How'd your back disk surgery turn out?

In My Humble Opinion
1

If you had surgery on your back for a disk problem, what procedure did you have? and how did it turn out?

I’m polling because I might need it, and my story is below. But please feel free to skip my story and just post yours!

I’m 47, male, overweight - sorry ladies but I’m married - and developed sciatica (leg pain due to sciatic nerve being squeezed or crushed) 6.5 weeks ago after shoveling snow; physical therapy seemed to be helping but at about 4 weeks I seemed to plateau. Since then I’ve been getting worse. Treating with about 6 Percodans per day, and working about half my normal hours.

I see a new Dr, a spine specialist for the first time, tomorrow. Her web biography says she’s expert at various conservative treatments. Whatever happened to all the knife-happy surgeons who couldn’t wait to start cutting? If my hand’s caught in a car door, I want the damn door opened first, then let’s consider medication. Am I wrong to be interested in surgery?

I’ve had about 10 surgeries for other things and they all turned out great - hurt like hell for a day or a week, then everything’s fixed for good. Is the picture way worse for back surgery?

Web research so far says high 90s % satisfaction for laminectomy when performed for leg pain (though not nearly as good for back pain).

2

I’ve had two from work related injury. First one was in '83, badly ruptured disk, and a bulging disk adjacent to that one.

Anyway, I can’t recall the name of the first procedure, radical disc something or other. The doctor went in and removed portions of the ruptured disc.

The effect was immediate and dramatic. I could barely walk before, hunched to the side, in immense pain, constant pain killers. After the surgery, I got out of bed and walked to the bathroom, upright, with no pain (well, a little from the cut on my back…). I was amazed and relieved, never even took so much as a Tylenol after the surgery.

And the doctor told me that my other disk would probably need to be operated on in 15 years or so, or they could fuse the two vertebra right then. I opted out of the fusion, and 13 years later had a microdiscectomy to fix it. That one was not nearly as involved as the first, and recovery was much faster. I was cautioned to be VERY careful about so much as even bending over or lifting ANYTHING after the first, after the second I was back to normal activities in a few weeks. Now everything is fine (9 years after the second surgery).

So my experience with surgery has been positive. I’d be glad to try to answer any questions, but after today I’ll be away from the computer until next Tuesday. I’ll look the thread up and answer anything I can then.

3

Hey, Duke, thanks. Most encouraging story. One question: did your original problem cause you back pain, leg pain, or both?

4

I had my lumbar 4/5 disc removed in 1997 with minimal complications. The disc had been herniated for nine months causing leg and back pain. So I did all the tricks in the book to handle the pain: rolled up towel whenever I sat down, sleeping on my stomach, etc. In fact, letting the disc press against my spine for so long was a bad thing. The disc built up calcifications (sharp bony bits that DUG into my nerves). When the pain got screamingly bad, I had surgery within a week. Tylox helped me manage the pain during that week.

I highly recommend surgery rather than handling back pain with medication. The incision is tiny. Recovery time depends on the individual. I was back to 100% in a month. My minor complication was that the incision started bleeding profusely days after the procedure (the day of Princess Diana’s funeral ironically enough). It turns out it was a subdural hematoma. But my surgeon still had to open up the incision and get a sample of the fluid in case of infection. Yeah, not fun.

The world becomes a much nicer place when you don’t have to deal with pain 24/7. If you do have surgery, I highly recommend seeing a psychical therapist. They can give you exercises that will help get your flexibility back plus strenthen your muscles. It was so glorious when I was able to tie my shoes with no pain. Since that surgery, I’ve had occasional twinges when it gets wet or cold. Otherwise, I’m shipshape. Also, weight is a huge exacerbator for back pain and wearing good shoes helps. Losing weight and wearing arch supports won’t fix anything physically wrong with your spine but it’s a good way to protect against future back issues. Good luck!

5

Well, I didn’t want to gush on, but I really can’t tell you how much it changed my outlook. The pain was so bad I was probably not far from losing it.

I was in my early 20’s and in denial, it just COULDN’T be my back. It started out like I had pulled something, just a nagging pain in my lower back. As it progressed, the leg pain set in. And I had both…the lower back pain was there, but nothing like the screaming leg pain. The back pain was worse when I was sitting or laying down, the leg pain worse when I was standing or walking, but both were there. Constantly.

