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Back Problems Message Board

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My, it sounds like he has had a rough time. I've had 8 spine surgeries, and the first couple were herniations, so let me provide just a little input there.

It is normal that one MAY experience a second herniation not terribly long after a partial discectomy. It isn't a given, but it isn't unusual either. However, not sure why the first doctor was supposedly doing a laminectomy if he wasn't doing a fusion. Now that you have or can at least obtain the surgical report from both (go to the hospital and sign to get them. Your hubby will have to do unless he has signed a legal statement authorizing you to obtain any and all medical information as needed.)

Once you and hubby have a copy of both said reports, then perhap it would be wise to speak with a medical injury attorney for at least the free consultation. They could then tell you whether there was a case or not regarding the first or first and second surgery.

Now, as for the surgery for a discectomy, I would not think it normal to have his symptoms this far after surgery. However, let me say that I have noticed comments from others who had the micro discectomies and sometimes they have mentioned swelling and soreness for some time following surgery. You see, mine were open discectomies and I recovered fully almost immediately. Sure, I had a 3-4 inch incision, but I was up and going within 24 hrs and totally back to a full routine in under a month. Sometimes having a little larger incision is not the worse thing.

Okay, all this brings up what I have said many times before on this board. Please, please consider getting hubby to see a true spine specialist and not just a general ortho or neuro surgeon. I'm suggesting that you research using the web (I have a post how to find a spine specialist in your local area) to view the credential and narrow potential doctors for his back to ortho and neuro surgeons who have completed extensive (more than a year - preferrably 2 years) spine fellowship and then go that extra step by limiting their practice to just the spine. Those who limit their practice to just the spine will be far ahead of the general ortho and general neurosurgeons who practice on all areas of the body as these others may spend maybe 20-25 percent of their time on the spine and the spine specialist spends almost 100% of their time on the spine. It is the spine specialists who will be more involved in clinical trials and it is they who will use newer procedures several years earlier than the general surgeons will.

After all I have experienced, I admit that it was a lesson I learned the hard way, but if you need more than a simple discetomy or if you have had such and experience problem, then see a true spine specialist. Even if a spine specialist says that what your hubby is experiencing isn't unusual for a microdisctomy, then at least he will have searched and found a doctor for when he has the next problem, because it will likely come to that point as he ages.

I hope his symptoms are not unusual for a microdisectomy, but I would certainly be checking it out. He surely is suppose to see the surgeon again, so please let us know what he learns. Best wishes.
[QUOTE=liberty72]Thanks for the quick replies on this. But I think that I got a little confused. Which is not hard for me... :confused: His 1st surgery was the microdisectomy and the 2nd was the laminotomy with microlaminectomy and discectomy. Is there a difference??
We asked the dr. if he would do a fusion on him with the 2nd surgery, but he said no. Because of his young age (33) and in good physical shape he would heal faster without it. I asked him also about the artificial disc replacement. But that was a no go also. Said that there was just not enough prooven results from it yet.

So, he should still be in pain 7 weeks after surgery after having a laminotomy?
I do have the operative notes from both dr's. Is that enough? I also have MRI reports from all the MRI's.
All of this is so confusing for me.
Thanks for the help.[/QUOTE]

Okay, yes there is a difference. Laminectomy, micro or regular is removing bone that may be compressing a nerve in what is called stenosis. Stenosis can take place as we age and ligaments thicken and harden and discs begin to bulge or perhaps we develop multiple bone spurs along the spine. Discectomy of course, is removal of part of or all of a disc which is the cushion between vertebrae. Doctors will almost always do laminectomy when they are doing fusion to prevent future problems, and to use that bony material with BMP for the fusion so that they don't have to take bone from the hip paddle.

There is a post near the top of the boards titled New Info for lots of us, where Bionic Witch has provided us the web site for spine universe. You might wish to visit that site as it will hold a lot more info than I can explain, and if I recall correctly, they even have a micro laminectomy demonstrated on there with the verbage, making it a lot easier to understand.

At only 33 years of age, I would reinterate my suggestion that your hubby see a true spine specialist. General ortho and neuros will not advocate ADRs for some time to come, but if your hubby had an ADR now,he would run less risk of spondylolisthesis. Even if the ADR held up for only 12-15 years, he would have normal spacing and functioning, not only be less likely to develop the slippage, but it could also prevent problems with herniations or other conditions in the levels above and below his current problem. Oh, how I wished I could have had the ADR when I developed the first problems. In my own case, instead of slipping forward or backward, mine slipped sideways and were about to sever my spinal cord. Of course, early on, I was dealing with typical ortho/neuro surgeons instead of a true spine specialist, so was not offered such options, and by the time I found a spine specialist it was too late for me. However, I did talk with several patients who had the ADR's and they were ever so happy with the results.

You and hubby should be pleased he did not have the fusion, although a true spine specialist can saw apart a fusion to be redone later. However, if he were to need a fusion, especially at a young age, I would suggest he investigate the DYNESYS which is a flexible fusion. You can find it at the site I mentioned as well as others.

Informing yourself will help you more than anyone, and that web site as well as other searches of his condition on the web are helpful. If you are informed you can ask the appropriate questions of doctors and makek a more informed decision. However, extremely few general ortho/neuro surgeons will take the lead and accept the newer techniques right away. By the time some accept what can be done today, even newer methods are established, but then as general ortho/neuro surgeons they cannot possibly stay up and trained on the newest techniques in every area they operate on, like a spine specialist who is treating just one area.

General ortho/neuros can be excellent doctors and I don't mean to put them down. Once an individual's back has worsened beyond a simple discectomy, and if they are active individuals, and want the very best treatment so that they can retain normalacy, then I recommend getting the doctor who is the most specialized and the most up to date and most trained on the specific area. Sometimes seeing a specialist later after more surgery or damage works out okay, and sometimes too much additional damage has occurred as was my case. Luckily, at least I am still functioning thanks to the spine specialists skill, but had I sought him out before I was temporarily paralyzed I might not have had to endure all the surgeries and deteroriation I have because at that point I probably would have been able to have at least one level ADR and possibly the DYNESYS flexible fusion. Just ever so thankful this doctor has been able to keep me going, even with 10 levels being fused.

Best wishes.

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