Anyone here ever have a lumbar microdiscectomy?
June 30, 2005 12:47 PM Subscribe
Anyone here ever have a lumbar microdiscectomy?
Did it work? What was recovery like? Was it worth it?
Did it work? What was recovery like? Was it worth it?
I had one on L5-S1. Recovery was about 3 weeks of flat-on-my-back-nothing (except for physical therapy and occupational therapy 3x week). Then I was still in PT and OT but I was able to sit up for a few hours at a time. I went back to work (desk job) part time after 6 weeks, and then back to work full time 4 weeks after that. I would say I was "100%" within 6 months after my surgery date. At the time, I lived alone, so recuperating was a gut-wrenching nightmare (I lived on the 2nd floor of a two flat and have a dog that needed to be walked; I had a friend who voluteered to help out for a while but after about a week I was on my own. It was a real shitter.)
I had no problems -- not even a twinge -- for 3 years. Then I became one of the 5-10% that have recurrence of pain. It now "goes out" about 1x/year (to the point of needing a blisterpack of steroids and painkillers) and I have stiffness and twinges every day. I manage my day-to-day pain with Aleve (2-3 pills over a day) and ice.
My dr. has said we could do the surgery again, but my memories of the recuperation process have thus far prevented me from exploring it. The pain I have now is nowhere near where it was before I had surgery (save for those occasions when I end up on steroids) so I am managing. And it also may not even solve the problem.
Recommendations: Make sure you have someone who can be at your beck and call for about 2 solid weeks. I didn't need help using the bathroom, but I did need help getting to the bathroom; it's pretty impossible to cook or clean for yourself; and someone else should be walking the dog for those first couple of weeks. Also make sure you do the physical therapy -- no matter what it is -- and continue to do it long after you feel better. I pretty much can pinpoint the recurrence of my back problems with the cessation of doing the exercises. Hydration is important.
One neat thing: My phys. therapist told me it was important to massage my scar once it was healed over. He encouraged me to "rub it till it pops like bubble wrap" because that ensured it to become a smaller, smoother scar. My scar is pretty small and flat (a little pink, but it is fading), and I don't know if the rubbing helped that, but one day after 3-4 weeks it did pop loudly like bubble wrap. Which was creepy, yet also cool. If you're into weird stuff like that.
posted by macadamiaranch at 2:38 PM on June 30, 2005
I had no problems -- not even a twinge -- for 3 years. Then I became one of the 5-10% that have recurrence of pain. It now "goes out" about 1x/year (to the point of needing a blisterpack of steroids and painkillers) and I have stiffness and twinges every day. I manage my day-to-day pain with Aleve (2-3 pills over a day) and ice.
My dr. has said we could do the surgery again, but my memories of the recuperation process have thus far prevented me from exploring it. The pain I have now is nowhere near where it was before I had surgery (save for those occasions when I end up on steroids) so I am managing. And it also may not even solve the problem.
Recommendations: Make sure you have someone who can be at your beck and call for about 2 solid weeks. I didn't need help using the bathroom, but I did need help getting to the bathroom; it's pretty impossible to cook or clean for yourself; and someone else should be walking the dog for those first couple of weeks. Also make sure you do the physical therapy -- no matter what it is -- and continue to do it long after you feel better. I pretty much can pinpoint the recurrence of my back problems with the cessation of doing the exercises. Hydration is important.
One neat thing: My phys. therapist told me it was important to massage my scar once it was healed over. He encouraged me to "rub it till it pops like bubble wrap" because that ensured it to become a smaller, smoother scar. My scar is pretty small and flat (a little pink, but it is fading), and I don't know if the rubbing helped that, but one day after 3-4 weeks it did pop loudly like bubble wrap. Which was creepy, yet also cool. If you're into weird stuff like that.
posted by macadamiaranch at 2:38 PM on June 30, 2005
I had no problems -- not even a twinge -- for 3 years. Then I became one of the 5-10% that have recurrence of pain.
Depending on where you look, the figure is as high as 79% in good studies. 5-10% is an underestimate in any neurology clinic I've ever been to, but it's pretty typical figure to hear from a surgeon - how many surgeons do you know who spend clinic days doing long term followup and management for back pain? 5-10% is probably the failures they hear about.
Anyway, this makes me reluctant to recommend discectomy unless clear indications are met which are too complex to go into here. But, when the indications are in place, all other things being equal I'd prefer my patients to have microdiscectomies instead of the traditional open discectomy - less wound pain, faster recovery, faster return-to-function, less adhesions (as a profession we're deeply divided over what role, if any, postoperative adhesions play in 'failed back' syndrome.)
Whether to have an operation or not is something I'll discuss only in my clinic office after a history, exam, and review of the films and EMG studies. But I hope the above was useful anyway.
posted by ikkyu2 at 3:52 PM on June 30, 2005
Depending on where you look, the figure is as high as 79% in good studies. 5-10% is an underestimate in any neurology clinic I've ever been to, but it's pretty typical figure to hear from a surgeon - how many surgeons do you know who spend clinic days doing long term followup and management for back pain? 5-10% is probably the failures they hear about.
Anyway, this makes me reluctant to recommend discectomy unless clear indications are met which are too complex to go into here. But, when the indications are in place, all other things being equal I'd prefer my patients to have microdiscectomies instead of the traditional open discectomy - less wound pain, faster recovery, faster return-to-function, less adhesions (as a profession we're deeply divided over what role, if any, postoperative adhesions play in 'failed back' syndrome.)
Whether to have an operation or not is something I'll discuss only in my clinic office after a history, exam, and review of the films and EMG studies. But I hope the above was useful anyway.
posted by ikkyu2 at 3:52 PM on June 30, 2005
I had a traditional laminectomy 20+ years ago--excellent results and no subsequent problems--I had a severe herniation (had lost all deep reflexes left leg)--I bicycled from Toledo Ohio to NY seven weeks post op--I think the secret is good post op care first 72 hours, faithful adherence to life long program to strengthen back and abdominal muscle (I worked with an exercise physiologist) and maintain reasonable weight--overweight/obesity wrecks havoc with body mechanics--good luck
posted by rmhsinc at 7:29 PM on June 30, 2005
posted by rmhsinc at 7:29 PM on June 30, 2005
This thread is closed to new comments.
The followup went well, and the scar healed down to about an inch from its original 4. It's been about 4 years since, and I still get pins and needles on occasion down my left leg, but no true pain. If I get dehydrated, it will start to twinge a little bit, and I've only had one visit back to the doctor for pain, which turned out to be extreme dehydration. I got some valium (Apparently it's a muscle relaxant) and was sent home, and it was good before the day was over. You're welcome to email me if you'd like.
There's a new procedure where the excised matter is replaced with a supportive foam of some sort that's supposed to improve the cushioning of the disc (better than natural support in some cases) that I might have held out for, but I don't know how prevalent it is. Having the surgery when I did was worth it, and I might have had it sooner if it had been presented as an option.
posted by boo_radley at 1:36 PM on June 30, 2005