Now what do I do?? :confused: :confused:

So anyway, I called my family doctor and I have an appointment with him this Thursday at 11:15 AM. So, we'll see what he says. I am going to tell him how I am numb and have been since January 18th. He however, did admit to us back in December that he does not know how to treat my back problem so that is why he sends me out to places. So, I am not sure if I can ask him if he can send me to Physical Therapy or not?? I will ask to see what he says. I have never tried PT yet and I have been dealing with this back stuff on and off since October 2002. No doctor here has ever offered that to me :eek: :eek:

I hope that this is not permanant nerve damage!! My family doctor might send me to get an EMG again ... had one a long time ago but I didn't have nerve damage back then. Although, I wasn't numb either back then! Now I am numb but I don't have the pain. I just did Pilates again .... trying to keep my left side a little active. I hope it won't cause any harm doing Pilates till Thursday when I see my family doctor. I figured I better do some exercises while I am not in pain! Sometimes I wonder about these doctors in my area. Oh well .... I guess we'll see what happens after my appt. Thursday.

Thanks again everyone!! I read this board several times a day, it is very helpful and I am glad it is here!! Off to do more research, I would still love to talk to a doctor who does that Endoscopic procedure .... not having any luck in my area yet! I am gonna keep looking. Bye for now :wave:

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Tifferzz, I have one more suggestion for you to consider. If you do decide to have surgery, make sure the surgeon performs a proceedure that he/she is familiar with and comfortable doing. I would rather have a doctor that is very experienced in open microdiscectomies do my surgery than have an endoscopic discectomy from an inexperienced surgeon. The endoscopic discectomies are a little less invasive but it is also very important for the doctor to be able to see all the damage. I think that when the endoscopic discectomies fail, it is often because the surgeon missed some disc material. By the way, I believe that my decision to have my surgery was the one of the best decisions I ever made. I have NO regrets. Good luck and please keep us informed. We can all learn from your experience.

Alan

I am now 10 weeks + post op. My muscle weakness or deficit remains as do the other symptoms of pain, numbness, swelling, burning and tingling which I described. The only symptoms which I had preop were sciatic pain (buttocks and back of left leg above knee joint) and numbness on left and bottom of left foot. I had no loss of muscle function preop. What drove my decision for surgery was the pain, especially when standing or walking. However, preop, I could reduce or avoid pain by sitting or lying down. Now, my problems are ever present and unavoidable. The best relief which I have now is to walk and I must do so with a limp. Again, I would counsel all to carefully weigh the risks of surgery against the benefits. I'm not sure that pain alone should drive the decision. Somewhere, I read that herniated disks can and do respond to conservative treatment and bulging disk nucleous can and will be reabsorbed by the body over time. I wish that I had waited for my surgery until something more that pain drove my decision.

Regards, Stan

Thank you Quietcook :) Yeah, I go to my family doctor tomorrow morning. I am going to ask him about PT. He doesn't know that I am now numb. My Neuro. knows but my family doctor doesn't. Neuro. told me it was normal under my circumstances :rolleyes: So we'll see what my family doc. tells me tomorrow. :) I have never done PT ... but trust me, if they cause me any pain ... I will literally FREAK OUT!! Then never go back LOL. I will make sure I tell them that if I do end up going .... I'll tell them before they start, hee hee.

Yes Al, I have been reading that about the Endocopic as well. About them missing disc material. It's just a tough decision to make. I don't like the idea that they take a piece of bone out (with the Hemilaminectomy Microdiscectomy) to get to my one bad disc. I have read that it makes the spin "un-stable" when they do that. So that scares me! Then I wonder, hrrrmmm, I am not in pain right now but I am numb. Do I takes the chances of it healing itself?? I have heard that over time your body re-absorbes that disc material. Since I am not in pain right now .... I kinda wanna hold off on surgery and see. But ... I know if I get real bad pain again, I will be thinking just give me the surgery to takie away the pain!! It is a tough decision. I have DDD too ... so I wonder ok, he does my L5-S1 but what about the bulge that I have in L4-L5 .... what if that ruptures then I need another surgery to fix that one. Hrrmmm, I dunno .... I go to my family doc. tomorrow, I guess I will see what he has to say about this numbness then go from there :confused:

