Microdiscectomy = Not a surgeon?

[LikeDaniel]

Hello all,

So I'm a long term planner, highly aware that chances are I will change my choice of specially before the end of medical school, but currently (and for the past 25 years) my hope has been orthopedics.

This year, long story short, I had to have an unexpected L5-S1 microdiscectomy. From what I can see, medical journals express that 84% of such patients say that their results were Good/Excellent after a median of 6.1 years, a smaller study showed over 90% after 20.7 years. Recurrence of herniation after microdiscectomy also appears to be between 1-20%.

I went to a follow-up appointment with my surgeon's PA yesterday and she was talking as if it were inevitable that 1) my back will continue degenerating causing me to be unable to stand or sit for appropriate periods of time, and 2) that I would eventually require another surgery (likely fusion). My surgeon never mentioned anything like this.

This brings me to my questions:
1) Of course understanding that none of you are my doctor, etc... Am I missing something? Is another surgery inevitable for your average microdiscectomy?
2) Does this end my plans of orthopedic surgery (or other surgical paths)?

Thanks everyone,
-LD

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[LikeDaniel]

Just spoke with the PA again. Said that after removing part of the disc, further degeneration is all but inevitable. Another surgery coming likely in 2, 5... Maybe 12 years.

Please tell your patients this before doing surgery. I would have easily opted to delay surgery and try more conservative measures had I known.

I assume that's it for surgical specialties then. If I'm wrong, please let me know.

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[OrthoTraumaMD]

I know some surgeons who have had back fusion, hip replacements, etc. It’s not necessarily an end for your career. I would suggest you speak with your doctor about this, however.


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[LikeDaniel]

I know some surgeons who have had back fusion, hip replacements, etc. It’s not necessarily an end for your career. I would suggest you speak with your doctor about this, however.


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I really, really appreciate your reply. That's very encouraging.

Again emphasizing that you haven't seen my MRI, you weren't there during my surgery, etc... Do you know if what she said is typical for two to five years after a routine microdiscectomy? I was under the impression that this was a relatively minor invasive surgery.

Planning on getting a second opinion elsewhere, for peace of mind if nothing else.

Thanks again,
-LD

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[OrthoTraumaMD]

I really, really appreciate your reply. That's very encouraging.

Again emphasizing that you haven't seen my MRI, you weren't there during my surgery, etc... Do you know if what she said is typical for two to five years after a routine microdiscectomy? I was under the impression that this was a relatively minor invasive surgery.

Planning on getting a second opinion elsewhere, for peace of mind if nothing else.

Thanks again,
-LD

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Not a spine surgeon, will not comment. FYI if you ask for something that even sounds like medical advice the thread will be closed by the moderators.


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[LikeDaniel]

Not a spine surgeon, will not comment. FYI if you ask for something that even sounds like medical advice the thread will be closed by the moderators.


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Okay, thank you for letting me know. Sorry about that.

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[jesspt]

I really, really appreciate your reply. That's very encouraging.

Again emphasizing that you haven't seen my MRI, you weren't there during my surgery, etc... Do you know if what she said is typical for two to five years after a routine microdiscectomy? I was under the impression that this was a relatively minor invasive surgery.

Planning on getting a second opinion elsewhere, for peace of mind if nothing else.

Thanks again,
-LD

Sent from my SAMSUNG-SGH-I337 using SDN mobile

How about considering a consult from a non-surgical specialty? PM&R might be a good place to start.

BTW, the PA is practicing fear mongering, and it doesn't tend to be very helpful for patients.

 

[SSdoc33]

lets just say that anyone with a decent sized disc herniation will have progressive degenerative changes with or without a surgery. a microdiscectomy in a younger patient with a disc hernation and symptoms that havent responded to conventional therapies is completely reasonable.

2 take home points: #1 do whatever specialty you like. if pro athletes can have this surgery, so can you. #2 never trust a PA (or NP for that matter)

 

[kitsunepixie]

I'm a neurosurgeon who does MLDs all the time. Go become an Orthopedic surgeon or a spine surgeon if you want! Don't focus on what "might" happen. There are some patients who do require multiple operations but they are the minority.

 

[VincentAdultman]

This sounds a lot like medical advice and you should talk to the surgeon who did your procedure instead of soliciting opinions on a message board.