Sciatic pain following laminectomy/discectomy

[WestHighland]

Hi there,
I've posted before about my situation, but have a specific question for everyone about sciatic leg pain.
I had a discectomy/laminectomy in August 2009, and was diagnosed with an annular tear in January 2010. I have a lot of sciatic twinges in my thigh area and at the back of my left knee, and numbness/pins and needles in my left foot.
My surgeon is suggesting that if the pain doesn't go away by August 2010, I should consider an artificial disc, which I'm not at all keen on. Does anyone have any advice about whether I should just wait it out, or try any other procedures?
A lot of the procedures recommended on this site - nerve fusion etc - aren't available in the UK unfortunately, so I'm left with the choice of continued sciatic pain; more steriod epidurals (which don't help - I've already had two); or the artificial disc (or bone fusion).
Thanks all.
WH

[Maria]

I'd try getting a few more qualified opinions to say the very least before going back into surgery again. What makes your surgeon suggest ADR in terms of diagnostics?

Sometimes it's time that helps with certain situations unless there is something there diagnostically that indicates definately more surgery. Even sometimes when there are things that could be addressed surgically as evidenced by diagnostics pointing to pain generators time can be beneficial in terms of alleviation of pain or at least lessening of pain.

[dshobbies]

WH,

Though a disco/lami is a good idea before trying something far more invasive, it's success rate isn't great. I do wish doctors would offer the statistics before surgery so you are aware of your success odds prior to cutting. Having said that, my mind tells me your doctor wasn't as thorough as he good have been, which doesn't make it so. I have found many spinal doctors are self serving (to put it nicely).

Regardless, you should get a second and perhaps a third opinion before deciding on your next course of action. You obviously still have some spinal cord involvement with whatever's going on and further testing is a good idea. More and more doctors are performing ADR surgery as it becomes a respected alternative to fusion but experience is still the name of that game. I'd look for a heavy hitter and ask questions until you're satisfied with your own understanding.

You may need an ADR but it is not an easy surgery. Certainly less invasive procedures are the way to go but not always successful. BUT ADR surgery is no guarantee either. This decision should not be entered into lightly. Most of us waited until we were on heavy meds and had no lives left.

You should also know that too many of us had to pay for this ourselves. If that's viable, you might want to consider getting opinions from Germany.

Good luck, Dale

[WestHighland]

Thanks Maria and Dale,

I'm not sure why the surgeon is jumping to the artificial disc route, but he is a specialist in this area, and has pioneered a new kind of disc with a ball in the middle to make movement easier (according to the literature).

Having said this, he only performed the discectomy/laminectomy last year because I literally couldn't move: I was operated on in emergency circumstances because the surgeon thought I might lose bladder function without the surgery.

I will definitely take your advice, Maria, and wait it out. I find the waiting hard only because I'm never sure whether I'm improving or getting worse, as the pain can get better for a few days, and then worsen considerably for a period.

Thanks again for your replies - I appreciate them very much.

WH

[wilsonrob]

Have you tried any injections to calm things down?

[WestHighland]

Thanks - I have had two steroid epidurals, which take about 2 weeks to work, but then have only relieved the pain for a week.

I'm hoping time will be the healer here...

[kelly from ontario]

hi.I am in the same situation.off work since 2008 with annular tear.mark is consulting with dr.Yeung in pheonix on my behalf to see what he may be able to do for me.i have had 4 epidural cortisone and increased pain meds.have lower back pain and an electric currant that runs down back of my legs in to both feet.pain different every day and sometimes get a break for 4-5 days then its back with a vengence.also may have adr.whatever it takes to make me better and i can have a life again.
kelly

[Crystal33]

If you are having "some" good days that is a good sign. For some, improvement has been slow but genuine over a period of years.
Is the annular tear in a different disk to the operated disc?
Unless only a migrated disc fragment is removed, discectomies purposely create an anular defect that is not repaired by most surgeons and may never heal.

There are emerging methods (link below) for sealing anular defects that you could consider ahead of major surgery.

http://www.ispine.org/forum/ispine/1...reatments.html

[nomorepain]

i had a lamo way back in 1979, however the surgery never relieved anything, in fact i felt worse after that surgery. my surgeon said i would be in for many more surgeries and most likely fusion. although i held off for almost 30 yrs, my ADR surgery was for me the best thing i have ever done. So to wait it out, i am not sure that is a good idea. you should maybe get another opinion, as it seems a lil strange that your Doc is recommending ADR as your solution, but it's definetly worth checking out with the right Doc.

[kelly from ontario]

hi
i recently had mark (thru global patient network) introduce me to dr zeegers who works out of beta klinik in bonn germany , and he feels a adr would be the most effective way to deal with my annular tear.at this time i am able to move better than i have in 2 years and i did tell him this.he did say that the body can heal and he hopes it lasts but will be available if i dont stay pain free.i am so relieved to finally have a solution after being off work x 17 months.will keep you posted.
kelly from ontario

[mmglobal]

I had microdiscectomy / laminotomies in 2000 and 2001. Leg pain was mostly resolved by ADR surgery in 2002. Still mostly gone.

Mark

[Maria]

WH,
the only thing with waiting it out and wait and see type of mentality is to know when waiting it out time is over and action time is now .. that is an individual choice once reputable recommendations are given/obtained.

Now I must tell you that even tho I have waited it out.. I rather over waited it out re being able to do anything like ADR surgery as my facets are now shot per my OSS at the levels I would have had ADR and I've had lumbar osteoporosis for a while now.

Currently I'm pretty functional given I don't work which actually I often wish I did again because I miss being in the world of medicine (was RN/NP and retired in 2000).

Wait long enough to see whether you get relief or results from waiting and or conservative treatment tho also act if and when you have to as many here have. I didn't want to come off as one to just say "wait" indefinately~