Aa
Aa
A
A
A
Close
656111 tn?1273820739

Do I need surgery or not?

I'm just curious do I need to have surgery or not for my L5-S1 lower back? I have had it since year of 2006 to now. Since it has been almost 3 years that I haven't had surgery for it and will I have this for life or what? Like if I left it untreated only took medications for it that can damage it or what? I just want to learn more about it and when I see doctor so I can talk to dr more about this. Thanks.
21 Responses
Sort by: Helpful Oldest Newest
547368 tn?1440541785
Hello Sunflower,

I have had steroid injections into my SI joint and they did not help. It as basically an epidural, just not into the spine. But SI Joints are very difficult to treat. I doubt I would have another one.

However my brother's back was so bad he was crawling. He could no longer stand due to the pain. He had 3 epidurals and is up and about without a lot of pain. That was 2 years ago and he would be the first to say they were successful. He still has to be careful how how bends, lifts or moves. He will always have a back issue and we beleive that surgery is still in his future. He never misses a day of work and his work can be physically demanding. He does not take pain pills or muscle relaxants. My brother prefers to drink a beer or two after work now and again and that does not mix well with medication. So I do know that epidurals can work.

I beleive much is dependant on the skill of the physician performing the procedure and of course the severity of the condition. I would have bet my brother would have required surgery but the epidurals were very effective.

If you do not receive many responses to your last question I would post again with the epidural question as the header. Good luck to you. I am glad that you are keeping us posted. I will look forward to your future updates. Take care, Tuck
Helpful - 0
656111 tn?1273820739
Okay, I had an appointment on 19th. She is sending me to other hospital to get Epidural injection on my back. They'll call me soon with date/time for Epidural injection then afterwards give me date/time for PT.

Anyone had experience with Epidural injection? I'd like to hear your feedbacks about Epidural injection whether if it'd help.... bad or good feedback about this? Thanks. How many times do they give to you? As far as I know if PT doesn't help, then surgery will be last resort or just be on medications for "life"? Thanks for anything if you have experience in these areas. Greatly appreciated. :)
Helpful - 0
547368 tn?1440541785
Hi Sunflower,

Actually you have good news, the best a CP sufferer can hope for a doctor you trust and that listens. If you have that all the rest will come in time. I am glad you are starting all over with the specialists. You will obtain a better, current picture of your condition today.

Your B/P is not horrible. The Systolic (top number) is perfectly normal at 107, in fact that is a good reading. The Diastolic (bottom number) just a bit elevated at 87. Normally they like to see it 80 or below but 87 could even be from the stress of seeing your physician. So I would not be overly concerned with your hypertension. Your physician is doing the right thing by having you check it so often and than returning to evaluate the effects of the hypertensive agent. That tells me he is a good physician.

Your Cholesterol while high is manageable. There is good cholesterol and bad cholesterol and those are the numbers to watch. LDL is (bad) cholesterol, HDL is (good) cholesterol. There is another substance called triglycerides that adds to and better assesses the entire picture. I am confident that you had that checked also. If it was not mentioned I assume your triglycerides are good.

I am very glad to hear that you will be seeing a new Ortho. I tend to think that because your new PCP is so good that he will select equally as good of support physicians, such as the Ortho. I think you are on the right track and I am very happy for you.

Please let us know how you're progressing. I appreciate the update. I hope you'll soon be feeling much better. Take care, Tuck
Helpful - 0
656111 tn?1273820739
This is why I have an appt with Ortho. I'll let you know what they say if I need surgery or not. I'm waiting for new neuro as he's referring me there as well.

Also as for BP, its 107 over 87.
Helpful - 0
656111 tn?1273820739
Oh, to add that I will see my new Ortho on Nov. 19th and he is also referring me to new neuro as well.
Helpful - 0
535089 tn?1400673519
Hi Sunflower:

Sorry to hear the news. If you don't mind me asking, what is your BP? Did you know that pain can make your BP on the higher side? As far as the possible surgery, what did the Doc say about the Herniated Discs?..umm so many questions:) I'm curious as to what your Doc will do. Usually when you have a multi-level herniation the Doc will fuse it. Well, take care and let us know,
Mollyrae
Helpful - 0
656111 tn?1273820739
Want to update with you all... bad news.

I saw my PCP (primary doctor) today and found out what the results. I'm kinda upset, but... oh, well. :( Anyway, what I have is:

High Cholesterol -- its 244
Hypertension (meaning high blood pressure)
Herniated Disc on L5-S1 AND Degenerative Disc Disease

So I was given new medicine for Hypertension - Bystolic 5mg and Pain meds - Percocet 10/650mg for my back. And gave me paper of "Dietary" for my Hypertension and Cholesterol as well.

I have to go to pharmacy every other day to take my blood pressure and write it down on logbook. Blah. Then see him on Nov. 25th.

