surgery or no surgery - herniated disk

Hello @helenr. I'd like to invite a few members who have discussed herniated discs on Connect who can maybe share their treatment experiences. @ktgirl, @babette, @salsa, and @candrgonzalez all discussed shots/injections for herniated discs with varying results. I'd also like to invite @pines who ended up having surgery for a herniated disc.

@helenr, if you are comfortable sharing, what type of surgery would you be getting?
https://connect.mayoclinic.org/discussion/herniated-disc-1/

@helenr Hi Helen and welcome. I had a herniated disc too and eventually I did have spine surgery a couple years later. Mine was in my neck. Doctors like to recommend injections to avoid surgery, and they are calculating the risks of surgery and they worry about poor outcomes. Their statistics of success rates for procedures are recorded and they don't want to take risks that could lower their success ratings, and if a patient also has other health issues or they smoke, those play a part in the success of the outcome. They also make a lot of money from spine injections. I had an adverse effect from a spinal injection and refused to do any more of them. None of the surgeons I saw wanted to operate, and I came to Mayo and had spine surgery 3 years ago. I had symptoms that they didn't understand, and they didn't want to take a chance on me.

Do not let anyone pressure you into doing something. You do not have to do another spine injection. They carry real risks of serious adverse effects and they will not cure anything and spinal epidural injections are not FDA approved. The best thing you can do is learn about your condition and get multiple opinions from the best surgeons you can find. You don't want to rush into anything as this is an important decision, and there are choices to make if you are headed for surgery. Lumbar spine surgery is a much bigger recovery than cervical surgery because the lower end of your spine is bearing all your body weight of everything above it and there is twisting and bending. Surgery can make a patient worse, and usually surgeons don't promise to cure the pain, but instead to stop the progression of a structural problem.

There are also issues with pelvis alignment that can mimic a spine problem or add to one that is there. Spine injuries also cause muscle spasms that can cause the misalignment. Physical therapy might be able to help with that.

I am also a patient who was terrified, and I learned how to manage that and be calm on my surgery day. It helps a lot to have support of people who have been there, and I'll help you with that. In the future, I'll be speaking at my library about my experience and how I overcame my fears of major surgery. It actually wasn't as bad as I had imagined, and I had a great surgeon and a great recovery. 5 local surgeons turned me down which is OK, because one gifted surgeon at Mayo gave me my life back, and there was a huge difference in the efficiency, quality and compassion in the care I received there. I didn't find that anywhere else, and having a surgeon who really cares about you helps a lot in recovery. Sometimes surgeons are too eager to operate on any disc that is bulging, so you need an opinion that you can trust.

A herniated disc is when the outer fibrous layer of the disc is breached and the jelly like material squishes out. This causes inflammation and the growth of bone spurs over time because of the uneven pressure on the end plates of the vertebrae. For me, that was cervical stenosis with bone spurs and the ruptured disc pressing on my spinal cord. I watched a lot of spine surgeons presenting their cases to other spine surgeons in online conferences and discussing the outcomes, and even discussing cases where the patient was worse off because of a surgery, that then was corrected in a re-operation with another surgeon. I have a biology background and have read a lot of medical literature and research about spine procedures and that helped me a lot because I needed to understand in detail how surgery could help me and understand the choices I had. For me that was choosing not to have hardware placed on my cervical spine. Not all surgeons would have allowed that, and I am glad I could make that choice. Lumbar surgery often depends on correct placement of hardware with the correct angles of screw placement because of he pressure on the lower spine. I'm not trying to worry you, but these are reasons that hardware can fail. There are different procedures that might be offered. This is why you need multiple opinions, so get as many as you need. I had 6, and only the 6th opinion was a good one.

Here is a link about pelvic alignment issues that may be of interest. https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/

My patient story https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

thanks so much, Justin. I don't know exactly what kind of surgery - the doctor said there would be a small incision in my lower back - and they go in with a tiny microscope and sort of smooth out the disk that is herniated. It is not major spine surgery - where they open you up. I'm not there yet - and would certainly get a second opinion before I do anything like that.

Helen

From my perspective of being a retired RN, I am wondering if you are concerned about repeat injections because of the pain of the injection or for a different reason? Because if it is because it hurt so much, you certainly have a right to tell the doctor that and request that you have either some oral anti-anxiety med ahead of time or of asking for mild sedation immediately before the procedure - as in you would be in position for the injection(s), you would have intravenous access already in place and you would HAVE to have someone come with you to drive you home. Just something for you to be aware of! Hope this helps and hope you feel better!

thanks you for your response. Update - I knew about the alternative of "going under" to get the shot - and I actually started to consider it seriously - but then when I thought of the hassle of getting someone to pick me up, having to stay home afterwards until the anesthesia wears off - I thought I would try to get the second shot without it. I did and it wasn't as bad. I took 2 painkillers before the shot, and I asked the doctor to douse the area with extra numbing stuff. I also concentrated more on my breathing during the procedure - something I got from yoga and Pilates classes I take. It was much better. I had also been healing. At this point I think I may be out of the woods in terms of surgery. I'll know more next week. I want to thank everyone who contributed to this post. It helps a lot to hear from other people who have gone through the same thing.

Helen

Great! I was a Labor & Delivery RN and do believe controlled breathing can help a lot, but not everyone buys into that, so.....of course everyone reacts differently to IV sedation - I am fine almost immediately - not to drive of course - but have had it for multiple jaw procedures and two colonoscopies and immediately afterwards my driver friend and I have gone out to eat brunch/lunch, shopping etc. I have other friends who say they sleep all afternoon! Here’s hoping it all helps you for quite awhile in terms of pain relief!

All good