Persistent Lower Back Pain

[Atrecord]

6 hours ago, Sporkypiggy said:

@Atrecord So what kind of key-hole surgery did you do?  Can elaborate a little bit more?

What i see from the discharge summary, states:

Lumbar spinal stenosis. Lateral recess stenosis
Foraminotomy and microdiscectomy 

Do these sound obvious to you? 

In any case, what the doc told me was there a metal tube will be inserted to dilate the space (i think the nerve canal?), and then another tube will be inserted to remove the fragments of the damaged discs that are compressing on the nerve.

After the surgery, i was given a container containing the fragments. Actually my brother told me he went for a similar op 2 years ago, and the fragments i have, are maybe 6-8 times more than his... 😓

Initially i was worried about the doc having to cut off parts of the discs to remove the parts compressing on the nerve, but he clarified that there's no need to cut, as the damaged discs are already broken, and he will merely 'pick up the pieces' during the surgery.

[Atrecord]

6 hours ago, Etnt said:

I think sometimes surgeon will also see actual condition in OT bah. Before going into OT, I was told keyhole; after woke up, open back.

Actually, from the photo my wife took, the wound is about a finger long... my sis-in-law commented that keyhole also such a big wound...

Now that you say this, i also dunno was it still keyhole, or open back (is that what's normal surgery is called?)... 

😓

[Atrecord]

5 hours ago, Sporkypiggy said:

@Etnt For Herniated Disc (cervical or lumbar), most public hospital tend to perform fusion surgery. Whereby they will removed the herniated disc, place a bone graft between the 2 vertebral segments to fuse them together. The surgeon will say that this is a minimally invasive surgery as the cut is about 5 to 6 cm.

Lumbar Fusion: https://www.spine-health.com/treatment/spinal-fusion/lumbar-spinal-fusion-surgery

Cervical Fusion: https://www.spine-health.com/treatment/back-surgery/cervical-spine-surgery

Some private Ortho doctor may perform a more minimally invasive or they claim key hole surgery to remove part of the herniated disc instead of removing the entire disc as in the Fusion technique.

The surgeon will usually run through the sequence with you in detail and have you sign the agreement form before proceeding with the surgery.

Do take note that it will take at least a year for the vertebral to fully fused together. So its a long journey to full recovery. The doctor will give you guidances on your daily activities.

The doc said my bones are still aligned and it's the discs that are damaged. Was told that in some cases where the bones have degenerated too, might need to put screws in place to keep the bones in fixed position... that's no fusion, right?

[Atrecord]

4 hours ago, Windwaver said:

Nobody upper back pain?

where's considered upper back? i know someone who had a surgery for Cervical Spondylotic Myelopathy... this one is near the neck...

[Volvobrick]

10 minutes ago, Atrecord said:

Actually, from the photo my wife took, the wound is about a finger long... my sis-in-law commented that keyhole also such a big wound...

Now that you say this, i also dunno was it still keyhole, or open back (is that what's normal surgery is called?)... 

😓

They didn't clarify the size of the key. Anyway have a swift recovery! 

[Windwaver]

36 minutes ago, Atrecord said:

where's considered upper back? i know someone who had a surgery for Cervical Spondylotic Myelopathy... this one is near the neck...

Thoracic Spine, neck is common.

[Etnt]

8 hours ago, Volvobrick said:

They didn't clarify the size of the key. Anyway have a swift recovery! 

lol. my key about this size.

[Sporkypiggy]

@Atrecord Not too sure if your condition is due to lumbar herniated disc. Bulging disc or ruptured disc.

The herniated disc may compress your nerve and even spinal cord. Nerve compression may generally lead to pain. And it may send shooting pain down from your back to your leg. And worst case, case numbness and tingling sensation down to your toes.

I am not familiar with the DIAM spinal spacer, it  may seems to be explained in the below video. If so, then your case is not fusion.

 

[Atrecord]

12 hours ago, Windwaver said:

Thoracic Spine, neck is common.

oh, then nope. only heard lower back where it's always the lumbar that's affected. you have upper back pain?

[Atrecord]

13 hours ago, Volvobrick said:

They didn't clarify the size of the key. Anyway have a swift recovery! 

another important lesson learnt. Must ask specific dimensions instead 😂

Thanks...

[Atrecord]

2 hours ago, Sporkypiggy said:

@Atrecord Not too sure if your condition is due to lumbar herniated disc. Bulging disc or ruptured disc.

The herniated disc may compress your nerve and even spinal cord. Nerve compression may generally lead to pain. And it may send shooting pain down from your back to your leg. And worst case, case numbness and tingling sensation down to your toes.

I am not familiar with the DIAM spinal spacer, it  may seems to be explained in the below video. If so, then your case is not fusion.

 

wow, informative... i'll ask my doc when i go for follow-up whether mine is which one... i had the impression that it's cos the 2 discs somehow got out of alignment and parts of them were damaged, so the fragments were compressing on the nerve.

but he did say my case quite straightforward, and everything went well. 

[Windwaver]

2 hours ago, Sporkypiggy said:

@Atrecord Not too sure if your condition is due to lumbar herniated disc. Bulging disc or ruptured disc.

