Discectomy L5/S1 - riding/activity post op stories please

[Birker2020]

Hi

Has anyone had the above operation please? I spoke to my GP on a telephone consultation last week and she has agreed to put me in touch with an Orthopedic Surgeon for a consultation, but this will be after Covid-19 is more under control.

I was first offered the op in around 2011/2012 but thought I would go down the prescription drug route first which was initially effective but now I'm struggling and having all sorts of issues with my legs and feet as a result of my back, overcompensation, sciatica, etc, etc. Somedays I feel so miserable with the constant nagging aching and the way the drugs make me feel after I've taken them.

I have what was described on MRI as 'a very large prolapse L5/S1 with a sequestrated disc which was free floating' although was told at the time that the sequestra would be dissolved by the body. I slipped my disc originally as a result of a number of falls over many years from my horse usually onto my right hip (used to compete every weekend) and one day at work I stood up from a chair and that was it, my disc went, the agony was terrible. I was at the time seeking the help of a Chiropractor who also thought I'd slipped a T4 or T5 but nothing has ever really come of that.

I can see on a search of this forum stuff about the operation but it dates back to 2009 and 2013 so I was kind of hoping for a bit more updated info, especially post op activities.

What I really want to know is can you still ride as normal, do you have any limitations in terms of what you can do, i.e. jumping, mucking out, carrying items, etc, etc? How long was recovery? What was long term prognosis?

Many thanks, so grateful for any first hand accounts.

 

[Trouper]

I had more than a discectomy at L5/S1 - I am permanently plated and screwed in place there. Honestly, it was the very best thing I have done.
Prior to that we had tried exercising, facet joint injections, nerve root injections - everything rather than have surgery but in the end I just could not carry on. I had not gone back to riding at that stage (mid 60's) but felt so well afterwards that I decided my retirement needed more excitement. Surgeon was happy, so I was introduced to a back protector (still hate it) and off I went. I am sure I could not have done it before the op as the pain and stiffness makes you hold your body protectively and you are really unbalanced.
Obviously I am a little stiffer at the base of my spine now but there is no pain.. I took my time over recovery and had help from a physio. They always say 6 weeks for a basic healing but I have also had a discectomy higher up and even that took longer to really heal well and get proper movement back - say 4 months. At my age heavy work like mucking out and gardening take their toll anyway so you will always need to be careful and if you can do any exercise such as pilates it will really help you to keep strong. In the early days, the pool was my friend to start getting the initial strength back.
My only advice is to research your surgeon really well - there are varying standards!.
Good luck.

 

[wren123]

My friend had a posterior lumbar discectomy/decompression and insertion of lumbar interlaminar stabilisation done privately by Mr Mo Akmal at the London spine unit last summer. He's thrilled with the result he doesn't ride but is active, he'd suffered years having injections, physio, pain killers but it had got progressively worse and he had had enough.

 

[Birker2020]

In the early days, the pool was my friend to start getting the initial strength back.
My only advice is to research your surgeon really well - there are varying standards!.
Good luck.

Hey thanks for your reply Trouper.
I love swimming and was going everyday through lockdown when we were allowed, so I could always do that to strengthen up. I'm also going on a bit of a diet to see if I can lose some weight.
I won't be able to research my surgeon, this is going through the NHS and not privately so I won't have much choice in the matter.

I think Spencer Harland is the chap my friend had for her back op when she was dumped on the road by a horse she rode for someone. I think he might have been the one who I visited in 2011/2012 or whenever it was. I know he does limited NHS work, but to be quite honest I'm not that bothered.

I've just looked on my CV to see when it was that my disc went as I remember what company I was contracted at, at the time, and shockingly it was in was 2008, so I've done well to cope until now. But with most things, you learn to cope, it doesn't mean to say it ever goes away. I think I had my facet joints medicated in around 2013.

 

[Birker2020]

My friend had a posterior lumbar discectomy/decompression and insertion of lumbar interlaminar stabilisation done privately by Mr Mo Akmal at the London spine unit last summer. He's thrilled with the result he doesn't ride but is active, he'd suffered years having injections, physio, pain killers but it had got progressively worse and he had had enough.

