two level fusion VS microdiscectomy

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john40w

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Hi I'm new to this board and have a few questions? I hurt my back at work moving a heavy object with someone the result was two herniated disk on my L4 and l5
s1 the bulge on the disks are 8mm and 7mm and have a constant pain on my left ass cheek. I saw two doctors this week the first said he would do a microdiscectomy me i asked about a epidural injection he said he doesn't do those. I didn't get a good vibe from this doctor. So i went to another surgeon who dose epidural he looked at my MRI and said i was messed up I did some tests on me. He told me i needed a double fusion If the epidural doesn't work. He told me i have lost Half function in my right leg about a third function in my right leg. I asked about a microdiscectomy

he said my disks were so budging that it would lead to degenerated disk in a couple years and wouldn't do that surgery. I got a better vibe off this doctor he seemed to be honest. I was hoping to get any input on what i should do. my feet are swelling up is that related the first doctor said no the second said yes. also if i wait to get the operation could i lose total function of a leg? I'm getting a epidural in a couple of weeks the second Doctor wanted to try that first even though he doesn't think it will work . how successful are they? please help thanks
 
I do agree with paying attention to the vibe you get and the gut feelings that you have when seeing a doctor. I've had two times in my life when I just knew the doctor I was seeing was not right, and I let one work on my knee and he did my ACL surgery backwarRAB. It took another surgeon 2 procedures to fix it.

My concern with microdiscectomies is sometimes they seem to be going after the symptoms and not the cause. And sometimes it seems that they can lead to more instability in the spine. This isn't always the case, as there are some good candidates for microdiscectomies out there. It sounRAB like the second surgeon is looking at the whole picture, not just the immediate symptoms, but the overall health of your spine.

I agree with trying the epidurals. Many insurance companies are looking to see that non surgical treatments are tried first before moving toward surgery. For my neck, ESI's worked for nearly 2 years. When they stopped working I had to have ACDF (cervial fusion).

For my back I also tried ESI and had no luck. They also tried RFA (nerve ablation) and that did not work. I went out of work in May of 09 and didn't have my surgery until 2/10. The reason again came to a vibe from a doctor. I went to see my neck surgeon in June 09 and the vibe I got was that he was totally disinterested in my back and even me. I had to work on finding another doctor and immediatley upon meeting him both my husband and I felt the good gut feeling that this guy was good. He had me go through PT, did CT myelogram, etc and he found the cause and did the fix.
 
I did the epdiural shot and It did nothing at all. I am having surgery on the 9th and have been in constant pain for 10months. If the doc is suggesting surgery for u do it :)
 
Sorry you are having nerve pain I do not wish that on my enemies. I had 3 lamis on my L5S1, had a foot drop the first time. My dr at the time said they would solve the problem. I should not have had 3 on the same disc, got other opinions when disc herniated 4th time. My opinion is that my joint became more in stable after each lami. I went to see 5 doctors and 4 said fusion was my only option. Before fusion I had 2 shots given sideways into my disc(epidural cortisone given by pain medicine dr) The first shot went in fine and that night I felt a throbbing ache, it took about a week to feel some relief. Got a second shot same way and 2 weeks later was off all pain meRAB and pain free. Was going to wait to do a fusion but I teach so had to do it to recover b4 sept. I had an EMG to study how damaged my nerves were and the dr said to prevent more damage I needed to have a fusion. The longer the disc sits/pushes on the nerve(your butt pain) the more damage is done to the nerve. The shot can shrink the swelling but you can not have more then 3 in one year. Shots and PT are good options if they work, just know they might be temporary (months or years) to fend off pain but if instability is there it may reherniate.

You need to do what is best for you. Seek several opinions from different doctors neuro and ortho spine surgeons if you have access to them.
hope this helps
 
In most cases you can do 2 "sets" of ESI per year, on set every 6 months. A set is 1 shot every 2-3 weeks. Once that "set" enRAB you can do it again in 6 months. And, in cases where the ESI are working well sometimes they'll allow it a bit more often.

And it's so true that when the spine becomes unstable, be it from the initial disc problem, or subsequent to any treatments or as time goes by, a fusion is the only procedure that will stabilize the spine.
 
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