Has anyone had lumbar disc surgery?

[Selkie]

Long story short, I am trying to decide whether and when to have a lumbar microdiscectomy. I am hoping for some information and advice from anyone who has had spine surgery, or even you've considered it but ended up deciding not to. I've also been reading some forums specific to back pain and surgery, but while they are helpful, the posters there tend to be people with chronic problems and failed surgeries. Those boards tend to be biased towards the negative, I think. I wanted to ask here too for balance, since there's more likely a representative mix of people with similar issues. I'm also writing this out for myself so I can think through things a little more clearly.

At this point, I know most of the basic details if I decide to have the surgery: what hospital, what doctor, what procedure, and how it works. I am not sure what additional questions I should be asking him. I also am wondering about recovery times, and whether the 2-4 weeks I keep hearing about is adequate to return to normal life and work. Any stories and advice would be extremely helpful.

Factors in favor of having surgery: I'm relatively young (3 and healthy, and it's a less invasive surgery. It's been months, rather than years, that I've had the problem. I've got a supportive boss and plenty of sick time available for healing. I've got a great husband and friends to help out.

On the other hand, it's surgery, there are risks, and there is a definite possibility of relapse. I'm not in constant pain at the moment, and can cope with the numbness and weakness. But I don't know for how long my current situation will last.

Background: I've been diagnosed with a herniated lumbar disc, resulting in sciatica. I had severe hip and leg pain along with numbness for about 6 weeks in December and January, when I had my MRI. My primary doctor finally put me on neurontin, which is an anti-convulsant that can often relieve nerve pain. Although the neurontin has alleviated most of the awful pain I was experiencing, my foot is still numb. So basically, I have had direct nerve impact from the herniation for at least 4 months now. I do not know how people can deal with this kind of thing for years, but I've read many stories from folks who waited forever until something REALLY drastic happened before having surgery.

I've seen two neurologists and a neurosurgeon in addition to the PCP. The first neurologist recommended trying PT first. I asked how long I should go with that before reconsidering, and he said one month. That was in late January. It's now April, and while PT and massage have definitely helped with the muscle pain, I still have weakness and numbness in the left foot. I have not tried chiropractic or acupuncture, though I have considered it. My main reason for not doing either is that I believe, just like medication, they will only treat the symptoms. Since I know the primary cause is the severe herniation, I am focused on dealing with that.

The second neurologist was basically totally unhelpful beyond referring me to the neurosurgeon, since most of my questions revolve around the actual logistics of the surgery. I went to the neurosurgeon this week, and he basically confirmed what I had already thought, that the herniation is unlikely to resolve on its own, since it has been over 12 weeks. He said that he would recommend surgery, and the sooner the better, but that it was my decision.

I hope this isn't too tl;dr. I really appreciate anyone who's read this much, and has anything to contribute!

 

[somethingshiny]

Selkie~ FIrst off, OW. I'm sorry you're dealing with this.

My best friend has been researching this same surgery. Her disc problem area is up toward her neck so her numbness and weakness is in her arm and hand. She hasn't felt her thumb for most of the past year. Her doc also put her on Neurontin and something else (don't remember the name. Think it was another fibromyalgia med) The meds provide some relief. The docs really wanted her to consider the surgery. She's only 35 and is having a hard time thinking about having back surgery. She started seeing a chiropractor (against her doc's wishes) and he has alleviated a lot of her symptoms. She still has numbness, tingling, weakness but not all the time. She said she's finally started sleeping for more than an hour straight. I have an acquaintance who had surgery for a herniated disc in her mid-back. She's been in 3-4 times because something went wrong and she's leaked spinal fluid. Obviously this is not the norm, but I'd really look into every possible side effect if you do decide on surgery.

Good luck with whatever you decide!