Gosh that's good news. As far as I see it Lumbar Decompression Surgery has three options,

• laminectomy – where a section of bone is removed from one of your vertebrae (spinal bones) to relieve pressure on the affected nerve
• discectomy – where a section of a damaged disc is removed
• spinal fusion – where 2 or more vertebrae are joined together with a bone graft

I'm hoping I can have the discectomy as I think it's a faster recovery rate.

 

[Tirna]

I had an L5/S1 discectomy in 2017. Id previously been receiving epidural steroid injections and twice weekly physiotherapy sessions over 18 months in order to treat the disc prolapse, along with Gabapentin and various pain medications. It got to the point where the pain meds weren't even touching the sides and I had increasing lack of feeling and function in my left foot, so was admitted for an emergency discetomy on the NHS. I've never looked back, the pain relief was instant and even the usual post-surgical soreness was nothing compared to the previous neuronal pain i'd experienced which was all-consuming.

I've been able to get back to riding, hiking and gym classes. I choose to avoid running and heavy lifting on the advice of my surgeon, which doesn't seem like a big sacrifice at all given the overall improvement. So i'd echo Trouper's thoughts that it's more the yard jobs such as mucking out that you might need to consider carefully (I moved to a part-livery yard), but I ride my horse most days and don't feel any pain either during or afterwards. Best of luck

 

[wren123]

I'm sure you get a choice of which nhs consultant you're referred to. Just found this https://www.gov.uk/government/publi...k-what-choices-are-available-to-me-in-the-nhs it says at point of referral.

 

[Birker2020]

I'm sure you get a choice of which nhs consultant you're referred to. Just found this https://www.gov.uk/government/publi...k-what-choices-are-available-to-me-in-the-nhs it says at point of referral.

Oh wow I had absolutely know idea at all that you had these choices. The last time I had an op I was 5 and had my appendix out.

Thank you so much, that is really helpful.

I had an L5/S1 discectomy in 2017. Id previously been receiving epidural steroid injections and twice weekly physiotherapy sessions over 18 months in order to treat the disc prolapse, along with Gabapentin and various pain medications. It got to the point where the pain meds weren't even touching the sides and I had increasing lack of feeling and function in my left foot, so was admitted for an emergency discetomy on the NHS. I've never looked back, the pain relief was instant and even the usual post-surgical soreness was nothing compared to the previous neuronal pain i'd experienced which was all-consuming.

I've been able to get back to riding, hiking and gym classes. I choose to avoid running and heavy lifting on the advice of my surgeon, which doesn't seem like a big sacrifice at all given the overall improvement. So i'd echo Trouper's thoughts that it's more the yard jobs such as mucking out that you might need to consider carefully (I moved to a part-livery yard), but I ride my horse most days and don't feel any pain either during or afterwards. Best of luck

That sounds really positive, thank you Tirna.
I'm having issues with my feet too, the way I walk, extensor tendonitis, very tight calves, and archilles tendon soreness. I'm on Gabapentin, Co-codamol and Ibruprofen and have been for many years. Sometimes I am suprised how I actually function and hold a conversation, much less a job!

I love the bit you wrote " I had increasing lack of feeling and function in my left foot, so was admitted for an emergency discetomy on the NHS". My doctor is blooming useless, I've been multiple times to tell them about my extensor tendonitis, numb part of my foot, increased sciatica which keeps me awake at times, and decreased lack of forwards motion (difficulty propelling myself forward at times) but they have just not taken my concerns seriously. I wish I had your doctor!

I've even been to the doctor before now and said I think I am seriously addicted to my pain killers as I have terrible withdrawal symptoms if I go a couple of hours over the time I'm meant to take them and was just told to cut down the codeine by replacing one of my six to eight a day with paracetamol instead!

