mikul515MemberJanuary 18, 2013 at 9:04 pmPost count: 4
I had l4-5 lamenectomy/discectomy in 2003, after surgery everything was ok, except for mild pain and some discomfort..
10 yrs. later i wake up one morning with that same lightning bolt type shooting pain down the left leg..i knew something was not right.
i just got mri results whch i will not list because im not a good typist,
but there is a SEVERE BULGE L4-5, and from what it says there is alot of compression on this thecal nerve…i just started pain mgt.and discussing ways to ease the pain right now… since this has been the most informative site on the web ive come across, and to get a professionals opinion…lets start off by saying “im scared doc”..im 40 y.o. now, and not very happy about this surgery again..mostly because im not under the same insurance i had 10 yrs. ago. im in a managed care system, in ny, and im so afraid im going to get a surgeon without experience.(paranoia??)
#1) re herniated?? i thought surgery took care of this yrs. ago??
#2) anything to ease my mind, that may help with this surgery, or make the recovery time faster?
Staten island,N.YDonald Corenman, MD, DCModeratorJanuary 19, 2013 at 1:11 amPost count: 8459
You have a recurrent herniation at L4-5. This is not uncommon as the chance of recurrent herniation is about 10% in the general public.
A large recurrent herniation can create some problems that need to be addressed. Makw sure you have no motor weakness as this is the one problem that needs surgery sooner than later. If no motor weakness and no cauda equina syndrome (see website for description), then therapy, epidurals and medications can be used.
If the pain to too intense and surgery is called for, a managed care system does limit your choices of surgeons. Pick the one that has more experience, compassion and seems to “understand” what you are going through. The technical ability of the surgeon is very difficult to judge unfortunately.
It is nice to know that redo surgery is still not that difficult in good hands.
Dr. Corenmanmikul515MemberJanuary 19, 2013 at 11:25 pmPost count: 4
thanks for the reply doctor,
i think this thing will be ok, since i dont think motor skills have been lost, i was able to walk on my heels, while pivoting my left toes in and out..so thats good, i guess..
the tough part is dealing with the pain, and im not too wild about starting the painkillers again…
Do you think this re-do surgery will be the same as my last one?(lamenectomy/discectomy)?,
ive read that the microdiscectomy pushes the muscles to the side, instead of cutting through them..maybe could be a better choice to get quicker healing time?
I do realize you are busy with everything you do, and want to thank you for you input with this, and helping so many with your experienceDonald Corenman, MD, DCModeratorJanuary 20, 2013 at 8:22 amPost count: 8459
The redo surgery should be similar to the last one. There is slightly more scar tissue and a very slight increase of the potential for a dural leak but the outcome should be as good as your first surgery.
The microdiscectomy can be performed many ways but the outcome should be the same with any technique amd the healing time should be about the same.
Dr. Corenmanmikul515MemberFebruary 10, 2013 at 3:49 amPost count: 4
I finally was seen by a neurosurgeon, in which he was leaning toward screws, and rods . but first he wants another mri with gadolinium to make sure it is a re-herniated disc.(and not scar tissue)
My concerns are;
1.)can i get another discectomy to avoid such a big surgery?
2.)if the spinal fusion is necessary, is there a test to see how strong the bone is ,to make sure the screws will hold? Im a little freaked out to think the bone can crumble when putting in these screwsDonald Corenman, MD, DCModeratorFebruary 10, 2013 at 5:20 amPost count: 8459
The neurosurgeon is talking about a fusion along with the microdiscectomy. Fusion is reserved for a third time disc herniation, instability of the vertebra (degenerative or isthmic spondylolisthesis), collapse of the foramen (angulation of one vertebra on the other that causes the foramen to narrow substantially), significant lower back pain that can be determined to originate from the disc level and deformity (scoliosis).
If you have one of those, a fusion might be needed. If you do not, in my opinion, you do not need a fusion.
Even if you had osteoporosis, there are techniques to prevent the bone from “crumbling”. Bone is more resilient than you think.
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