Back to the future

I came to - slowly - after the operation

I came to - slowly - after the operation. Having established where I was and why I was there, the next wave of consciousness confirmed the good news: I was pain-free in my left leg for the first time in over four months.

In some ways, my experience of back pain is atypical. But in so far as it does away with some of the myths surrounding back surgery, it is important to share my story with a wider audience.

The road to the Mater Private Hospital and Mr Padraig O' Neill, the surgeon who removed a disc from my spine, was a convoluted one. For years I had episodes of back pain which were largely self-limiting - a few days with a heat pack at my back got me over the worst of the pain. I blamed a squash injury from 18 years previously, following which I had back pain for six weeks. The episode eventually settled with treatment from the college physiotherapist.

This time was different, however. The pain was less acute initially, and it quickly spread into my left buttock. This was the first indication that the sciatic nerve was being irritated on this side. When it did not settle with the usual heat treatment I started to swim - a bad move, as it turned out. My favourite stroke is the breast stroke - which, because it causes your back to extend, is not very back-friendly. The pain actually worsened at this point and began to travel down my left leg. Physiotherapy was the next port of call, but the expected improvement did not take place.

READ MORE

Finally (and so typical of the medical profession, who find it hard to behave like normal patients) I went to see a colleague. He organised an MRI scan which confirmed my worst fears: I had slipped a disc in the lumbar region of my spine. We discussed my options, including surgery. I opted to take bed rest for a couple of weeks.

A disc is the structure which separates the bony vertebrae. It acts as a shock absorber and is an essential part of the normal architecture of the back. Discs have an outer portion (the capsule) and a central portion (the nucleus).

Christmas intervened, bringing a slight improvement, but the pain never shifted from my left leg. In late January the pain got much worse, with pins and needles occurring down the outside of my leg and foot. Still I held out. However, after a week spent lying on the floor with little sleep, I turned to Mr O' Neill for help.

Padraig O' Neill is a neurosurgeon who specialises in a procedure called microdiscectomy. Discectomy is a medical term for removing a disc from the spine. "Micro" refers to the use of an operating microscope which allows the disc to be removed with minimal interference to the spine. A window is made in the capsule of the disc and the soft centre is emptied thoroughly. Because of the microscopic approach, the hospital stay is usually limited to four nights.

When Mr O' Neill informed me of the minimal risks attached to the surgery, I had no hesitation in agreeing to go ahead. There are four distinct areas of risk, each of which carries a one per cent chance of occurrence. Nerve damage can occur as part of the procedure, the practical outcome of which is a "drop foot" - in other words an inability to stand up on your toes.

Infection and haemorrhage are standard surgical risks common to any operation. The possibility of a leak of fluid from the spinal cord itself did not sound too pleasant. However, it is treatable. The overall success rate of microdiscectomy is in the range of 86 to 92 per cent.

And so, day one post-op found yours truly with some pain around the site of the incision, but hugely relieved to have left behind four months of chronic and debilitating sciatic pain. Mr O' Neill came to see me early in the morning to report on what he had found and done. The disc had come out nicely.

Quickly he turned to the future. I was not to sit for the next few days. He suggested I eat standing up. Next the physiotherapist came in and I was helped to walk the stairs. I actually felt taller and straighter. She then illustrated the exercise programme I had to follow on my return home. Finally, I was told in no uncertain terms to lose weight!

I have not looked back. My back feels freer, especially after swimming, which I try to do three times a week, using front crawl and back stroke only. And I now do as many tasks as possible standing up.

Clearly, back surgery is not the treatment of first choice for most people with back pain. But for those with a prolapsed disc which is pressing on a nerve and causing debilitating back and leg pain which can be attributed to a particular nerve root, then it can be life-changing.