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Old 01-04-2013, 09:32 AM   #1
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How many Micro D's can you have on one disc.

I had a microdiscectomy on L5/S1 last February. On some notes I have seen it referred to as a hermi laminectomy - I dont know what the difference is?

Anyway this was after two prolapses over 4 years with the latter being a substantial prolapse. The surgeon stated after initial surgery that he had removed a large part of the disc.

Three months after the op the disc re-herniated again on the other side (so 3 herniations on same disc). After a further MRI scan the surgeon mentioned fusion and that basically scared the hell out of me .

I have since had a caudal epidural which has failed so am looking at further surgery. How many Micro D's can you have or will I be looking at fusion if there isnt much disc left?

 
Old 01-04-2013, 10:34 AM   #2
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Re: How many Micro D's can you have on one disc.

It's really not a matter of how many discectomies can you have if you have had a laminectomy...because a discectomy removes part of the disc and a laminectomy removes the laminae, which are bony segments that help form the arch across the back of the vertebra. A hemilaminectomy removes one of these segments. It is done to make more room for the nerve so it is no longer badly irritated or compressed.

If this is done too many times, it makes the back unstable at this segment where bone is being removed, and a fusion is necessary.

The general rule of thumb, at least in the US, is that the surgeon will perform a discectomy two times. If it herniates again, a fusion becomes necessary.

 
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Old 01-04-2013, 12:23 PM   #3
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Re: How many Micro D's can you have on one disc.

Many thanks

So its two then fusion ? I have no idea why, when I last saw the surgeon he was on about fusion after the one. The hermilaminectomy was clearly done at the same time as the micro discectomy ? (They never told me this, it was only when I saw the latest MRI.)

Last edited by ossie1; 01-04-2013 at 12:35 PM.

 
Old 01-04-2013, 12:24 PM   #4
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Re: How many Micro D's can you have on one disc.

d/p ...........

Last edited by ossie1; 01-04-2013 at 12:34 PM.

 
Old 01-05-2013, 10:03 AM   #5
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Re: How many Micro D's can you have on one disc.

No it is not a hard and fast rule that you have fusion after two failed discectomies. It's just that many surgeons (I'm only familiar with what goes on in the US) figure that if it has reherniated twice, it will probably do it again...so they opt to go with a fusion. The laminectomy is often done with discectomy....I guess it isn't always made clear to the patient.

Surgeons do not like to go in too many times at the same location. The risks for infection and development of epidural fibrosis increase...so that's another reason for not just doing a discectomy over and over again.

 
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