next steps?
 

Been awhile since I've posted, last set of problems in 2005.

What I've got...in 2000 had a laminectomy and diskectomy on L4-L5 due to large herniation. That solved the intense leg pain, and I went through back strenthening exercises and got better. 5 years later, had a relapse, doc did an ESI, and I actually ended up in pain management because that little shot put me in the hospital on morphine. Symptoms started again this april. Had an MRI, was prescribed prednisone, gabipentin, and PT. Neurosurgeon did not sound promising about a surgical fix. Then symptoms were worse recently. Missed a full week of work and was only able to work half time last week. Couldn't get into see the neurosurgeon, but say my PCP and a physiatrist who did two ESIs...at L5 and S1. He said I had a lot of bony bits (trying to fuse myself apparently), and seemed surprised the neurosurgeon wasn't talking surgery. I go back to PT on Friday. So far, shots were 5 hours ago,doing better, but lidocaine still in system. I have a followup with the physiatrist in 2 weeks....should I make one with the neurosurgeon to ask about the physiatrist's fusion comment.Bottom line, I'm in my mid 50s and tired of hurting. If there's something safe and effective and that would prevent yet another occurrence, I'm all for it. Or, should I find an orthopedic surgeon? Tonight, I'm just hoping for some painfree sleep thanks to the lidocaine.

Kay

Hello. I hope you were able to get some "good" sleep in. I understand how those long sleepless nights go. BTDT (been there done that) and still doing it.

I would see an orthopedic doc if it were me. It may not be a revision you need. It could be the hardware needs looked at (assuming you had plate put in for stabilization until fusing occurred) It could be something totally unrelated to your prior surgery. Never know unless you go and get it looked at.

Nothing to loose by going and having it checked out and could be the doc will have some answers and maybe a treatment option or two for you. I do wish you the best of luck and hope you get some relief soon.

Hang in there Kay. Gentle hugs. (((hugs)))

Thanks for the good wishes. My previous surgery involved no hardware, just removal of bone and herniated part of the disk. PT is helping, and the ESI did move the pain lower into my calf, so it's actually easier to walk. I go back to the physiatrist next weeks, and finally got a consult appointment with a neurosurgery practice in 3 weeks. It's still hard to do a full day at work, but I've acquired a desk that adjusts from sitting to standing, and that makes a huge difference (since sitting is the most painful). I'll ask my PCP for an ortho specialist recommendation too. It seems like multiple opinions may be a good thing. What I really need is a lumbar spine replacement...too bad they don't actually exist.

Kay

update and a question
 

I've been through more tests (bending xrays, emg), more steroids, PT, and have been back to the neurosurgeon. I've not had the intense pain recently, but have lower leg numbness and weakness. The surgeon was more concerned about the weakness, and has recommended a diskectomy done as an outpatient procedure. Has anyone here had a second diskectomy done at the same level? Am I just looking at more trouble?

Thanks,

Kay

I would get a 2nd neurosurgeon opinion, but I agree that successive diskectomies lose effectiveness. Since it's at L5-S1 and your body is trying to fuse, why wouldn't they consider a one-level fusion? You lose very little mobility with a fusion that low, and motor nerve involvement is nothing to fool around with. Good luck!

The doctor doesn't want to do a single level fusion because I've got scoliosis as well, and most of the curvature is in the lumbar spine. He's concerned that a single level fusion would start off a domino effect of more back problems. He wants to try the minimally invasive procedure first, then more PT, and if that doesn't work, then I'd need a multi level fusion and lots of time off work. They claim this can be done as an out patient procedure, and I could even drive the next day. I'll give a report on that when it's done.

Kay

just back from surgery
 

I'm amazed at current surgical techniques. I had a laminectomy in 2001, and was in the hospital for 2 days following. I just had revision surgery on the same level today, and it was done as outpatient (at the hospital). Surgery took an hour, and included a nerve monitoring procedure that I'm pretty sure didn't exist in 2001, a very small incision, and no stitches. Although my back hurts a bit (and I'm taking a fairly strong pain meds and muscle relaxant, I was up and walking within an hour after waking up from anesthesia, my leg pain and foot numbness is gone, and I'm home. I'll not got to work for 3 days, but after I'm off the pain meds am cleared to drive, and am not supposed to sit for too long, so will make good use of my new adjustable sit to stand desk. The exam after surgery indicated that my leg strength has returned (after unpinching the nerve at l4/l5) There's still the possibility of additional instability (I've got scoliosis, and that was a concern), that will be monitored, but I'm happy so far.

So, good luck to all of you on this board, and have a wonderful holiday season.

Kay

laminectomy and fusion L4L5
 

I'm doing better, I had a laminectomy and fusion done minimally evasive. Three weeks out and my legs have no nerve pain and my back is feeling great if I wear my brace. I see surgeon on Tue next week so he will let me know how I am doing. I will let you know too.