Question
i had a discretion 2 months ago.At first my symptoms of pain in lower back and severe tingling and numbness were relieved.Now gradually i have increasing tingles coming back in my foot and down my calf plus aching constantly in my back.my specialist and family dont seem to understand this and i believe think i dont want to go back to work which i am due to in two weeks.After my mri scan i had before my op also revealed a sequestrated disc fragment and mildfacet joint arthropathy.What do these mean for the future and why do i not feel my op was a success like i was told it would be? many thanks

Answer
Hi Adrian,

These are questions you should be asking your doctor, I am surprised that they are suprised the surgery didn't help. Even if it was done correctly, scar tissue proliferation after a year and disc weakness from partial discectomy inevitably lead to re-herniatin and degenerative joint disease. The fragment should have been removed during surgery but nothing can be done about the joint arthritis in the facet. Follow up ultrasound and glucosamine sulfate should be a 3x/week post-op regime for a month or more. I recommend you aggressively peruse multiple opinions before any further action is taken. You may be surprised when you take a look at the countless posts in the Spine Surgery section of this site and read the typical outcomes of spine surgery, rarely, if ever, will you find a positive outcome. Many times surgery cannot be avoided, so follow-up care is critical to a successful outcome. Many times patients are mislead into thinking surgery is the only option, herniated disc rarely require surgery, <5% of the time, often leading to more problems then originally present.
The numbness you are having may also be from swelling and fluid pressing against sensory structures and can be abated with ice. This minimizes the swelling and inflammation and should always be used while you are symptomatic.

I trust you had no options and needed the surgery so one step at a time is the best methodical way to get the answers you need. Confront your doctor and ask him "why?" he doesn't know. Since half fail and the other half fail a year later he should know why.

I know why they fail but it would take a long time to explain why, in short, they fail because the structural integrity of the disc is compromised secondary to the outer annulus being removed exposing non-structural material to do the same job which inevitably fails causing problems that are all to common with back surgeries.

Other surgeries like laminectomies have their own ICD code used to describe the expected outcome, {Post-laminectomy syndrome}, so I would say that it should be no surprise that it didn't turn out, being the fact that ICD codes and known re-heriations are used commonplace to describe a patients present diagnosis following surgery.


Good Luck!

Dr. Timothy Durnin