 

[Hexx]

Yes - I had a prolapsed disc L5/6 in 2001. It was so far gone that surgery was my only option by the time I got to see a consultant. I blew the disc sneezing, of all things! I had six months of severe sciatica resulting in almost not being able to walk and losing sensation in my toes on the right, the final straw was getting stuck on the examining table at the Doctors trying to persuade her to refer me for an MRI, it took 3 nurses and the doctor to get me safely off the table as my whole back and leg had gone into spasm and I couldn't move.. I saw the Consultant on the Monday, had the MRI on Wednesday and was booked in for surgery for Friday!

The majority of disc was removed and I never looked back. The sciatic pain continued for a couple of years after, but sporadically with flare ups maybe 1-2 times a year, but in the last 5-6 years I have had no symptoms.

I was lucky in that I managed to come off the painkillers quite easily (tramadol, diazepam and co-codamol).

Back on a horse within 3 months and back competing within the year, but dressage only. I don't jump anymore as i am more likely to fall off!

The only thing I have been left with is a scar on my back and a numb right middle toe! I do have to be a little careful about lifting heavy objects and bending over for long periods of time, such as when gardening as I can get stiff muscles and soreness. I had my 4 year old cob backed last year and will be cracking on with him this year.

 

[Jumoro]

I had L4/L5 discectomy + laminectomy 1994 and L5/S1 discectomy 1999. Surgery removed pain (which was agonising) and restored function in my legs although I was left with some nerve damage (due to pre-op nerve compression). Rehab then was a bit patchy & I was basically advised to be careful and "protect" my "weak" back (no riding, skiing etc.). Although much better I more or less avoided any activities that might "hurt" my back & had flare-ups of back/sciatic pain several times a year, which my GP said I just needed to learn to live with. About 6 years ago I saw a specialist privately after a particularly severe flare-up and was advised that I actually needed to be fit and flexible to look after my back - lots of physio and pilates! I'm now fitter and stronger than I have been in years thanks to some great physios, Pilates & yoga. I have my own horse and ride most days - including sj & xc with no problem.

 

[Bosworth]

I had a micro disectomy in 1999, prior to that I was collapsing multiple times a day, I’d lost the feeling completely in my right leg below the knee and the pain in my legs and back was unbearable. The surgery was an instant relief. I woke up crying as I was out of pain for the first time in 12 months. Since 1999 I’ve had no problems whatsoever and no pain. I still have an area of complete numbness in my right calf. But no pain at all.

 

[suebou]

L4/5 fusion about 7 years ago. Very important to keep as fit as possible but I can do everything I did before riding wise. It get stiff in cold/damp weather but it’s a LOT better than before.I’ve since knackered rotator cuff and snapped long bicep head but that’s another story!

 

[BBP]

I’m sure you will have tried this, so it’s probably useless information, but it took me 10 years to even think about it, have you had your foot balance checked? I prolapsed L4/L5 about 10 years ago and in 2019 I had ridiculous sciatic and central back pain and also numbness that made it’s way from my foot all the way to my groin. I had trouble walking at times as the sensation in my leg was so wrong and my leg would buckle. I couldn’t touch my knees let alone my toes. As a last resort (after years worth of physio/osteo/chiro) I got my feet scanned at a podiatry stand at burghley horse trials which showed I was pronating badly on one side. I paid for custom orthotics and within 6 weeks the sciatica was gone, numbness was gone, and I could touch my toes. The pronation was having a knock on twist up the kinetic chain and the twist was causing compression of the nerves in my lumbar spine. I only mention it because not one single doctor, physio, osteo, chiro noted it, despite all having me stand and look at my posture. Buying those orthotics is the best thing I ever did.

 

[Shysmum]

Yes, I had a micro discetomy, L5/S1 at the London Spine Clinic. Within half an hour I was walking to the loo, all pain gone. The sciatica had affected my bladder, and use of my left foot, but that went immediately. I was able to return to work as an RSPCA Inspector after 4 weeks, on the safe side. I still have crumbling spine problems.

