I had 2 surgeries at the L4-L5 disk, last one 2010, after my last surgery I managed to run myself over a week after I went back to work, I was in the hospital for 4 days. I didn't have any noticeable back pain then but I am now having some back pain and leg pain. I had an MRI last week and was told I blew out the disk again. I do not want a fusion my sister had 2 or 3 hasn't helped her at all. I am going to get a ESI tomorrow hope it helps. I also have a bulge at the L4-L3 level but it's still quite small.
any advise and stories would be helpful to me as I'm not quite sure of what to do anymore.
have to add the the pain is not painful enough for me to even consider surgery for now but I know that could change in a minute.
Your options are somewhat limited. You can live with the situation and try the conservative measures, which may temporarily help with the pain.
Some surgeons will operate a third time, but many draw the line at two discectomies. The problem is that usually with each surgery more is removed from the disc and surrounding areas, and it can lead to instability at that particular spinal segment that has been surgically altered. This is why a fusion is recommended when two discectomies have been tried and have failed.
I was wondering since I have a bulge at L4-L3 and a herniated disk at L5-L4 would they want to do a 2 level fusion? and does the bulge at L4-L3 leave me out of the running for an ADR?
Look into how bad the bulge is and the future risks if you don't do it. I had the disc removed and a fusion done eight yrs ago. I was to the point that I had violent muscle spasms in bed and could hardly get any sleep. My daughter( 12) had to come roll me out of bed in the morning and it was so painful to lift my right leg that it would take me five minutes and a bucket of tears to get to my bathroom eight feet away. If I sat my legs jerked constantly. My right foot tingled, sometimes burned. Pain in my right hip was insane. All this and I still refused to have surgery. The disk was desiccated and pushing into my spinal cord. The Dr said if it moved any more at all I would lose bowel and bladder control. I probably wouldn't walk and sex would be a thing of the past. The steroid injections never helped me at all but I've heard people who said they helped them. Fusion may not solve all your problems forever but it's well worth it for however many good yrs you get.
Those are good questions to ask your spine surgeon. I couldn't venture a guess. It would depend on the size of the bulge, whether there is associated stenosis, the extent of nerve compression that the bulge might be causing, etc.
A fusion would only be recommended if the discectomy is creating instability at that segment.
Regarding ADR, it might be possible, but it would depend on how much has been trimmed away with your two preceeding surgeries. I guess there are a couple places that will do a two level ADR in the US, but it is not commonly done, and insurance carriers are getting balky about covering ADR. You would need to determine these things for the area in which you live.
