Does a laminotomy with microdiscectomy eliminate/decrease your chances of adr working?

[sportsnut3007]

I was asking if a laminotomy with a micro d eliminates or nucleoplasty lessens the chance of ADR working. I ask bc I currently have contained herniation at l5-s1. They say the best way to do it is go conservative at first pt which i am in and will soon start traction which did help last time pain flared up or whatever. As we know here in they states they say snip snip snip then fusion lol. So I was just curious if a laminotomy eliminates/decreases chance of adr working in the long run. Im sure I could google it and find out, but any personal insight would be helpful. Thanks for any help.

[Keano16]

Laminotomy/laminectomy can definitely lead to less success rate in ADR and fusion.

As for nucleoplasty coblation, PLDD and smiliar percutaneous procedures, they do not affect ADR or fusion outcomes.

[Ben]

Had two laminectomy surgeries in 2006 and adr in 2009. Adr went great. Laminectomies only helped for a while. PT is great. Keep at it. Good vibes for you.

[Lynda]

Hi there,
Below is some scientific medical research which should reassure you too Sportsnut:

Title: Effect of previous surgery on clinical outcome following 1-level lumbar arthroplasty.

Citation: Journal of neurosurgery. Spine, February 2008, vol./is. 8/2(108-14), 1547-5654

Author(s): Geisler FH,Guyer RD,Blumenthal SL,McAfee PC,Cappuccino A,Bitan F,Regan JJ

Abstract:
OBJECT: A secondary lumbar surgery at a previously surgically treated level is believed to result in minimal clinical improvement. The clinical results of the CHARITE Investigational Device Exemption (IDE) study were analyzed to assess the effect of previous surgery on clinical outcomes following either total disc replacement with the CHARITE device or anterior lumbar interbody fusion with a BAK cage and iliac crest autograft.

METHODS: Patients with prior microdiscectomy, laminectomy, or minimal medial facetectomy were not excluded from enrollment in the CHARITE IDE study. Thus, the following 3 groups were analyzed: all patients treated with the CHARITE Artificial Disc, whether randomized or nonrandomized; only patients treated with CHARITE devices randomized against patients with BAK devices; and control patients with BAK devices. Each group was further subdivided based on the patients' medical history, whether they had undergone prior surgery (prior surgery group) or had not (no prior surgery group). For all groups, baseline demographics were collected and compared for any potential recruitment bias. Postoperative improvements based on Oswestry Disability Index (ODI), visual analog scale (VAS), and patient satisfaction scores were further collected and statistically analyzed.

RESULTS: For all 3 groups, there were no statistical differences in clinical improvement from 3 months to 2 years postoperatively as measured using ODI and VAS scores between the subgroups (those who had prior surgery and those who did not).

CONCLUSIONS: Patients indicated for 1-level lumbar arthroplasty with previous lumbar decompressive surgery can be expected to have similar clinical outcomes to patients undergoing arthroplasty without prior lumbar decompressive surgery. Similarly, candidates for anterior lumbar fusion with prior decompressive surgery may experience similar benefits from the surgical procedure as those without.

[sportsnut3007]

Thanks Linda for the info. I honestly dont think i need surgery yet bc i think the recent left foot/leg pain is a muscle that i hurt doing "exercises" to try to help my back out from my initial l5-s1 herniation. I feared it was something to do with that, but on mri review i dont see anything/read anything that would cause this new pain on left, doc didnt seem to see anything different either. Also, I have read some articles about a muscle pain can cause this pain. I initially wasnt as bad for 2 months or so, then got way worse, then getting somewhat better but still in pain sometimes pretty bad and i have had some muscle spasms at night and have the pain sometimes up the back some. So, I am thinking it is a muscle issue and hopefully gets better with pt and I am starting to take some naproxen every day for a month i suppose to see if that finally helps for good.