Oh, I was also given medicine of Chantix to quit smoking. This will help while I have hypertension and with the fact that I was just DX'ed having Degenerative Disc Disease. I've had Herniated Disc since year of 2006. Plus if continue smoking, it can eat my bones = bone loss. And I want to live longer... Emphysema do run in my mom's side. So I don't want to have that. Plus I have been smoking since I was age of 18. Wish me a luck to succeed quitting smoking.

Honestly, I've gained weight and well, need to avoid fatty, oily, salty foods for awhile. :(

**sigh**
Helpful - 0
656111 tn?1273820739
I'd like to update with ya'll:

I had Physican and Surgery Doctor appointment today. Anyway, I never had him as my doctor until today. I found him through new directory listing for this area from my mailbox. Anyway, He's really great doctor and actually listens, communicates with me. asked questions or I ask questions, etc. He asked me if I smoke and I told him truth is that I smoke, but only 1/2 pack a day as I am cutting it down as I used to smoke up to 2 packs a day. He told me there is a medication that is for to quit smoking and suggested me to try medicine called "Chantix" I have heard about it before. So he said do I want to try that medicine and I said yes. So, he wrote me a prescription of Chantix and want to help me to quit smoking because I told him that I really want to quit smoking and live longer because of my kids plus I don't want to end up having Emphysema what my Mom have right now so that scares me. I have heard how horrible it is to go through with Emphysema disease. I don't want to go to the same step she's at, ya know? He also wrote prescription of Percocet 10mg/650mg, Clonazepam 1mg, and Flexeril.  And he made arrangement setting up an appointment for me to see Orthopedic Surgeon doctor which is about half hour away from here because that is the only place that accepts the kind of insurance I have. And will refer me to Pain Management as well to try those several methods to try out first such as getting injections in my back to see if that helps and so on. If no success, then will go ahead & set up surgery as a last resort. I already told him what's going on with two neurologist doctors, EVERYTHING I left nothing out about one neurology in IL and other neurology in MO, I told him everything nothing but truth. He says that his opinion it would be better just to start over from all those mess which it would be headache and hassle to get everything together - like I said before in other post that one Neuro dr in IL will just take FOREVER to fax medical records - just waste of time, you know and plus that my neuro dr in MO has not gotten ANY medical records faxed from Neuro dr in IL. Basically it's REALLY screwed up whatever you call it. I even gave him my two previous Neuro's names, address, and phone number. He told me he is going to call them and be right with me after he's done. He verified that what I told him is true that those two were my doctors. Then he told me about it and then he suggested - just get new MRI, blood work, all the works then is going to refer me to Orthopedic Surgeons doctor and Pain Management Doctor. Its better that way. I absolutely agree with him.

He is very really good doctor. It is about time that I finally I found great doctor that I've been looking for long time because other doctors I had previously just would by giving me bunch scripts of pain medications & other different medications. It is like other doctors would just send me off, that doesn't care except that other doctors cares about money out of it, more profits for himself. Digusts me!

So, my new doctor gave me prescription orders that I will have to go hospital within a week to take new MRI for my lower back (to see if it has gotten worse, stayed same, or improvement - highly doubt that it has improved!), some blood tests - I'm not excatly sure what but I'll find out in next appointment on the 19th this month though, and EKG for my heart (due to high blood pressure) and stuff. So next appt is Nov. 19th to see my dr again to get the results, etc.. I'll keep ya'll updated!  :-)

Dr told me not to drink or eat anything for 10 hours before going to the hospital to get those stuff done. UGH! But I'll live. *chuckles*

About a time that my new doctor actually listens to me and willing to help me as he can! I'm   V-E-R-Y  happy! :-)
Helpful - 0
Avatar universal
Dynesys is not new -  only here and in the US.  My neurosurgeon learned the procedure in South Africa.  What convinced me to have the operation was the fact that it is a minimally invasive surgury( they work thru small incisions) & if it doesn't work the "hardware" can be removed.  I was taking 120mg+ of oxy IR at the time and it barely touched the pain.  So I opted for the surgury and after 6 months I am back to work (and have been for three months), and I am 20 days clean of opiates.  Yes my back still hurts - but not nearly as bad or as often ( and this is without meds!!).  I'm now quite sure it will always hurt in certain situations, but at least it's tolerable.

I have no regrets having this operation.  Please ask your doc about it or do your own research.  It may not be for everyone - but it is for younger people who are in general good health - besides the back problems and have a good experienced surgeon.  
Helpful - 0
656111 tn?1273820739
As for Chiro.... I don't want Chiro. to mess with my back - I'm afraid and don't want to damage my back even more. I'm in pain already so I don't want to be in extreme pain. I can't tolerate pain at all. Thanks though. I'm glad it worked for you though. :) Not just that, I'm mother of ages 8 and 5 - it'll be hard for me just to lay and barely do anything if it hurts my back real bad. It's just hard for me and I have to decide what is the best and what I should do. Ya know?

