BACK SURGERY........

[emmatom]

I have chronic sciatica. I had an op when I was 12 years old to correct symptoms, then led very active sporty life with only sporadic symptoms.

4 years ago I had to take medical retirement as it came on with a vengence. I've since adapted my life to cope with the pain and leg numbness.

Upshot is, latest scans show protusion at L4/L5 so severe that violent coughing/straining could harm my bladder/bowel nerves to the extent of irreversible damage (catheter etc).

Risk of this is 2% and op could make pain in legs Worse!

Should I be careful and go on as I am, coping with lifestyle and hope protusion doesn't worsen or opt for surgery to prevent future damage but give me more pain?

Don't expect many replies, just hoping maybe someone has had similar situation.

PS. Apparently not brill idea to have surgery on same sight as having it before, just to add to dilemma.

[merrygoround]

You say the risk of damage through coughing etc is 2%, and also that the op may make the pain in your legs worse. What are the positives from the op? 2% sounds a low risk, but the consequences sound very severe. How would any worse pain in your legs be managed? Stronger painkillers? Why exactly would the pain be worse?

Sorry for all the questions, I am not a medic and am just thinking of all the info I would need to be able to make this decision if it was me.

[emmatom]

Thank you MGR. I should have said the risk was 5%, not that much different to us lay men but professonals have to talk in these terms I suppose.

The positive from the op is I don't end up with a catheter for the rest of my life if the worst happens and I would up my painkillers to cope with further pains. These pains would be exacerbated by the fiddling around done during the op etc.

I think my thinking is I'm coping now with my lifestyle (I'm 40 by the way) but I don't want to leave it til I'm say mid 50s and I really have to have the surgery and I'm that much older to cope with the op itself and the recovery.

[Carmenere]

Hi Emmatom, your back pain sounds horrible, as does your quandry. I'm afraid I don't have any advice but my dp is a registered osteopath and I will ask him to look at this thread this evening. He may have heard of/dealt with similiar cases to yours, good luck

[merrygoround]

Hmm, difficult. So, the op is only to avoid something that may never happen? It has no other purpose? You said that the pain after the op MAY be worse - is there any chance it may NOT be worse?

The thing is that you asked if you should go on and "be careful" - but how can you possibly know that you could avoid a violent coughing or sneezing fit? All the care in the world can't stop that surely?

How much does the thought of being catheterised bother you? Would it be potentially for bladder AND bowel? People can and do live very full lives in those situations.

To give a personal view, which is irrelevant I know, I would not like to live with the fear of an imminent collapse of my spine leading to terrible pain and being rushed into hospital for emergency surgery. I THINK (I don't know because it's never happened to me of course) I would go for the op for peace of mind, and tackle any increased pain if I had to. HOWEVER I think I would also want a second opinion, or if not, then the chance to talk it through in detail again with my consultant.

[emmatom]

Thank you again MGR. Your last paragraph is how I'm thinking. Also, I have asked my consultant so many questions, repeatedly (poor man having me harrange him!) and he said, if it was his wife, he'd advise her to have the surgery. That's a good sign for having it I suppose. Thanks for your advice.

Thank you also Carmenere. If your partner could give an opinion and doesn't mind doing so whilst "off duty" that would be wonderful. I will check in later to see what you say. I appreciate that.

[Carmenere]

Emmatom Carmenere's dp here -It is difficult to give an opinion over the internet, but it would help if you could answer these questions so I know a bit more about your condition,
:
what was the cause of your sciatic symptoms when you were 12?

If your recent symptoms started 4 years ago, I assume that you were 36, so you had been absent of symptoms for 24 years. Do you know what caused these recent symptoms and what did the orthopaedic surgeon say about the cause of your condition and what operation is he recommending?

Where do you have refered pain ?
What type of pain is it ?
Which part of the leg(s)is/are involved ?
What movements make it better or worse ?
Is it worse at certain times of the day ?
Is it getting better or worse in general?

Do yo have x-rays (they can be obtained from your local radiology department at a small fee and although they will tell you it its difficult or they can't, they are obliged to so keep at them). They can be usefull if you decide to seek a second opinion.

If you are unsure you could see an Orthopaedic Surgeon privately for a second opinion. This can cost as little as £80 - £150, which can be considered as a good investment if you are concerned about your future back health.

[emmatom]

So kind of you to get back to me. Thankyou.

I will try to be brief.

I fell down some steps aged 12 - it was thought this was the onset of my sciatic type conditions. My notes from those days are long gone, so not sure exactly what surgery was performed (but not a fusion apparently.)

Over the 24 years I was an active sports woman and siatic symptoms would come on ocassonally after hectic games of squash or long runs. I took pain killers and lay on boards to recover (usually over a couple of days or so).

1st pregnancy caused this complete upheaval of symptoms. I was flat on my back in hospital for a month at 4 months pregnant and ever since them have had numbness,/tingling/loss of sensation in leg and foot and pain in buttock.

When really bad I just wish I could cut my leg off! Sometimes I can do some gardening without too much trouble, other times a good sneeze can leave me rigin and in trouble!

I do very litte now ie. have retired from a very active job, no sports etc. I just walk, so a complete lifestyle change to cope with this. Providing I'm sensible like this I've reached a level of lifestyle that now suits me.

Sitting here nowI'm obviously pinching something as my left leg is tingling and my foot is numb. Changing position would help.

MRI scans and my consultants have saidI have spinal stenosis, protusion of disc at L4/L5 to over 3/4 of the space in spinal canal, protusions at L3 arachnoiditis, cuddly toy and teasmade!!

I've had 3 epidurals (1 worked for a while, others didn't) and a couple of spinal block type injections( didn't work).

If I was Carmenere would you advise her to have the surgery to prevent irreversible damage from the severe protusion or for her to wait and see if things worsen.

Thank you again so much.

[emmatom]

Bumping for evening back sufferers with similar experiences.

[emmatom]

Are you there Carmenere's dp?

[Carmenere]

Sorry emmatom he's out with his workmates tonight and I don't think he will be much good when he comes back in

[Carmenere]

Hi Emmatom,
Carmenere's partner writing
Emmaton - you probably know that spinal stenosis is a narrowing of the spinal canal, where the spinal nerves travel through. An obstruction within the canal can compromise the spinal nerves, as you have said.
I can't tell you whether to have surgery or not and if I were to advise 'Carmenere', I would want to know a lot more about the condition, see the MRIs etc. I would also want to know what surgery the consultant advises.

Look up the details of what the consultant has told you on the internet (you can start with Wheelers textbook of Orthopaedics, which is an easier site than it sounds), write down a list of questions and ask you consultant, write down what he says and research that. Remember that it is your back and your future health, you deserve to know the full facts, if you have to make a decision.

Do you trust the consultant ?. Sometimes the medical world can 'dumb down' information too much. This surgery is about you and for you and the object of 'Medicine' to benefit the patient.

In principle it sounds like some surgical intervention may be necessary, but you have to know what it is and right for you (what are the risks and consequences).

Your consultant will be well educated in his field,however you seem unsure of him.
I'm not certain, but you may be able to obtain details regarding consultants and different hospitals on the 'Dr Foster'website.
Hope that helps

[emmatom]

Thank you so much for responding. I found a website with a discussion group where others share their experiences of ops and pain control etc.

The main thing I've been told is to get a second opinion, so I'm asking my GP to refer me to the Spinal Unit at Oswestry and they havn't got a very long waiting list apparently.

I'll also go and have a nosey round the websites you've referred to.

Thank you again.