Back surgery is one of those things no one wants to experience. Many doctors now even discourage patients from undergoing back surgery until every conceivable option has been exhausted. In my own case, I tried every option and was reduced to popping oral narcotics in order even to work because the pain was so extreme – yet still I postponed the inevitable. Until, that is, the disc that had been slowly herniating for several years finally ruptured in a spectacular way. The disc rupture necessitated an emergency hospitalization and surgical disc repair – a discectomy.
I wrote about my experience with lumbar-sacral herniated disc repair in September 2010. Honestly, I did not expect much interest in the article. At the time I was bored and home-bound while recovering from back surgery and, in an effort to entertain myself, decided to write about my experience. To my surprise, that article has remained one of the top articles on my website during the 17 months since I first published the essay. Apparently I am not the only one with an interest in this surgery.
It occurs to me each time I look at my site traffic statistics that I should update that first article about back surgery to reflect my experiences in the months since. During the months that have passed, I have experienced both improvements and setbacks. This essay can be considered part two in my ongoing adventure of recovering from a disc rupture and back surgery.
My early recovery progressed as expected and by late November I was cleared by the neurosurgeon for normal life after back surgery – permanent 20-pound lifting restrictions, and care with bending, twisting, or jumping. I was also forewarned that my first winter might be rough due to possible arthritis. It was rough. It was better than life before back surgery, but I still spent every cold, damp day awaiting a warm, dry day.
Late spring found me feeling good and able to move around without much thought for my back. Unfortunately, it was not to last. Summer brought numbness in my left leg again, along with increasing lower back pain. The numbness in my foot and leg worsened to the point where I suffered a severe ankle sprain walking across the lawn because I could not feel where I was walking. (Six weeks walking with a special boot that effectively made one leg longer than the other did nothing for my lower back problems!)
I finally made an appointment to see the neuro-surgeon again after the ankle sprain. An MRI and x-ray series identified the cause of my problem: scar tissue at the surgical site.
The symptoms has worsened to the point that I was reduced to walking with a cane by the time I saw the neurosurgeon. It was this or “furniture walking” where I leaned on furniture and counters to move about the house. I could not hold myself up because my back was so bad.
I spent two months debating with the neurosurgeon’s office about the treatment direction. The neurosurgeon refused to consider surgically removing the scar tissue, based on the assumption that it would just recur. (It might, but at my age I would try anything for a chance at normal functioning.) The doctor wanted me to have an S-1 nerve block performed to treat the symptoms. I declined. They wanted me to see a pain specialist for consideration of a dorsal column stimulator implant. I grudgingly consented, though I very nearly canceled the appointment several times. I did not feel the treatment options that my doctors were recommending were appropriate for me, and I did not feel that they were taking the time to listen.
I finally saw the pain control specialist in the fall of 2011. This doctor agreed with me that an S-1 block would be useless. Further, he felt that a dorsal column stimulator implant would be a bad choice for me as well. He did recommend considering another epidural injection at L4-L5 though – one level above the surgical site. I decided, in this case, I had little or nothing to lose. The first three epidural injections done before surgery had not been helpful, but this doctor suggested that it was a different situation after surgery and worth an attempt.
This epidural injection provided substantial pain relief within about 30 minutes of the injection. I was amazed as I had not expected any relief. I was even more impressed when, within 60 minutes of the injection, I was almost pain free. This was the best I had felt in months! (Too bad it cost $2,000 for the procedure.) I was suddenly able to walk without a cane.
The benefits of the epidural injection, sadly, did not last. I enjoyed substantial pain relief for a full week. Within two weeks I was pretty much back where I started. Now, several months later, it is like I never had the procedure. Of course, these procedures can be performed three times per year, but $6,000 per year for injections is a little rich for my blood. I also question the safety and efficacy of repeated epidural injections. Each injection carries the risk of infection, hemorrhage, and the puncture of things not intended to be punctured. If the injections provided three to six months of relief I would probably consider continuing with this treatment course. One or two weeks is not an acceptable result though, in my mind.
I still wonder whether a spinal surgeon could successfully remove enough scar tissue with a microscopic surgery to relieve the nerve compression. Unfortunately, I live in an area of the country that lacks many specialties – including a spinal center.
My only other treatment option is to consider a spinal cord stimulator unit, but I am quite skeptical that this would be a good option for me – as is the pain management doctor.
Meanwhile, I wait and suffer – and rely on oral narcotics to manage intractable pain. Fortunately, I have a desk job these days, but I am now beginning to experience days where the pain is too bad to sit or concentrate. Damp and cold days are particularly difficult.
Am I glad that I went through with the surgery? Yes, I am. My condition was so bad at the time that I had no choice. I would never recommend this surgery to anyone as a first-line treatment option, but sometimes all other options are exhausted. In the end, an imperfect treatment is still better than no treatment, and I am glad to have had the disc repaired. I do wish the end result had been more successful. I’m really too young for this level of disability.