Now, I ride carefully. I find the side to side movements of my back very muscle building, and riding has helped enormously. I take it careful, and appreciate my limits. No pain whatsoever x

 

[soloequestrian]

Mine was maybe the 2009 one you looked at already! I went straight for the op and it has been very successful. The only thing that knocked me was how long it took to get back to near normal afterwards but that was because I didn't do my physio properly. I hadn't grasped how much of the pain was coming from muscles working to hold things in ways that they were never supposed to, and they didn't realise that the back issue had gone. As soon as I got proper physio help and stuck to the exercises everything improved.

 

[Trouper]

Just returning to echo everyone else's comments on the importance of physio and doing your exercises. The physios are able to tell you how, where and how much to use your body post surgery and thereafter exercises to keep you strong.
I am afraid the exercises are a life sentence but if I don't keep my back strong with them I soon start to notice. For me, it is a small price to pay.

 

[sherry90]

I had a laminectomy and microdiscectomy in 2019 after 18 months trying to fix it with physio, acupuncture and just pushing through the pain (bad idea!) I did mine heavy lifting water buckets ?

My right side, the side I was operated on is now fine but I do still have some residual sciatica and stiffness on the left side. I have had this MRI’d again and the disc has prolapsed again but only a third of what it was and so I am holding off anymore surgery and I am relatively ok day to day.

I was back riding (walk only) 6 weeks post op. I am now back doing everything although have been told no heavy lifting so I am now on full livery as I found it was the heavy lifting, waters, hay nets, barrows etc that made mine worse.

Physio post op via the NHS wasn’t great so I do have the odd physio session, probably should have more, but the horse takes priority and has more regular physio ?

 

[Birker2020]

I’m sure you will have tried this, so it’s probably useless information, but it took me 10 years to even think about it, have you had your foot balance checked? I prolapsed L4/L5 about 10 years ago and in 2019 I had ridiculous sciatic and central back pain and also numbness that made it’s way from my foot all the way to my groin. I had trouble walking at times as the sensation in my leg was so wrong and my leg would buckle. I couldn’t touch my knees let alone my toes. As a last resort (after years worth of physio/osteo/chiro) I got my feet scanned at a podiatry stand at burghley horse trials which showed I was pronating badly on one side. I paid for custom orthotics and within 6 weeks the sciatica was gone, numbness was gone, and I could touch my toes. The pronation was having a knock on twist up the kinetic chain and the twist was causing compression of the nerves in my lumbar spine. I only mention it because not one single doctor, physio, osteo, chiro noted it, despite all having me stand and look at my posture. Buying those orthotics is the best thing I ever did.

Ahh well when I slipped my disc initially all those years ago I went to a Sports Injury Centre and the chap there had me walking and taped my feet up, etc, etc as I had really bad plantar fascitis which I suffered from in total for 12 months (went from left foot over to right foot after 7 months or so).

He said I would need orthotics but said that I would need them for all my shoes. That meant orthotics for my shoes for work (low heel wedge type court shoe) and then a pair for my jodphur boots ~(mucking out and riding) and a third pair for my trainers for getting around in between work and the horse, like shopping, etc. I was earning really poor money then, about £8 phr less than I'm on now and each week was a struggle to make ends meet. So I didn't bother as he said they were £80 a time and I just didn't have £240 to spend. But my right foot pronates badly to the inside and I have an over developed calf muscle and arch on my foot on my right leg too.

The reason I'd got Plantar Fasciitis I think was the odd way I was walking at the time and I'd just taken up jogging with trainers from Tescos which did nothing to help.

Maybe I can revisit that now I am earning decent money again.

 

[Birker2020]

I was back riding (walk only) 6 weeks post op. I am now back doing everything although have been told no heavy lifting so I am now on full livery as I found it was the heavy lifting, waters, hay nets, barrows etc that made mine worse.

This is what I try to avoid, I have a little trolley I bought from ebay for £24 and it fits to water bucket on, and I can balance a small haynet on top of that. It's a life saver, but its still having to lift them off the trollery and hang them and empty the haynet into a haybar, but I try really hard not to twist.

