Microdesctomy and drop foot.

Hi everyone. About 2 months ago I herniated the L4-L5 disk in my back. That itself did not cause much pain. A week after herniating the disk, my sciatic nerve sent me to the hospital. After getting out of the hospital I was sent to a neurosurgeon to see if I was a candidate for a microdesectomy or if cortisone shots would be better. During the evaluation the surgeon noticed that I have foot drop. I cannot stand on the heel of my left foot. While sitting down I can bring my foot completely up, but I can't while I have weight bearing on my leg. The neurosurgeon told me I needed to get the microdescetomy because the nerve root was already showing signs of permanent damage and will continue to deteroriate until I lose all function in my leg. I'm 25 and not ready for surgery. I'm undergoing PT right now for 5 weeks and have noticed some slight improvement. My concern is will my leg weakness continue to get worse or will I be able to heal it on my own. Should I go ahead with the surgery? 


  • Weakness is the MAJOR warning sign. You need to take it seriously. I've read that after 3-6 months with weakness, the chances it can reverse go waaaay down. I feel like I nearly waited too long and it was only a month - month and a half. Another thing to think about - serious nerve compression can lead to incontinence if it gets worse.

    You say you've experienced slight improvement - well, I fooled myself into thinking that I had been improving too when really, it was worse. That could be the case with you too. The doctor did the weakness tests on me a second time and sent me immediately for an MRI and surgery consult because I was so much weaker than when I presented with symptoms and needed an epidural injection just to stand up. I had a bilateral microdiscectomy of L4-L5. I think the only way you could reasonably think you don't want to consider surgery is if your MRI shows that the problem disc is NOT pinching nerves. How are you going to get the disc to move off them? Can you? I couldn't. My herniation was too large. Some myofascial therapists and chiropractors think they can do it - but some herniations are just too big.

    I thought I could put off surgery until I was 40-60 years old. No such luck. Even the day of the surgery I wondered whether I really needed it (I did!).  Do you want to risk permanent paralysis just because you think you aren't the kind of person to have surgery at your age? Kimmy72 is right to suggest you know what the neurosurgeon's prognosis is for you if you don't have surgery.

    It's 8 weeks out from my surgery and I no longer limp - but I still have some drop foot. If I'd had surgery to remove the disc from pressing on the nerve sooner - I might be able to jog and fully use my leg right now. We'll never know. The strength may return - experts give the recovery period 12-18months after decompression before it's unlikely you'll see any further improvement from nerve regrowth.

    Finally, I don't understand how people start PT. I'm just a huge PT skeptic for disc bulges. I don't understand how anyone can expect to fix themselves when they're still damaged (the bulge). It seems counterproductive. Maybe the hope is the bulge moves back off the nerve given some special set of movements? Sorry if this post seems a little harsh. I just see myself in what you wrote and want you to have a good outcome.
  • JillyJJilly CaliforniaPosts: 1
    Hi Acarm.  Your situation is exactly the same as my husbands.  Because he longer is experiencing the sciatic nerve pain, which initially was extreme, and generally feels like he is back to normal, it was hard to come to grips that surgery is needed.  He has a 20% disc herniation and foot weakness (can't hold up left foot when walking on his heels).  However, after my husband talked with his internist, his PT and the orthopedic surgeon, we now are convinced that surgery is what is needed to prevent further nerve damage.  He goes in on July 15.  We have not heard or found any evidence that non-surgical methods can relieve the pressure on the nerve.  
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  • SavageSavage United StatesPosts: 4,299
    edited 07/23/2019 - 1:08 PM
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  • jsquaredjjsquared North TexasPosts: 7
    I had a herniated disc at L5/S1 (twice actually) and luckily wasn't in a lot of pain but did have weakness in my leg/left foot.  What I was told is the longer I waited the greater the chances the damage would be permanent.  And, if the herniation is causing nerve impingement there is no way, besides surgery, to get the disc off the nerve.  There's no shots or therapy that can alter the shape of the disc.  I was super bummed but had my first surgery on 9/29/15.  I, unfortunately, re-herniated the same disc (I think about a month later) and just had a revision surgery 2 weeks ago.  I'm trying to be super diligent with my recovery instructions and sure hope this time it holds!
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