Tuck, thanks! I appreciate it. Now I understand what my MRI results mean. :)

I was in pain and desperate for awhile. I'm in worse pain now due to the fact that Im on "time of month" - I'm sure you know it does make my back hurts even more. Ugh, fun... not! :P Anyway, I gave up as I couldn't take it anymore and thought to call my Neuro Dr in MO tonight and see if she can call in prescription of Vicodin for me so she did. I haven't heard anything from my old Neuro Dr in IL so I left message again to make sure because I'm not sure if they forgot to put note down or something that I called. (it has happened before that secretary didn't inform Dr. that I called, that's why). I'll wait tomorrow and hopefully I'll hear from them. *crosses fingers*

Hmm, I'm not sure about new procedure of Dynesys Spine Stabalization. It's just that I have hard time trusting wondering will that work or not since it's new and unheard of? IDK. lol.
Helpful - 0
Avatar universal
Please ask your doc about DYNESYS SPINE STABALIZATION.  It is used in lieu of fusion and has helped me significantly.  It is a new procedure for the US and Canada, but has been used in Europe and South Africa for years.  It basically uses "shock absorbers" screwed into either side of the affected area and stabalizes the spine.  It is also reversable (unlike fusion) if there are any problems post op.  Please google it and do some research - it has saved my life.
Helpful - 0
547368 tn?1440541785
Yes pain can be helped and in some instances resolved with good physical therapy by a good physical therapist. BUT not all conditions will respond as well as yours did. I am very happy it worked for you. There are some ppl that PT does not work as well for or that PT does not work at all and they require pain medications. When narcotics are used as prescribed to control CP. In those cases the CP Sufferer should never be made to feel that they should be ashamed or have to apologize for requiring narcotics.

I appreciate your input. PT should always be tried unless contraindicated, just remember that it does not work for everyone.  Take Care, Tuck  
Helpful - 0
547368 tn?1440541785
Hi Again Sunflower,

This is the best explanation that I found on the web, as below:

Begin Quote "To understand what a Paracentral Disc Protrusion is, it is important to understand the anatomy of the disc. The center of the disc is called the nucleus pulposus and has the consistency of crab meat. Surrounding the nucleus are the annular fibers, which are concentric rings of tough fibrocartlidge arrange similarly to the rings of a tree. These tough rings prevent the nucleus from pushing through or protruding. If there is a tear in the rings sounding the nucleus it can protrude and put pressure on the Thecal Sac (aka. Dural Sac). The Thecal Sac is a tough tissue that surrounds the spinal cord.

What you have is a part of the Nucleus Pulpusus that has broken through the layers of the Annular Fibers and is putting pressure on the left side of the Thecal Sac. This can happen from one traumatic incident such as lifting something heavy or it can be from multiple smaller injuries, which typical go unnoticed. " End quote

I hope this helps you understand it better. The "narrowing" is most likely caused from the protrusion into your spinal canal. Initial treatment is conservative with PT, acupuncture and other non-invasive methods. If numbness and tingling or more severe symptoms appear than other often invasive methods are utilized.

I wish you the best. Please let us know how you are progressing. Take Care, Tuck
Helpful - 0
Avatar universal
Well, I was in a major car accident and had the exact situation happen with my back. I was young... only 20 so maybe that had partly to do with my healing but honestly I was fixed by the grace of God and my Chropractor! He would stem-cell, massage, stretch and then strength train my abdomen like I was going to me a stomach model! :) Nonetheless, 5 years later I no longer have the Siatica (sp?) nerve damage or the pain. Seek things other than pain medications and surgery. It can be done and I am living proof.
Helpful - 0
656111 tn?1273820739
This what it says on my MRI results (from 2006):

There is no foral disc protrusion, central spinal, stenosis or foraminal narrowing seen at L1-L2, L2-L3, L3-L4 and L4-L5. There is central and right posterolateral disc protrusion seen at L5-S1 that compresses the orgin of the S1 nerve root as well as narrowing of the right neural recess seen. No significant central spinal stenosis is seen at any level.

Summary:
Central and right paracentral disc protrusion is seen at L5-S1 with narrowing of the neural recess noted on the right.

