T Nation

Huge Hernia Between My L4 and L5


#1

Hello everyone, and thanks to all who take the time to read this.

In 1998 I suffered a spinal injury and misalignment due to a parachute accident while serving in the US Army. The Army's answer was motrin and water. I could not bend at the waste for four days to put my boots on until I took a friends advice and visited a Chiropractor. I was touching my toes 30 seconds later.

Since then I have carried 100lb rucksacks for thousands of miles, made over 100 more parachute jumps, squatted and dead lifted good weights, competed in BJJ tournaments, fought Muay Thai in Thailand, and fought in two wars. I have always needed chiropractic alignments and have kept the newest back rehabilitation techniques a close part of my life.

About 6 months ago the pain escalated and became unbearable after moving into my new home. I finally decided to face my fears and had an MRI done last week. The results, not good. I have a huge hernia between the L4 and L5 that is pressing against my nerves. No one wants back surgery, but you don't have to be a surgeon to see that my back is completely fuck*d. I am thankful that I don't experience more pain than i do on a daily basis. The doctors advice is hernia surgery to remove about half of the hernia and then to add a brace between my L4 and L5. Mind you he is just my first opinion, but he says the procedure is about 95% successful and I could be back to living a normal active life in as little as 3 months of rehabilitation. Although i have read so many horror stories from this type of operation.

So my questions to the forums are these. Has anyone else experienced this type of surgery, how was your recovery? Who are the absolute best orthopedic surgeons for people who consider themselves athletic?

Thank You for any reply


#2

I have juts had a discectomy and still recoverying. I will let you know how it goes, but it feels good so far.


#3

Thanks,

Did you get a brace put in also?


#4

What size is the herniation? Specific milimeter measurement would be great. Do you have the MRI report? Is there any other pathology associated with it? Was there a specific incident that started causing the increased neuro symptoms?

How old are you as well? Did the doctor mention the option of epidural steroidal injections as a treatment option?

From the initial accident (parachute incident), you may have torn ligamentus structures around the vertebrae which may be causing the instability in the lumbar spine and the need for repeated manipulations.


#5

Also, has anyone here had any success using traction in order to receed a hernia?


#6

I'm assuming you mean herniation and not hernia. I would ask to see the study that shows a 95% success rate with ANY back surgery. Also why is he only removing 1/2 of the herniation? Especially if he's fusing it. I'm not a surgeon either, so I'm not in the best position to 2nd guess what he feels is the best approach, but if I were in your position those are just a few of the questions I would ask.

Study after study I have read shows that you have a 50-50 shot that you're going to wish you had the pain you have today. The results from surgery and people I talk with in public and those I see in my office (I'm a chiro and ART doc) tend to be around that 50% level too. Surgery may get you back to doing things slightly faster, but your back will never be the same, and you are more likely to have another back surgery than if you went the more conservative route.

Have you tried decompression, or someone who knows a lot about soft tissue treatment to do what they can to help unload the disc as much as possible? You may have to pay for decompression out of your own pocket, but I'd rather pay $7-800 and not have surgery, even if the surgery was completely covered by my insurance.

I tell people there are three reasons to have low back surgery 1- you're on a high dosage of opiates and pain still bleeds through. 2- You start to lose function in your lower extremity (foot drop, etc) and 3- You start to lose bowel or bladder control (this one is an emergency situation)

If you're going to have surgery, you need to see a neurosurgeon, or an orthopedic who is a spine specialist and that is absolutely all they do, I would avoid seeing an orthopod who does other things beyond the spine, even if they are a "sports medicine" ortho. If this is going through the VA your choices may be much more limited than other people though, so best of luck no matter what you choose.


#7

no. Just a discetomy I have got some pics if you want to see them?


#8

Im 32, and am not sure of the specific Milimeter, but from the looks of things I have exceeded any recommendation for surgery based on Milimeter of the herniation. I think there has been several incidents over time that has reinjured over and over the disc, but after moving my house I woke up after the long weekend in more pain than I have experienced in the last 12 years.


#9

another


#10

and one more.


#11

I agree about the 95% sucess rate being bull. The idea was not to fuse, but to cut out part of the disc and then add a plastic brace that holds the L4 and L5. I have been advised on possibly seeking traction, is that what you mean by decompression? I am in the San Diego area, if you are aware of any specialist in the area who deal with the alternative treatments you are speaking of, I fully plan to seek alternative methods and get another MRI later in the year.

Although my MRI calls for suregery, my pain symptoms are just not there yet, thankfully. Trust me I have no desire for a back surgery and the idea scares me more than just about anything I have personally faced in my life. I am very interested in all alternative methods and if you can compile a list for me I will inquire locally. My choices for a surgeon are almost limitless as this WILL NOT be through the VA thank God... then I might wake up with a left leg missing and my back untouched. I am fortunate that I have alot of options in who I would use if I decide to go the surgery route.

Do you know who the most sucessful neurosurgeon in the US is? ALso, who did Rafael Furcal's surgery?


#12

Sure. If you dont mind me asking what was your atheletic past and how did the injury occur, your age, etc? How bad were your pain symptoms and why did you choose surgery at the time you did?

Thanks


#13
  1. Played a lot of roller/ice hockey for years as a goalie and when I left that I start lifting more. Not sure how I do it to be honest (worst part of all), and the surgey was the last resort really beuase it should have a lot of time to heal with me being so young.

#14


1st


#15

Wow, so what exactly did they do? Make a cut to remove the part of the disc that was buldging? Did they remove the entire disc? Did they have to cut the bone of the spinal colum itself in order to move the nerve to get to the herniation?


#16

Just shaved the disk that was on the nerve and I dont think they cut anything else just make there way through muscle, scar tisse etc.


#17

front shot


#18


Not nice!


#19

Essentially inserting a plastic brace would act to fuse those two segments together, so although it isn't a bony fusion, or a cage, it will alter the kinematics (movement) of that joint. Decompression is a specific form of traction, traction and decompression will sometimes be used interchangably, but at the root they are very different. Decompression is computerized and pull weights and vectors can be altered.

I can point you in the right direction, but I don't have the time to compile a list for you of possible providers, that's why google was invented my friend. I don't have anyone I would personally recommend in the San Diego area if that helps. Ask around, see if there are any chiropractors, MD's who have experience with decompression.

When looking for chiros, generally speaking, Active Release Technique (ART) certified docs tend to be more sports minded than your general chiropractor. http://www.activerelease.com/providerSearch.asp has a list of providers you can input to find an ART certified practitioner. At this stage in the game, at 32, with your history, wanting to do what you want to do, I think you should gather several opinions and research prior to initiating an aggressive treatment plan.


#20

First quoted price for decompression is $5,000-$7,000 for 20 sessions on a machine (DRX 900) Seems like quite the rip off, especially in my case due to the size of the herniation(not sure the exact Millimeter), but I was told mine is huge. I was also told that herniations of about 5mm or less are typically more salvageable. I dont know if Im willing to shell out this kind of money, I was thinking maybe $1,000, not $5.