The herniated disc may compress your nerve and even spinal cord. Nerve compression may generally lead to pain. And it may send shooting pain down from your back to your leg. And worst case, case numbness and tingling sensation down to your toes.

I am not familiar with the DIAM spinal spacer, it  may seems to be explained in the below video. If so, then your case is not fusion.

This kind straight forward, MRI sure can pick up and it's only a matter of surgery or not.

People who don't have a clear diagnosis but is suffering are worse off.

 

[Etnt]

Spoiler

This is the wound, not say very big but not small

and I dunno why they like to return to owner the removed parts. These are the discs they took out

Edited April 22, 2021 by Etnt
put in spoiler tag, some might find it offensive

[Kxbc]

1 hour ago, Etnt said:

  Reveal hidden contents

This is the wound, not say very big but not small

and I dunno why they like to return to owner the removed parts. These are the discs they took out

Looks like 5 to 6cm. And very ouch. 

Return you is to tell you got work done. Not just cut open and sew back up. 😁 Something like workshop change the wipe blades for you. My workshop always return me the old ones as if got value. 

[Sporkypiggy]

@Atrecord Did some read up. Below is what I extracted. For sharing purpose: 

An interspinous spacer is a device that is inserted into the back of the spine, between the spinous processes. The device is used to treat spinal stenosis. Spinal stenosis occurs when the passageways of the spine are narrow and compress the nerves of the spine.

Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae.

I think your doctor would be the best person to give you the true diagnosis.

For bulging disc and slipped disc,  X-ray may give you a hint. But MRI can confirm it. The cost of X-ray (<$100) vs MRI (>$1000) is quite big. Usually doctor would recommend physio and give you pain killers if you have back ache. But if you start to have constant numbing and tingling sensation (24x7), then it is a cause of concern. If a patient leave it untreated, it may get worst. And if a patient waited too long, finally cannot take it, and decided to go for operation. The nerve may be compressed for too long and may take longer time to heal itself. Or in worst case, will not heal at all, meaning the numbness and tingling sensation may not totally go away after operation.

My advice to those who have neck and lumbar pain. Don't wait too long to go see a doctor. After getting the diagnosis, then you can decide what is your best approach.  Spend 5-10min every morning and evening to do some light stretching maybe your best medicine.

 

[Atrecord]

On 4/22/2021 at 1:29 PM, Etnt said:

  Hide contents

This is the wound, not say very big but not small

and I dunno why they like to return to owner the removed parts. These are the discs they took out

i think my wound a bit shorter than yours, but more 'rugged' i am told.

And i think my 'removed disc fragments' got more than yours... 😂

[Atrecord]

On 4/23/2021 at 9:03 AM, Sporkypiggy said:

@Atrecord Did some read up. Below is what I extracted. For sharing purpose: 

An interspinous spacer is a device that is inserted into the back of the spine, between the spinous processes. The device is used to treat spinal stenosis. Spinal stenosis occurs when the passageways of the spine are narrow and compress the nerves of the spine.

Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae.

I think your doctor would be the best person to give you the true diagnosis.

For bulging disc and slipped disc,  X-ray may give you a hint. But MRI can confirm it. The cost of X-ray (<$100) vs MRI (>$1000) is quite big. Usually doctor would recommend physio and give you pain killers if you have back ache. But if you start to have constant numbing and tingling sensation (24x7), then it is a cause of concern. If a patient leave it untreated, it may get worst. And if a patient waited too long, finally cannot take it, and decided to go for operation. The nerve may be compressed for too long and may take longer time to heal itself. Or in worst case, will not heal at all, meaning the numbness and tingling sensation may not totally go away after operation.

My advice to those who have neck and lumbar pain. Don't wait too long to go see a doctor. After getting the diagnosis, then you can decide what is your best approach.  Spend 5-10min every morning and evening to do some light stretching maybe your best medicine.

 

yes, quite similar to what i was told by my GP and also the orthos i saw.

My GP sent me for x-ray in Jan, and expectedly it came back normal. After a dose of painkiller and the pain persisted, he wanted to send me to private MRI, but my company would not cover so i asked for a referral to see specialist instead. The wait was a couple of weeks, but longer wait was in store when the ortho ordered a MRI... Never knew so many patients need MRI that queues could be for months in the RHs... (compared to the GP said if he referred to private radiology clinic, can be next day...)

The orthos said that if i choose not to go for surgery, the conservative approach would be to continue with painkiller (since the pain persisted), and then try physio, but this is not guaranteed to work, esp given my condition.

Also said there's chance the left leg might get weaker if left as-is, and the lost strength is usually not going to come back after surgery - and that's another reason why i thought it better to go ahead with the surgery now...

[Sporkypiggy]

There is a minimally invasive surgery called Endoscopic Lumbar Discectomy, which is widely adopted in the US.

It removes the herniated portion of the disc instead of removing the entire disc like fusion does. There are some private Ortho who offer such surgery, but I am not sure if the public hospital does offer. But as I understand, this technique is mainly use for lumbar herniated disc, not so much on cervical (neck). 

 

@Atrecord,

 Btw, did your surgeon say how long you need to lay off from physical exercise?

Will you be able to do running and other sports after a period of 6-12mths after your Diam Spacer surgery?