Disectomy

[Jim]

I am a 33y/o male having prolapsed disc at L5/S1 which caused serve pain in my left leg for about a year. I went through disectomy on 10/Dec,99 and discharged on 20/Dec,99. My pain gone the third day after the surgery. I enjoyed only 20 days pain-free. But until 4,Jan,2000, when I walk, severe pain (say, degree 10) together with toes numbness comes back in my left calf just like before the operation  I have to stop a while to get relieved and can walk again.My right leg calf sometimes got minor pain (degree 2-3)too. When I sit/lie down, my left/right toes still suffer numbness and mild pain in thigh and ankle.

My doctor told me he had taken the whole disc out between L5/S1. Rupture disc again should not be the case. The left leg pain is caused by nerve decompression while it is moving??? But he don't know the cause of my right leg pain and just gave me some pain killers and told me not to worry.

This makes me very nervous and don't know what to do next.
Should I need another MRI and surgeon again? I can't stand another operation. Is it normal in the recovery process?

Jim

[CCF Neuro[P] MD, RPS]

Dear Jim:

Sorry to hear about your pain.  Usually, the rehab is several months but everything depends on the etiology of the disc, the duration of symptoms before the surgery, the compromise of the nerve before the surgery, the type and extent of surgery, and then the ability and commitment of the patient undergoing rehab.  I would ask both the surgeon and rehab physician and the PT what they think is going on, they are much more familiar with your case.  Yes, pain after surgery is the norm and it is usually intense.  However, one must be sure it is part of the normal healing process and not something new like inflammation.  Most patients usually have to live with some sort of pain for the rest of their lives, sorry to say.  I would talk to your physicians and stick to rehab, it will pay off in the long run.

Sincerely,

CCF Neuro MD

[Jim]

Thanks for your advice CCF,

I still have have questions. My doctor told me he took the complete DISC between L5/S1 away.  I found from the web that, in many case, that is only be done while in fusion surgery and some sort of "cage" will be implanted in the spline to hold the L5/S1 together. But my doctor only remove the DISC! That it. The L5/S1 is now hanging around. Am I wrong in interpreting the web message? or I did a wrong surgery? I am so scare if I was done with something wrong. My doctor is a neurosurgeon in Hong Kong.

Jim

[Joanna]

Hi, I am 28 years old and facing surgery on the disc at L5\S1 as well as having "hardware" put in my back to correct a spondylolithesis .  I have been unable to work since Aug. of 99 and am terrified about this surgery .  I have been trying physotherapy but can't get in a pain free position to actually start the therapy.  At present I am taking pain killers daily,and still having pain in my lower back and down my right leg.  Two neurosurgeons have told me that the only solution now is to have this surgery.  Any advice or comments would be greatly appricated.  
                   Sincerely, Joanna

[Valerie Bos]

I had a microdisectomy to L5-S1 on 2-23-98. 3 days after surgery I was walking with my dogs I recovered very quickly, and was up to 3.5 miles a day. I returned to work 4 weeks post-op I work as a veterinary technician. In june following the surgery I woke up and to my great dismay had pain return to my left leg. My surgeon, Dr. St. Elmo Newton thought maybe I had just irritated the nerve. I had another MRI (my first, prior to surgery was inconclusive, the rupture was found with a discogram and CAT scan [a procedure that was very intense for me I would prefer to give birth]) I was told by my Dr. that I needed to lose weight (after walking for 4 months I lost not one oz). I felt great though. I am now seeing a new DR. that has told me fusion is also the only answer for me. As you may imagine the thought of another surgery is  not apealing to me, I am afraid of going through it again and then not having a good outcome or worse feeling great for awhile, then a sudden recurrence for no apparent reason. The other alternative is to live in this pain and taking pain meds to sleep(my work requires I be alert). Now at 36 years of age I face some problems that 70 year olds face.I would appreciate any comments from post-op patients on this sx.

[izzet]

Hi everybody !
   After intense pain and a debut of numbness on my right leg doctors decided that discectomy was the
best solution and I had surgery on December 10: Apparently  
everything went well and I was on my feet again 5-6 days later.
   I was recommended to swim, which I did several times, and
although I could not walk great distances I seemed that complete
recovery was on its way.  But exactly a month after my operation
the pain came back, starting from the back and when I try
to stand over a minute or so, all the way down to my ankle..
    I am really upset and confused and I am starting to think that I was
not taken care of properly! Both surgeon and therapist recommend
patience and electric currents, perhaps ultra sounds later,
but no one seem to care about the intense pain I have when trying
to walk ( Degree 10 I would say )Pain killers have almost no
effect.
    6 weeks after surgery  I will have a new MRI taken, and we'll
see if anything went wrong with the remaining disc.. I really
don't want to confront another surgery after all my troubles,
My question is ; How about Pain management Centers ? They
seem to work sometimes ?

