can severe spinal stenosis with grade 1+ spondylolisthesis wait

Check with your surgeon, but if you can deal with the pain for that long it might be best to wait. My spine doc was reluctant to do more surgery because of the scar tissue he would have to cut through. If that's the case I don't see how some can go through 10 or more surgeries.

@millironk Your surgeon really has to make the determination for when you should have surgery. With a lumbar procedure, your spine is bearing more weight at the lower end and right above the pelvis, most of your body weight. Pedicle screws used to secure lumbar spine hardware depend on bone density to stay in place, and they can pull out. A grade 1 spondylolisthesis is the least amount of slippage. Your imaging or report probably shows where nerves may be compressed or if the spinal cord has some pressure on it. 4 months isn't an excessively long time unless you have more of an emergency situation. Some patients wait that long for a first appointment with a spine surgeon.

Keep track of your pain on a diary, and if it is getting worse, tell your surgeon. The more serious nerve pains tend to be stabbing burning sharp pain or electric zaps. Loss of function and changes in bowel or bladder habits and control as well as walking difficulties would be reasons to tell your surgeon. I don't know if a surgeon can specifically tell you when permanent nerve damage would happen, but they may have a general sense. Physical therapy may help stabilize the situation and buy sone time because it can strengthen muscles supporting the spine. That was true for me with my cervical surgery. I waited 2 years for surgery only because it took that long to find a surgeon willing to help, and I did ok. I lost some shoulder muscle and most returned, but not all, but I am fully functional. Of course, it is different for everyone, but it does sound like your surgeon advises waiting in order to build bone density. Many surgeons do that to promote success of the procedure.

I wonder this too! I have had on and off numbness in legs and feet. Burning pain too sometimes. My surgery is end of January. I've been like this for 8 months!

@mcnairh
I had PLIF surgery August 27th of this year. I have had sciatica and hip bursitis off and on for about 20 years. I am a 67 female. I work out faithfully and have 5 young grandchildren that keep me hopping! Long story short, after 3 months of PT for bursitis in my hip, to no avail, my PT recommended that I see an orthopedic surgeon and get my hip worked up. After MRI and xrays, my hip was fine! He (Orthopedic surgeon) said I believe this is coming from your back. MRI showed an L3 spondylothesis and severe stenosis from L3 down. (It was completely clamped off due to a herniated disc.)
I was told by 3 different surgeons that this was a severe case and that if I didnt have surgery, I would be left with severe nerve damage. After interviewing 3 different doctors, we settled on a superb neurosurgeon. I am 4 months post op and my recovery is going well. I no longer have nerve pain BUT the weakness that I had before in my left leg is still there and doctors and PT are telling me that my recovery will be much longer because the nerve damage had been happening for years. I would never advise anyone to rush into this type of surgery without solid evidence, but just be aware if your symptoms have been happening for awhile, heed those warnings signs. Had I have had the benefit of knowing how bad my back was, structurally, I would have done this much earlier. You can look up PLIF surgery on the web.
Blessings on your decision.

@wywomanjk Thank You!