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Old 07-29-2011, 05:42 PM   #1
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Question Need advice about L4-5 disc herniation

I have been having back pain with radiating sciatic pain to some extent for nearly six months. Sometimes it has gone away to the point that I could function normally and even work but for the past two months I have since been having severe sciatic pain again, and it has affected me to the point that I can not sit at all and can only stand for short periods of time. I was in physical therapy for six weeks and was seeing slow improvement, but since then bent down to pick up my tens unit off the floor and re-injured myself. My doctor gave me a medrol taper which I believe has helped the inflammation considerably. But the pain is still too debilitating for me to lead a normal life and return to normal activities.
My doctor ordered an MRI, and the results showed that everything is normal aside from this:
[B]"The L4-5 disc shows narrowing, desiccation, and a right paramedian disc extrusion. While not causing a severe degree of central stenosis, there is clearly nerve root compression in the right lateral recess. Radicular symptoms would be expected in the right L5 nerve root compression."[/B]
The radiologist said I seemed to be a perfect candidate for surgery. My doctor told me he wouldn't mess around with epidural cortisone, especially since I've been on two rounds of oral steroids in the past two months. He said if it were his back, he would have the surgery. I meet with an orthopedic surgeon in about week and am considering this if the surgeon wants to do microdiscectomy, but would be very reluctant to do anything else. The thought of any surgery scares me to death honestly. But given where I am now with my mobility, I don't see many other options for me. I want my life back. Any information that anyone can provide would be greatly appreciated. Also, looking for real life stories about microdiscectomy surgeries, and how long it takes to recover from something like that. Are there less invasive options?

Last edited by melody84; 08-02-2011 at 12:15 PM.

 
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Old 07-29-2011, 10:24 PM   #2
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Re: Need advice about L4-5 disc herniation

Welcome to the board.

Do you have any fellowship-trained spine surgeons anywhere near where you live? This could be either a neurosurgeon or an orthopedic spine surgeon who devote their practice to issues of the neck and back. Sometimes in smaller communities there is a general orthopedic doctor who had some training in the spine during his residency, but doesn't really see enough spine cases through the year to keep his surgical skills current, etc. If you decide to have the surgery, be sure you are going to the most experienced spine surgeon that is available to you.

A discectomy should be a relatively simple surgery (as surgery on the spine goes) but it is not without risk, so you want to evaluate the surgeon carefully before you let him operate on your spine.

Often people realize they have been abusing their backs only after they have sustained an injury. If you are to have a successful outcome you will need to revise your habits...and you will need to be patient in your recovery. Some doctors will tell their patients that you can go about your normal activities after several weeks...but you really need to be mindful of your back, avoid any activity that involves bending, twisting at the waist, pushing, pulling, reaching up overhead or to the side, lifting anything beyond the limit the surgeon gives you, etc. You will need to "baby" your back for awhile and learn to be patient....giving up some things until you know you are fully healed.

Some people don't realize that you can reherniate a disc fairly easily....They think that by having surgery, it will return their back to the way it used to be, prior to injury or the onset of pain. But the back will never be the same. In time, it may come close, but it will always be altered and you will always need to be mindful of how you treat it from now on.

If you do not also have a spondylolisthesis, if you were patient and careful and did the McKenzie exercises faithfully several times each day, chances are you could repair the herniation on its own without having surgery...but it does take time...3 to 6 months perhaps. Most people don't have the patience for this and usually opt for surgery, but, it is possible in most cases. This would be something the spine surgeon could assess for you. Americans are much more likely to operate on a herniated disc than is the norm in any other country.

Good luck to you and let us know how things go for you.

 
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melody84 (07-31-2011)
Old 07-31-2011, 02:00 PM   #3
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Re: Need advice about L4-5 disc herniation

Thanks for your response! My doctor referred me to a fellowship-trained orthopedic surgeon and from what research I have done he seems quite qualified. It is a four hour trip to the city to see him though.
I have heard that discs can heal themselves, but honestly I don't think that I could endure this pain for another 6 months, and I'm concerned about the possibility of doing permanent nerve damage.

Last edited by melody84; 07-31-2011 at 10:21 PM.

 
Old 07-31-2011, 11:38 PM   #4
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Re: Need advice about L4-5 disc herniation

I had an L-5, S-1 microdicectomy in April. I could not function, couldn't take care of my kids, my youngest is 7, or work. I am stronger now than before surgery and in better shape. A neurosurgeon did my surgery. I had a BIG bulge, physical therapy and two courses of oral steroids didn't fix. Surgery worked out well for me. I did go to physical therapy after surgery, but my advice is to find a really good PT that specializes in your condition. My experiences with PT were vastly different. I had to pay more the second time around, opting out of the previous PT my insurance paid for entirely for the PT I had a much higher deductible for. But the second PT really stressed body mechanics and knew how to help me allow the disc to heal properly, "don't bend". If you opt for sugery, let people help you, take the time off alloted you to heal properly and follow the surgeon and PTs directions. I'm back to work, and taking care of my kids. I feel really good. Remember, if you opt for sugery, you want to give yourself every opportunity to heal properly and get the best outcome possible. But it can happen! Hope that helps. (P.S. no pain meds post surgery, YAY!) : )

 
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melody84 (08-01-2011)
Old 08-01-2011, 01:08 PM   #5
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Re: Need advice about L4-5 disc herniation

It's good to hear a positive outcome is possible with surgery. Whatever treatment I end up having, I'll be sure to make PT a top priority afterwards. Thank you for sharing your story!

 
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chronic back pain, herniated disc, l4-5, microdiscectomy, sciatica



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