Has anyone ever had or know someone who has had a Micro Discectomy or Laminectomy?

[nickerjones]

Sorry new thread for a possible new procedure..

See : http://forum.calgarypuck.com/showthread.php?t=118367

well i ended up having 3 shots with the last being the first week in July. The pain is back again. I saw the doctor. They are sending me for a discogram and another MRI. They are saying since the steroids arent having a lasting affect , that surgery is now my option. They said they could try ablation or nerve blocks but they dont usually help with pain going down the leg as intense as mine. They are thinking a laminectomy would probably help me immensely bc a lot of my problem is caused by stenosis. Anyone with experience with these?

[Puppet Guy]

A guy I know through my old job had a laminectomy about ten years ago (this was before I knew him). Aside from being two inches or so shorter than he was before the surgery he's had no ill effects. He's still very active, and pain free.

[nickerjones]

How did he get shorter?

[NuclearFart]

What sort of injections were they - epidural or peri-neural? Also, were they performed using an xray/fluoro machine, or was it just done blindly? Did you attempt core/back muscle exercises during the period of injection relief?

Back surgery (especially discectomy & laminectomy) is HUGE business in the US, and if you actually look at the good quality medical evidence, the true therapeutic benefit is quite poor for the average joe with backpain/sciatica. Even if your MRI shows "severe" narrowing at specific levels, the clinical correlation with pain for that specific anatomic distribution is frequently not there; this is why there is ton of "failed back surgery" in the north american system because 1) they operated at the wrong spot 2) the surgery often doesn't work that great anyways when truly evaluated under evidence based medicine. Further to this, there is a not insignificant chance that the surgery will actually make your pain WORSE from the development of epidural fibrosis (basically rampant scar tissue conglomerating around your spinal cord and nerve roots), which is virtually untreatable. The other problem that occurs is destabilization of your back at the surgical level, which invariably leads to shifting that will then cause worse stenosis. This gets treated with surgical fixation -> which then puts additional mechanical stress on the adjacent disc levels -> which then causes premature disc/facet degeneration creating disc bulging & facet hypertrophy that will then create stenosis at that level -> more surgery....etc.

My medical opinion if you are still young and not debilitated by this, is to optimize non-surgical treatments like injections & back strengthening exercises as long as possible, and only use surgery as a last ditch option if you find your pain is intolerable.

[NuclearFart]

Originally Posted by Puppet Guy

A guy I know through my old job had a laminectomy about ten years ago (this was before I knew him). Aside from being two inches or so shorter than he was before the surgery he's had no ill effects. He's still very active, and pain free.

If your buddy truly lost 2 inches, he didn't have a laminectomy. A laminectomy doesnt remove any the axial load bearing structures.

[nickerjones]

Originally Posted by NuclearFart

What sort of injections were they - epidural or peri-neural? Also, were they performed using an xray/fluoro machine, or was it just done blindly? Did you attempt core/back muscle exercises during the period of injection relief?

Back surgery (especially discectomy & laminectomy) is HUGE business in the US, and if you actually look at the good quality medical evidence, the true therapeutic benefit is quite poor for the average joe with backpain/sciatica. Even if your MRI shows "severe" narrowing at specific levels, the clinical correlation with pain for that specific anatomic distribution is frequently not there; this is why there is ton of "failed back surgery" in the north american system because 1) they operated at the wrong spot 2) the surgery often doesn't work that great anyways when truly evaluated under evidence based medicine. Further to this, there is a not insignificant chance that the surgery will actually make your pain WORSE from the development of epidural fibrosis (basically rampant scar tissue conglomerating around your spinal cord and nerve roots), which is virtually untreatable. The other problem that occurs is destabilization of your back at the surgical level, which invariably leads to shifting that will then cause worse stenosis. This gets treated with surgical fixation -> which then puts additional mechanical stress on the adjacent disc levels -> which then causes premature disc/facet degeneration creating disc bulging & facet hypertrophy that will then create stenosis at that level -> more surgery....etc.

My medical opinion if you are still young and not debilitated by this, is to optimize non-surgical treatments like injections & back strengthening exercises as long as possible, and only use surgery as a last ditch option if you find your pain is intolerable.

The shots were epidural with a fluro machine.
I had 4 in summer of 2010 and the pain was gone until Jan of 2012. I have 3 in Jan/Feb of this year. It knocked out the pain til June. The pain came back so bad in June that I was in bed for 3 weeks. I had 3 shots in June/July and the pain was gone until last week. I did physical therapy and exercises as well. Im a self contract employee and when I am stuck in bed I am not getting paid. Then my brokerage has to hire someone else to do my job and that could potentially lead to the broker not giving me anymore work when Im better.

The pain mgmt doctor doesnt do surgeries so he isnt pushing me into just doing surgery bc he wants to do it. I dont know what other choices I have. The doc said he could do nerve blocks or ablation but they usually dont help people with the amount of severe pain in my leg. Also they dont want to go in blind but said it looks like I need a laminectomy. They are going to do a discogram first to find out exactly which vertebrae is causing my pain.

[NuclearFart]

Originally Posted by fotze

I had a ballsectomy.

Did you hang em' off your truck hitch?

[NuclearFart]

Sounds like a challenging position to be in. If you do consider surgery a discogram may help localize the back pain - provided they do it properly with a "control level", but you should know that 5+ year follow ups on discogram patients has shown accelerated disc degeneration. The other thing to consider before surgery is having an upright MRI or upright myelogram performed. Imaging while having the spine under gravity has shown good promise in helping to identify the problem level of clinically relevant spinal stenosis - the presumed cause of your leg pain.

