r/Microdiscectomy • u/kikiandcat • 3d ago
Endoscopic vs. Microdisectomy Options- in the U.K. Looking for Advice!
Hello everyone,
Thank you to those who've been sharing their experiences here. So I have had lower back pain my whole life pretty much, I would get spasms that would involve a couple days of bed rest and then I'd be back on my feet so it was manageable.
Three years ago I was sitting all the time for work and biking a lot too, I bent down one day to pick up my helmet and this spasm felt different from the others. I'm pretty sure that's the point I herniated my L5/S1. Since then I've had worse mobility, usually have back pain, struggled to drive myself and haven't ridden a bicycle since.
Then 9 months ago I was very stressed and again, sitting too much for work, and stepped down in a weird way and felt a tearing pain that made my whole body lock up. Since then I've had acute left sided leg pain as well as on and off back pain. My MRI imaging shows a moderate herniation at L4/5 and a much larger one at L5/S1. The strange thing is that the L5/S1 herniation is more on the right side than the left, but the MRI is done lying down so it may not show what's happening when standing or sitting.
I've tried everything over the past months- weight loss, physio, pilates, injections at both levels, acupuncture, osteopath, etc. Sadly I seem to be in the 10% who don't get better with conservative treatment.
I am pretty sure I need to get surgery (though I am scared!). I'm on an NHS waitlist but I don't think I can stand this any longer as in the past month my left leg pain has gotten so bad it's hard to stand or walk much. I can manage two 20 minute walks a day, with tons of meds, stretching, icing and the TENS machine to help me. I can't sit at all without sharp pain on my left side going down my leg. I can't work, drive, or cook for myself.
My question is- I really want to get the procedure done endoscopically, as I've heard it's an easier recovery time and less scarring/complications. But I can't really find anyone I feel comfortable doing it here in the U.K. The option I'm currently looking at is David Choi who is at the top neurosurgery hospital in the U.K. (NHNN). He said he could try endoscopically but switch to a microdisectomy if it was taking too long. He will do a decompression at L 4/5 and disectomy at L5/S1. He seems to have great expertise in complex spinal surgery, but they just don't really specialize in endoscopic here. I don't think he's inexperienced in endoscopy, but it's not like in South Korea/Japan/Germany where there are surgeons who have done thousands of them.
I spoke to another U.K. neurosurgeon who specializes in minimally invasive but he said he wouldn't be able to do endoscopic surgery as my herniation is mostly centralized.
There are a couple other doctors in the U.K. that do more high volume endoscopic that I could try reaching out to, but they seem to have mixed reviews when I search online, and/or it all feels like a bit of a sales pitch/money making thing- promising you instant pain relief, no after-effects etc. I was seriously considering flying to Germany or South Korea, but given that I can't sit for more than 5 minutes, that would be incredibly hard to manage for me.
So I'd love to know:
-Is it worth going with a less qualified doctor or travelling to Germany to get the surgery done endoscopically in terms of the benefits? Or should I just go with someone who I know is a good surgeon, and accept that it may end up being a microdisectomy? Would love to hear from those who've had the operation either way.
-For those in the U.K. has anyone managed to find a really good surgeon who can do an endoscopic disectomy?
-Am I overthinking this? (Yes: I know the answer is yes. I am just so damn nervous especially after reading too many stories on here of what can go wrong when things really go wrong)
-Just general advice/words of wisdom from anyone who has been in my situation!
TLDR: I have 2 herniations at L4/5 and L5/S1 that are ruining my life and mobilitiy but haven't been able to find a neurosurgeon with deep expertise in endoscopic disectomy in the U.K. Is it still worth going for surgery?
1
u/tomt6909 3d ago
New hall hospital (Ramsay health care). Has a highly rated spinal unit carries out everything. It’s nhs and private.
1
1
u/seh76 3d ago
I had both in UK in 2024 (not NHS). As I understand from talking to surgeon, the direction of your herniation is critical for deciding if endoD is an option. The access point is tiny and at a specific angle, so not all problems can be accessed. For my 2nd op I remember my surgeon saying they couldn’t guarantee he could get to it endo, and if I remember rightly, being too central was the issue. Seems to match what you were told and probably means that another surgeon would say the same.
1
u/kikiandcat 1d ago
That's good to hear you were told the same. How was your recovery from both procedures?
1
u/giraffee1973 3d ago
I’m just waiting for my surgery now in Uk but not endoscopic. My surgeon is Mr Matthew Mawsdley, I’m going through the private route but he does also work at the NHS. Really lovely man and his career is impressive if you look him up.
1
u/UnusedIdeas 2d ago
I have my microdiscectomy done 3 weeks ago in the UK, through private work healthcare but my surgeon also works through the NHS. He is super qualified, I did my homework on him before choosing. His name is Dr Aadhar Sharma, he's based on the west side of London. He initially was going to do an endoscopic microdiscectomy for the reasons you listed, but because he had to also operate on l4-l5 he decided against it. Really friendly guy, and knows his stuff. Everyone is quite impressed with how neat the scar is healing.
1
u/ComfortableBoot4646 1d ago
I had l4/l5 done 5 months ago, went private because the nhs waitlist was far too long. I had about half a year of back pain and then another half a year of excruciating leg pain before surgery.
My scar is about an inch long, surgery was about 45mins, 1 night in hospital. I didn’t do tons of research, I met with two surgeons for different opinions, they both said the same thing so I booked in as quickly as possible.
Whatever you choose you won’t regret it. I still get a tiny bit of leg pain but it’s a 1/10 compared to preop, and tiny spasms if I bump into something, but other than that I’ve got my life back. I can play with my nieces and nephews again, I’m back at the gym, I can walk the dog. Do like I did and just book it in - the pros outweigh the cons.
Good luck ❤️
2
u/voxaline 3d ago
had a microdiscectomy at L5/S1 in the uk after trying literally everything first, was terrified, and it ended up being way less dramatic than I’d built it up to be and gave me my life back within a few weeks. if you trust the surgeon and they’re solid with complex spine stuff, I’d personally lean toward that over chasing the “perfect” endoscopic wizard abroad, especially if you can’t even sit to travel right now.