Difficult decision for sure....

I am 69 y/o. In 1974, I incurred what they called an acute Grade 2 Spondylolisthesis with a pars defect after a football injury my senior year in high school. My football days were over.

It was unstable, but I was then strong and only had recurrent episodes of LBP for many years. It was generally relieved by flexion and rest. Finally, about 2009, I got to where I could only walk a few steps w/o severe LBP w/o any real radicular symptoms. I gave in...and elected to have surgery because my NCS/EMG studies were positive, even though I still had virtually no symptoms of radiculopathy.

Surgically, I had a plate put anteriorly onto a couple of lumbar vertebral bodies. Posteriorly, I had screws and a bar put in unilaterally. Additionally, I had a cage put in, (I'm not sure at what level) and I was told that I had a bone allograft done, for further stability. I was placed in a lower body cast and sent home with a bone stimulator. It was a big and painful surgery. (oddly, after surgery, I began having intermittent pain and burning in my toes and the soles of my feet) My neurosurgeon said that it would go away in about a year. It did not.

Over the last few years, I have deteriorated. My balance and proprioception are affected. I cannot walk on uneven surfaces. I can only walk about 30-50 steps without LBP and severe neurogenic claudication which is generally relieved by sitting or lying on my left side.

I now have numbness, pins and needles, and significant burning in the soles of my feet, generally when I walk or when it is cold. I am not diabetic. I have somewhat controlled hypertension. I am post triple bypass surgery since December 2022. Other than my bp meds, I take 600 mg Neurontin 5X per day. Allergy: Lyrica - swelling in feet (at least that's what my neurologist said)

I have been refractory to spinal injections and ablations.

Obviously, I did not have a complete decompressive laminectomy due to the doctors’ fear of making my Spondylo more unstable.

I feel that my L5-S1 Spondylo is stable now. My CT/MRI studies do show degenerative disc disease and mild to moderate stenosis of the lateral recess and IVF. Additionally, it shows hypertrophy of the ligamentum flavum. I do have a disc bulge, at what level, I am not sure.

No one including my regular doctors, pain management, and neurologist have been able to help. I need help, but I am not sure where I need to start.

My goal would be to be able to walk again without the pain and neurogenic claudication that I am currently experiencing.

My fusion worked, It stabilized my Spondylo, but I have issues now that were never previously addressed. I think a complete decompression and fusion may have been a better alternative for me back then.

Good luck!