Do a couple of quick tests. Set on the edge of the bed and straighten the leg that hurts and have somebody GENTLY lift your foot, keeping your leg straight. If you jump off the bed after a few degrees, that’s not good. Then try to hold your toes as perpendicular to your leg as you can and have somebody hold your heel and try to straighten your ankle. If you can’t keep them from pulling your toes down, that’s not good.

While I was in the hospital for my first one, I shared a room with a guy who needed surgery. Well, when they told him he was going to have to have back surgery, his blood pressure got so high they sent him home. Didn’t bother me, I was just happy to know they were fairly confident that they could fix me up. So after I had mine, and the results were so dramatic, I called him and let him know that it was no big deal, compared to the pain. His went fine, and he called to tell me that after he got home.

Since then I’ve known a couple of other guys with the same problem, and they were both afraid of the surgery. Watching them try to walk just about made me cry, but both had it fixed and went on with life. I bet they can fix you up, too.

And to inject a little humor, the operating “table” for back surgery… Well, just think “Squeel Like a Pig”… or “Full Moon Rising”…

6

I didn’t have back surgery, per se, but 4 weeks ago I had a level 5/6 cervical spine (neck) discectomy and fusion- kinda the same thing.

I was numb from the neck down, could barely walk, and had pins and needles sensation in most of my extremeties (fingers, toes, and believe it or not, my penis).

Immediately after surgery, numbness was gone except for a small region in my lower back/hip area. Sensation has returned to important body parts, as well. :slight_smile:

I can walk almost normally again, and no more tingling.

I have to wear a stiff cervical neck brace for 8 weeks (5 to go) since I opted out of the metal plate with my fusion.

I highly recommend you see a neurosurgeon. It was the best thing I’ve done. Without my surgery, I would have eventually been paralyzed from the neck down.

I’m 31, for the record. None of my doctors could tell me the exact cause of my injury, and all of them told me not to try to figure it out. In most cases, patients never know why this particular disc ruptures. In my case, it almost completely compressed my spinal cord.

I’m expected to make a full recovery over time. Nerves can take a long time to heal.

Good luck with whatever you decide!

7

Thanks, everybody, this has been great!

I read weight made a big difference, and so I have lost almost 20 lbs since this thing started. I know - maybe a little TOO fast - but the first few pounds are mostly salt water, right? But this kind of nasty experience will do wonders to take the shine off a banana cream pie.

>Do a couple of quick tests.<
>Set on the edge of the bed and straighten the leg that hurts and have somebody GENTLY lift your foot, keeping your leg straight. If you jump off the bed after a few degrees, that’s not good.<

OK, the physical therapist did this one with me a week ago, and I almost jumped out of my own skin. Try explaining that to the people in the waiting room. The range of motion without instant terrible pain was small. Therapist shook his head and said nerve was still very irritated. I take this as a very poor result of the above test.
>Then try to hold your toes as perpendicular to your leg as you can and have somebody hold your heel and try to straighten your ankle. If you can’t keep them from pulling your toes down, that’s not good.<

Yeah, we’ve been monitoring this one too. At first I couldn’t resist at all and could only walk by dragging my right toe out to the side. Then it improved, but I still could never raise my toe while standing - that is, I couldn’t stand on my heel. But then it got worse again, so I couldn’t even see movement in the top of my sneaker when standing and trying to raise my toes, and also could just barely raise my heel, which is pretty important for walking. That scare prompted getting a new Dr.
Today they’ve been a little better and just now I tried standing barefoot and raising my toes; I can see them shift a little, which is a good sign, but they are still resting on the floor, can’t get them off the floor. On my good foot they go up a good 50 or 60 degrees! I can raise my heel about a half inch, while on my good foot I can raise it so far I’m afraid of somehow flipping my foot over forwards and breaking my ankle. And of course I can’t balance on that foot, as I can’t shift weight around with it.
I take this as a surprisingly poor result of this test.
The more I hear about it, the better surgery sounds. I wonder what the Dr. will say???

8

I’ve not had the sort of back problems you describe, but I’ve treated, and continue to treat, many, many patients with sciatica or radicular back and leg pain. And the worst description I can give them when I write up their chart is “Failed back surgery”. Not to say the surgery was done wrong, but their backs can look like a railroad yard, with all the incisions, and they say that they’re in more pain than they ever were.

