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Herniated disc sciatica, leg pain, rectal pain, ED, loss of bladder control. Treatment ?

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Orthopaedic Surgeon
Practicing since : 2005
Answered : 43 Questions
Hi. I am 28 year old male, Active duty Army. I have a herniated disc, L6-S1 and slight compression in L5-L6. Symptoms of sciatica, i.e, pain radiating down buttocks into legs, numbness in toes, at times rectal pains, numbness in genitals, ED, also loss of bladder control and sometimes stool control . numbness around damaged area on the outer parts of my back, pain in my lower back. Can't do set-ups, can't run. my walking stride has changed, sometimes i feel like i have to force my legs forward just to walk. I have tried traction, specific therapy excercises. Epidural injections, Platlete injection into the illeo-sacral joint. Another procedure where they stuck six needles into the "knuckles" of my spine, and aplied heat or electic shock to try and i guess deadend the nerves. All with minimal results. MRI before and after procedures showed minimal difference. I am ready for surgery. I would like to know which surgery might benefit me best as far as long term results. I don't really like the idea of discectomy, because parts are taken out and not replaced. Definetely don't want Spinal Fusion. Was considering disk replacement. Any advice?
Posted Fri, 27 Apr 2012 in Brain and Spine
Answered by Dr. Sangeet 13 hours later

Thank you for posting the query.

Well, you have a very good information about your condition.

The treatment of prolapsed disc compressing the nerve roots is discectomy. It is the disc which is causing your symptoms. Hence it ought to be removed.

Exercises and injections are only tried for the initial stages. It works good for some and worsens for others.

Disc replacement surgery is definitely superior to fusion, however its effectiveness compared to that of discectomy is almost the same. There are various studies comparing discectomy to disc replacement which claim to have better results with discectomy alone.

Finally, it is the surgeon's personal experience that counts. As some surgeons achieve good results with discectomy while the newer ones achieve the same with disc replacement.

So, My advise is that you leave the decision up to your surgeon as this surgery has a subjective outcome which varies from surgeon to surgeon.

Don't worry and kindly go ahead with your surgery.

I hope, my suggestions will help you. I will be available for any further queries.

Thank you.

Wish you good health.

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