Failed laminectomy? What next?

[phenom34]

I am in my 20s and have had back problems for a couple years.
Ive had some unique stuff but its from my l5-s1 disk that herniated.

I had the sciatica + some genital numbness. After doing all the conservative things with no success, I tried microdiscectomy. It seemed to help for a long while but about a year later, my progress fell apart and I ended up getting a revision laminectomy.

I am 6 months post op and I feel that the second surgery didnt work.
I can barely do anything and I am starting to get depressed from lack of being able to do anything strenuous.

I have bad tingling in my foot, tingling in groin, and pelvic/hamstring spasms, I have minor back pain and no sciatica. I am not sure what to do at this point. I thought i was doing a bit better a couple weeks ago and went to the gym for a light workout which i was cleared to do and that really set me back a ton.

I can't sit, i have a hard time laying on my back, cant exercise.

My surgeon told me all this would get better after my follow up but it seems to have gotten worse instead.

[mmglobal]

The term laminectomy is somewhat ambiguous. I've heard minor decompression surgeries that undercut the lamina and have only minimal removal of bone, described as laminotomies. Also referred to as laminectomy is a full on 'hemi' laminectomy where they remove the entire spineous process and much of the lamina. This procedure will make you inelegible for ADR because structures needed for the stability of the ADR have been too severely compromised.

Your next step will likely be dictated by how severely your prior surgeries have changed things. I'm hoping that your surgeries were less invasive and that you have the full array of options.

Good luck navigating the process of sorting out all of the info you'll be receiving. Unfortunately, much of what you'll here will be colored by reimbursement issues. It would be great if we could make our decisions with accurate info and access to all reasonable option. Most of us don't have that luxery.

Mark

[phenom34]

I asked my surgeon about the "laminectomy" as everyone had a different version of it. He said he actually didn't remove much bone, he drilled a hole that was 1mm bigger than the microdiscectomy hole, it allowed him better visualization due to the fact that it was a revision and he wanted to make sure he got the offending stuff out. He said he removed the entire nucleus pulposus and said it'd be extremely unlikely for it to reherniate.

I dont think it reherniated but I feel like something is definitely putting pressure on my sacral nerves whether it be from lost disk height or the remaining disk under load.

Would a fusion help me?

[Maria]

Any medications for the neuropathies (tingling and such) like Neurontin, Lyrica or Topamax? How about an epidural if that were to be offered?
Do you have any scar tissue showing on recent MRI?

Personally I'd not want to consider more surgery so soon w/o giving the body a bit more chance at recovery on it's own though of course your frustration and depression regarding the results are quite understandable.

[ADR seeker]

Originally Posted by phenom34

I asked my surgeon about the "laminectomy" as everyone had a different version of it. He said he actually didn't remove much bone, he drilled a hole that was 1mm bigger than the microdiscectomy hole, it allowed him better visualization due to the fact that it was a revision and he wanted to make sure he got the offending stuff out. He said he removed the entire nucleus pulposus and said it'd be extremely unlikely for it to reherniate.

I dont think it reherniated but I feel like something is definitely putting pressure on my sacral nerves whether it be from lost disk height or the remaining disk under load.

Would a fusion help me?

What they have been testing are nucleus implants. They remove the nucleus pupolsus and inject a flexible core. They are also injecting biological material that will cause the disk to regenerate. An injectable nucleus replacement as an adjunct to microdiscectomy: 2*year follow-up in a pilot clinical study

Compared to other technologies medical technology is in the dark ages. I think things may get better but medical customers get treated like patients once again we continue to receive care based on profit instead of science and compassion. Others may not agree.