Lumbar Decompression

Bones, joints and muscles
1

Don't know if this is the right forum and apologies if not.  I have over the past year been diagnosed with a bulging disc and told to take strong painkillers, which I have been taking regularly which hasn't taken the pain away completely.

Yesterday I had an appointment at Guys Hospital in London where I saw an orthopaedic surgeon.  On the computer screen e brought up the results of the MRI I had last July and explained that what I had was a Lumbar Decompression.  He is now recommending spinal surgery.  This to me is terrifying and to be honest I don't know what to do.  I am going to speak to my GP as well as the doctor at the Pain Clinic where I have an appointment already booked for next week.  Has anyone else had this procedure, did it help with the pain, was your mobility helped or worsened by this procedure.  I have posted this somewhere else on the forums as well in the hope that someone can help.  Still on the painkillers, including the Amitriptyline which I have upped to 20 mg each night.  Not sure it's making a lot of difference to the pain to be honest but up to yesterday my mood was a lot better.  Since yesterday though, because I am scared of what the surgery entails, I have been very weepy indeed.  Thanks for listening. 

2

Joyceb, thanks for your post.

This made me laugh quite a lot as I was in Guys hospital on Monday 23rd this week seeing the spinal team. They are fantastic, who did you see? Funily once more I am having a Lumbar Decrompression on Tuesday next week, also at Guys Hospital. I have already had 3 x cordal epidurals this year which although did not cure it, helped the pain for a short time.

From my side of things, I will take anything to help the pain. There are risks of course but you have to accept that, what level is your buldging disc? Mine is L5 S1, the lower down ,the more succesful the surgery is from what I have been told and read on a number of websites and books, which for me is great as it doesnt get much lower than L5 S1. Yes it is major surgery and yes I am shi*ing bricks, but I know it will help me, and I have all fairth in the team at Guys. I am lucky as my sister works there so I can say you will be in the best hands. I suspect it would be performed by Mr Lucas and he is one of the best if not the best in the UK.

Hope this helps, get in touch if you want any more support / advice

Nick

3

Ask about an endoscopic discectomy because it is far less of a major operation than the more old fashioned and traditional so-called Microdiscectomy, which isn't very micro at all. The former will involve less healthy tissue damage because it only involves an incision about a centimetre in length. The rest is done with gadgets and cameras. The old fashioned op is open surgery and involves a several inch scar down your back and a much longer recovery period. It also involves slicing away and the peeling back of muscles tissue and the drilling into of bone, which will leave less stability and strength for your back long-term and post op.

Unfortunately, not many British spinal or neurosurgeons can do the more sophisticated operation. So, do ask to be transferred to someone who scan if you are suitable for and would prefer this type of operation, which should be performed under local anaesthetic and not general. General anaesthetic is used for the traditional Microdiscectomy.

 

4

Thanks STD, that is really helpful.  I will certainly ask about this.

5

Hello Nick.  Thanks for that.  Yes it is at L5 for me as well.  The surgeon I saw was Mr Jaykar Panchmatia who was very nice and gave me several websites to look at before making what obviously is a serious decision.  I will definitely seek advice from other medical professionals.

Very best wishes for your surgery next week.  Please let us know how you get on.  

6

What type of spine surgery did he recommed? if it was a microdisectomy  dont worry about it its routine just recover as you are told.

7

I had a Microdiscetomy 8 weeks ago the scar is 3cm long sealed after two weeks. I am very happy with the results. Back to work and tickitty boo, prob 4 months before i can back to running etc  but I am walking alot and exercising.

STD ?   disease in an area for a diff website I suggest !

8

Anglo, thanks again for the messages, I am bricking it fir next week mate. What should I expect?

How did you feel after the op?

How long till you walked?

When could you wash? Or shower?

When could you bend or lift?

when could you drive?

Anything else I should know?

Nick

 

9

Seriously its not that bad. Firstly stay in 1-2 nights minimum.

I had the operation at 3pm and awoke at 4.30pm briefly, then woke up again at 18.30. Interestingly, the op itself only takes about 20 mins or so. Make sure they give you a pre med pill to calm your nerves before you go to theatre.

I stayed in bed until the next morning and gently got up an brushed my teeth and then the nurse ordered me back to bed.The aesthetics will make you a bit unstable so best stay in bed. Drink prune juice because you wont be able to 'go properly' for a couple of days, but that's normal it's the anesthetics. At some point you will be shown how to get out and back into bed, so you dont bend your back.

Late morning the physio came in to test to see if I could walk up and down the corridor and up some steps. I wouldnt say I was in pain just weak. The drugs are so strong you dont feel much anyway. I could go home, but decided to stay another night it seemed the best place to be although hospitals can be noisey. I went home the following day and slept most of it.

You can shower, but keep the plaster dry or change it if you get it wet. 

Bending not for 5-6 weeks it does comes naturally.

Lifting - 8 weeks out; I still avoid heavy lifting.

Driving 4 weeks minimum and drive a light car (Ford KA, SMART)  if you do and only a couple of miles. This will also depend on your recovery. 

Dont go back to work for 6 weeks (if office work) and then start half days. Try working standing up leaning against a high chair.

You must take advice from a physio, vitally important dont just get aload of exercises off you tube. 

Recovery is 6 weeks its not 4 or 5 but 6 there are no short cuts. As my physio said the surgeon has done his job now do yours. After week 2, I was given 2 movements a week neural glides and a stomach tensing exercises- really gentle.

The scar tissue will clear up after two weeks, but your internal muscle tissue about 5 weeks. This is the riskiest time to reherniate so you have to be very careful. 