[Jim]

I met someone from web who had similar to us. Returned pain may be part of the healing process. Her pain went away with time (few months). I hope we are on the same  boat.  If you like to share her experience, email me ***@****. I will let her know and contact you.

[CCF Neuro[P] MD, RPS]

Dear Izzet:

What did your rehab specialist tell you about the pain, your PT?  Pain can reoccur, but it may be just you over did it and tried to progress too fast, but since I do not know your exam and extent of damage I really can't say for sure.  See what the MRI shows and check with your rehab specialist.

Sincerely,

CCF Neuro MD

[Jim]

I am a 33y/o male having prolapsed disc at L5/S1 which caused serve pain in my left leg for about a year. I went through disectomy on 10/Dec,99 and discharged on 20/Dec,99. My pain gone the third day after the  surgery. I enjoyed only 20 days pain-free. After that, I started to experience numbness and mild pain in both legs. On 20,Jan,00, I have anther MRI which show imflamed s1 nerve roots and a lot of  imflamed post-surgical tissues. My doc told me that's the casue of my feeling on both legs. By then, My doc told me to do PT and I follow. After a week of PT, 27/Jan, I started to have some feeling of urinary urge. This lead to ejectculation at nite 2 times.  I stopped PT but my doctor told me not to worry and this is a response from PT.


My question are:

1. Do S1 nerve roots  related to bladder control?
2. Do you think inflame on S1 nerve can casue that?
3. if 2 is yes. how long to get it settle down? any estimation?

I am now offered NSAID, LODINE 400mg, but it only help my legs but not on my urinary urge feeling.

Jim

[Sheri]

L5-S1 laminectomy about 6 weeks ago. Leg pain has improved and I'm off the pain killers. Was on anti-inflamatories and pain killers for about 7 months prior to surgery. 3 epidurals and PT before surgery also that didn't help. Anyway, my question is what kind of exercise can I do without hurting my recovery. Dr. says I can walk on treadmill...start at 1/4 mile per day...add 1/4 mile each week so I am up to a fairly slow 1 1/2 mile per day. Slight weakness and periodically a sharp stabbing pain in my calf, but I'm definitely better than a couple weeks ago.After reading others pain reoccurances, I just don't want to over do and go through this again. Any suggestions as to safe exercises would be appreciated. Thanks.

[heather]

I am scheduled to have a discectomy soon.  I have gone from being totally immobilized with pain and numbness to my left side (from hip to toes) to no pain and only numbness.  For the last 4 days, I have walked 4 km daily with no adverse consequences.  Do I still need surgery?
I'm dealing with L5-S1 herniation.

[CCF Neuro[P] MD, RPS]

Dear Heather:

I would speak with your neurosurgeon before undergoing disc surgery at this point.

Sincerely,

CCF Neuro MD

[Lumbar.caracci.]

To those patients who have taken the MRI, what exactly is it
like.  Is it painful? are there side-effects?

[Stan]

Re: MRI
As long as you are not clustraphobic, the MRI is a snap.  If you are claustaphobic, there are new open machines but you may need to search for one.  The MRI machine is sort of like a big donut

Basicly, you lie on a movable bed/tray.  Once positioned, the tray slides you inside the MRI (basicly a long tube).  All you do is lay there.  It's magnetic, so unless you have any metal in your body, I think it's completely safe.  The machinery (rotating inside the unit) is very noisey, so you should be given ear plugs.  There is no radiation and no side effects.  All you have to do is lay still while the images are being made.

Good luck and don't worry!

[jimmy mc leod]

i have been off work for a year with a prolapsed disc. i get around great but certainly don't feel fit enough to carry patients which is a big part of my job- but occupational doctor seems to think this would be no problem. could such work cuase my conditon to worsten? the prolapsed disc showed up on a MRI scan.

[jennifer]

I am 26 and had a discetomy on January 7,2000, everything was great until on day in April 2000 I slammed my pick up trucks door and went to the ground.  On July 21,2000 I had to have a L4-L5 anterior back fusion w/cages.  I wasn't too hip on them going through my stomach, but they did.  So far so good.  I still have alot of pain in my right leg.  But I have a lot of releif in my back.  (some problems at night still) But it has only been 2 1/2 weeks.  One thing I learned WALKING that is the key.  My doctor kept telling me to walk and I told him I couldn't walk much it hurt, but know I know why, it makes for an easier recovery.  WALKING !! YES !!

Good Luck