It didn't help that for a long while I had to move my shavings when they were delivered and roll a giant hay bale down the yard to my pallet squeezing in between piles of hay and other peoples bales and trying to upturn it with all the weight that encompasses.

 

[Birker2020]

Thank you all for your comments and tips and advice. I have really got a lot of information and feel much happier about the operation.

I currently have an elderly horse who I've not been able to ride since before Xmas due to lameness and I can only hack a couple of times a week anyway as anything else makes her lame again. But I do want another horse when this one eventually goes (God forbid) and I want to revisit my competitions and go out at weekends competing, especially want to start jumping low level again and the only way I'm going to do that is by losing about four stone and having this operation.

I am really determined and the future looks rosier now, so thank you so much all.

 

[Evem]

I had a discectomy and laminectomy at L5 s1 on the 30th October last year... mine was complicated slightly as I had a plexus of veins that had wrapped themselves around the nerve - something the neuro surgeon had never seen before.
Recovery wise I started in walk for 10 mins 3 or 4 times a week at the end of December (8 weeks post op) and I am now doing around half an hour 3 or 4 times a week in walk and trot.
I am thinking of starting some canter work soon.
I have used the Rider Rehab Centre physio (via zoom) in addition to my nhs physio to advise on rider specific exercises.
I do get achy but no sciatic pain which is great.. I have dropped mucking out 5 days a week as it was a big no no! I do it on one of the 2 days I don’t ride.
The biggest thing I have struggled with was returning to work. My back didn’t like standing for long periods of time and you are very limited with how long you can sit for, this is for at least the first 3 months
Hope this helps! Pm me if you want to know anything

 

[Tirna]

Oh wow I had absolutely know idea at all that you had these choices. The last time I had an op I was 5 and had my appendix out.

Thank you so much, that is really helpful.

That sounds really positive, thank you Tirna.
I'm having issues with my feet too, the way I walk, extensor tendonitis, very tight calves, and archilles tendon soreness. I'm on Gabapentin, Co-codamol and Ibruprofen and have been for many years. Sometimes I am suprised how I actually function and hold a conversation, much less a job!

I love the bit you wrote " I had increasing lack of feeling and function in my left foot, so was admitted for an emergency discetomy on the NHS". My doctor is blooming useless, I've been multiple times to tell them about my extensor tendonitis, numb part of my foot, increased sciatica which keeps me awake at times, and decreased lack of forwards motion (difficulty propelling myself forward at times) but they have just not taken my concerns seriously. I wish I had your doctor!

I've even been to the doctor before now and said I think I am seriously addicted to my pain killers as I have terrible withdrawal symptoms if I go a couple of hours over the time I'm meant to take them and was just told to cut down the codeine by replacing one of my six to eight a day with paracetamol instead!

Sadly the sentence you've highlighted is only reflective of the VERY abridged version, as I was trying to just provide the highlights I had to push very strongly for the surgery and it was only when the sensation loss and function in my foot deteriorated to the point where I repeatedly fell over (at one point face-planting into an elderly gentleman in the street), did I even get a referral to a neurosurgeon. This was before the current Covid crisis and the associated surgical waiting list increases. So i'd suggest that you are as proactive as possible in pushing for the surgery, but do be realistic about a possible long wait at present if, like me, you require NHS treatment over private care. Best of luck!

 

[Birker2020]

Sadly the sentence you've highlighted is only reflective of the VERY abridged version, as I was trying to just provide the highlights I had to push very strongly for the surgery and it was only when the sensation loss and function in my foot deteriorated to the point where I repeatedly fell over (at one point face-planting into an elderly gentleman in the street), did I even get a referral to a neurosurgeon. This was before the current Covid crisis and the associated surgical waiting list increases. So i'd suggest that you are as proactive as possible in pushing for the surgery, but do be realistic about a possible long wait at present if, like me, you require NHS treatment over private care. Best of luck!