That’s not to say there aren’t good outcomes. Testimony here shows that there are. But the sheer number of outcomes where the symptoms are unchanged, or even worse after surgery (or surgeries) makes a lot of surgeons be very cautious about picking up the knife to operate on the lumbar spine (Success rates are much higher for cervical radicular problems).

Remember the unofficial motto of the Orthopedist: “I don’t know if I can make you better, but I can sure make you different!”

9

I am not a doctor, but I do work in a medical research group.

From what I’ve seen of the literature on back surgery… well, be VERY cautious and don’t be too quick to go under the knife. Surgery can be very, very successful… or it can make you worse off. Same problem, same surgeon, same technique, two very different results and no one is sure why.

Back surgery/disk fusion for traumatic injury (which was the original use of it) such as fractured vertebrae tends to have better results than for the sort of back pain that comes on gradually. Surgery for when something is physically impinging on the spinal column also tends to have better results than when the cause is less obvious.

If conservative treatment fails, you can always go to surgery. If surgery fails, you’re stuck. From my time as a long term disability administrator I remember quite a few people for whom back surgery turned into a horror - comments like “I only thought the pain was unbearable before the surgery. I’d give anything to go back and just have to cope with that instead of what I have now.”

On the other hand, I’ve also known some people for whom the surgery was exactly what they needed and they have no regrets. It’s like they got their life back.

The OP said he’s doing research - and that’s exactly what he should do. Do LOTS of research, get second opinions. I know you’re in pain and it’s nasty but you want to get better, not worse. Be careful

10

I have two herneated discs (L4-5 & L5-S1…the most common I’m told).

The only way I’d have surgery is if I lose stregnth in my legs due to nerve damage or if I somehow make it worse and can’t bear the pain anymore.

My Dr (who’s an orthopedic surgeon) said pretty much the same thing QtM said.

11

Count me in the very successful surgery category.

When I had a bulging disk my symptoms weren’t typical. For me the pain was in my hip so I went for six months being treated for early arthritis. Anyway, the disk finally stopped bulging and ruptured, causing all sorts of pain and imparement to the movement of the foot. They got me in to surgery after a couple of days and when I woke up the hip/leg pain was all gone. The incision site pain was so minor compared to what I had before that I didn’t bother with the pain pills. The foot motion came back quickly but I had some numb spots on my leg for almost two years afterward. One of the reflex tests they do shows there is some permanent nerve damage but my body compensates so I don’t notice the difference.

12

Hell no, this isn’t unreasonable at all. My father, by description, is basically your twin. About the same age, same problem, and the same causes. He is in dire pain right now, and the doctors want to keep shoving pain prescriptions down his throat. They’re trying steroids now. :rolleyes: He doesn’t want to be a Rush Limbaugh, but hey, how else are drug companies going to make their money? :rolleyes: He’s at the point of crying quite often because of the burning pain down his leg, and it makes me pretty sad. It’s obvious that time and medicine are not going to work in his case, yet the battle continues, and the doctors keep putting it off. :mad:

13

My experience was almost exactly like Foible’s, which the exception of the numb spots that slowly improved. Mine improved immediately. Having said that, however, I have seen cases of failed back surgery and they aren’t pretty. I hope that your outcome is good, no matter what road you take.

14

It’s not that easy to choose the right path, apparently.

Outcome of this morning’s Dr consult at the Spine Center: my disk is herniated, and pretty badly, not just bulging. The further loss of foot motion in the last couple weeks is troubling. Dr had me trying all kinds of foot motions that did not work, and slow straight leg movements that hurt plenty bad quite early. Multiple discouraging versions of the tests discussed earlier. So, Dr says stop all the physical therapy till further notice, and we do a stearoid injection 6 days hence. Also says one injection is not likely to help in my case, so there will probably be a second, maybe a third.

I was dismayed Dr.'s specialties are conservative methods, and when I get there the whole place is named “Physiatrist Associates” on the paperwork (but “Spine Center” on the door). I mean, how did we choose to continue focus on conservative methods, now that we’re in 7th week and PT isn’t working? Apparently just by the referral my GP gave me - after he hasn’t seen any of the films, and hasn’t seen me in weeks. So I asked about surgery.

Dr says longer prognosis of surgery is troubling because of scar tissue growth which can encircle nerve, making hell of a mess, and other issues. But we can consider, can consult surgeon. Stearoid shots don’t need to delay surgery any. So I got a surgeon recommended, and made app’t with him, almost a month away, his first opening. Also, while 6 months delay would limit expected recovery due to permanent nerve damage, at 6 weeks we still have time.

