Herniated discs, history of injections, is it time for surgery?

In 1978, I also had the disk at L5 herniate. After two months of bed rest and trying to get the disk to slip back in place, I had surgery at Mayo. Immediately after waking up from surgery, I knew they had fixed the issue. A therapist helped with recovery and gave me a set of exercises that I have pretty stuck done regularly since then. Until advanced degenerative arthritis showed up about four years ago, i had had zero back problems. The exercises focus on the core and posture. I can offer only one piece of advice. In my case, I am sure the physical therapy helped me live a relatively pain free life. At least until this #$!# arthritis came into my life.

L4-L5 herniated disc. What's the latest and greatest procedure to fix the spinal cord pressure from the disc ?

Hello @kyana . Welcome to Connect. I had a similar situation with a herniated disc and bone spurs pressing into my spinal cord in my neck. My disc had collapsed 50%, and there was no way to save it. It was compressing the spinal cord and that needed to be freed to avoid permanent damage or disability. The bad disc was removed. I had a choice of a fusion using a replacement cadaver bone disc (or they can take a graft from your hip bone) or an implant of an artificial disc. I took the fusion with donor bone and chose not to have any hardware attached to my spine which meant I spent 3 months in a hard collar until the bone fused together. Of course every patient is different. What is important is to see a good spine specialist who can assess the impact to your spinal cord, and how to prevent any further damage. Lumbar surgery is a harder recovery than cervical because the lumbar spine is bearing most of your body weight. Find the best surgeon you can because you have one chance to get it right when you go through surgery.

I did not have much change in movement because my level was C5/C6 that was replaced, and that does not do much at all for head turning, so my movement is pretty much the same as I was before surgery. Any type of implant screwed into the spine has the potential to become dislodged or migrate, break, or cause an immune reaction. Bone quality is very important. Sometimes metals in surgical hardware can cause pain. I had that experience when I had titanium plates because of a fractured ankle. I had them removed. Of course surgical hardware would be more difficult to remove, and sometimes it is designed so bone grows through it making it a permanent addition to the spine. These are all questions to ask your spine specialist.

How did you receive your diagnosis? Have you been referred to a spine specialist?

I've had neck surgeries years ago.
After your first neck surgery, 12 years later you might have trouble again. Do you have any pain in your arms ?
I have four vertebrates fused together in my neck.
The surgeon couldn't make it to my appointment yesterday so I have to wait two more weeks to talk to him about my back. I don't know what he's going to suggest. I'm hoping to avoid fusion. I'm concerned with the nerve that is responsible for left kidney function. It has been malfunctioning for about a year.
Thanks for your input. No one else has commented.
I live near Louisville Kentucky.

Hello @kyana and welcome to Mayo Clinic Connect. I noticed an existing discussion on herniated discs so you will notice that I have moved your post here: https://connect.mayoclinic.org/discussion/herniated-discs-history-of-injections-is-it-time-for-surgery/

What types of procedures have you already explored or do you have experience with?

