Reherniation

[Gil Denis]

Reherination Microdiscetomy

Hi All

I just came home from my surgeon and the MRI results were not good
L2-L3 Bulge,L3-L4 Bulge, L4-L5 re herinated, L5-S1 no change but not much disc left, She wants to do injections at L4-L5 to try to dissolve the disc that is pushing on my nerve,"three should do it". Also suggested to do a repeat microdisctomy which may or may not work?
Also suggested to send my information to Denver for a second opinion, that does ADR!
I have four very bad levels and she thinks only one level is the pain generator,I think that there is more going on.
I am now taking the bull by the horn and sending all my information every where, any suggestions would be greatly welcome.

Mark you were correct!

Thanks
Gil

[Maria]

I had two discectomies and both rebulged. I'm pretty certain the work on L5S1 set L4 up for more rapid demise and then the work on L4 really rattled my cage so to speak. Further surgeries were recommended ~ still holding out here tho I sure was gung ho to get more opinions after the one in 2001 re getting a 3 level global fusion! So very glad I didn't do that one (have an anular tear/internal disc disruption at this level and DDD at all lumbar levels)!

Keep on getting those opinions and when you've found someone that makes the most sense to you re advice and you think you might be able to live with whatever the results are good or bad because of your choice~ then go with it.

Sorry to to read it appears you have multiple level problems however maybe it is just one or two levels that really need to be addressed and others can be left alone to best treat the situation. That'd be ideal (or nothing needing to be done would be more ideal w/no pain/probs). Good luck!

[dshobbies]

Gil,

Ouch - and only 1 pain generator out of 4 bad discs?????? It's possible but the only way to find out is a discogram, which may cause even more problems. However, the possible solutions for 1 disc vs. 4 will be different so you have to decide if the disogram is worth the risks.

I had my first discectomy/lami in 1994. S1/L5 reherniated as did L4/5- my second surgery was in 2002. Less than 1 year later I had 4 bad levels, 3 of which were pain generators. This 'disease' is call failed back surgery syndrome. It has a name because of the frequent occurrances. Though my first surgery was an emergency, knowing what I know now, I would not have had the second. Looking at successful percentages, they are not in your favor.

I also want to mention that prior to my first surgery, until the very last days, I had almost no leg or hip pain. It was mostly contained within my back, my muscles seizing tight, drastically limiting my mobility. Standing in the shower was almost impossible. Even now, L2/3 has become a pain generator, not because of nerve involvement but those damned muscles have simply had enough. So just because your MRI may not show nerve compression, you could still have significant pain.

Note to Mark - would a discogram reveal this muscle 'protective' mode?

The short of it Gil, IMHO, I wouldn't have more discectomies. Something else you may want to consider is scar tissue which might make ADRs more difficult. You have a lot to think about and I wish you a lot of luck.

Dale

[Maria]

Gil,
I had started my original post to you with the same thought in mind that Dale mentioned re not having another discectomy or at least not at the same level. I just think they're basically a prelim to more spine surgeries and or bigger surgeries down the road and maybe very shortly down the road.

Perhaps techniques have improved alot since my last discectomy so perhaps I'm being unfair or just stupid to say what I did tho I do think that my spine became far less stable after the 2nd level discectomy and set me up for further bigger surgeries which may have all been inevitable anyway.

I've had 3 discograms and I don't think they further harmed the levels injected however I had them done between 2001 and 2006. Two of them were done a year apart.

Again.. more opinions, consultations with highly reputable outstanding spine surgeons is my advice.

[Gil Denis]

Hi Maria and Dale

Thanks for your information, My Surgeon does not want to do another microdisc, instead is trying injections that may help?And to get another opinion with Dr that does ADR and has more experience I am sending all my information to the TBI today and see what they could do for me?

Thank You Very Much

Gil

[Crystal33]

Gil,
Sorry to hear of your prolonged suffering. Did you do anything in particular to cause the reherniation? It is my greatest fear. The only survey i could find stated that 10 out of 14 reherniations were reported to be caused by a particular event such as bending and lifting or driving over large bump or pothole.

IF your main symptom/s is from recent reherniation, and is bearable, you could try some months of conservative approach, to see if your body can reduce it and hopefully ease symptoms without cost, risk and worry of surgery. A lot of reherniations are at a different place on disc. If so I guess they should be approached same as a new herniation. Maybe your MRI shows if in same spot.

Never heard of the disc herniation dissolving injection. What chemical?
These injections have potential...
Minimally Invasive Oxygen-Ozone Therapy for Lumbar Disk Herniation -- Andreula et al. 24 (5): 996 -- American Journal of Neuroradiology

This study reports outcomes for various surgical approaches to reherniation, though carried out by a spine surgery dept so they could be glossing up the reporting on their own surgeries.
[A contrastive study of treating single level recu... [Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008] - PubMed result

A different view below.
Lumbar instrumented fusion compared with cognitive... [Pain. 2006] - PubMed result
It's hard to find good long-term independent data on ADR.