 

[Skippy123]

I would try a chiropractor. I have had such good luck with mine and I am very skeptical of alternative medicine like this. The way I see it is that we do things to get our back out of alignment (such as sitting for ours when our bodies weren't designed to do that, etc) so it makes sense one chiropractic adjustment isn't going to fix it all because we keep doing things to make our back stay out of alignment. I have a friend who had surgery for her slipped disk and then later it moved back out of place and she started cortizone shots. To me that is big (surgery and what is the chance of it reoccuring), so it is worth just trying the chiropractor for a few sessions? I am sorry you are hurting and hope that you find relief soon. I will be thinking good thoughts for you too, hugs

 

[Pandora II]

I have had spinal surgery. In 2004 I had a discectomy and laminectomy. I had two herniated discs at L4/L5 and L5/S1 and lumbar spinal stenosis. I was 32 at the time. I saw one of the best spinal neurosurgeons in the UK and had 2 years of specialist spinal physio at the Royal National Orthopaedic Hospital in London. I also use accupuncture a lot to help with muscle spasm in my lower back.

The surgery was deemed a success - I have a 60% reduction in pain, but still take 125mg Lamictal (an anti-epileptic also used in nerve pain) and 200mg of Tramadol every day.

Before the operation I was finding it hard to walk, had terrible pain in my left leg and was unable to move my big toe on the left as well. Since the operation I don't have problems walking, but the nerve pain is still bad and the movement in my toe did not return.

Eventually I will need more surgery and will probably opt for an artificial disc - but they won't operate again until I'm over 50. Normally they like at least 12 weeks physio before considering surgery here.

I spent 5 days in hospital with obscene amounts of morphine and then I would reckon it was 4-6 weeks before I could do what I was doing before.

I'm definitely glad I had the surgery as the 40% reduction made a massive difference to my life. Since then I have had a few epidurals and nerve root injections to see if anything can be done to improve things.

I think the recovery time etc is much, much less if it's just a discectomy and not removal of bone as well.

A herniated disc can't go in or out, however, once the nucleous has seeped out of the fibrous tissues it eventually dissipates - the nucleous inflames the surrounding nerves and tissues causing the pain, as it dissipates the pain goes away. Discs can also re-herniate. Sometimes the disc is only bulging and this can put pressure on the nerves, sometime it has actually split. Sorry, very basic info there.

ETA: I wouldn't touch chiropractors with a barge-pole. I want my back treated by someone with a medical degree and someone who has access to MRI scans and x-rays.

 

[blondebunny]

I had a discectomy in July 2009. The recovery was 4 weeks. The surgery actually made my problem worse I actually re-herniated my disc in December 2009 (well not sure when i did it or even how because i was bedrest for the entire time besides going to school) along with a considerable amount of scar tissue causing some of the problem as well.From the surgery my left pinky toe..to my heel up the back up my calf to mid thigh is permanently numb. Lovely. I also have horrible chronic pain. I have tried epidurals, nerve blocks, PT, chiropractic, spinal decompression, trigger point injections, personal tens unit and now I am onto pain management. They have me on a patch called Butrans? I just started it Friday.. so we will see how it goes. Hopefully I get some kind of relief because i am tired of living like this. Its ruined my life the past 2 years.. I cant even get a job bcuz I am always in pain

I recently went to a neurosurgeon and my last option is to have an anterior lumbar interbody fusion...which i will not have because its just too invasive. I swear ever since I decided i wasnt going to have that surgery 2 weeks ago Ive been in so much pain. Yesterday My butt/leg pain was soo horrible that i nearly puked in the store... talk about fun If i could go back in time I wouldnt have had the surgery.. i would have just tried to let it heal on its on or try other things...something

Goodluck with whatever you decide to do... maybe it might work for you!

 

[Blenheim]

I had a microdiskectomy on a badly herniated L5/S1 when I was 22 years old, which was 5 years ago now. Prior to surgery, I tried PT and a series of 4 epidural shots. I was in pretty bad pain and couldn't function out of bed or the pool without some serious muscle relaxers and pain killers, which made functioning mentally difficult, but what made them want to operate is that I was losing nerve function and reflexes in my leg. My understanding is that back surgery is not usually recommended for pain alone as the prognosis is not necessarily better than would come with conservative treatment plus time, but that they do want to prevent permanent loss of nerve function and will want to operate if it is becoming clear that will happen.

