long term results after lumbar laminectomy?
 

Hello,

I am contemplating having a semi-lumbar laminectomy done and wanted to know if anyone else has had this done and if so what have been your long term results.

Just a brief disagnosis and why i am so hesitant to go through with surgery...

August 2005 was in a major head on motor vehicle collision...

MRI in 2006 showed L4-5 extrusion measuring 9mm x 26mm, moderate loss of disc height at L5-S1 small tear and mild bulging of disc

MRI in 2007 showed L4-5 extrustion measuring 11mm x 30mm, severe loss of disc height and spinal canal reduction of 50% at largest part of extrusion (the L4-5 disc extends down over the body of the L-5 vertebrae)

EMG shows L5-S1 radiculopathy

After the first MRI i was told by several doctors that these things can heal themselves given time. I believe in natural healing and so i continued on with PT (4 rounds of it- including a Mackenzie specialist) also did chiro, TENS, and later gave into pain meds, muscle relaxers, etc... when the pain got too much to bear- but i can't function on them, so i don't take anything but Aleve, later went to an orthopeadic dr. where i tried epidural steroid injections, first one helped, but the next three did nothing...

a month ago finally saw a surgeon, older fellow who did my grandma's spinal fusion over 20 years ago... he said time for surgery. wouldn't give me an answer on the chances of additional surgeries down the road- in fact he ripped into me about waiting so long to see a surgeon. (no way in hell i would have him operate on me- he couldn;t even answer my questions, just told me that he has done over 10,000 surgeries, he KNOWS what he is doing...)

i decided to do a little research and found a much younger surgeon who was recently brought to the same hospital that the above surgeon works out of. he was brough here because he specializes in a less invasive procedure) schedule and appointment with him and he was FANTASTIC! he spent a long time talking with me about the pro's and con's of surgery, mentioned that in my case there is a 70-80% chance that i will end up having a fusion in the future if i do have a laminectomy- due to the fact the extrusion is so large, there isn't much of a disc left between vertebrae. all makes great sense.

the second surgeon also sent me to a rehabilitation dr with Mary Freebed and he ended up telling me there was nothing he could do - he said that i should probably really consider surgery...

i am deathly afraid of the idea of having to go through a fusion later down the road, but also am just so sick of the chronic pain etc...

i am 34, a single mother and self employed as a photographer. i just am so perplexed and really want to hear what others have to say- especially those who have gone through a laminectomy... how are you today? what results did you have? was it worth it?

_thanks much!
Theresa

I had a micro-disectomy/laminectomy in 2001. I had a a huge herniation, at L4/L5, and tried conservative treatment for a year (because my insurance wouldn't even let me go to a surgeon until after trying all that). When I finally saw a neurosurgeon, he said that I should have had surgery within 3 months of symptoms starting, because I probably had permanent nerve damage, but he thought the surgery would help with the severe sciatica and occasional leg numbness I was experiencing. He was right, I had immediate relief from the pain, but the numbness persisted (and has to this day.) I have had one relapse (more herniation at the same place, plus scar tissue complicating things), but that was helped by steroid injections, and the surgeon I saw that time didn't recommend another operation (and in this case, it would be fusion) until I get to the point where I am not able to walk relatively normally. I was tested by a neurologist, and found to have permanent nerve damage (I have a partially numb foot and leg, but it's much more tolerable than the pain of sciatica.) This surgeon also told me that had he been the original surgeon I saw, he would have recommended fusion at that point.

You could also look into a surgeon who works with artificial disks, to see if that is a possibility for you. Once you've had the laminectomy, that is likely not an option (or so I've been told).

You're very young and will likely heal quickly, so I'd seriously consider the surgery. If you have a minimally invasive procedure, you won't be out of commission for very long (I was traveling 3 months after my micro-disectomy/laminectomy). Since it looks like your herniation is growing, you should probably get something done. Just don't do any lifting for a long time afterwards. If you've got a young child, it could be difficult, but an elementary school child should understand and be able to help even. Or hire a cleaning service. (I couldn't vacuum for a good 6 months after my surgery.)

Was it worth it? I'd say yes. Although I'll never be 100%, I'm much better now.

exactly what i was looking for...
 

indeed-
same situation as this is from a car accident, i have tried everything at least once...

i completely understand the numbness, and sometimes tripping over my own foot, but i can deal with that, my main concern is the pain. after a year and a half of some days not being able to get out of bed, interrupted sleep, and a complete change in lifestyle (20lb weight gain due to physical inactivity) i am ready to move forward but highly concerned about the long term effects of the laminectomy.

i luckly have a teen age daughter who is so understanding and luckily i landed a part time job recently where i can work from home doing lead processing. i think the time may be now...

if you have any other input- or suggestions, i am game...
Thanks so much!
-Theresa

As I said, when I was in your situation I went for the surgery, and it really did help. The long term issues to think about are spinal stability, as in a laminectomy they are removing bone. Because of that you won't be an ADR candidate at that level later if you're interested in that possibility. However, the ADR surgery is a much more invasive surgery than a micro laminectomy.

The micro laminectomy is a relatively short surgery, and I was in the hospital just one night, and out of work for 3 weeks total. Since you've got a helpful teen at home, you should be able to cope just fine.

Good luck in your decision.