Hi Stan, sorry to hear that you are still in pain!! So you had the same surgery that my Neuro. wants to do on me? Yes, I have read about the body re-absorbing that disc. I haven't been in pain since last week ... I am still numb ... but I dunno. Surgery is definitely a hard decision for me to make. I am worried about the numbness though. I have been numb for a little over a week .... and I am not sure what that will lead to if I don't have the surgery. I am not sure if it causes permanent damage or not :confused: I dunno .... like I said above, I will go to my doctor appointment tomorrow and see what he says. I am also going to suggest that my family doctor and my Neurosurgeon talk that way we can maybe find a good Physical Therapy place for me to go to without them causing me further damage. I'll find out tomorrow!!

Again, thanks all for your comment and replies!! Hope everyone has a good day. :wave:

Tifferzz

I just read my surgeon's discharge summary again. The procedure which he performed was "Left L5, S1 hemilaminotomy, medial facetomy, forainotomy and microdiskectomy". He states the operation was without complications, but that post operatively, I developed muscle weakness. I want to reiterate: I had no muscle weakness prior to surgery.

Wow, ok Stan, thanks!! I am not sure if I have muscle weakness or not :confused: I can walk fine .... but I did notice something weird the other day. Like on my right foot .... I can take my big toe and cross it over to the toe beside it and I can like get it to crack. Well, I have been trying to do it with my left foot ... and I can't!! That's been that way for a few days. I wonder if that is some muscle weakness :confused: I know I used to be able to do it on my left foot too and now I can't. Like now I am sitting here trying ... and on my left foot .... that big toe just does not cross over the toe beside it so I can't crack it that way. Heck, I dunno, it's frustrating though LOL!! Other than that ... I can walk fine and stuff right now. I am gonna look up the difference between a "Hemilaminectomy" and what you had Stan ... a "Hemilaminotomy".

hi tifferzz. i am 2 days post op. i had a left and right side hemilaminectomy and micro d at L4 L5. i have know pain and i am not using any pain killers. i am able to walk fine shower and use the bathroom with out any trouble. after my op. i was able to go home in 4 hours. i know everyone is different and we all heal at different time frames. i wish you luck. steve

Hi Tifferzz. I had a disectomy-laminectomy Nov. 13, and my doctor removed 60%-70% of my disk. I was pretty much walking and pain free by my fourth week post-op. I had muscle weakness and numbness in my right leg, and pain, and it´s all gone away.

However, I operated 3 weeks after the initial pain started. I read in different places online that the longer you wait (more that 6 weeks) the chances of your surgery being as successful go down. I would look into that, and I would see more doctors. I saw 3 different doctors, and I chose the one I felt good with. Find out what your doctor´s experience is, how often he performs that surgery, etc.

Hi Tifferzz

I think that you've received good advice on finding and choosing a qualified spine specialist surgeon. Finding a surgeon who is willing to observe you and help you weigh the risks in a reasoned, seasoned and dispassionate manner appears prudent as well. In my case, I pushed to have the procedure done and there was no one to put the the brakes on. On the contrary, my surgeon pushed on the accelerator. He recommended surgery based on seeing my MRI without consultation. I arrived in Houston on a Monday, he examined me on a Tuesday and operated on a Thursday. I walked into the hospital firing on all four cylinders; I walked out limping on 3.

Now, I'm approaching 11 weeks post op, and I have a noticeable weakness in my left foot and I walk with a pronounced limp. I hope that since I have some strength in the deficient muscle, I can recover some more. However, since I have no idea of what caused the muscle weakness, I am struggling to find reliable information to help me assess my prospects. Today, I'm scheduled to have an EMG performed at the state hospital here in Doha and next Tuesday, I have an appointment with a neurosurgeon to evaluate the results. I'll keep you posted.

Best of luck with your own assessments. Regards, Stan