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Old 12-11-2012, 09:45 AM   #1
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Question Lumbar decompression (laminectomy, foraminotomy, discectomy)

Hi everyone,

I've been reading a bunch of threads about people's experiences with surgery. I know we're all different, so I want to give a brief history and ask for opinions.

April 2012 - Bent over and suddenly had excruciating pain in low back.
May 2012 - About 2 weeks later, I felt like it was almost better until I apparently blew my nose too hard. Started physical therapy. Over the next few weeks, the back pain improved, and that's when the leg pain started (mostly in left leg).
July 2012 - After 2 months of physical therapy, I was referred for epidural steroid injections.
August 2012 - MRI showed DDD at L3-4, L4-5, and L5-S1. Most pronounced at L4, along with a herniation and lagimentum flavum hypertrophy. Moderate stenosis noted at that level.
August 2012 - First epidural
September 2012 - Second epidural
November 2012 - Third epidural

The epidurals unfortunately did not help. Prior to this, I was very active. I did intense exercise for at least an hour a day 6 days per week. Since this happened, I continued to be as active as possible. However, my activity level has progressively gone down and down and down. I've gotten to a point where I've pretty much given up on exercise because I haven't been able to do anything without causing a significant increase in leg pain.

I recently had a follow-up, and the surgeon suggested spinal decompression surgery consisting of a laminectomy, foraminotomy, and discectomy at the L4-5 level. I'm in the process of getting a second opinion. I understand that the surgery would primarily address the radiating pain and not the back pain as much, and I'm okay with that.

I've been debating this in my mind, and what makes the decision more difficult for me is that if I sit around and do nothing, I don't experience much pain. I'm able to work since I mostly work at a desk. Since I'm not in a lot of pain, I keep asking myself if it's worth it to risk surgery.

However, my quality of life has suffered tremendously. I love exercising, and not being able to is very depressing. If there's a chance I might be able to get that back, it might be worth it. But I know there are no guarantees either, so it seems like a pretty big gamble. I get the impression that a lot of people opt for surgery because their pain is unbearable. Mine is bearable, but I feel like I've had to stop living my life in order to make it bearable.

I'd like to know people's experiences regarding the level of activity they were able to return to following this type of surgery. I know the recovery would take a while, but will I ever be able to do intense exercise again? Or will I be limited to walking, cycling, and swimming forever? I know these aren't questions that can be answered in regard to my own experience, but I'd appreciate people's input. Has anyone been able to resume things like running, kickboxing, dancing, martial arts at some point after major back surgery?

Thanks so much everyone!

 
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Old 12-11-2012, 03:00 PM   #2
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Re: Lumbar decompression (laminectomy, foraminotomy, discectomy)

You did a good job of summarizing your condition, of raising some questions and answering most of them! There isn't too much to add. If your surgery goes as planned and there are no unintended results, you would be happy with the surgery. After about six months' recovery you would probably be able to resume at least some of those activities.

I know people who have resumed mountain climbing after a lumbar fusion. Part of the decision regarding what activities one resumes depends on your outlook on life. Some people, having been through the agony of sciatic pain, etc. will do most anything to protect what they have left of the spine and are reluctant to participate in activities that we all know are not kind to the discs -- things like contact sports, running or something where there is a repetitious pounding that really jams the discs, etc.

Other people think "life is short and I want to do what I want to do and possible consequences be damned.... "

Presumably, if the only problem with your back is what you've described and you don't have a lot of degeneration going on, you could have the procedure, heal and go through a thorough rehab and go back to the sports you love. You do have three levels that are showing degenerative disc disease. The thickening ligamentum flavum is also a sign of wear and tear and the beginnings of arthritis...so you'd want to discuss these issues with your surgeon...but, the other side of the coin is how much are you going to be able to do without the surgery? The disc could heal but the stenosis is unlikely to improve on its own unless it is completely causes by the disc herniation. The fact that you had three ESIs that had little effect makes me think that even if the disc healed on its own, it would not resolve your pain.

But there are those rare instances where something goes wrong and the person ends up in more pain than they had previously, or they end up with a drop foot, etc. Then they wish they had put up with what they had and had never had the surgery. It is a tough decision, and as you note, there are no guarantees. Also be aware that the back is never the same post surgery. By that I mean that back surgery does not return the person to the way he/she was prior to the advent of back pain or injury. Some people are mostly back to "normal" but the spine has still been altered in some way!

