Hi Zak,

I'm sorry to hear that you are suffering like this at such a young age, and I understand the kind of pain you are in. I've been in your shoes twice over the past few years, but I'm a lot, lot older than you.

It's really hard to answer your questions about microdisectomy vs. hydrodisectomy since hydrodisectomy is a new procedure with no long term study results available yet.

It appears that hydrodisectomy is a good choice but only time will tell how good a choice it is.

As for microdisectomy, it can be very, very affective at relieving your pain and getting you back to functioning again.

I, myself have had 2 done on 2 different discs and have been able to go back to my normal lifestyle, but it is not that of a 17 year old or playing contact sports of any kind.

The best advise I can give you is the following.

Before deciding on which of the 2 types of surgery to have done, I would get at least one more opinion, maybe more than that.
Since hydrodisectomy is so new, you will need to be sure that the doctor you use for this, if that is what you decide, has done many, many, many of this type of surgery.

Also you need to find out if there is even a chance that there is any narrowing of the foramen in the vertebrae involved or if there is any possibility that there are is nerve compression in the lateral recess area of your vertebrae.

If any of those possibilities exist or if they do exist, then you need more than just the hydrodisectomy done. You would need both a microdisectomy, and widening of the canal that the nerves go through. If that isn't done, then doing either just a microdisectomy or hydrodisectomy will not relieve all of your pain as there will still be nerves being compressed.

One of the most common causes of falied decompression spine surgery is the lack of decompression of the lateral recess area of the vertebrae and it has resulted in fusions being done for no reason.

For example.

Several years ago, I suffered with what have and got several opinions on what to do. The surgeon I chose to do my surgery diagnosed me with lateral recess stenosis that was causing the disc to herniate. He did not believe that a microdisectomy would help me at all, but rather a widening of the lateral recess area was all that was needed.
He also disagreed on doing a laminectomy to do this surgery, but would rather do, what is called a laminotomy and remove only enough lamina to access where he needed to and widen the lateral recess area.
That would keep my spine stable and be far less of a risk of future problems with vertebrae slipping and requiring a fusion.
He told me that if the disc did not pop back into place with the surgery, he would then proceed to do a microdisectomy as well, but didn't believe he would need to.

Now I had 5 other opinions before having surgery and all wanted to do a laminectomy and microdisectomy.

Well, all I had done was the widening of the lateral recess with a laminotomy on one side, the disc popped back into place and has been fine for about 7 years.

Then after a rear end auto accident, not my fault, the disc above this one decided to be a problem and herniate.

I tried all the same things you did to heal and ended up with a microdisectomy through a laminotomy, but there was narrowing at the canal, and the doctor also widened the canal, including the lateral recess area and I've been fine for 3 years since that surgery as well.

That's why I'm saying to get more than the 2 opinions you have had. At your age, I would suggest that you try seeing a sports medicine orthopedic surgeon that specializes in spines.
You are young and active and you are an athlete. You want to preserve as much of your spine as you possibly can and stay as active as possible as well.

Sports medicine doctors are well aware of that kind of problem and deal with sports injuries of athletes all the time, including spine ones.

Is there a pediatric, adolescent hospital near you? If so, you could see if they have a good sports medicine department there, I would expect that they do. You are still young enough that they would see you. It might be a place to start, and if they say you are really too old, they may give you some names of doctors to see.

Good luck and keep us posted.

Fran

Fran, thank you for your response and well wishes. I went ahead and underwent a microdiscectomy with a neurosurgeon yesterday. As soon as I woke up my leg felt fantastic and still does. However he said that the chance of leg pain returning here soon is really good because of inflammation from the surgery and the way my body reacts due to me being only 18 years old. I'm up at 4 in the morning writing this because the incision is uncomfortable to sleep with and I slept a lot yesterday. Thanks again Fran and all the best to you and your back!

Hi Zak, that's fantastic news that you went ahead with a micro and had instant relief after surgery.

It is true that the pain, or at least some of it may return as the days and weeks go by. Usually it will start around 3 weeks post op.

My own experience was around 3-4 weeks, I started getting sudden nerve jabs in various parts of my leg and foot from the thigh down to my toes.
Sometimes it was just a quick jab of nerve pain and other times it would last a while, but it was never as bad as before surgery and it didn't hinder my ability to function and move around.

It is the nerves starting to heal and recover from being compressed before surgery and manhandled during surgery. Doesn't take much of anything to fire up the nerves and get them angry, so the slightest movement of them, done ever so carefully during surgery, is like manhandling them.

First they are relieved to have the compression removed that was on them. Then they get to rest. As you start to move more and more normally again, the brain starts to fire up the nerves to start functioning properly again and they got used to working the way they did before surgery.
The response of the nerves is to resist the messages from the brain to get moving again and in turn, because they have no choice but to start moving again and functioning, (you are forcing them to do so by moving around), they find themselves injured and sore from the compression and what you feel is the nerves learning to do their thing again.

I had those off and on nerve jabs and lasting bits of nerve pain for about 6 months. What I never had was the entire leg having nerve pain all at once, and the worst was at night trying to go to sleep. It wasn't that it hurt so much, because it didn't, it was just that I got more of it when trying to sleep.
I never did figure out if it really was worse at night trying to sleep or I just noticed it more because I wasn't doing anything to keep myself busy and occupied.

By the time you read this, I'm betting the incision discomfort is all but gone. If not it does get better within a week. I found it nothing anywhere near as bad as the pain I had before surgery.

Now the most important thing is to follow all of your spine surgeon's orders. Don't even think about cheating on any of those rules, even once. Even when you are really feeling better.

NO BENDING, NO TURNING, NO TWISTING, NO STOOPING, NO LIFTING ANYTHING MORE THAN THE DOC SAYS AND NO REACHING FOR ANYTHING.

Wait until the doc gives you the all clear.

Once he has, you should begin a program of physical therapy to help heal even more, strengthen the cores, the quads, the hamstrings etc. Learn to move properly and how not to do anything to re- injure your spine again.

Remember it is still healing and it can take a while to do so. It doesn't heal over night, even when you feel like it has.

I know, patience is not part of a teens life. I've been one myself and had to recover from some very major surgery when I was in HS and it took most of the school year to do so.

It wasn't fun, and my patience wore very, very thin. I felt fine and docs kept me restricted for so long, I though my sanity would go. I often wonder, to this day, how anyone in may family survived that year when they had to put up with me and my impatience.

Couple of times a did more than I was supposed to, and believe me when I say, I payed for it big time and it delayed recovery.

So try and not make that kind of mistake.

Good luck and from a mom to a teenager eager to get his life back, behave and try not to be a teen right now. Just be a post op surgical patient that has to take time to recover both physically and internally from some very major spine surgery.

Keep me and everyone else posted on how you are doing.

Fran