Surgical Risks L5-S1 Herniated Disk

[Vasilios]

I have two herniated discs (right side) at L4-L5 and L5-S1.  I now have constant searing pain at L5-S1.  When there is any compression on that side, the pain becomes acute.  The entire back side of my right leg, and my foot, is numb and I am experiencing increasing weakness.  At one point, I would lose control over my right leg and I would simply collapse to my knee without any warning.  I have been living with this condition for 4 years.  In the more acute stages, I had incredibly severe pain streak across my lower back. This would put me on the floor and I required crutches to walk.  Up until now, I have been able to control the pain with chiropractic adjustments to that area.  But the numbness and weakness seem to be progressing.  I have had three MRI's.  One was taken 4 years ago (L4-L5) and two were just taken last week (L4-L5 and L5-S1).  My chiropractor suggest that I should see a physiatrist.  I believe that would be a waste of time and money.  My wife has had a very successful back surgery (stenosis and herniated disc), and that encourages me to explore that route.  Are the surgical risks any greater at L5-S1 than at other locations on the spine?  Your comments would be appreciated.  Thank you.


What are the surgical risks (with complication rates) for resolving a herniated disc at L5-S1?

[CCF-Neuro-M.D.-JT]

I agree with your thoughts - it sounds like it's time to see a spine specialist, either a neurosurgeon or orthepedic doc.  If there is significant pressure on a nerve root by the disk that is no longer amenable to conservative therapy (NSAIDS, stretching, PT, etc), then it's possible you could have long term, permanent damage to the nerve if no intervention is considered.  L5 S1 disk surgeries (assuming there is nothing tricky, or complicated about your anatomy) are routinely done and the risks are not considered greater than other sites. The complication rate of infection, bleeding, and permanent neurological damage depends on many factors, including your age, health status (any other medical problems), the actual procedure and approach as well as the surgeon's experience and skill.  Talk to a spine surgeon and bring your films so he/she can review them personally. Good luck.

[nurse12hr]

Thought I would just let you know that I had a microsurgical lumbar discectomy at L5-S1 just 6 weeks ago.  Had surgery on Thurs, back at work on Monday with only restrictions against heavy lifting.  
While my recovery wasn't as rapid as I hoped (had to have 2 post op rounds of a few days worth of oral steroids), now I am virtually pain and numbness-free!  Definately worth it to me.  I put it off fearing a long recovery, missed time from work, etc, but it really was nothing at all like I feared.  I had the surgery at 11am, was home by 4pm.  Up and around the very next day, driving, showering, walked 2 miles the second day.

Incidently, a coworker had a herniated L5-S1 last year, had chiropratic tx for a long time when one final treatment caused her leg to become totally numb.  There ARE RISKS TO CHIROPRACTIC ADJUSTMENTS when you have a herniated disk.  

Good luck, thought I would give you my 2 cents worth.

[Sue2]

Your story seems a bit like mine.
I went to a chiropractor for too long, he never referred me to anyone else.
Until it was too late!
Now I have permanent nerve damage, from nerve entrapment.
Go to a neurologist ASAP and a good orthopedic doctor.
The pain I put up with now is a piece of cake compared to how I was before.

By the time I went to the orthopedic doctor, he looked at my x-rays and all the test results and asked me what I was doing tomorrow.
Without the surgery I wouldn't be able to function at all.
Also after the surgery he told me - if I had moved the wrong way I would have become a paraplegic.
I'm not trying to scare you, but you need checked by a specialist.
They'll fill you in on the risks.
Good Luck!
Sue2

[madaboutyou]

Hello,

Sorry to hone in on your question, but I cannot post my own.  My sister has Severe Degenerative Disk Disease L4,5,6 and S1 and has recently had a Kenalog epidural.  She thinks she may be suffering from side effects - or an improper procedure.  Is there any resource for finding out the side effects of this procedure and what should be done?  

Thank you.

[Gatorlope]

Regarding my own herniated disc that affected the nerve to my right leg and how I successfully avoided surgery...

   The initial onset was while lifting a heavy box at work in Boca Raton, Florida about 19 years ago.
   The diagnosis was by an orthopedist in a well known group, also in Boca Raton and surgery was recommended.
   Having some understandable nervousness about exposing my unprotected spine to men of uncertain ability and who play with very sharp knives, I looked farther afield to consider other options.
   I have no trust of chiropractitioners either, suspecting that it is more pseudoscience than science.  Some of the comments I see here affirm that suspicion...
   Through my wifes' family, I located an old school orthopedist in the Fort Lauderdale area...  Very old...  He was at least in his seventies.
   He made a body cast for my midriff by wrapping heated PVC webbing over a felt lining.  He then put two web belts around the cast and secured them with another layer of PVC webbing.  Unstrapping the belts to let them hang loosely, he then cut completely through the cast along the ventral line.  The cast had enough flexibility that I could remove it to clean myself as necessary and then resecure it using the web belts.
   I wore that cast for a few months (At least 3- no more than 6)and continued my regular activities (Work, etc.)without any abnormal time off.  The disc healed completely and the proposed surgery was never necessary.  I have had no further difficulty for nearly twenty years now and I do a lot of very physical work as a mailhandler for the U. S. Postal Service.
   There was one unexpected side effect since I was somewhat overweight at the time...  The presence of the cast and it's resistance to my stomach muscles caused me to lose inches off my waistline and I had to return to the doctors' office every so often to have some of the material trimmed away (from both sides of the ventral cut)so that the cast would continue to fit me and support my back while it healed.

[cole hunter]

I have  6 mm bulge on my l5-s1 which has caused me a great deal of pain and discomfort(it ha salso effected the left side of my penis which tingles and feels cold all the time-also as if I have to pee) I have had 4 epiderals and 5 months of physical therapy but am still in serious pain-I take celebrexa and 60-90mg of roxicodone a day and want off the pain pills-I am only 29 annd I know I should not feel this way! it was due to a car accident (not my fault) and she didn't have any insurance as well-I have the money to cover everything but want to know the next step. I have seen so many neurosurgeons which tell me 5 different things etc.-what should I do-the penis and the pain in my lower left back, down left leg, ankle , left side of foot are killing me-this had gone on for 8 moths now and I am concerned of the longterm effects-Please help-Thanks Colecoon

[beebug]

I have an L2 herniated disk and an L4 bulging disk. In February the doctor sent me in for a steroid shot. That wore off in May and I was hurting much worse.  The shots just cover the symptoms up.  ANyway, I was send to therapy for four weeks and that didn't even help.  The next step is to go to a neurosurgeon for an opinion.  I have problems with being able to move my left leg after I have been sitting a while.  My physical therapist told me one should never to to a chiropractor with a herniated disk.

[haglet]

I had surgery 3 years ago for L5-S1.  I had all hopes of feeling much better after and returning to work.  Well, I was wrong.....I now have more pain than before and numbness in my legs and feet.  Peripheral polyneuropathy to be exact.  I am totally disabled now.  Pain all the time which never goes away even with pain meds.  I wish I had never had the surgery.  I don't sleep at night due to the pain, have a hard time walking and doing most everything.  Can't sit in one place for more than 15-20 mins due to pain.  It is a nightmare.  Wish I could wake up.

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