I think the surgery went pretty smoothly from their perspective. I was in really bad pain afterwards and had maybe 4-6 weeks of serious recovery at home with my parents, and after that I was able to return to school. I wasn't "recovered" at that point though - was still in quite a bit of pain trying to get around and lifting a gallon of milk was too much on my back. It took me probably six months or a year before I really started to feel back to normal. I'm still not where I was before surgery - ran cross-country and track competitively prior, and now if I get above 6-8 miles per week the sciatica sets back in - and I still have an occasional pain flare up, but I am not in pain on a regular basis, I can run and generally be active, my back didn't really bother me during pregnancy past what effects pretty much all pregnant women, and I can pick my toddler up as much as he wants without aggrevating my back. Oh, and while my foot is occasionally numb, and is right now in fact, I do pass reflex tests. All in all, I would say that it was a success and I have no regrets.

I don't have any real advice, as I don't know everything that your doctors know about both your history and current research, but just wanted to give you another success story. Best of luck making a decision, and I hope that your back starts feeling better. It is so hard being in that amount of pain on a continual basis.

Blondebunny - I am so sorry that you are still in so much pain.

 

[charbie]

I have not had back surgery, however I work in a nursing home and see many happy people post back surgery! The recovery time post surgery varies greatly person to person, but generally within a month you'll be much better off. Your age willl only help in your recovery!

My DH comes from a family who I swear all have back problems. DH has degenerative disc disease, and his lumbar discs will only continue slipping out of place. He currently suffers from the same ailments you describe, and my heart breaks to see him suffer. He has done physical therapy, which helps some, but he has been told he is just delaying the inevitable-surgery. He has tried a chiropractor, which only caused more pain...(although some people have great luck with a chiro). He uses Neurotin, ice, and heat to help, and we are ordering an inversion/traction table for our house.

His cousin had a repair to his back done last year. He told DH his only regreat is that he did not do it earlier. Bc he waited so long, his nerve damage was pretty great, and now he will always walk with a limp due to drop foot. He was told had he had the surgery a few years before, he would not have lost as much feeling in his foot. His pain has been reduced greatly, but he said he can't play with his kids the way he wants to, simply bc he didnt get surgery earlier. He went through therapy, chiro, but eventually i fear surgery becomes the only option. DH only has lost feeling in a toe or two, and plans on having the surgery in a few (2-3) years. His pain has steadlly increaded over the past year.

Best of luck! Only you will know what is best for you, but I hope you find that answer! After seeing how this has effected my DH, I wouldn't wish back problems on anyone!

ETA: I just read what Blenheim wrote, all of which sounds quite familiar to the experience of DHs cousin (time for "full" recovery in particular) and I also second that they will check to see if you are losing reflexes. DH has had two consecutive epidurals, which provided very temporary relief, and has lost only 15% of his reflexes in his leg/foot at this time, which the doctor actually said isn't too terrible.

 

[Pandora II]

Just to add a few things:

If I'd had the surgery earlier I would have not lost the movement in my foot - unfortunately it took nearly 2 years to get the operation here in the UK (the NHS is pretty crap for not urgent conditions).

I also had one of the discs re-herniate. It's far lateral and putting pressure on my L4 nerve which causes most of my leg pain. I also have significant scar tissue plus it would mean removing all the disc and replacing it or doing a fusion - neither of which my neuro-surgeon is willing to do.

Instead I worked with a pain-specialist to find a cocktail of meds that give me as good a quality of life/pain management as possible. I spent 2 weeks as an in-patient on a pain management course and it was a complete waste of time.

I would still have the surgery again like a shot as the 40% reduction in pain was well worth it - I did have spinal stenosis as well though and that was the bigger issue at the time.

 

[Selkie]

Thanks to all of you for your stories and information. Even though nothing is straightforward about this, everything I hear helps me move toward making a decision. This is very scary, and there’s no right answer. I do feel VERY lucky that it didn’t take too long to hit on something (neurontin) that would control the pain as well as it does, because back in December it was so painful that I didn’t know how I would continue working. I can’t imagine dealing with that long term.

Somethingshiny and Skippy, though I haven't gone to a chiro I have been having muscle work and stretching done by a therapist, as well as doing the McKenzie technique (exercises to help lengthen and decompress the spine). I look at this more as a way to strengthen the core muscles and improve my posture, all of which help to relieve the pressure somewhat. But again, a chiropractor (no matter what they claim) isn’t going to be able to unherniate a disc, unfortunately.

