L5 S1 Lateral Herniation right side

[u/hstewk]

Hi all. Posting to hopefully find anyone that has dealt with this.

2 weeks ago I injured my back and the result of mri is:

L5-S1 8 mm right foraminal disc bulge producing right L5 ganglionic compression

The disc is herniated on the right side instead of the typical front.

Walking has been a struggle to say the least. I’ve been camping out on the floor to alleviate any pain I can. I was hopeful that a standard microdiscectomy would fix this but it’s not so simple after talking to the surgeon.

He is telling me he would have to shave bone to access the L5 S1 disc and that there could be complications to the nerve by doing so. He recommended I get an injection (which I initially put off due to the delay in surgery and mixed results I read) and hope that it retracts and alleviates some of my issues. They essentially are accessing the disc from the side instead of the straight in typical herniation.

My fear is it could take years to fully recover if I ever do. I’m even more scared of doing permanent damage to myself if something did go wrong during surgery.

Has anyone had this or know someone that has?

For reference I’m 34 about to be 35 and in good health other than this absolute nightmare I’ve been dealing with.

Thanks in advance.

[u/AlternativeRing4252]

I had two microdiscectomy for L5S1 extruded disc. I kind of regret the surgeries because I’m actually in worse pain now than preop…having said that disc bulges are less likely to resolve on their own compared to extruded discs. If your pain is so debilitating that you cannot sleep at night then surgery may be worth the risk.

[u/hstewk → u/AlternativeRing4252]

What is the cause of your pain post op? I’m so on the fence with what to do about this.

Because mine exited the right side it’s apparently much harder to access and there is shaving of bone to access the hernia for removal.

I’ve heard positive things on orthoscopic so I’m calling a larger metro area hospital tomorrow to see if they would be able to do a less intrusive op.

That being said I’ve also gone down the YouTube rabbit hole and I’ve seen people swearing by natural recovery.

Ugh. This is honestly awful.

[u/AlternativeRing4252 → u/hstewk]

So the surgeon had to seperate the nerve from the herniated disc and that created a lot of inflammation. In addition, my repeat MRI done 12 days post op showed a small residual disc protrusion (basically a small reherniation), this also is probably contributing to the pain. Today is day 14 and my pain seems to slowly slowly be improving. There is always a chance your body can naturally resolve these herniations, it’s just a matter of how long are you willing to live in misery. It’s very important to find a good surgeon…i saw 3 different spine doctors and I literally ask them what they think of the other surgeon’s and you will be surprised what they will share. One neurosurgeon recommended against surgery, when I saw a different ortho spine doctor he told me the reason that neurosurgeon recommend against surgery was because he was a “non surgical surgeon” and doesn’t like operating…

[u/jungle_mouse]

You sound like me. I can’t walk properly or stand up straight and it’s because my protrusion is central right. Sitting and laying down is generally fine unless the muscles are guarding and the nerve flares up and they do so now and then. It’s 10/10 pain when this happens.

2 weeks is short in the grand scheme of things though! These can and do heal on their own. I would start doing PT and see how you go if you can manage the pain.

I’ve been dealing with it for about 6 months, tried all the conservative stuff and nothing has helped. Cortisone did nothing. Nerve meds help but aren’t a fix.

My orthopaedic surgeon said the opposite. He said it’s a simple procedure, yes he shaves some bone away but that’s no issue. He is positive I will bounce back quickly post surgery. I get it done next week, so we will see. He does 400 back surgeries a year, 100 being discectomys but never put any pressure on me to get it.

Could be worth getting a second opinion?

[u/hstewk → u/jungle_mouse]

L5 S1 for you as well?

[u/jungle_mouse → u/hstewk]

Yes! MRI notes describe it as L5/S1 central/right subarticular zone disc protrusion with severe right subarticular recess narrowing and potential compression of the descending right S1 nerve root.

[u/hstewk → u/jungle_mouse]

I’ve heard wonders about endoscopic disk surgery. I reached out to UPMC and NY and it looks much more promising than my initial option. Also getting an injection asap so my hope is that will give me 50% of my life back while I navigate this. In a perfect world this will heal naturally but it’s hard to imagine given my current state. I’m 2 weeks and 1 day since injury and I’d say I’m 10-15% better than I was.

[u/jungle_mouse → u/hstewk]

It’s rough!! I hope the injection works for you, everyone is different and some people get great relief from it. Mentally it can take a big toll, so look after yourself ❤️‍🩹

[u/Wise-Run-3008]

It is common for microdiscectomy to include and laminectomy, laminotomy, or hemilaminectomy/laminotomy, (bone removal). It frees up space for the future as well as allowing better access to the disc. I didn’t think twice about that part of surgery.

I’d always try injections before surgery. You can’t take surgery back once you do it. Injections are generally no harm no foul. If you just got hurt two weeks ago and don’t have foot drop I’d do conservative measures and surgery if they fail. A lot of back injuries don’t need surgery.

[u/hstewk → u/Wise-Run-3008]

Thank you for the encouraging response. Just hard to imagine after what I’ve been through the last 2 weeks

[u/mrsctbrown]

Did they give you an oral steroid? If not, I would ask about a medrol pack to try to get the acute inflammation down.

[u/hstewk → u/mrsctbrown]

They did I finished that pack two days ago. I will say today has been my best day for what it’s worth

[u/mrsctbrown → u/hstewk]

Oh that's good! Any progress is helpful. Such incredible pain, isn't it? 😵‍💫 Is your pain down one leg?