Upcoming Back Surgery Question

Hi, Everyone...
Last May (2014) I started having pain in my left buttock when sitting on hard surfaces or just sitting for too long (which I tend to do since I also have bone-on-bone osteoarthritis in both knees). The pain got worse and worse and then I started having tingling and numbness all down the left leg and into the 3 left toes (middle toe to pinky toe). Then the pain went up into my lower back. I'd been seeing chiropractors for about 30 years now and never had have lower back issues that wouldn't resolve quickly with adjustments. However, this time it didn't so he ordered a lumbar MRI which showed 2 herniated discs (L4/L5 and L5/S1) as well as a bulging disc at L3/L4. Oh, I'm 54 years old and have also struggled with morbid obesity for many years, but during this last year have lost 87 lbs. so far. I also see an orthopedic doctor for my knees and mentioned the sciatica pain to him so he looked at my MRI and took x-rays of his own... The MRI was done in July.

I finally resorted to an ESI at L5/S1 (which is where my ortho thinks the pain is coming from) in August which TOTALLY 100% stopped the pain (AMAZING feeling!!) - for all of 10 days. Then it came back with a vengeance. Tried a 2nd ESI in September but it didn't help much at all that time. I had begun researching spinal decompression therapy and decided to try that - had 28 treatments total on the Z-Grav machine). The 1st week I did that I had VERY good results - similar to the first ESI results. But after that 1st week it didn't seem to be doing much any more. I then started researching piriformis syndrome and my chiro did a leg stretch test and said oh yes, that's definitely a problem. He said I could have that PLUS the spinal component both causing my pain, which is what I personally think is going on. So he had me doing stretches - which every time I did them, my overall pain got worse and worse so I finally quit. He also has me seeing his massage therapist who knows all about piriformis syndrome and does massage specific to that problem. When I have that done, it feels better for maybe a few hours and then comes back.

Have still been seeing my ortho - who agreed to try a steroid shot right in the piriformis just to see if that helped - it didn't. He truly feels it's the herniation at L5/S1. Since my pain meds have gone up up up (I'm now taking 3 10 mg. percocets a day, plus Soma twice a day) that it was time to consider surgery. He is talking about a microdiscectomy at L5/S1. I asked about having L4/L5 done at the same time while we're in there and he said that would only add about 20 minutes and he's willing to do that but he doesn't think that level is causing my problems. I'm still wondering if I should go ahead and have that herniation fixed so it doesn't end up getting worse later on, causing a 2nd surgery. What are your opinions on this?!!!

Also, when I called his scheduling nurse last week, she said I'm having a "lami" done - I said I thought it was a microdiscectomy and she said it says "lami" in my chart but I could ask the doctor when he gets back (which is today). I then started researching that and found there is a laminotomy and a laminectomy and they're very different. If he means laminotomy - does it sound like this still means a microdiscectomy? I'm confused...

Sorry this is so long, but just trying to figure out what to do here and they could literally call at any time and say they have me on the surgery schedule, so I want to be prepared. Also, does it sound like surgery IS my best (only) option at this point? I canNOT go on living with this excruciating pain - it is turning me into someone I'm not - angry, sullen, frustrated, etc. I'm not physically active at all yet because I was waiting on the knee replacements after I lose more weight(!) - but not THIS has come up and taken a front seat to my knee issues. So the only thing I really do is play piano at church. Wondering how long after the surgery it would be before I could do this again...?

Thanks so much for being there and for any info and opinions/suggestions!

Before resorting to surgery, you could get a nerve ablation. I've had several and won't get surgery until they stop working. I see an anesthesiologist pain doctor.

Ablation is just heating the pain nerve covering until the nerve can no longer transmit pain messages. It's not a cure, but it lasts, for me, 10 to maybe 18 months. Look it up! Lots of CPers on the forum have tried it.

I'd at least get a second opinion.

Hi Jackibar, sorry to read what you have been dealing with. I can see why you are somewhat confused about the proposed surgery.

If this were me I would get myself a 2nd opinion. Any time a person has spine surgery recommended its always best to get a 2nd & sometimes even a 3rd opinion. Better to be safe than sorry. I am with WhiteBeard, only type of dr I would let do surgery on my spine would be a neurosurgeon. They do brain surgery & that says they have the best set of hands as far as I am concerned. You really may want to consider seeing a board certified, fellowship trained neurosurgeon prior to having any type of surgery.

I sure would not agree to any kind of surgery unless every one concerned was in agreement as to what kind of surgery is being proposed too. We don't see many successful microsurgeries being done. They sound great when given the pitch but the ending results generally are not always too good & then another surgery is needed. My motto is do it right the first time so there is no second time.

Take care.