Help,please, with back decision
 

This is my first posting. I'm confused and thought I would seek some advice. About 8 months ago, I began to develop numbness and pain in the right foot. It gradually extended up the leg to the buttocks. To make a long story short(podiatrist,physical medicine doctors,physical therapy, chiropractor, epidurals,pain drugs, accupuncture!), the bottom line is that my mri's show L4-L5, L5-S1 and L3-L4 anomalies that coincide with the symptoms. I am able to manage. The pain is never sharp, but it is very annoying and increasingly continuous. Two surgeons, at major centers, say it is a common stenosis problem ie a mix of hemilaminotomies, foraminotomies and partial medial facetectomies(all of which would preserve the left side and central spine structures) have an 80 to 90 % chance of relieving the symptoms with "only" a 2% chance of destabilizing problems and a less than 1% serious complication chance. One says that I should do it relatively soon and the other says waiting will do no harm. I can manage ok on 1-3,50 mg tramadols a day, but I'm uncomfortable and it's beginning to affect the way I live and think. Should I go ahead?? One surgeon says it would involve an overnight hospital stay and two weeks at home without driving. The second says that he would do it with microsurgery on an out-patient basis with 5 or so days at home. The latter sounds a lot let invasive. Has anyone had these procedures? What were they like?? Thanks for any comments.
Alan

Hello Alan:

If I were you - a decision like this is a major decision. If I were you I would do the following:

1. Fill out an Oswestry disability Index questionaire
2. A Roland Morris questionaire
3. List the pros and cons of surgery
4. Quality of life

Review all your answers and then make your decision. I have opted against surgery. It was a personal decision. Maybe because my doctors want to be a bit more envasive, i.e: Lumbar Fusion, Laminectomy, and disk replacement.

The internet is a wonderful place to research this type of surgery's pros and cons.

I wonder why other than what you listed your doctors have not followed the guidelines for "Conservative Therapy" other than medicine.

Are you undergoing physical therapy, massage, exercise's such as stretching, heat/ice therapies or even an anti-inflammatory diet?

I have lived with my back injury and degeneration for 11 years now, and still cope without the surgery.

Good luck

Alan,

I answered you on another board with this post and thought I would post this here as well so you would see it here too....

First, almost all surgery is elective, unless you are in a life threatening situation...I had a sinus infection with a lesion going to my brain, that was life threatening...It was still elective surgery...that said...I think you need to do some homework and then think about how "you" feel...not about how I feel or anyone else on this forum feels about your surgery. This is a life altering experience for you. Many of us have been through this and some have had good experiences and some have not...Most of those with the good experiences are not on this board, unfortunately...They are out playing golf today..so please note that...

My husband has a business that gets him into the homes of many, many people...and I know there are many, many successful spinal surgeries, both lumbar and cervical...and thoracic...so you have to do your homework...

First, you need to find the absolute best spinal surgeon in your area. If that means driving 100 miles to a teaching institution to find one then you get in the car and drive. Spinal surgery is not anything to sneeze at. You need the best surgeon possible..If they screw up, you will pay for it forever. I saw surgeons into the double digits before I allowed surgery...but I have cervical and lumbar problems...

Your problems seem as though they are nerve related. If nerve damage sets in, it will last a life time. Nerve pain is very painful and is difficult to treat, if not impossible in some cases.

Facetectomy: An operation to remove part of the facet. To prevent a degenerated facet from pinching a nerve.

Foraminotomy: An operation to make the foramen larger. To provide more space for the nerves and blood vessels

Laminectomy: An operation to remove the lamina. The purpose is to allow more room for the spinal cord and nerves.

Laminotomy: An operation to remove part of the lamina. This is done to allow more room for the spinal cord and nerves. Hemilaminotomy means they will remove part (half) of the lamina...in your case the left side, I think.

I am posting some pictures of hemilaminotomies, foraminotomies and partial medial facetectomies...

I hope this helps you understand what will be happening to you....These procedures do not always help in all cases, but are used to give space and ease stenosis...It sometimes only lasts for a few years. My friend's husband just had a laminectomy done by a top doc and he is out golfing this year...Wise? Maybe, maybe not...It might force him back to the operating table sooner than he might want to be...but I have a friend with a thoracic fusion that has golfed for ten years now...We are all different in how we recoup from these surgeries..

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