 
Old 12-12-2012, 08:31 AM   #3
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Re: Lumbar decompression (laminectomy, foraminotomy, discectomy)

Hi....I too loved to work out.....had surgery 15 years ago for herniated disc. I was doing great!!! No pain at all. I retired and decided to take up running again. That was a bad idea! I had to have surgery and now live with nerve pain that the surgeon has said will not go away. So......u have to choose. If I could do it over I would walk and swim. The constant pressure on discs due to running is terrible...I wish I had been advised not to run!! Good luck!

 
Old 12-13-2012, 08:23 AM   #4
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Re: Lumbar decompression (laminectomy, foraminotomy, discectomy)

I had unsuccessful epidurals for spinal stenosis and neurogrenic claudication. I then had an x-stop decompression. My understanding of laminectomies is that they are hit and miss. I've had several surgeons say to me that any surgery on the spine is really a gamble, they may make it better, they may make it worse. But I've seen many people who have had a laminectomy say they regret it.

I don't notice my x-stop but it has by no means 'solved' my back problems, it did for a few years, but I now 'slip' a disc every few weeks and have really bad claudication (I'm a relatively fit 28 yr old )

Give your pain is bearable, I think you should focus on a strict physio regime rather than opt for surgery. Or at least try that out for a year first. You might have to change the exercise you do.

 
Old 12-13-2012, 05:32 PM   #5
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let me walk HB Userlet me walk HB User
Re: Lumbar decompression (laminectomy, foraminotomy, discectomy)

Hi evian 7,

I am now 9 days post Laminotomy (not Laminectomy) and formaminotomy on L3-L4, L4-L5. I didn't have any disc issues. Like you, I was very athletic, love to move, etc. I've been dealing with my left leg weirdness for over 5 years and my left lower back started really hurting about a year ago.

I did everything I could to manage the pain and improve my mobility: neuro-prolotherapy, physical therapy, ASTYM, acupuncture, aqua therapy, chiropractic, meditation, modifying my activities, etc. I did the ESI injection about 8 months ago and that bought me some time. However, the pain just got too much for me-especially the past year.

I sought out 3 opinions and all were in agreement that I needed the Laminotomy. My stenosis was severe and my facet arthritis was (and still is on other levels) extensive. I was an emotional wreck on 12/4/12 going into surgery b/c, like you, I've heard so many bad stories (on this board) about Laminectomies but I have also heard of many success stories (not from this board).

I have gone through the emotional process of accepting my limitations and being OK with them. It's taken me a long time (and 7 surgeries to get there...I'm an ortho wonder). I know of people who have the surgery, recovered (long recovery) and are back to triathalons, rock climbing, extreme hiking, etc. I am NOT one of those people.

I'm 48 years old and was advised by one of the PA's in the hospital to respect my spine. He knows my ortho history. My spine is compromised and now it's changed b/c of surgery. It will NEVER be the same and I will ALWAYS have to be careful and mindful about my movements.

You said that you love to exercise and not being able to do so is depressing. Have you tried different activities like aqua jogging, low impact aerobics, biking, weight training? Heck...I've had 2 ankle surgeries and was NWB for 8 months and I found ways to move. I've had both of my knees replaced at the same time and still found ways to move. I had compartment release surgery on my left calf and found ways to exercise. I now have the spinal stuff going on and I still am finding new ways to exercise. I aqua jog 3-4 times a week, I bike 3 -4 times a week, I do low impact aerobics daily (to get my joints movin), I weight train, I hike, I walk. (I'm walking up to an hour daily 9 days out of surgery).

I'm saying this b/c you might want to make a serious effort to modify your activities and see what happens. If anything, you'll learn more about your body and you might find a new activity that you enjoy.

I am still not sure that this surgery will help me. So far it hasn't done much to improve my leg...but it's still early. Time will tell.

I hope this helps. It's a tough decision.

-Julie

Last edited by let me walk; 12-13-2012 at 05:39 PM.

 
Old 12-13-2012, 06:14 PM   #6
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evian7 HB User
Re: Lumbar decompression (laminectomy, foraminotomy, discectomy)

Thanks everyone. I really appreciate your input!

Julie- Yes, I have tried low impact everything. The difference it made was negligible. I'd like to clarify that I do still exercise. It's just that I haven't been able to find any activity whatsoever that doesn't worsen the pain. I don't ever expect to get back to the same activity level I had before, but the activity level I'm able to maintain now is unacceptable to me.

 
Old 12-13-2012, 06:20 PM   #7
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let me walk HB Userlet me walk HB User
Re: Lumbar decompression (laminectomy, foraminotomy, discectomy)

Good! Good luck with your decision.

 
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