Diskectomy to Repair Disk Extrusion
I used this board to try to research people's experiences with surgeries related to relieving back/nerve pain associated with herniations and extrusions. I wanted to share my experience.
Symptoms-six months of leg and back pain. Pain radiated over the right buttocks but not extensively down the leg. Pain was manageable with Tramadol but mornings and nights were very uncomfortable. I could not sit down and stand up without a significant amount of pain. I have had about a 1 cm herniation in the L5 Disc for about ten years. My previous MRI was about two years old. My most recent MRI showed that the herniation had become an extrusion. I had about a 1 cm piece of disk material outside of the disk. My Neurosurgeon recommended removing the material to relieve the pressure on the nerves. Previous treatments included oral steroids and OTC anti-inflammatory drugs. Based on my research surgery was the only true long-term solution. That and I was just tired of dealing with rehab and pain meds.
I'm retired Army and used a military facility for the procedure. The Surgeon performed the procedure that uses about a 2 inch incision. He did not use the expanding tubes that are on several web sites. He did not feel it provided him the necessary surgical field. I'm sure all procedures are dependent on the surgeon's level of comfort using the procedure.
Day of surgery I began at 5:00 a.m. Pre-op included a blood check due to a previous test indicating a high Potassium level. Assumption was there really was not a problem, but they had to double check. Did the normal blood pressure and temperature checks. One Doctor marked the surgical site. I was moved to the OR Prep at 7:30.
At 7:30 in the OR prep I was put on an IV, the Neurosurgeon met me and reviewed the procedure. He also marked the site. Relatively, quickly I was moved to the OR. They were still waiting for the Potassium test results. After about ten minutes I was put out by the Anesthesiologist. This was my first surgery, and this is an amazing phase. You are literally knocked out in seconds.
I awoke in the post op OR area a couple of hours later. Time is lost at this point due to grogginess. In post op the nurse monitors a few things and you slowly gain your wits. The Neurosurgeon conducted a few checks on my feet. Push, pull, and sensitivity. All were fine. I had some pain from the surgical site, but the leg/nerve pain was gone.
I eventually was given ice and water and offered crackers. My mouth was extremely dry, and I had a scratchy sore throat. All discomforts not extremely painful. I'd recommend a patient have some type of throat lozenge's that they prefer for the potential sore throat. Something to help get moisture back in your mouth is probably also helpful. I had lemon drops when I went home.
I was later moved to a hospital room. Probably around 12:00 or 1:00. In my case I was coherent, but definitely feeling the effects of anesthesia for several hours. I was given Percocet for pain and Methocarbanol for a muscle relaxant. I also received Colase for a stool softener. I eventually ate lunch and steadily improved from surgery. I was able to walk around the ward around 3:00. One other key factor in going home was the ability to urinate about 250 cc of Urine. I was able to accomplish this with no problem, but I felt the need to urinate frequently even though I did not have a lot to urinate. I'm not aware if that is a symptom of having a catheter during surgery.
My Neurosugeon did another evaluation and was willing to release me if I wanted to go home. By nature I do not like a hospital environment and preferred going home. I ended up being discharged around 7:00. I did ask the Surgeon how the nerve looked and he said was pretty red/inflamed. He removed one large piece of disk material and believed my L5 problems would be a thing of the past.
The night after surgery was the most painful. My pain was only associated with the surgical site and muscle tissue that was cut. My nerve pains had subsided. In my view I had traded a nerve pain for a surgical pain-which was a fair trade since the surgical pain would subside. First night was painful, and I did not sleep well.
The pain was still only related to the incision. I went for a walk around our culd de sac at around 10:00 a.m. Maybe 500 ft total. I took successively longer walks about every three or four hours. Walks do seem to help with pain management. As the day went on my pain was less. There is a certain amount of laying around you have to do, but mild exercise seems to help.
Day 3 I continued longer walks and more movement around the house.
Additional info-I recommend the frozen blue ice bags available at most stores. They are relatively flat and easy to manage. I have one bag that is thick with blue ice gel material. It seems to work well for cooling the surgical site and the material moves so there is not a lot of pressure on the site. I'm a fan of cold for relieving the pain.
I'd recommend a high in fiber cereal snack. Constipation would be a bad thing to have post surgery. Fruits were also recommended.
Things pretty much progressed well. I had one scare where I had shooting nerve pains while doing some PT Stretches. I also have a lot of muscle weakness from months of poor posture trying to dodge the pain. While this is frustrating I believe it will be corrected over time.
I'm about six weeks past surgery. I returned to work after four weeks. Sitting is still somewhat problematic. After a day of work I need to simply lay down for about an hour.
Overall, I am a lot better off than before surgery. I realize a lot of post are from people who have not had successful results. My research indicated that a lot of the surgeries are successful, but with the back and associated nerves there are a lot of things that affect everyone differently. If you are in severe pain, the surgical procedure is not what I would consider worse than the nerve pain. Granted all surgeries have life threatening risk and potential to do harm. I think most just have to evaluate the risk based on their personal health status.