Discetomy and spinal fusion

[BLT812]

I was just told that I need to have lumbar back surgery, discetomy and spinal fusion.  Three months ago I had back pain which radiated into both my legs, although the right one seemed to be more affected.  I have lupus so the rheumatoid dr thought I may have bee in the midst of a flare up.  I went for PT, took pain meds and muscle relaxants.  Things seemed to be improving and overnight I was back to being in severe pain. My neurologist did a physical exam along with an EMG test and found moderate nerve and muscle damage and weakness. Neurosurgeon agreed with his findings and added that I also have moderate dropped foot.  Told I need the surgery ASAP to prevent further damage to nerves and muscles.  I am told this is major surgery and am scared.  I am wondering it is truly necessary and if so, what can I expect in regards to the surgery, recovery time and the future.  Any thoughts and/or suggestions would be greatly appreciated.

[brenpain]

you absolutely can have a discectomy and a fusion at same level.  If the disc is a far lateral herniation compressing the exiting nerve just performing a fusion would not relieve nerve pain.  The disc on the nerve needs to be removed.  If there is not much space between the vertebra a fusion is needed so the nerves don't become irritated due to narrowing of the foramin, which is where the nerves exit the spine.  A fusion allows the bones to have an appropriate distance from each other so nerves are free.  With that being said, a fusion at one level does make the joints above and below that level vulnerable for problems.  Any joint that lacks mobility will cause the joints next to it to become more mobile, and problems can arise.  Got to keep that core strong,,,,very strong.  

[brenpain]

I''ve had 5 back surgeries total
last december I had a fusion L4L5 with discectomy at same time
I continued to express no change in pain if anything the volume was turned up in my nerve pain.
I just learned that the disc at that level had flattened the L4 nerve, which is what they "fixed"…..after a fusion should it be necessary to have a discectomy?

[cowgirlinwyoming]

Hello, I had lumbar fusion for L4/L5 S1 and waited too long to have the surgery. I now have permanent nerve damage in my left leg from the pinched nerve and my leg aches all the time as well as numbness in my feet. If your mri shows serious issues I'd recommend getting the surgery.

[lilly434]

Hello,

I work at a hospital with the best surgeons in the world and when I saw my doctor he told me if he does a discectomy my back will hurt for the rest of my life.  I took his advice very seriously as we all know, back pain is no joke.  

Also,  femmy29 is correct, if you don't fix the underlying issue of why you herniated your disc to begin with you can either injury other discs or injure the same discs again.

I herniated my disc two months ago and thankfully I am doing better but I changed the entire way I function down to how I bend for brushing my teeth.  Give your body a chance to heal and help yourself by getting a good physical therapist (there are many bad ones) and learning how to use your body so you stop hurting hour discs.  

Give yourself a chance,  surgery will always be an option.

[femmy29]

Realize that back surgery is only 50% successful at reducing or eliminating the pain related to the discs and it should only be considered for spine stabilization to prevent further degeneration and permanent nerve damage.  

I have been told that I need a fusion from L4-S1 but I am not doing it...EVER!  Opioid medications do not touch nerve pain and anti-convulsants only do so much.  My father had a friend who committed suicide after having a fusion as the nerve pain was so bad and nothing would reduce this pain.  My best friend is married to an orthopedic surgeon and he told me to not have the fusion surgery (I consider this input very valuable as his words were not influenced by monetary factors).

Why are the doctors saying you need a discectomy and a fusion?  I am assuming these would not be done at the same level???  You usually have one or the other as with a fusion surgery they remove the disc completely sometimes leaving behind the outer wall to house the bone graft.  With a discectomy they extract a small amount of disc material that is pressing on the nerve via a very small incision.

If anything, I am considering a discectomy to get some of the ruptured disc material off the nerve.  Why don't you try that first before going for a full blown fusion?

The recovery time after a fusion is 6 months to a year with restrictions for many months after that.  The recovery time for a discectomy is 3 weeks.  

femmy

[BLT812]

HI Dee1956.  

Thanks for your post.  It appears you were in a similar situation to I.  You are correct that is a very hard decision to make.  I hear so much negative things about this surgery and it is good to hear from someone who has had good results.  

Can you just tell me what your recovery was like?  Did you have to stay in the hospital for awhile and then do PT afterwards?  Just curious how long it will take me to recover and be up and around.

[BLT812]

My disc issues (herniated and bulging in lumbar) are not the result of an injury.  In February, I just started having back pain.  After a week, I went to an urgent care center and x-ray showed nothing so I was given muscle relaxants.  I have lupus so my rheumatoid dr felt I may have been in a lupus flare up.  She added pain pills and sent me for PT.  The pain continued to get worse.  Saw my neurologist who noticed severe weaking on legs, especially right side and said that I needed a MRI which I had been putting off.  MRI showed the disc issues.  Both drs said I needed to see a neurosurgeon ASAP.  They are all concerned about the increasing weakness and the rapid deteriantion of the discs.  Have to go for three more MRI of the total spine to see if other areas are effected.  I also have cancer which I was treated for with radiation.  As I said in original post, there is major concern about further damage to nerves and muscles which is why they are all saying (3 opinions) that surgery is my best option.

I have looked at other postings which is why I am scared.  However, I am not sure if I really want to risk the possibility of losing the use of my right leg because of deteriation of nerves and muscles.  I am already showing signs of foot drop which means if it continues, I will not be able to lift my food to walk.  I am trying o weigh the benefits vs. the risks but it is not easy.

[Dee1956]

Hi about 14 years ago I had alot of pain in my back I tried physical therapy, heat, ice, rest, Motrin, tylenol.  I did this for 8 months..
In the end I had to go to a neuro surgeon who said that I needed surgery.  I told him I did not want it and he said that was fine however the longer I waited the more damage was being done and at some point it would not be repairable.  He mentioned the drop foot that I would experience as well. I had the surgery and am very glad that I did.  
I wish you the best
It is a very hard decision to make

[lilly434]

Hello,

What is your injury?  You shoild really think long and hard about getting back surgery.  Most people who have back surgery are in more pain than what they started with and are stuck with that pain for years to come.  Look at the postings in this forum, people are suffering. If I were you, I would get a few more opinions.

Please post what your injury is. Herniated discs? You got in car accident?