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Chronic lower back and leg pain

  I am a 28 year old female with a history of lower back and left leg pain.  In 1991 I underwent a discectomy/hemilaminectomy on my L5-S1 disk.  The surgery did not relieve my leg or lower back symptoms.  
  Recently, after years of very conservative, non-invasive treatments (medication, heat packs, tens unit) I agreed to a caudal epidural injection.  A week after this injection I experienced a DRASTIC increase in my lower back pain and BOTH legs were having symptoms (previously my left leg had radiating/sharp pain).  
  MRI's. CT Scans, X-Rays and Bone Scans were done.  These studies showed a large HNP @ L5-S1, severe degenerative disk disease at L5-S1, severe spinal stenosis at the same level and mild spondylolisthesis.  It was suggested that I undergo a microdiscectomy and a possible fusion. (It was also noted that my L4-L5 disk was bulging).
Dear Denise,
You likely have pain from a recurrent disc at L5-S1 pressing on the nerves.  As with any disc the first line of treatment is conservative as a large proportion of the disc is water and will often be reabsorbed on its own, alleviating the symptoms.  If after a period of conservative therapy - it sounds like you have done this - surgery may be considered.  Your situation is complicated in that it is a redo and they are already seeing some signs of spondylolisthesis at that level.  Spondylolisthesis means that one vertebral body has 'slipped' forward on another.  It can cause pain and eventually weakness and incontinence if allowed to progress to the extreme.  A 'slip' sometimes happens after disc surgery, and the fusion you talked about is the answer.
Whether or not you will have problems from recurrent scarring around the nerve roots remains to be seen.  If you do have an impressive disc and an early 'slip' of the vertebrae, the suggested surgery is likely appropriate.  
Speak to your surgeon for further details on the surgery and what to expect.
Good luck.  

  BOTTOM LINE......I AM IN TREMENDOUS PAIN...I TAKE NUMEROUS PAIN MEDS...I ATTEND PHYSICAL THERAPY 2 TIMES A WEEK FOR E-STIM AND HEAT.  I have been told that my symptoms did not improve after my first surgery because the nerves got "tied up in scar tissue".  I am very reluctant to consider a second surgery if success is unlikely and if the majority of my symptoms will not be improved.  I would like to know which of the above listed "problems" CAN improve over time with conservative treatment.  Also, if you could reccomend sources for information on laymen information regarding microdiscectomy and spinal disc conditions I would greatly appreciate it.
  I posted a similar message a few months ago but never got a response.
  Thank you for your time.

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