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Back surgery or not?

Hello. I am hoping to hear feedback from others who have had partial laminectomies (herniated disc shaved). I have a posteriorly herniated L-4/5 with a partial rupture. My L-3/4 has mild deterioration. The pain from it varies, much worse (requiring narcotics for pain control) when aggravated. The dull ache is always there and I have a persistent numb strip down the outside of my right leg because of the injury causing pressure on the nerve root. I have been in physical therapy for 6 months and occupational therapy for over two. I have also tried the cortisone injection once. It took 3 weeks to take effect and only lasted about 1 month.
I need to decide whether or not to have surgery. My progress in PT is very slow with frequent set-backs as I try to increase the weight I'm able to lift (I am a paramedic and need to lift at least 165 lbs in order to return to work.) At this point, lifting any weight over 90 lbs creates more pain and increased leg numbness.
I'd like to hear from those who've had this surgery and their input on whether it was worth it. Did it remove your pain? Did it set you up for future problems like worse herniations or arthritis? If you didn't have surgery, were you able to return to work without chronic pain? Thanks.
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Avatar universal
We've had quite a few people on here over the years share their experiences with these surgeries, although I think the majority of them were done endoscopically. It seems the recovery times on these procedures are really short 3-6 weeks compared to the 8-12 month ordeal one goes through with fusions. So that's definitely a plus.

On the down side, I have heard that reherniations can occur, but again this is just 2nd hand info.

Also I've read that these procedures are good for younger people 30-40s because supposedly you don't get the adjacent segment disease 10 years down the road like you do with fusions. How true this is, I don't know, but it does make some sense. Mine was done when I was younger and sure enough, 10-11 years later I began to have some problems again. I'd still do it again though.

6 months is a long time to suffer, you've probably tried everything else. Might be worth seriously considering.
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Avatar universal
I saw your post a couple days ago, and didn't weigh in because I haven't had this specific type of back surgery. I did have a successful fusion at L4/5 several years ago.

Are you referring to an minimally evasive microdisectomy? Done endoscopically??? Where the disc is just trimmed and not removed?

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Avatar universal
Yes. I am lucky enough to just have a herniated disk at one level, and only minor deterioration at the disk just above it. I believe it is an open surgery, but as minimally invasive as possible as it will shave off the bulge causing the irritation. I'm just trying to weigh the risk vs. benefit of doing such a surgery. It would be worth it if I had a high chance of getting the chronic pain to stop and if I could get back to work. At this point, it has been 6 months since my injury, and the pain prevents me from moving forward with my lifting strength or from being able to pull a weight backwards up stairs. I wish I knew if back surgery would or can fix this...Sigh.
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Avatar universal
Thank you for your reply. I have done everything I can think of and everything the Dr has suggested to give my back a healthy environment to heal. 6 months of physical therapy, a cortisone injection, cardio/core/and fitness workouts X4 days a week at the gym, an inversion table, regular chiropractic visits, and I've even hired a personal trainer to hopefully help where occupational therapy could not. I've even lost 20 lbs (have a few more to go). It seems that the microsurgery would be the next logical step -if it would help. I am 48 years old and I have a very physical job (Paramedic). I'm not afraid of doing whatever it takes to get me back to work, -I just don't want to waste more time doing things that don't work...
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Avatar universal
I had 2 "micro D's" at L4/L5 and for my 3rd surgery I had a fusion. I felt great after the first 2 Microdisectomies, but found the discs reherniated after 6 months. I'm not sure if it was my fault for not taking it easy or if it was bad luck.

I'm coming up on 3 years since my L4/L5 lumbar fusion with a cage, rods and screws. It's held up well so far, and that includes me having a couple of nasty slips on ice where I slammed onto the ground, and being tossed around in a big wave in Hawaii and California a couple of years ago.  Believe me, I start to panic when I feel pain the next day after an "incident", but I've found that the pain tends to go away after a few weeks and it's probably more muscular vs another disc above/below herniated or something going wrong with the fusion.  

For me, the 3rd surgery was a life changing event. I was in a tremendous amount of pain and my left foot was numb and would slap the ground when I walked. The first 2 surgeries were worth it was well for the pain relief, but I wish I had done the fusion after the 1st failure and bypassed the 2nd "microD".

I thought I was going to live a life of misery and be on pain killers, but my surgeon has given me hope that this might hold as long as I'm a good boy and take care of things.  

Having said all that, a girl I work with had a very nasty L5/S1 herniation 10 years ago and had a MicroD and she hasn't looked back. She's runs marathons, teaches yoga, plays golf etc. She also gets some odd pains here and there but sometimes one surgery will fix it for good.

Good luck!

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Avatar universal
Thank you so much for your feedback! It seems the successes/failures of back surgeries I've heard and seen are about 50/50. I am determined not to live the rest of my life in pain .(I plan on being around for quite a while yet!)
I have a pretty good pain tolerance (have passed 7 kidney stones at home and endured a 45 hour labor with natural childbirth -at home also) but this back pain thing becomes exhausting after a while and it interferes with my quality of life. Not acceptable! I have sh!t to do! :)
I have a consult with my ortho Dr next week, and I'm hoping he feels that the microD is the way to go rather than attempting another round of cortisone injections...I really hope it is the lasting answer...Thank you again for your input.
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Avatar universal
I found the cortisone injections very little value for me, but my disc was probably too far gone at that point with 2 prior surgeries and a 3rd herniation.

Good luck with your ortho appointment.  

I would like to think the success ratio for spinal surgeries is better than 50/50. Sometimes, it takes a few kicks at the cans for one to hold.  

My friend had one microdisectomy and was very good afterwards.....mine took 2 micros and a fusion to get it to a point where I can live a "normal" life.

Also, patient expectations have a lot to do with it.  I have minor back pain/discomfort all the time, 24 hours a day. It's not excruciating...but just enough to remind me not to take all those grocery bags into the house in 1 trip when I can make 4 trips and carry one in each hand, or making sure my back is straight and legs are bent when I go to pick up my 14 month old daughter.  Sure, it's embarrassing for me at the airport luggage area when people stare at me while my petite wife has to pull the big, heavy luggage off the conveyer belt......but those are the simple lifestyle modifications that have to be made once you go through back pain.

I know how you feel and hopefully I never feel that way again as I need my fusion to hold....but take some comfort that no matter how bad the pain/discomfort is now, these surgeries can be life changing events.

I'll never forget walking down the hall to the surgery room before my lumbar fusion. I made sure I took mental notes of how bad I really felt. The constant throbbing in my groin that felt like someone was hitting my testicles with a hammer, the constant lighting bolt feeling in my left buttock, the pain shooting down my leg and the numbness and throbbing in my left foot and toes. When I woke up after the surgery, it was all gone.



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