Guess there’s still no incentive to push less conservative approach any sooner, but not sure, just mulling it all over.

Still hurts like hell, though. Wow. I’ve had kidney stones that were worse, but not for 7 weeks. This is wearing me down.

Broomstick and Quadgop, your testimony is troubling - how much of what you say is still true if you only consider cases limited to leg pain? In other words, cases with no back pain? Several refs say surgery to fix leg pain is much more successful than back or leg+back. Broomstick’s remark about “physically impinging” seems on point here.

15

Shooting from the hip, I can say the odds are better for relief of symptoms if the surgery is done for leg pain alone. But scarring at the site of the surgery causing later problems for the nerve root is still a concern.

I’d counsel strong consideration of injections, if so advised by competent physiatrists and/or spinal surgeons. As you note, you still have time.

Bottom line: A lot of these problems do improve by themselves in 6-12 weeks with little more than time and rest alone. So conservativism, in the form of not committing to permanent solutions for what may be temporary problems, is not inappropriate for many of these types of cases.

Just remember to tell them that pain is a problem, and solicit their advice for better short-term pain solutions (sometimes this means more narcotics, sometimes not). Also keep them informed if your nerve deficit is progressing.

16

I can’t diagnose either on or off-line, and I know Qadgop won’t diagnose in this case either.

There is NO way for anyone on this board to determine what is right for you. However, seeking other opinions, including the experiences of others, is exactly one of the things you need to be doing.

If I were you - and I’m not, I’m only telling you what I, personally would do - I’d exhaust all non-surgical treatments before going to surgery. And it does sound like that’s what’s occuring in your case. I know you’re in pain, I know you’re frustrated, but it’s better to take a few extra weeks now (and yes, I know you don’t want to wait for relief) and be sure before going under the knife.

Note that those folks who had a good result from surgery have mentioned immediate relief - a significant drop in pain, if not it going away altogether. And whatever treatment you wind up with, that’s the result you want. You only get that from a careful, thorough doctor(s) who are willing to look at all the possibilities and options.

You’re also going to have to deal with some uncertainty here. Prior to going to ANY treatment no one can give you 100% guarantee it will work and will be without complication. Even if it has a positive result, that doesn’t mean always mean all pain, numbeness, and weakness will go away - as some other posters have mentioned.

I wish you the best, and I hope you do find all the relief you desire. Just be cautious, be careful, and be informed. Injections and pain pills are reversible, surgery is not.

On preview, I see Qadgop beat me to the post, with sound advice as usual.

17

Two more good explanations why study and care are good things.

This is all hugely important to me and I’m inclined to go on and on - pardon me if I drive folks away - you can imagine why, tho, right?

So I’m scheduled for an injection (and perhaps a second) before I even talk with a surgeon, who (the Dr predicts) will say I should be doing injections first anyway.

Pain meds are a more urgent concern because the pain can really be maddening. I don’t get any relief from aspirin, naproxen, ibuprofen, acetominophen, demarol or codeine (pardon any bad spelling). I have been taking percodan. The first 11 days my average was 7.3 tablets a day but with improvement I was down to 1 tab per day for two consecutive days, and 2 or 2.5 for the next few days. But the last week I’ve been up to about 6 per day again. The side effects have been somewhat troubling but I’ve learned to minimize and manage pretty well. Drs have been cooperative but still for a variety of reasons I wind up short now and then, and it makes for a nightmarish evening.

The loss of movement was worst at first, got somewhat better (at one point I felt like I was walking symmetrically if slowly), and has gotten a bit worse again.

The pain is worse than the loss of movement, but if the pain were fixed I’d be plenty worried about never walking smoothly again, I guess.

Anybody else care to share what their pain or movement progressions were like?

18

Survivor of five “failed” back surgeries beginning in 1982. I am sure procedures have improved and everyone is different. Began with L 4/5 ruptured disk, sciatica, intense pain and nerve numbness in right leg. Conservative treatment for one year. First surgery had improvement for about 6 months before return of all symptoms; scaring at the surgery site. Long story shortened. 4 “revisions” over 4 years without improvement, Pain Rehab (good help) and large doses of steroids to control swelling and scaring. Resulted in Avascular Necrosis and replacement of both hips (X2 at this point). At this point, 20 some years later still have same sciatic pain and numbness hips work “OK” but not great, 55 years old with arthritis in knees and ankles.
Recommend: as much conservative treatment as you can possibly stand first. Honestly if all else failed and knowing what I know now I would still try the surgery but would consult both an Orthopedic Surgeon and a Neurosurgeon before and see which approach both would take. Good luck!