Hi babette,
You mentioned 3 vertebrae, so I'm not sure if you have 2 problem disks or 3.
Warning: if you ever have continence issues and a disk problem (soreness and so on), go to the ER immediately. Directive from my doctor. Delaying treatment has a strong likelihood of permanent incontinence from nerve damage. More about that in a subsequent post.
I have problems with L4-L5 and L5-S1. I'll write more below my family history.
My family has a history of back surgeries. My father has had 6. Five in his low back and a fusion in his neck. One of my brothers has had 4 including a neck fusion. One of my sisters had a neck fusion.
I was fortunate. I had a surgeon who is considered one of the top neurosurgeons in the world. He was on the Presidential medical team when President Clinton was in office.
My surgeries were not optional. I have had 3 back surgeries on L4-L5 (2 on the left side, 1 on the right side) and one surgery on L5-S1. One of my surgeries was a twofer - L4-L5 and L5-S1 rupturing on the same weekend. All of my ruptured disks happened when I was not doing anything active. The first one I was sitting on the deck relaxing. I felt something really strange in my back. I told my spouse "I don't know what it is, but something just went terribly wrong in my back". 4 days later I was unable to walk and was sent to the hospital. All of my ruptured disks happened while I was inactive. After the first one, the rest started out by me "not feeling well". I would lay on the couch almost exclusively. After a few days the disk(s) would rupture. I would have pain relief, but I could feel the disk "jelly" in my back (it comes out when the disk ruptures) in the wrong place. The 3rd time I needed surgery the rupture happened on a weekend. I set my alarm and called the surgeon's office first thing Monday morning; told them I had ruptured a disk. They told me to go to the hospital and get checked in. I had surgery a day or two later
I wrote all the above to give my example of what happens to me when I need a back surgery. I had no choice. I lost feeling in my lower left leg and my right foot. It is from nerve damage in my back that happened when the disk(s) ruptured. None of my ruptured disks could be repaired by injections (I had one on my first rupture - it did nothing).
You mentioned getting tired of injections. Having surgeries for me does not alleviate pain. It allows me to walk. It means physical therapy appointments. They help but they do not make the pain go away. Physical therapy was mostly teaching me stretches and how to get thing of shelves and so on. I am left with a lifting weight restriction of 20 lbs or less. When I exceed it, the pain returns. I learned from my health care providers that surgery weakens the muscles in your back. The muscles likely will never be full strength again. (I had a microsurgery the first time, but the subsequent surgeries, microsurgery was not an option.) When I had my surgeries, they would slice a pie shaped piece out of my vertebrae. If you have enough bone they repair the disk (cut some disk off and glue the remains back together) and sew you back up. If not, they fuse the 2 vertebrae. I did not have any fusions. I have had multiple slices taken out of my L5 vertebrae.
If, I had a choice, (and that's me) I would try to stay on the injections for as long as medically possible. You can always have surgery in the future. You cannot undo a surgery you've already had.

Hello all.

I’ve been diagnosed with a herniated disc at C6/C7.

The injury originally occurred 18 years ago. It was painful when it occurred but it healed after about a month. After that I just lived with it but it would occasionally nag me in they daytime with some minor pain, maybe a 2 on a 1-10 scale.

In December of last year, it really reared its ugly head. I did something to aggravate it. My pain was a 10 for two months. My arm ached and burned. I’d wake up 5-6 times a night to put hot water in from the shower on it. It was misery from December to February.

In the last two months, my pain has subsided substantially. I’d say day to day it’s at about a 3 or 4. My forefinger has numbness at the tip and my right arm will tingle or burn if I lay or sit in just the right position.

I met with my surgeon yesterday and he basically said I can have the surgery if I’d like to have a disc replacement performed. But he also asked me “what pain medicine are you taking for it?” To which I replied “nothing.” He then put his hands up and said “you really don’t need the surgery then. If you’re in no significant pain and you have no weakness in your arm, I don’t think you need to do it.”

I’m just having a hard time determining my best next step. He encouraged me to try to do things I like to do physically, like running doing some light workouts to see how my neck does. I just am uncertain about if I should have the surgery. One part of me says my neck is damaged and I need to fix it. Another part of me says, if you’re not on any pain meds why would you do a surgery? Is this just the new norm for me? Trying to figure out the best decision I can make. Would love any feedback.

I would avoid surgery at all costs. I would try PT, anti inflammatories, and topical treatements before anything. I had a C5-6 fusion with hardward and discetomy. I had numbness down both my arms before I decided to have surgery. I have not been the same since.
Best of luck to you,
Kat

I had a two-level cervical fusion years ago. It's not a small surgery. I would consider my options working from conservative to more aggressive treatments. In addition to the ideas mentioned above by @katcollins you might consider cervical traction or an epidural steroid injection to see if you get any relief.

Hello @quickray, and welcome to Mayo Clinic Connect. It sounds like your doctor feels that because you can manage your pain without meds, you are likely not at the stage of needing to consider an invasive surgery at this point. How fabulous!

You will notice I have moved your post into an existing discussion, which you can find here:
- Herniated discs, history of injections, is it time for surgery?: https://connect.mayoclinic.org/discussion/herniated-discs-history-of-injections-is-it-time-for-surgery/

I did this to allow you to review others' thoughts given their circumstances and will enable you to respond to the members who have replied to you already, like @katcollins and @vincescs.

Have you started taking your doctor's advice and seeing how your neck does with some light activities?