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@siamesevet

My surgeon is recommending a two stage surgical procedure. Day 1 would involve replacing the discs at L4-L5 and L5-S1. Day 3 would be a lumbar fusion from L2 to the pelvis.
MRI indicates : severe lumbar stenosis L3-L4 central, left L4-L5 lateral
recess, bilateral L5-S1 recess
- L2-L3 dynamic, L3-L4 les dynamic high grade
retrolisthesis
-Left L4 IAP ventral subluxation and coronal
angulation =low grade rotatory spondylolisthesis
-thoracic hyperkyphosis, 60 degrees
-Left L5>S1 lumbar radiculopathy
-Lumbago
-prior left L1, L2 transverse process fractures
-T11 wedge fracture, fragility= clinical osteoporosis

I am a 58 year old female who has pins and needles in the left foot. I struggled with a painful bout of sciatica this summer but it resolved over the summer with gabapentin. I go to the gym daily to use the treadmill and and the weight machines. I started Eventity in December for osteoporosis and seem to be tolerating it well. My bone density tests have always been normal. However, I couldn't argue with see thru appearance of my bones on the radiographs.

The local neurosurgeon recommended an outpatient surgery which seemed minimally invasive. I was utterly taken aback by the 2nd neurosurgeons opinion. I am scheduled for a 3rd opinion with another local neurosurgeon next week and hoping for an additional referral to the state university hospital.

When I walk, after about 10 minutes it feels as if someone is continually tightening my shoelaces on the pins and needles foot. I also have poor balance and some lower back pain which resolves with sitting.

Lastly, I need a new knee on the left side.
Any thoughts would be appreciated.

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Replies to "My surgeon is recommending a two stage surgical procedure. Day 1 would involve replacing the discs..."

It's great that you're being deliberate about reaching an acceptable diagnosis. It can be frustrating to hear conflicting opinions from the docs!

I had L2-5 decompression and fusion surgery last May '23. I'm a 70 yo male in better-than-average physical condition. I had managed my back/leg discomfort for literally decades with exercise, over-the-counter meds, and caution regarding not doing too much (like heavy lifting, twisting, and such). I had the firm opinion I would not endure the disruptions and unknowns of spinal surgery until I felt I had no other option.

What made the decision for me was when I started to experience what I called "sudden leg numbness" where I would go from fine to totally numb legs in literally 60 seconds. When it hit - I had to sit down immediately or I'd fall down. I grew concerned that the numbness might suddenly develop when I was in a precarious situation...like at the top of the stairs. I sought multiple opinions until I was comfortable that I had: The best facility with the best diagnostic equipment with the best docs for my case.

I am nine+ months post lumbar surgery and am 90%+ of the way back to normal. The journey has been a challenge at times but I'm glad I'm where I am now.

Are you experiencing balance issues such that you feel you might fall? How often do you get that feeling?

Hi @siamesevet. I combined your discussion with an existing discussion titled "Anyone had surgery on spine who also has osteopenia or osteoporosis" - https://connect.mayoclinic.org/discussion/anyone-had-surgery-on-spine-who-also-has-osteopenia-or-osteoporosis/. While the diagnosis may be slightly different, the topic at hand is similar in trying to gauge the best steps forward with your spine health while balancing osteoporosis/osteopenia diagnoses.

@siamesevet, it is nice to read that you have been able to get multiple opinions and are being thorough in your preparation to find the best route forward. With two wildly different approaches, are you hoping to present to the 3rd appointment an option that confirms one of the other two that has already been presented to you?

I have many of the same issues. I have spent six years trying to figure out how I want to proceed. I would love to find a surgery that would allow me to resume all the activities I love but I do not what to chase something that may not exist and has the possibility of resulting in a worsening outcome. I have tried every non-surgical outcome and consulted more docs than I can count. Many surgeons do not follow patients for more than a year iso it's hard to get accurate information about their results. I use google scholar to read the most resent evidence based research. My husband does research so he helps me evaluate the quality of research. Here is a link that may help you make an educated decision. Please share any info you discover that helps you make an educated decision.

https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14120

Hello, I can only tell you my experience, as your back issues are more serious than mine. I have osteoporosis, and am improving after my second fusion in July, 2023. The first was an L4-5 fusion in January, 2021, but it did not stop the pain. I still had problems with walking, bending, sitting, and nerve pain, numbness down my left leg, burning in my feet when wearing shoes, which the second surgery helped with. I went to Mayo in Jacksonville, the neurosurgeon removed the hardware at L4-5, then extended fusion down to L5-S1. The pain was improved, but I still had nerve pain radiating down my left leg. After three months I went to PT and started strengthening my core. The nerve down my left hip and leg was so bad, then one of the PT interns started pressing on the worst spot in my spine, and it helped a lot! I’ve continued doing that with a child’s tennis ball and the wall, that way the pressure can be adjusted. It’s returning my life back to normal, I’m getting out, riding my e-bike with my husband, getting off the bed more than being in it!
I encourage you to find the best neurosurgeon and get that fusion done. I’ve been in pain since 2011, gradually getting worse. It’s lifting my depression up and off, something we don’t like to talk about. I wish you the best.