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Sciatica L4/L5 surgery Now what?

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Posted 12/27/2013 12:29 PM (GMT 0)
Hi everybody,

I have been reading "My Microdiscectomy Journey" and found it to be inspirational so thought I would join and introduce myself.

i am a 43 year old male from Australia. I recently collapsed in pain at work after of all things sitting in on a work meeting. Although I had back pain on and off for years and an incident 3 years prior. This level of pain was way above all of that and had instant numbness through my left leg.

Anyway ended up in hospital and after MRI had an immediate microdiscectomy on my L4/L5 the relief was instant and cannot tell you how fantastic it felt. For 6 weeks I just went from strength to strength then suddenly developed tightness in hip buttock which got worse with each day. I ended up in hospital of all days on christmas day after a plethora of drugs it was agreed that i leave until i could have a follow up MRI a few days later.

I just had this today and it shows the same L4/L5 has prolapsed but not as bad although constant pain I am in certainly contradicts this.

My surgeon has suggested going back in as it may have just been a bit missed or not quite enough taken out(he is a surgeon who doesn't like to take too much disc away). After the instant pain relief I got from 1st surgery I am certainly leaning this way.

I have decided on a second opinion to be sure has anybody else been through this same experience?

I have the added problem that this is under a thing called work cover here and they have rejected my original claim and now surgeons won't operate until they give go ahead so very frustrating. Also they all seem to be on holidays until 6th January.

I am on strong oxycontin as well as diclofenac and various other over the counter drugs. None are stopping the pain which is a worry.

I guess the main reason I am here is to find people who have had to have a second surgery on same disc and how they went the good and bad. I honestly don't think i can live with the pain but also don't want to go ahead if this is going to continue to happen.

Hope this site can be of help to me and my experience can be of help to others as well Cheers Scott

Hey Scott, I broke your post up into paragraphs to make it easier to read, some of us have tracking problems when reading.....Susie

Post Edited By Moderator (straydog) : 12/28/2013 10:46:13 AM (GMT-7)

Posted 12/28/2013 3:43 AM (GMT 0)
Hi Scott and welcome to CP forum . Glad to hear from another person who had this type of surgery . I am sorry to hear that you are facing another surgery . I have read stories where people herniated for a second time a few weeks after surgery even a third time they usually end up getting fusion . It wasn't on this forum. I could share the link but not sure if its against the rules to share a link of a another site . Was there something that you may have done to cause this ?
Posted 12/28/2013 4:16 AM (GMT 0)
Hi pieNic thanks for reply. I am certainly not wanting fusion and that is why this is such a hard decision for me. It seems I have just been in the unlucky 5% that this can happen to. The surgeon only removes the bare minimum when he operates and he believes a bit may have been left that has become aggravated. The only other possible cause that the physio thinks may have aggravated area is when going for my independent medical assessment I was stuck in a car for 80 mins which was 4 times longer than I had previously sat in previous weeks. Its hard to believe how good I felt only a few weeks ago best in years and exercise in pool was only a week away something I was so looking forward to.
Anyway hopefully some people can give an insight I am going to tough it out for another 48hrs until Monday and hopefully get second opinion and advice. i am leaning towards another microdisectomy I would love to have success and be active once again. i shall keep this thread updated with how I go. Cheers

Forgot to mention I have private health insurance so I think its possible I can go ahead with surgery if I choose but forfeit all claims for wages,holiday and sick pay as well as medical expenses from my claim.

Microdisectomy L4/L5 November 3rd, 2013

Post Edited (Scott43) : 12/27/2013 9:20:11 PM (GMT-7)

Posted 12/28/2013 4:50 AM (GMT 0)
hi scott, welcome to the forum. sorry to hear about your pains. well i have had two laminectomies and two fusions on L-4/L-5 over the past 8 years. i first injuried my back in november of 2004 at a job i was working at.(heating and a/c). at first i went thru therapy and was also going thru my first sets of MRI'S and CT-SCANS and it wasn't til august of 2005 that i had a mylogram done that reviled that i had a herinated disc at L-4/L-5. my first surgery was set for two weeks after the mylogram. at first i felt pretty good, the nerve pain disapated and over all did ok. now about 2 months later i started having more pain were i first had the surgery. basically the same problem as before. though this time during the second surgery(i opted for the second surgery with the idea that it would help) they(surgeons) discovered some vertabrae fragments that didn't appeer on any films they took prior. anyway felt better after the second surgery. for the next two years i still had pain to the point where i was unable to work but i could function to some degree but i did get progresivly worse as the two years went along. now in november of 2007 the pain was unbearable and after another mylogram my surgeon recommened i have a fusion done which he beilieved would take care of my pain. well i had that done hoping that would be beneifisal to me. now the first three surgeries were done by the same surgeonand the fourth and fifth surgeries were done by a new surgeon. turns out the third surgery which was my first fusion failed. my new surgeon needed to go in and replace the hardware and everything else because he said everything was loose and moving around inside. well with no major relive after around another two years we started talking about a pain pump which is were i am now. my fifth surgery was the pump and that was installed this past november. right now i'm in the process of having it properly adjusted. takes afew appts to get that happy medium from what i've heard.
hope i didn't scare with all my troubles but i also had the idea that if i needed a surgery to feel better i would have it done. i hope things work out for ya. again welcome and keep us updated...
Posted 12/28/2013 10:15 AM (GMT 0)
Hello Scott and welcome to HW. Certainly sorry to see your surgery didn't end up being the success it set out to be!

Yes, definitely get that 2nd opinion!! It's important to have another set of eyes looking at that MRI! Also, don't wish to rain on your parade but obviously not all spine issues can be fixed and not all surgeries are guarantee's or this forum would have far less members.