19

Just had back surgery in December, wish I did it sooner! My story:

Last February,while landscaping in the backyard one day (lots of backbreaking stuff: yanking up tree trunks, digging drainage lines, moving boulders, etc.), I developed intense pain in my lower back. I tried to ignore it for most of a month, but the pain worsened and started to radiate down my left leg and into my foot. With the increased pain came a decrease in mobility: more difficulty in bending and my walk developed a limp. When the pain had reached the point where my wife had to put my shoes and socks on me and my sleep was down to less than four hours a night, I finally went to see my primary physician. He sent me for an MRI which showed a moderate bulge of the disc at L4-L5. Conservative therapy was recommended by the Dr. and he strongly advised me against surgery. I was prescribed 2400 mg of ibuprofen a day and Vicodin for nighttime use to help me sleep. I started physical therapy which consisted of back stretches, strengthening exercises and sessions on the traction machine. I did this for four months, with little improvement. The only thing that gave me any relief were the drugs, which would only last two hours max. I went back to my doctor to seek advice, he sent me to an accupuncturist, which did nothing to help (maybe I’m just too skeptical to believe in the “magic” behind it for it to work on me :dubious: ) Shorty thereafter, the straw that nearly literally broke my back occured in September: I somehow aggravated the bulging disc and ended up having to go to the ER to get a shot of morphine and torridol to deal with the pain that literally left me writhing on the floor. I demanded to see a surgeon ASAP. After the spine surgeon evaluated me, he said I should’ve seen him months earlier as my case was severe enough that conservative treatment was never likely to have worked :rolleyes: So, on December 23 I had a microdiscectomy and it was the very best Christmas present I could’ve been given. The surgeon sliced me open and shaved out a bulging disc which was much worse than what the pre-op MRI or X-rays indicated. The relief was nearly immediate (cliche anyone?)…no more sciatica or stabbing back pain, just some lingering numbness in the leg and foot. After a week, I could’ve gone back to work (but I took another week off per doctors orders to allow the incision to fully heal). Three months later, I’d say I’m about 90% back to normal…I still have some numbness in the two small toes of my foot and if I do too much bending or lifting my lower back gets a little sore. The surgeon says that it may be six months to a year post-surgery before I’ll be back to pre-injury status because the nerves went so long being compressed.

Bottom line, I can appreciate the value of avoiding invasive procedures while conservative treatments have a chance of success. But, I should have demanded an evaluation from an orthopedic and/or a neurosurgeon instead of solely relying upon my primary Dr.'s advice, especially after my problem didn’t clear up after six weeks of conservative care. However, my primary physican was blatantly anti-surgery and this was an HMO afterall, so I wonder how far such demands would’ve gotten me that early in the game. I’m particularly peeved that my case had to reach emergency status before a surgeon was allowed to become involved.

Napier, your condition sounds a bit worse than mine was; so make sure you don’t get the run-around like I did and get the straight dope on what all your options are ASAP…I suffered too long because I wasn’t a good enough advocate for my own care. FWIW, my surgeon discussed steroid injections with me, but it was his opinon things weren’t going to just heal on their own with me, their side effects weren’t worth the risk, and that surgery was the best option. It’s too bad your appointment with the surgeon isn’t for another month, so you could actually get his advice before doing the injections.

20

Boy, this can turn out rotten either way, can’t it?

>It’s too bad your appointment with the surgeon isn’t for another month, so you could actually get his advice before doing the injections.

I’m hearing that the injections don’t in any way inhibit our chance to do surgery, so I think the possibility of side effects is the only remaining issue with injections.

I found a paper on the web entitled “Epidural steroid injection for sciatica: An analysis of 526 consecutive cases with measurements and the whistle test” that concludes “93.35% [of patients] achieved excellent to good pain relief… But … 3.46% of this group required surgery later. … It also serves as a method for crisis intervention and as a prognosticator.” This adds votes for the “try injections” option.

I hope I’m doing a good enough job by seeing a surgeon on April 12. This will be under 2.5 months post-injury. This should test the possibility that “my case was severe enough that conservative treatment was never likely to have worked”.