Walking: you'll shuffle about for 2-3 days then some really short walks 50 metres or so no more from then on. Lots of walking in the early stages wont get you fixed up more quickly you are just risking further injury. 

If you drop something on the floor leave it!!!! or buy a grabber or BBQ tongs to pick it up. you'll find a litre of milk heavy in the early stages. Aftger a couple of weeks you could do a lunge whilst keeping back straight to help you get closer to the ground.

Sign up to netflix.

8 weeks out I feel good, my back aches from sitting too long so I try not to. I lie in bed and watch tv or stand and work on a high table: its better for you. There is a lot of help from patients on utube, just dont start doing too much too early. 

Feel free to ask more questions happy to help. Enjoy the time off !

 

 

10

Thanks for that Nick.  It really is a lot of help.  My back is particularly bad today, stiff as a board and feels like it's locking up if I sit for any amout of time.  All this info that kind peeps on here are providing is really helping me to put together questions for when I go and see the surgeon in a few weeks time.

11

Sorry Anglosaxon, just realised this was a reply to Nick.  Thank you for the details.  It really has been helpful to me.  I will make a note of all the questions I need to ask when I go back in April.

12

Dear Joyceb

i just joined this forum and i am living in Wales. I totally understand you being weepy, be kind to yourself its ok to feel as you do with such debilitating pain, i hope you get some relief soon.

my story started 18 months ago i woke up with awful back ache and shooting pains in my butt, down my left leg and into my toe, i was misery. GP diagnosed sciatica and said it could improve with physio in 6 weeks, how very wrong he was. I saw physiotherapist and she recommended an MRI ths showed dsc bulge sat l

L4/5 and deterioration at lower disc. I won't bore you with details but after paying for private treatment i had no insurance i was given nerve root blockers and CT guided injection these did nothing for me. I had a discectomy may 2014 which consisted a nights stay in hospital. This procedure took away my nerve pain but then 3 months after i had stabbing pains horrific in my back further investigation showed massive inflammation and a spinal fusion offered to me. I had no choice as i couldn't live with the stabbing pains,driving my car hurt. Getting in and out of car difficult as was sitting for any length of time. Apoarently the discs low in your spine are the mechanical ones  

And sitting is the most uncomfortable. I had my spinal fusion done 3 weeks and 3 days ago. I was in hospital for 6 days.hadbone, with metal cages and screws put into my spine at 2 levels. Stabbing pains gone and its very early days yet but i am taking things slow, walking abit every day, lying in bed watching movies.sitting for longer than 20 mins and i have to get up but doing ok 

13

Sorry to hear about your story, certainly a back fusion is more serious than a microdisectomy. My friend had a fusion and is pleased that he had it done, so hopefully things will get better for you. 

14

So the time has come, tomorrow at 7:30am I will arrive at Guys Hospital London, to have my L5 S1, Microdistectamy. I will have my amazing sister and wonderful girlfriend on hand to support me through this very difficult time. Anglo Saxon, would love to be able to contact you post op for any support I may require.

I am [removed] extreme bricks but I know this is for the best to have this surgery. Take care all.

Emis Moderator comment: I have edited this post due to the swearing. These are open forums so as per the T&Cs please do not use offensive language in posts otherwise they may be deleted.

15

Dont worry about it at all, it's not that bad plus just think that the pain will be gone when you come round. Fantastic!

Just make sure you get your pre me/op pill to calm your nerves, but enjoy the time off and the all the fuss that goes with it! 

 

16

Wishing you the best of luck Nick.  Let us know how you get on when you get the chance.  

17

If you ask the surgeon nicely he 'll put the sequestered disc in a bottle for you. It looks like a ball of crab meat.

I keep mine on my bedside table. 

18

Hello mate as i respond to you from my bed at 3:56am, i can announce to you that ive just wee'd out over a pint of fluid into the fantastic tubes, and vommited into at least 10 of the circular tubes. The service i have recieved from the team at guys is nothing but exceptional. My back pain is ok, leg pain minimal, hopefully ill be off home today to sleep & rest. I havent be able to keep much down recently but i can live with that, i wanted to lose weight, Anglo any chance you can send yiur email address so i can hit you up with questions? jay go for it, i was very scared blood pressure hit 226/129 prior to operation, but i was in super hands, long procedure, 2 hours.

19

Crickey sorry to hear you have been sick. I'll email over my address in private when I have worked out how to do it. Someone responded to me in private so I know it can be done.

My advice stay in as long as you can unless you cant sleep.

20

First of all, Nick I hope you're feeling a lot better now and the pain is much less.

Today I had to go back to the hospital for the result of the MRI I had a few weeks back.  The consultant still felt I should be looking at surgery (lumbar decompression) but did say the MRI hadn't altered since my first one, last July.  I don't have to decide straight away.  I have an appointment pencilled in for the second week in May and if I don't decide on the sugery then I could leave it 3 or 4 months before deciding.  If I leave it longer the chances are I would need to have another referral from my GP.

I was able to get a CD of the MRI as well as written details of what was found.  The images on the CD are confusing to me, as a novice but the written details were surprising.  For instance, at the end it says that I should have a DEXA test to see whether I have osteopania (the onset of osteoporosis).  There were a few other details I was confused and surprised about as well.

Fortunately I have an appointment at the Pain Management Clinic at the end of this month and I will be asking all sorts of questions.  I also have an appointment with my GP next week and I will be asking him whether I should be seeing an orthopaedic specialist rather than the Pain Management Team or the Orthopaedic surgeon, who, as good as he is I'm sure, is bound to push me towards surgery.

It's still a decision I will have to make at some stage but right now I feel I have more options and the right questions to ask more health professionals before making the final decision.