Blondebunny, I'm so sorry that your experience has been so awful and that you're in so much pain. Do you mind if I ask how you were injured in the first place, and how old you were (roughly)? What kind of symptoms did you have before the first surgery that made you decide to have it? I've heard many stories about people re-herniating discs after surgery; that is my primary concern. I wish you a ton of luck with finding relief from your pain.

Blenheim and Pandora, I was hoping you two would chime in because I knew you both have had surgery. Blen, do I remember correctly that you were in a car accident? Or is that someone else? How long did you go before having surgery? It’s good to hear that your recovery has been pretty successful in the long term.

Pandora, why won’t your surgeon re-operate until you’re over 50? Is your condition primarily due to the stenosis or DDD? I’ve always been somewhat in awe of how active you are despite your health issues.

Charbie-I’m sorry your husband is in a similar situation. And thanks for telling me about his cousin’s experience too. I can’t believe how young everyone is to be having so many problems!

Thanks again…

 

[swingirl]

Sorry for your pain. Back pain is difficult. I hope yours can be resolved.

My husband had a herniated disk from a skiing fall. He tried to tough it out for a few years trying exercise and everything else, but the sciatica was getting worse and the numbness in his foot was very bothersome. He opted for surgery and as soon as he woke up from the anesthetic the pain was gone. It took several weeks to completely heal but he was back to work in two weeks. This was 20 years ago and I am sure the methods have improved since then. He is completely pain free. No numbness. No regrets.

 

[Blenheim]

Mine started immediately after a cross-country race. I felt fine before the race and when racing (adrenaline?), and then when I went to cool-down afterwards, I immediately realized that I had injured my "hip" - later found out that it was my back but the pain was radiating and first presented in my hip. I'm not sure how running can herniate a disc, but somehow it did. That was in mid-November, I saw my orthopedic surgeon and got an MRI over Thanksgiving, and then my surgery was in April.

I did have another MRI during a pain flare-up in the fall of 2006 that showed (IIRC) a minor herniation, but the pain resolved on its own and we never followed-up further on that. So re-herniating discs isn't necessarily the end of the world, although I shudder to think of another, more severe herniation.

 

[Pandora II]

Pandora, why won’t your surgeon re-operate until you’re over 50? Is your condition primarily due to the stenosis or DDD? I’ve always been somewhat in awe of how active you are despite your health issues.

My neurosurgeon was the first 'spinal' neurosurgeon in the UK and the first to introduce the artificial disc over here. Ideally he would like me to have one of those. They are reckoned to last around 40 years but they've only been doing them for around 20 years so no-one knows for sure.

If he operates now and does a fusion, it is likely that the upper levels will start to go more quickly than they otherwise will. It also means that I wouldn't have the option of the AD. If he does an AD now and it doesn't last the 40 years then I'm in big trouble when/if it fails. So, much better to wait till I'm in my 50's. He also wanted me to have any kids I'm planning to have first.

The stenosis is a bigger problem for me - in my case it's congenital which is pretty rare - but the discs add to the pain.

My big find was the Lamictal which has been life-changing. Before I took insane amounts of codeine as well as the tramadol and I still tended to drag my left leg a lot. I remember seeing a friend a few months after I started the Lamictal and they just couldn't believe how normally I was walking - said they almost didn't recognise me without the limp!

I must admit I'm not a fan at all of the MacKensie method - I tried it for ages and it actually caused more pain. The two things that really helped for me were accupuncture (I used TENS at the same time as I don't like the sensation of accupuncture) and core abdominals - they're tricky to learn (normally takes 6-8 weeks to learn where the muscles are - my physio sticks people on an ultrasound machine to help find them!) but really make a huge difference. It was the only exercise I was allowed to do for 2 years.

Having my daughter has also helped - I carry her in a Mei Tai a lot of the time and since I started when she was around 9lbs, I have done tiny incremental increases in weight every day. She's now 22lbs and I can easily carry her for a couple of hours. I am very careful not to twist my spine and to keep the abdominals strong (also helped get a flat stomach again after giving birth - and I'm nearly 39 so not a spring chicken!). I do have to try and avoid carrying her on my hip at all as that is painful.

I hate being unable to do things and so I will pop whatever it takes to give me a normal life. If that means serious quantities of narcotics then so be it - I now function extremely well on them (heck, I got 93% on the last major exam I sat, and passed my driving test on them )

It's a huge decision, but if I was in your shoes I would have the surgery and have it as soon as possible. Which level is the herniation?

