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Old 07-09-2004, 03:11 PM   #1
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Surgery for fragment/sequestered disk - is it necessary?

Hello,

I have a herniated disk and the CT scan shows that pieces have fragmented off (sequestered disk). My question is, how necessary is it to have these fragments removed? I am having a hard time finding info on "sequestered disks". I am only 21 and really do not want to have back surgery, but at the same time I do not want little fragments constantly floating around back there cauing problems my whole life. Can fragments heal on their own just like a herniation can? Or do they really need to be surgically removed?

My family doc did not want to tell me too much. He said it is best for me to discuss with the neuro. but that I will most likely need surgery. In the meantime I am being told not to do physio, massage, accupuncture, basically not to do anything until I see the neuro. except for like light walking. Is this good advice? He said that it is really risky to strain my back anymore when it is in this condition as it can cause way more serious nerve issues when fragments are involved, basically doc scared the heck out of me. I am young and frightened and would really like to no more about this "fragment" issue.

Thank you and good luck with your own healing everyone

 
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Old 07-09-2004, 04:09 PM   #2
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Re: Surgery for fragment/sequestered disk - is it necessary?

Well, a lot of your questions will depend on what disc has herniated. The disc material is normally like jelly, enclosed in a baggie. If the baggie ruptures (herniates) the disc material leaks out. Unfortunately, the disc material then hardens (I think it's a chemical reaction that turns the jelly into rock-like material). So the disc fragments are then hanging around out there. I've never heard of the fragments dissolving.

Again, what you have to do depends on where you have the problem. In general, cervical (neck) herniations are more dangerous than thoracic (mid back) herniations, which are more dangerous than lumbar (low back) herniations. Not necessarily more painful, but the danger order tends to work in that way because your spinal cord starts in your cervical area and actually ends in the thoracic area. Nerves still go on into the lumbar area, but the spinal cord itself usually ends around the thoracic-lumbar vertebrae area (T12-L1). Lumbar herniations can be real painful, but there's a much lower risk of any kind of paralysis. My dad, on the other hand, had a cervical herniation and has partial paralysis now.

If the fragments aren't pressing on any nerves, or aren't endangering any nerves, then you might be able to leave them alone. On the other hand, if you've herniated a cervical disc and you have fragments dangerously close to your spinal cord - which at that point is carrying pretty much all of your nerves for most of your body - then by all means you might want to remove them from the danger zone. And think about it - if you have some sharp fragments hanging around your spinal cord, maybe a massage or lots of physical activity are not a great idea. Those pieces might move somewhere you really don't want them to go. I'd agree with your doctor - low and slow until you know.

So I'd be conservative until you talk with a neurologist about where the herniation is, where the fragments are, how big they are, and how close they are to anything important. Then you can make a decision. There's not an answer until you have all of the information. Hope this helps ...

 
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Old 07-09-2004, 05:43 PM   #3
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Cool Re: Surgery for fragment/sequestered disk - is it necessary?

yes i agree with (i wan toheal) get set of x-rays done and then get a game plan,dont do anything till u see neuro good luck keeps us posted

 
Old 07-09-2004, 05:49 PM   #4
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Re: Surgery for fragment/sequestered disk - is it necessary?

Thanks for the response

I forgot to post where it was. The herniated disk is in my lumbar area. Unfortunately I cannot remember which one. I got hit pretty hard in the doctors office and I really can't remember much of what he told me because of emotion/shock. I need to tape record my doctors visits

I can remember the doctor said this, that from the CT it appeared that the herniation itself was not directly affecting any nerve as the herniation was fairly mild and that most likely it is the fragments themselves that are giving me massive pain in my right leg. I guess I just have to be patient and wait for my neuro appointment. (right now I don't know when it will be, could be 10 days, could be 2 months or more.)

 
Old 07-10-2004, 12:31 PM   #5
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Re: Surgery for fragment/sequestered disk - is it necessary?

You have gotten excellent advice and I have nothing to add other than backing up the info already given. Take things easy and slow, and please be sure to let us know how the doctors visit comes out.

Carol
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Old 07-11-2004, 01:51 AM   #6
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Re: Surgery for fragment/sequestered disk - is it necessary?

Hello again and thank you

So I take from agreeing with the opinion that I shouldn't do anything until I see the neuro does this mean this is really serious? Also, I am now starting to have symptoms, although way more mild, in my left buttock/lower back and big toe in addition to all the stuff on the right. Is this bad?

I can find info on what happens when a disk is sequestered/fragments, but nowhere does it say that it is MORE serious or requires surgery anymore than a regular herniated disk. Maybe I am just not looking at the right resources?

Sorry if I sound ignorant, but back stuff is just so new to me and I am young and terrified and I don't know anyone in the "real world" to ask these things except for the doctor. I need to write down questions to ask him when I am in the office I tend to freeze and get a complete mental block. I go back to the doc Monday a.m. and will bring a tape recorder this time and remember to ask more questions.

This board is a great resource and thanks to everyone! Even though I don't post alot it is because I am new and uneducated on most of these issues, but I offer you all my support and good wishes

 
Old 07-12-2004, 10:43 AM   #7
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Re: Surgery for fragment/sequestered disk - is it necessary?

I gotta confess I've never heard the term "sequestered" so I have no clue what they are talking about. Herniated discs can splatter all over, or they can rupture in a more contained mass. Maybe it means that yours is splattered all over, you'd need to ask your doctor.

You do need to take this seriously because your back is pretty unique in your body in that some problems can't be "fixed". A broken bone can heal, but soft tissue structures in your back cannot. Once your disc is ruptured, it can't be "made right" again. Nerves can regenerate, but it's a long, long process that is not always successful. Sometimes, if the damage is severe enough or it goes on too long, the nerve cannot regenerate. Back surgery simply replaces one set of problems with another; surgery to remove a herniated disc just cleans up the mess. The disc can't be replaced (short of major disc replacement surgery which is not yet common in the US), and it leaves you with scar tissue that can cause it's own problems.

 
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