Discectomy or fusion?

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Carl

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Hi there all
New to this forum.
I am having a L5-S1 Micro Discectomy on 23rd this month after having been through injections. Pain is excrutiating from lumbar area going through to my left leg and calf to my foot.
I have a question which some of you may have faced leading up to your op.
I have been reading that a Lumbar Discectomy if for the leg pain as the nerve is freed up by removing disc tissue.

My question is will it help with the back pain I have (which is probably worse than the leg pain).
I have been reading on the web that this kind of surgery is not for back pain but for the sciatica it causes.

I do not want to go through this surgery only to find out that it have fixed the leg pain but the back pain still exists.
Has anyone here been through the same dilemna?


Please if someone can advise I would be very grateful.
Thanks
 
Back pain is not usually caused by compressed nerve.

If the disc is causing your back pain, then the extruded part is not the problem. Problem is inside the disc where painful nerve endings are chemically irritated (chemical imbalance inside the disc).

However, be aware that there are few other sources of back pain, like facet joints, muscles, end plates, etc....
 
Hi thanks for the reply ...I should have added that my MRI showed that I have a failure of the bottom most disc L5-S1 - being a disc prolapse that is bulging back and towards the left side so impinging on the S1 nerve.
I have had:

1) Physio - No help whatsoever
2) Facet Joint Injections & Epidural - No help whatsoever

I can't see how a discectomy will help me having read what I have on them as it is for calf pain. Of course I have calf pain too. But the back pain is the main problem I have. I dont know what I am letting myself in for here. The Consultants secretary said he has chosen the best surgery for me.
Any ideas and thoughts on this?..I dont want to come out of surgery and the leg pain is fixed yet my back pain is still there. (which by the wayt has now kept me off work for nearly 2 months now.
 
If back pain is caused by your disc degeneration, answer for you is called SELECTIVE ENDOSCOPIC DISCECTOMY. Google it.

Regards.
 
Sorry, I didn't mean to create confusion.

There is a huge range of resources on HP and elsewhere who may have something to say on this problem. If you see the choice as between one medical procedure versus another, then you may be missing out on what else there is on offer. This is a complementary therapy forum after all.

I would not be deterred by lack of help from a physio or from more minor operations so far. It doesn't mean you necessarily need a more heroic procedure, it could be that you would benefit from another way of considering the situation. This is what alternative and complementary practitioners excell at. Not all physios are the same, by the way, and certainly not all manual therapies are the same.

I should say that thinking of this as purely a disc problem is in itself limiting. This is not like a worn-out tyre. But it is living tissue, and the whole body works to provide evey living tissue with what it needs. Discs do repair, and if they do not, then they are not occupying a favourable environment.

The favourable environment for a disc is not an operating theatre, it is a place of mechanical ease in the body, where forces are dissipated and not focussed. It offers the right nutrients and regulatory forces, and toxins must be carried away, otherwise it will remain stressed and weakened in spite of any operation.

So this is a whole-body problem, and the keys to success may be some distance from the actual injury.

Lastly, I would recommend you have a browse through the back operation sections of HP and read up on others' experiences - yours is a familiar story already. Surgery has its place, but if you think you have already explored all other options, it is quite likely you have not even begun. It is very frustrating being asked to help a problem after the permanent changes of surgery have taken place, rather than before, but luckily that can still work. So it would still be wise to remain on any waiting lists and prepare for surgery, but keep looking for another way in the meantime.

I hope that is in some way helpful.
 
Got a call back from the consultant and again he says a discectomy is the way to go and he insists that it is also for back pain. This contradicts what is said abt a Discectomy on the internet. So I am going for it. Although half of me is still in doubt. I have not read anywhere that a Discectomy is for back pain but for leg/sciatica.

Your thoughts on this...?
 
A ruptured disc could be very painful, or hardly painful at all. And there can be great pain without any noticeable disc damage. There are other structures that can account for the pain also, the chance of injuring one very deep, tough, disc, without causing strain to ligaments, muscles etc seems remote. So fix the disc and that will prove whether or not the disc was the cause of pain. On the other hand, what was the cause of the disc...? Incidentally, although I am not a spinal expert such as a surgeon, I would think he is right that discectomy is more useful. It seems that a fusion will lead to more loss of function and degeneration in the long run, so worth avoiding that if possible. Perhaps Keano can confirm this idea?
 
Fusion is very rarely indicated in cases with disc herniation (extrusion).

Discectomy is useful, but in 40% of cases it does more harm than good. Unfortunately.

Minimally-invasive treatments like laser and endoscopic surgery should be first line of treatment for most of spinal problems. In 10 years this will be standard - worldwide.
 
hi, i've had 3 discectomys in the last 4 years, 2 in the last 16 months!!! and the problems are still there, i am awaiting another appointment with my consultant, who said last time that the next op would probably be a fusion. what is the quality of life after this op? another question i have is, i have been told that i have a twisted pelvis in 2 directions and was wondering if this would cause my continued back problem as both my GP and consultant both skip round the problem. hope some one can help, i'm close to losing all hope of being better and pain free and am thinking about just trying to get on with it as much as i can
 
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