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About Making a Decision

jh236jjh236 Posts: 27
edited 06/11/2012 - 8:44 AM in Lower Back Pain
Hi All,

I know I'm not in anywhere near the shape of some of out friends on these boards but I'd like all opinions on my question below.

Briefly, I have L3-L4, L4-L5 and L5-S1 bilateral stenosis along with fairly significant osteophyte issues and degeneration going on. After months of conservative approach, PT, different Meds, a single ESI, etc., I feel like it's one step forward two steps back with all of this. I've pretty much resigned myself to the fact that, even if all this symptom treatment provides relief, I'm going to need surgery at some point; be it 6 months from now, a year, two years, ...

Has anyone reached the point of frustration and just talked to their primary and/or neuro and just said something like "I know I'll need surgery at some point in my life so let's just to do it now!".

It's a scary thought to be sure but I wonder if it would be just best to do it.

Thanks from All!


  • When I was injured last year I tried the conservative approaches. When it came time to do shoulder surgery I had it booked in 9 days. When that didn't work and I tried all the spine treatments which didn't work I told the doc I was ready for surgery. Unfortunately I will probably need more surgery in the same spot. I told the surgeon yesterday that I have a little less than two years for this to be completely resolved so we can try some diagnostic treatments but surgery will happen sooner than later.

    I think the doctors judge how ready you are mentally and physically for surgery. Everyone is different. I tend to analyze things and cut(no pun intended) right to the chase.
  • Thanks. I think I'm similar to you I think and I've maybe let the conservative approach recommended dictate my own decisions. It's time to (pardon my pun) fish or cut bait.

    Best of luck!
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  • Welcome to Spine-Health. You'll find a lot of information on the site, with some great articles and videos to help you understand what's going on and what your surgery will be like.

    When I saw my surgeon for my cervical issues, after he looked at my MRI, he came into the room and said that the situation was bad and that we could try an ESI, but if it worked, which he doubted, it would only be a bandaid. He said it wasn't a matter of if I had surgery but when. This was in September, so after some discussion, he told me that if I went ahead and scheduled surgery, he'd have me back on the golf course in May of the next year, and I also decided it was a good idea to go ahead so I could wear the neck brace in the winter (those things get so darned hot!).

    So I just went ahead with it and was glad I got it done.

    With my lumbar, we tried a lot of conservative treatment, but with the stenosis and facet joints being so bad (along with sponylolisthesis), nothing was working so we decided that surgery was the only next step and again, I went for it.

    I guess I tend to just want to get it over with if it's inevitable that it's going to be needed, I just hate the anticipation and would rather just have it done and get on with things.

    That's just my take and everyone is different. I know a lot oe people choose to wait until things get so bad they have no other option, so it's a very personal decision whether to have surgery or not.

    Good luck on your decision and please keep us posted.

  • however in my situation, surgery was not the first plan of treatment.

    I think all situations are different and it really depends on the actual diagnosis of your back problems. my daughter has a pars fracture and there is no conservative treatments, its leave it alone or surgically repair it...thats it!! Chances are she will require surery at some point but I don't think surgery is in her best interest right now.

    That being said, I had to do all conservative suggestions first before I was even reffered to a surgeon. They wanted to see if I would respond to PT, injections and the like first, because if you get relief from those measures you have just saved yourself a trip to the OR. I was anxious just like you, months of PT and waiting inbetween ESI shots, I wanted the quick fix, but even though I ended up with surgery it was not the quick fix I had hoped for! Don't think that surgery will immediately end your back issues, it may but it might not and you have the recovery period which is painful aand slow and may still require PT and ESI shots, so you are technicaly not always out of the woods.

    I just had a second back surgery to fix the issues from the first back surgery a year ago!! I am 2 weeks post-op and I am feeling better every day and finally feel like I have good results but it has taken a whole year to get to this point and I have still to go through PT and the rest of the recovery period, hoping and praying the pain does not return.

    Please don't think I am saying no to surgery, I am just saying think hard about your options and be realistic about expectations. No one can truly answer those questions for you except you and your doctor about your particular situation. We all have the mentallity of lets get this done and over with, but it just doesn't always end that way, you do have to recover from any kind of spinal surgery no matter how small.

    There are lots of success stories, it's not all bad and I hope i am one of them now because I do feel really good at this point. Take your time, educate yourself and listen to your doctors, get more than one opinion and in the end you'll do whats best for you.

    Good luck, keep us posted...I hope you find relief soon, we all understand back pain!! This is a great support network, everyone here has helped me tremendously.

  • You seem to have disease at multiple levels but multiple level surgery is much harder. I would suggest working with your doctor to see if you can localize where the greatest area is so that if you do need surgery you can minimize the area involved. What symptoms are you having?
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  • Jh236,
    Perhaps your condition itself will determine the time scale of when any op would be most appropriate. It is positive that you have some notion and acceptance of the inevitability and many here have that difficult decision of when the best time may be.

    You have given some time and effort to trying the alternative approach and for you that has not been successful and only in consultation with your medical team would give some support, we need confidence in the decision making process and if you have utilised what your options were at the time the logical step would be to move onto the next possibility. We are not doctors and getting addition opinions sometimes confuses what we have to do rather than clarify or support an alternative viewpoint. All of this process is a leap of faith into the unknown and we have to be as brave as ever.

    We are all eager to get on with our lives and that is a positive outlook, Sandra’s point is valid in that in comparison to the volume of surgery implemented overall success is positive and my own failed fusion is not reflective of the norm and should not be used on that basis, we all go into surgery with unique underlying conditions and collective evidence is no guarantee.

    Your time will soon come, when some change of approach becomes mandatory and I would not pre-empt that in adopting an irreversible process until you need, my own quality of life did deteriorate and I was becoming bent over and walking badly as the pain down both legs increased that in itself was the determinant of my own timing and only you know and can decide when that best time is, we are just suggesting options and our experience.

    Quantifying improvement is not possible and we all hope for improved mobility and less pain and that jump into the unknown experienced from many here, that one step forward and two back is a facet of the spine experience and well known, it is not easy.

    You have progressed logically from each step to the next and worked on each possibility individually and given it the best chance, you can do no more than that.

    Take care and good luck


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