Fusions don't have great success rates either and the odds aren't high enough for many to even take it. Im hoping you have a board certified or the equivalent of one in Australia, Neurosurgeon with plenty of experience?

Others will be in to welcome you and give you their experience and support. Glad you joined us.
Posted 12/28/2013 11:53 AM (GMT 0)
Thanks for input guys and yes Mark you have scared me a bit sorry your journey has been so hard. i am only at the beginning and its all very daunting. That was my first ever surgery and I had never ever considered it but the pain I was in 8 weeks ago was more than I had ever experienced. You have certainly got me thinking that maybe a 2nd round isn't the way to go or hold off as long as possible.

Vickie I have heard the horrors of fusion and that is something I definitely don't want to do. With how well my microdisectomy went the first time until it bulged again I was feeling it was worth getting done again especially as its smaller. Its a hard decision that has me changing my mind every day.
My first surgery was done very quickly because of the numbness,pain and the rate that I was deterioating I had confidence that my surgeon would be qualified in all areas working from the Epworth Hospital in Richmond.
I now after reading this shall try and find out more about whether he is board certified(i assume through an Australian neurosurgeon site) and his experience. if I do this a 2nd time i want to have as best a surgeon as possible.
Thank you for welcome and taking time to post Cheers Scott
Posted 12/28/2013 12:44 PM (GMT 0)
I agree with Vickie that getting a second set of fresh eyes to take a look is a great thing to do. Look at it this way,...it can't hurt to get that 2nd (or even 3rd) opinion.

I'm going to post from a different perspective. My SIL got a microdiscectomy performed on L4/L5 and she told me that for the first 8 months, she second-guessed herself....there were many moments of pain flaring up then dissipating.

(Here's a kicker: She works in a pain clinic).

She said there were many times she wondered if she did the right thing.

So, if the other eyeballs peeking at your surgery come up with something, some possibilities may be that it's soft tissue, (I got severe muscle spasms around my surgical sight for months), maybe injections could help relieve the inflammation. Just wanted to throw out some other possibilities.

I can appreciate your wanting to avoid surgery if possible. Let us know how you do on Monday! We'll be rooting for you.


M.
Posted 12/29/2013 2:56 AM (GMT 0)
Hi Scott and welcome to the chronic pain forum. So sorry to read that now you are having such difficulty after having this surgery & was doing so well, then suddenly the rug gets pulled out from under you.

It will be interesting to see what shows up on your MRI and see how it compares to the previous MRI. I urge you to get copies of the written reports on both of these for your own record. I think the microdiscectomies can be a little tricky. I have seen people do really well then suddenly they have the same old pain return or do really well. I would get myself an appointment with a board certified neurosurgeon if this were me. If indeed you need further surgery, I would have it done by a neurosurgeon rather than an orthopedic. You should also take copies of the films & written reports of both MRI's to the 2nd opinion dr for him/her to review.

You spoke of this onset of new pain after sitting for a prolonged period of time. I am wondering if you got something in there irritated & inflammed. Sometimes the drs can give the person a short round of steroids for inflammation & this can help.

Of course no one wants to think about more surgery. I just say cross these bridges as you get to them & take it a day at a time. I can understand your concerns about a fusion, that is a last resort for anyone when it comes to back surgery. You will not get glowing reports here about fusions because these are people that did not do well for one reason or another after having it done. However, I have seen a lot of people over the years have fusions done that did very well. It all depends on how good the surgeon is & how well that patient followed through on their post op care at home & doing exactly what the dr says. I have seen people have this surgery and do some really stupid things they had no business doing right after surgery & they messed their backs up. Then they want to holler the dr messed them up when it was not the dr. Lets be honest, if these back surgeries had such poor outcomes, the drs would not be still doing them. A person just needs to do their homework. The more educated a person is about their condition, the better. A good website that is devoted to the spine only is called www.SpineUniverse.com. Check it out...Take care...Susie
Posted 12/29/2013 11:20 AM (GMT 0)
Hi guys have already organised an appointment with a recommended neurosurgeon and will definitely be getting 2nd and 3rd eyes looking at this. My first surgeon certainly had no compassion or bedside personality. It was left to my wife and I to research what I could and shouldn't do after surgery and how to recover. Even when asked directly a joke was made and he would be gone. He also has the habit of talking over you. As you can imagine that being my first ever surgery I became quite emotional at not being able to get answers. In saying that the nurses were exceptional.
Susie I had my MRI and it has prolapsed again comparing the two MRI's they look exactly the same although this time not quite impacting on nerves as much.Thank you for your advice we already have the film so I will seek the reports as well this week.I am in the unlucky 5% that this happens to grrr. I am with you on post op. As I did this time I will be sticking to what I am told for as long as I am told. I too have seen some people get back to crazy things post op and wonder why they get hurt again.
I have certainly learnt in last week to take things one day at a time otherwise it just gets too much.
I am almost certain now I will go ahead with surgery but I will be waiting to see what these 2 highly recommended surgeons have to say first. As for work cover and worrying about the fact that my wages are now not coming in I have decided for now to forget about it as the priority is to get better something you cannot put a price on. Also thank you for website on the spine.
Thank you all for your input I am taking it all onboard and learning of new ways and directions I can take on things
Cheers Scott
Posted 12/30/2013 12:53 AM (GMT 0)
Hi Scott, oh so sorry about the prolapse again. Something else, since you do have nerve involvment, I am so glad to read you are going to be seen by a neurosurgeon. The neurosurgeons have more experience working with nerves, that is their specialty. I do hope you will come back & let us know what the drs have to say. Keep us posted......Suse
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