Herniated disk/pinched nerve

[luv2sew]

My 76 year old, very healthy mother was referred to a Orthopedic surgeon for her herniated disc from a pain management doctor.  My first question is; why wasn’t she referred to a Neurology Surgeon instead of a Orthopedic surgeon, or do both handle the same operations?  Even though she only wants to have micro disectomy with a scope, this doctor wants to make a full incision and shave the extra bone tissue off of 4 to 5 disks as a precautionary measure and then fix the herniated disk.  Does she really need to have all the bone tissue shaved, or can she just get the herniated disk fixed and go on her merry way?  Should she look for another opinion, but who does she see, an Orthopedic or Neurology?  She is a extremely active person, she already had 3 shots in the back to no avail, she wants her life back.

[Stephen Ryu, MD]

Nice nickname.

Herniated discs are very common and easily treated. It is almost the most basic of surgeries that a spine surgeon does. Spine surgeons comes in two flavors - orthopedic and neurosurgeons. I like to say that a bad orthopedic spine surgeon is a bad spine surgeon and a bad neurosurgeon is a bad spine surgeon. So it really doesn't matter which kind does it - most people have patterns of referral of people they are just used to sending people to.

A microdiscectomy implies a small incision and shaving a little bone off of the bone above and below to get to the disc. It is usually not an 'option'. The gold standard for a disc hernation is an open microdiscectomy with a 1 inch or less incision, bone shaving, and taking out the bulging disc. There are many other methods such as using needles or and endoscope, but the traditional opeartion is 90%+ successful with typically great results.

I would get another opinion if you at all do not like your current MD. Call your friends, this is a common enough operation that someone might know a good MD. I would avoid surgeons who promise you 100% results and those who use less conventional methods (some of this is just marketing and by no means better). Especially avoid those who say they 'are the only one who does this procedure.'  For some reason, there are lots of these in Florida.

Good luck.

[High Noon]

Spinal/Back surgeon. Maybe at a good local hospital.
It is important that he/she sees the films to make their own evaluation and not reply on the radiologist report. If the herniated disc is the cause of the pain and numbness (it really needs to be impinging the nerves), then that should suffice.

But that is what the spinal surgeon needs to tell you.

Good Luck

[High Noon]

Absolutley go for a second opinion.
Where does her MRI show the herniated disc and what did the report say?  I would see a spinal /back surgeon and bring the films for he/she to evaluate. I live in NYC and can suggest a Dr. here.

Good Luck

[luv2sew]

Thanks for the offer, but she lives in Florida (St. Pete).  The herniated disc is in her lower back.  This has been going on for over 6 months, severe pain & numbness in her left leg.