-------------------

Can anyone share with me to tell me what those means? I know I'll need to take another MRI to see if it has gotten worse or not. Thanks :)

Helpful - 0
656111 tn?1273820739
Also I remember it said "spinal canal narrowing" on paper from MRI results. I wonder what does that mean? I'll get my MRI results paper and type here what it says there. It's in box somewhere in basement.
Helpful - 0
656111 tn?1273820739
Yeah, that is what Dr. told me saying that I don't need surgery that time. That is why I haven't had surgery since I was DX'ed with L5-S1 almost three years ago. I guess Dr would want another MRI - recent one when I see him on appointment, so that Dr can decide whether if I need surgery or not. I could take more tylenol if I want but I don't want to because I don't want to damage my liver.... I believe maximum is 3,000 mg a day, right? That is why my previous Neuro Dr. gave me Norco 10/325mg so that I can take two with lower apap = 20/650 every 8 hrs for more relief of 20mg. You know what I am saying? Anyway, I left message on my previous Neuro's answering machine at his office. I hope they'll call me back and hopefully they'll take me back. So that'll be less hassle and save my time trying to find Dr.... I just hate to make too many calls and give me a runaround - what a headache to deal with!
Helpful - 0
547368 tn?1440541785
Hi Sunflower,

I remember your post a while back. I am sorry you are still struggling with pain and without a physician. You must be very frustrated at this point. If you are only taking a few Tylenol and you are able to function without a whole lot of difficulty my guess would be you are not a candidate for surgery but that's simply a guess. I don't know your DX or your pain level.

Any respectable surgeon does not rush into surgery, it is always the last option. My brother was in such severe back pain that even with pain medication he could only crawl for 3 weeks. He could not maintain an up right position. I was sure he would require surgery. His surgeon said no and gave him three steroid injections over the course of 6 weeks. It worked. That was a bit over 2 years ago. He still has to be cautious and his back still "goes out" but he has avoided a complicated surgery with a 9-12 month recovery. At least for now. Had he had the surgery he most likely would still have pain. Surgery doesn't usually eliminate your pain even 90%, except for the very lucky.

So my suggestion to you is to locate a good PCP and have an MRI. You will need a complete  work up on your spine rather you have surgery or not. I wish you the best of luck. Please let us know how you are doing and take care, Tuck
Helpful - 0
656111 tn?1273820739
Thanks for answering questions. I do know I still have back pain because I'm not on pain medications (ie vicodin, etc) just Tylenol for now. I still do get back pains daily and I only take 4 tylenol a day - I don't want to take too much because I don't want to harm my liver, you know. But of course, I still have pain even though I took Tylenol. I'm trying to find doctor soon so I can get my medications for the pains not just for my back pain, for migraines, anxiety too.. last Neuro Dr I had, I used to take two of 10/325 (20mg/650mg) every 8 hours, clonazepam, and Imitrex. I posted earlier "No doctor... help?" here. It was hell w/d's for me since I was on strong narcotic med. I'm fine now though, but just suck it up and bear with the pain for now. I can't go to ER's all the time as it won't look good and could label me as drug seeker so I don't want that. I only go there when I have severe migraines that is not helping by Imitrex - I have 2 pkgs of Imitrex left. I need to see dr as soon as possible before Imitrex runs out or I'll be in deep ****. lol
Helpful - 0
82861 tn?1333453911
Wow.  That's a loaded question!  There are so many different things that go into a successful surgery, and the surgeon is only one.  If you haven't had an MRI in the past 3 years, it might be useful to have another one done just to see if your condition has changed.  If it's become much worse, that might be a good place to start in making your decision.  Of course, no surgeon will touch you without having a recent MRI anyway.

What is the issue?  Do you have a ruptured disc at that level?  Some people can get by without surgery as long as they carefully exercise and keep their muscles strong enough to take the strain off the bones.  That means muscles both in the front (abdominal) and the back.  Make a good strong muscle sandwich out of your center and it makes a big difference.  Of course, it's a lot of painful work to get to that point which is one reason why physical therapy isn't always successful.  Some people are damaged so badly that PT is absolutely out of the question.  That's when you're pretty much stuck with medications.

My cousin had lumbar surgery in June, and her surgeon is the first doctor I've ever heard of who actually told her truth about recovery.  He said it would be 6 months of agony, and another 6 months of very slowly getting back to normal life.  Most docs will tell you "recovery in 6 weeks."  Well, that means you're healed well enough to start moving around a bit without messing up something else, but their version of recovery and the patien'ts version of recovery are usually two very different ideas.  :-)
Helpful - 0
518031 tn?1295575374
i had a bi-lateral lamenectry on l5 s1 done about 15 yrs ago and wish i had never had it done.. but thaqts just me i am no medical person just a long time chronic pain sufferer
Helpful - 0
Have an Answer?

You are reading content posted in the Pain Management Community

Top Pain Answerers
Avatar universal
st. louis, MO
317787 tn?1473358451
DC
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Find out how beta-blocker eye drops show promising results for acute migraine relief.
Could it be something you ate? Lack of sleep? Here are 11 migraine triggers to look out for.
Find out if PRP therapy right for you.
Tips for preventing one of the most common types of knee injury.
Here are 10 ways to stop headaches before they start.
Tips and moves to ease backaches