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Old 02-02-2013, 07:25 AM   #1
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Hemilaminectomy / Microdiscectomy L5-S1

I got Hemilaminectomy on the left side with L5-S1 Microdiscectomy about 5 weeks ago in Thailand. I am now back in Afghnistan with very light duty. I can get up and walk or sit down when ever I want, and I don't have to lift anything. I went to the best hospital in Bangkok and one of the best Neurosugeon, but there was still a lot that was not passed on to me due to the languege berrier. He said he took the entire disc out, but he didn't mention fusion or anything and he didn't not put anything back in place of the disc. Is this common? I feel OK. I still have some pain and numbness down my leg and calf, but I can deal with it compared to what it was. I just hope some one can tell me what kind of physical activeties I will be able to do once I am fully healed. I asked the dr. if I would be able to run marathons and fight competitively again, and he said yes. He said I should be able to start running again after 6 weeks. I'm reading a lot on the internet now and it just dose not sound like people do physical activities like that after that type of sergery. If he didn't fuse the bone back together and didn't replace the disc with anything how stable will it be in the future? Is it going to cause damege to other bone by grinding together? I hope you can help me to be more informed about the sergery I just had and what I can expect in the future. Thank you!

 
Old 02-02-2013, 11:54 AM   #2
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Re: Hemilaminectomy / Microdiscectomy L5-S1

Welcome to the board.

Would it be possible to get a copy of the surgery notes so you would know specifically what was done? I have never heard of a disc being completely removed without something being done to stabilize that segment. The doctor may have removed some of the disc, and the laminectomy is often done at the same time.

Sometimes in the case of a laminectomy, too much is inadvertently removed and the patient ends up with an instability that results in nerve pain. The point of the intervertebral disc is to provide cushioning between the bones of the spine, the vertebrae. When it is diseased and causing pain, it can be trimmed, or treated in a way that still provides separation of the vertebrae. Sometimes, particularly with the cervical spine, the discs will pancake, and eventually two vertebrae with fuse naturally, and the nerves are not affected to the point of causing pain.

This happens less often in the lumbar spine. Usually when too much disc or lamina is removed, it results in increasing nerve pain, and the patient ends up needing a fusion to stabilize the segment. For this reason, it would be important to find out exactly what you have left before you start a vigorous exercise program.

I think after spinal surgery of any type, it is important to consider the difference between what you can do and what is smart or wise to do when it comes to activities that we know are not beneficial to the health of the spine.

We know that running puts a great deal of additional stress on the discs and the structure of the spine. We also know that since the discs are composed of something like 95% "water" and that the "aging" process involves the drying out of the discs, causing them to get flatter, do you want to engage in an activity on a regular basis that contributes to this pancaking of the discs?

You need to understand that just because a doctor tells you that you can do something or engage in a particular activity, that does not mean it is not going to cause harm to you. He doesn't really care if you return in two years for a fusion or whether it is twenty years....

If you have had a discectomy, which I am assuming is the case, it takes a good six months for the disc to "scab over" to the point that it is strong. At six weeks you may feel fine, but the danger for reherniating is greatest during the first six months. During this time, i t is best to avoid activities where you have to repeatedly bend and twist at the waist, and you should avoid lifting heavy items. It is important to learn proper body mechanics so you are lifting, carrying, etc. in ways that are not stressful to the spine. If work demands that you sit for long periods, it is important to get up and move around every hour or two, and to be sure the workplace is set up ergonomically.

Once you are healed, then you can decide what your priorities are and how important certain activities are to you. I would caution you to learn to listen to your body and to gradually increase your level of activity so your back has a chance to get used to the new situation. Whenever one has had leg pain from a back problem or back pain and suddenly it is relieved by surgery, the temptation is to get out there and do everything that hasn't been possible while in pain. Almost always, the result is that the person ends up doing too much, perhaps even to the point of reherniation, or causing a major nerve flare...and then the cycle begins all over again. So, I urge you to be patient for awhile longer. Give your back a chance to not only heal but to recover...and then, see where you are.

People do go on to lead a full and active life. I know people who mountain climb, kayak and do all kinds of active sports...so, it is possible.

 
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