[nickerjones]

Originally Posted by NuclearFart

Sounds like a challenging position to be in. If you do consider surgery a discogram may help localize the back pain - provided they do it properly with a "control level", but you should know that 5+ year follow ups on discogram patients has shown accelerated disc degeneration. The other thing to consider before surgery is having an upright MRI or upright myelogram performed. Imaging while having the spine under gravity has shown good promise in helping to identify the problem level of clinically relevant spinal stenosis - the presumed cause of your leg pain.

I also have disc herniations. However how do I have a standing MRI if Im in so much pain I cant stand for more than a minute at a time ?

[NuclearFart]

A lumbar MRI can be done in 20 minutes, you honestly can't stand upright for that long? Get an injection before hand or wait for the pain flare up to die down a bit.

Also, are you fit? Loosing weight can work wonders for back pain that is worse with gravity.

[EVERLAST]

Conan used to order these things all the time remember?......"Crush your enemies , drive them before you and to hear the lamentations of the women"!

[nickerjones]

Originally Posted by NuclearFart

A lumbar MRI can be done in 20 minutes, you honestly can't stand upright for that long? Get an injection before hand or wait for the pain flare up to die down a bit.

Also, are you fit? Loosing weight can work wonders for back pain that is worse with gravity.

Since my back problems started I have gained almost 40lbs. I know that getting fit is something that would help but when all I can do is lay around its tough to go back to exercising and trying to play hockey to lose weight.

and no I can not stand up for that long. When I was bed ridden for 3 weeks. A walk from bed to the toilet when pretty much brought me to tears. The pain from my knee to my ankle on the outside of the leg is seriously unbearable. Now I can stand up and make it but the pain is getting worse. It's not only when im standing. The pain is also worse when sitting.

[EVERLAST]

Genuinely sorry to hear about your pain ...I hope they discover how to alleviate your pain and get you back to what you call normal . The amount of suffering you are describing sounds and likely is horrible and for that I really really hope some relief will come soon for you.

Keith

[Sliver]

Yeah that sucks major balls, nicker. Best of luck with this.

[meanmachine13]

Originally Posted by nickerjones

I also have disc herniations. However how do I have a standing MRI if Im in so much pain I cant stand for more than a minute at a time ?

I had a regular (lying down) MRI, even though I couldnt lie on my back AT ALL.

The MRI techs placed so many pillows and elevated various parts of my back/legs until I was able to keep the pain bearable.

You are likely not the first person they have dealt with that is in pain and they will be understanding and do everything they can to help you. I would call ahead and inform them so they can have extra items/time to help you.

[nickerjones]

Originally Posted by meanmachine13

I had a regular (lying down) MRI, even though I couldnt lie on my back AT ALL.

The MRI techs placed so many pillows and elevated various parts of my back/legs until I was able to keep the pain bearable.

You are likely not the first person they have dealt with that is in pain and they will be understanding and do everything they can to help you. I would call ahead and inform them so they can have extra items/time to help you.

That sounds like a good idea. My last MRI was an open air one. I just can not stand being in a tube. When i was playing college ball , I tore my labrum in 3 places. I was in the tube for over an hour and freaked out.

Anyway I dunno what they would do for my pain. Like I said... Even standing up now is a chore. If I stand up and walk to the bathroom and come back there is a 20 min bout with unbearable pain in my butt and down my leg. All I can do is writhe in pain and quite occasionally it brings tears to my eyes. It is quite severe and I havent found anything to abate it other than time passing.

Originally Posted by NuclearFart

My medical opinion if you are still young and not debilitated by this, is to optimize non-surgical treatments like injections & back strengthening exercises as long as possible, and only use surgery as a last ditch option if you find your pain is intolerable.

As you can read up there my pain is quite debilitating. I am bed ridden now. To be honest I dread even getting up to do the most mundane things such as the bathroom. I seriously dont know how I will even get out to go to the doctor's office to take the tests. That's how bad the pain is. The worst part is Im a self contractor for work. I cant work so I cant get paid. I just came off a 2 month lull in work because of my back.

As for your medical opinion what do you suggest for meds?
I am taking the muscle relaxer Tinzanadine. I was taking Morphine but it didnt do to much for me. I am now taking OXY IR.(These are not working) I tried a Medirol Dose pack starting yesterday but it hasnt eased any of the pain. I take Gabepentin but only 300MG 3 times a day. I know people who take 2700 MG a day but my insurance will only give me 3 pills a day. I also have MOBIC but havent taken it bc the doctors does procedures or tests on Tuesdays and Fridays and Im hoping they can put me in Tuesday. Usually you cant have other NSAIDs 5 days prior.

[GrrlGoalie33]

Wow Nick. I didn't know things were that bad. Chin up bud, and I hope things get seriously better for you fast.

K.

[TheSutterDynasty]

Originally Posted by nickerjones

Anyway I dunno what they would do for my pain. Like I said... Even standing up now is a chore. If I stand up and walk to the bathroom and come back there is a 20 min bout with unbearable pain in my butt and down my leg. All I can do is writhe in pain and quite occasionally it brings tears to my eyes. It is quite severe and I havent found anything to abate it other than time passing.

Have you ever seen or talked to anyone about chronic pain syndrome?

[nickerjones]

Originally Posted by TheSutterDynasty

Have you ever seen or talked to anyone about chronic pain syndrome?

No, the pain was alleviated with the shots. The first time for 18 mos. The 2nd time for 5 months, and this last time for 1 month. I can always ask I suppose. I would just like to end this problem and get on with my life.

[nickerjones]

I have been scheduled for another MRI on Wed and then a Discogram on Friday. I have been in the same place all day today. This week is going to be HELL!