Hey, I wasn't being funny to you when I highlighted that sentence, please don't think that. I know that if you get that Cuada Equine thing you have to go immediately to A&E and you will be whisked away for an op almost immediately as you are at risk of paralysis, that was drummed into me at the time. I don't really want to be too proactive just yet though for three reasons:

1. I've been like this for 12 years so a few more months won't hurt, it would be nice if I could have it done later in the year.
2. I really don't want to lose my job, I'm freelance so here to around June time and I totally love the hours/pay/people/role etc. And there is a chance of a follow on project if all goes well. As I only worked for 4 months last year I need this job for my mental health more than anything.
3. I really don't want to go into hospital at present for elective surgery which is what this is really due to Covid. If it was emergency surgery then it would be worth the risk but it's just too risky as I've not had a Covid vaccination yet. Maybe they vaccinate you as a matter of course if you go for an operation, I'm not sure.

I'm glad you got sorted. Thanks for your reply. I'm going to print off all these replies and read through them in depth over the weekend.

 

[Tirna]

Hey, I wasn't being funny to you when I highlighted that sentence, please don't think that. I know that if you get that Cuada Equine thing you have to go immediately to A&E and you will be whisked away for an op almost immediately as you are at risk of paralysis, that was drummed into me at the time. I don't really want to be too proactive just yet though for three reasons:

1. I've been like this for 12 years so a few more months won't hurt, it would be nice if I could have it done later in the year.
2. I really don't want to lose my job, I'm freelance so here to around June time and I totally love the hours/pay/people/role etc. And there is a chance of a follow on project if all goes well. As I only worked for 4 months last year I need this job for my mental health more than anything.
3. I really don't want to go into hospital at present for elective surgery which is what this is really due to Covid. If it was emergency surgery then it would be worth the risk but it's just too risky as I've not had a Covid vaccination yet. Maybe they vaccinate you as a matter of course if you go for an operation, I'm not sure.

I'm glad you got sorted. Thanks for your reply. I'm going to print off all these replies and read through them in depth over the weekend.

Oh, don't worry at all, I didn't take it that you were being funny with me in any sense, apologies if it came across that way! I just realised that I might have painted a more simplistic and easy picture in my first post and wanted to highlight the various barriers that I came across when trying to get the surgery. I totally appreciate that it's a balancing act between not wanting to live in constant pain, but having the necessary time (and means) to take a pause from work and recover. This is only complicated by trying to actually get the surgery through an already over-burdened NHS system!

I hope that you can make a plan that suits your personal circumstances and allows you to move forward pain-free soon

 

[BBP]

Ahh well when I slipped my disc initially all those years ago I went to a Sports Injury Centre and the chap there had me walking and taped my feet up, etc, etc as I had really bad plantar fascitis which I suffered from in total for 12 months (went from left foot over to right foot after 7 months or so).

He said I would need orthotics but said that I would need them for all my shoes. That meant orthotics for my shoes for work (low heel wedge type court shoe) and then a pair for my jodphur boots ~(mucking out and riding) and a third pair for my trainers for getting around in between work and the horse, like shopping, etc. I was earning really poor money then, about £8 phr less than I'm on now and each week was a struggle to make ends meet. So I didn't bother as he said they were £80 a time and I just didn't have £240 to spend. But my right foot pronates badly to the inside and I have an over developed calf muscle and arch on my foot on my right leg too.

The reason I'd got Plantar Fasciitis I think was the odd way I was walking at the time and I'd just taken up jogging with trainers from Tescos which did nothing to help.

Maybe I can revisit that now I am earning decent money again.

In that case I think it’s definitely worth revisiting. Don’t underestimate the effect foot balance can have on the kinetic chain. My orthotics cost me £250 ish!!! Which I thought was absurd at the time but I’m sooo glad I went for it. I only did because my parents both got a set and said their knee and back pain was so much better, and dad threatened to buy them for me as I was so crippled. I’m not saying they will work in every scenario, like when I first did my disc it was a traumatic injury, but for long term ‘soundness issues’ its well worth a try.