 

[Selkie]

It's at L5-S1. The MRI showed most everything else as pretty normal, luckily. I've always prided myself on being strong, and probably never took the care that I should have in lifting heavy things. I think I probably just broke it down through wear and tear, because the only thing that I did within the past year that caused me severe back pain was bending and twisting to the side while setting a laundry basket down. I'm betting that's when it herniated. After that, the occasional butt pain started, and at first I chalked it up to piriformis muscle spasms. Then it just turned into radiating hip and leg pain, along with the tingling.

Oh, how I long for the days when absolutely nothing in my body hurt. I really hate being unable to do things too, which makes me a terrible patient. If I do have it, my mother-in-law has offered to come out and help us for a bit. She's really sweet, and a wonderful cook, so that would be very helpful. On the other hand, she's a worrywart and a bit of a meddler, and would probably end up driving me crazy in short order!

 

[MsP]

I would wait.

I had this same surgery on several discs at 21. I had already done 2yrs of physical therapy by that point. I woke up with NO pain or numbness... do realize that this isn't really a "fix" as you will deal with issues for the rest of your life. TENS and core muscles were mentioned-- DO THIS! They helped me POST-surgery immensely! Had I taken the time prior I'm not sure I would have gone through with the surgery.

 

[Selkie]

I would wait.

I had this same surgery on several discs at 21. I had already done 2yrs of physical therapy by that point. I woke up with NO pain or numbness... do realize that this isn't really a "fix" as you will deal with issues for the rest of your life. TENS and core muscles were mentioned-- DO THIS! They helped me POST-surgery immensely! Had I taken the time prior I'm not sure I would have gone through with the surgery.

I'm confused. It sounds like your surgery went well, but you said "I would wait." Did you mean the reverse?

 

[Pandora II]

Couple of other things I learnt along the way:

- take painkillers consistently. Do not wait till the pain breaks through to take the next lot as you set up a bad muscle spasm/pain cycle. I find taking slow release medications helpful in this regard. If you have a really bad flare-up, I find diclofenac really helpful - sadly it's a NSAID and so you can't take it long-term.

- if you do have the surgery and you find you have a lot of muscle spasm when you come round, ask them for some valium or similar as it really, really helps. Also, if they give you morphine ask for some antihistamines at the same time as morphine makes you itch like crazy.

The surgery itself isn't that bad - I was up and walking about the same day (they make you get up asap in the UK) and although being careful I could go round a supermarket etc within 10 days, and I had lots of bone removed from my vertebrae and a 5 day hospital stay. Giving birth was a gazillion times worse and the pain from the episiotomy (which they put me on morphine automatically for) was far,far worse than the post-op pain from my spine!

I also have a scar that although about 3 inches long is subtle enough that I have worn backless evening dresses and have had to point it out to people! My surgeon is very neat and tidy...

For just a discectomy the recovery is much shorter I believe.

Regarding rates of success: prospects are much, much better if the pain is in your legs and not your back - if it's in your back I don't think surgery will help and will probably make things worse. I was told I had a 70% chance of an up to 60% decrease in pain.

 

[Selkie]

Sorry for your pain. Back pain is difficult. I hope yours can be resolved.

My husband had a herniated disk from a skiing fall. He tried to tough it out for a few years trying exercise and everything else, but the sciatica was getting worse and the numbness in his foot was very bothersome. He opted for surgery and as soon as he woke up from the anesthetic the pain was gone. It took several weeks to completely heal but he was back to work in two weeks. This was 20 years ago and I am sure the methods have improved since then. He is completely pain free. No numbness. No regrets.

That's good to know, especially that even though he went a while before the surgery, it was still successful. Thanks.

 

[Selkie]

Pandora, thanks for all the helpful hints. I'm already starting to think about how to deal with things like taking care of the cats, organizing the house, hiring someone to clean house for a while (though surgery would really just be a convenient excuse to do that, since I HATE cleaning! ). I am still waffling. It doesn't help that I'm also trying to plan our vacation for later this summer, and if I have surgery, I have NO idea how soon I'll be up for traveling across the country. On the other hand, if I don't have it, I won't really be able to do as much as I would like since I'll be hobbling everywhere.