For those of you who have read My Wretched Spine , you know that I have been having back trouble again.  I have since been back to the spine specialist and have a plan to getting better, at least somewhat.

I have to go the hospital in the morning to have my pre-operative screening done,  just some blood work. Provided that all checks out, I see no reason it wont, I will go in for surgery Thursday. The surgical plan is to do a hemilaminectomy and discectomy on two levels of my lumbar spine.

I am going to explain my symptoms and the surgery with the  use of some illustrations and try to not get too technical for my non-medical readers. For my medical reader, sorry for the over simplification.

Spine as seen in Gray’s Anatomy textbook on http://www.bartleby.com

The image to the to left represents the entire spine. In the image you can see that the spine is divided into sections, the cervical with 7 vertebrae, the thoracic with 12 vertebrae and the lumbar with 5 vertebrae. Between each of the vertebrae there is what is  commonly called the disc. The disc is filled with a jelly like substance that provides cushioning for the  spine.  Sometimes, when the back is injured the disc either bulges or ruptures. In the case of a bulge, the jelly like substance is pressing on the outer layer of the disc causing it to protrude outside the body of the vertebrae. In the case of the rupture (also known as a herniated disc) the jelly like substance breaks through the outer layer, dries up, and hardens. The bulge or rupture can happen toward the front, back or either side.

In my particular case the areas of concern for my surgery are with L4-L5 (the disc between the fourth and fifth vertebrae) and L5-S1 (Lumbar five and Sacrum or the tailbone).  I also have some slight bulge at the area of the L3-L4, but the surgeon doesn’t feel that this area needs surgical intervention. My disc are ruptured and bulged to back and to the right, thus the pain and numbness are on the right side of my buttocks and down my right leg all the way to the foot

Lumbar vertebrae as seen on http://www.back.com

The image above shows the lumbar vertebrae in the axial view. An axial view is as if the vertebrae is removed from the spine and is seen from above.  The vertebral foremen,  the hole behind the body, is where the spinal cord passes.  When the disc is protruding to the rear, it pushes on the nerves and causes pain and numbness to areas of the body below the area of injury.

Herniated disc as seen on http://health.allrefer.com

The above image shows a herniated disc that is compressing on the spinal cord. This a sagital or lateral view, which is a view from the side.

Now that I have went through mechanism of my pain and numbness, I am going to give a brief description of the surgery. First in a discectomy, the disc or protruding portion of the disc is surgically removed, to relieve the pressure on the nerves. Second they are going to do the hemi-laminectomy.  This involves shaving a portion of the vertebrae called the lamina(refer to the second image of this post), to remove pressure from the nerve roots.

In my past two surgeries the relief was immediate, but there is an eight week or more recovery period. Realistically speaking, the surgeon has informed me that getting a 51% percent improvement of my symptoms will be considered a success, especially given that I have had prior surgeries on these areas twice.  He feels that there is a good chance that I will get more than 51% improvement, but if that is all I get, than surgery has not failed.

Of course there are always risks with surgery and anesthesia. I am not too concerned with anesthesia, I have been through three surgeries under general anesthesia and never had an adverse reaction. There is an increased risk of a spinal fluid leak, as I have scar tissue from my prior spine surgeries. Even if a spinal leak occurs, it is a relatively minor complication.

Again, I write this to inform, not to search for sympathies.  I have a rather large family, and this seems the easiest way to provide the information to those who care to know.

As always,

Thanks for Reading

Steve aka FatherNoRest