Understanding surgeon speak and the different approaches to fusion

Just wondering if anyone had this done and the results they had.

Getting nerve blocks re L4,L5,S1

I know some people really need a fusion but in trying to make a decision about my own situation I found this interesting. I use AI to gather information. This is just an FYI obviously not relevant to anyone's specific situation.
• Utilization gap: Historic and current data show the U.S. performs far more back surgeries/fusions than Europe; drivers include payment, practice norms, medico-legal climate, and technology diffusion; watchdog analyses (e.g., Lown Institute) continue to flag overuse in Medicare.

WHEN FUSION IS INDICATED — EUROPEAN GUIDELINES

✅ Yes, consider fusion if:
- Unstable spondylolisthesis (symptomatic)
- Isthmic spondylolisthesis
- Loss of sagittal balance (deformity)
- Bilateral facetectomy >50%
- Adult scoliosis with stenosis
- Recurrent stenosis with instability

❌ No, fusion not needed if:
- Stable spine
- Only leg pain (no instability)
- Back pain without mechanical pattern
- Normal alignment
- Facet arthropathy alone

@jenatsky I have osteoporosis and scoliosis and had back fusion 8 weeks ago. I went to Northwestern and their neurosurgeon who specializes in deformed spines did a great job. I am 72 and doing well.
I trusted him completely. My pain is so much less than before surgery.

Yes, I had surgery at Northwestern with Dr. Tyler Koski. My pain prior to surgery was all kinks, throbbing, stabbing, aching…It was in my back, hips IT Bands and quads. With a walker I had trouble walking. It had been getting worse in the last few years.

@carolinec
Were your symptoms in your legs? That's where mine are mostly and no one's ever offered me nerve blocks. One pain management doctor at the hospital said it wouldn't help me. But I want to look into it anyway. Did it help with leg pain or did you not have leg pain? Thanks

@htolan
Did you have osteoporosis also ? My throbbing is in my calf muscles mainly but now for the past five months I have had increasing pain on the side of my right thigh, maybe that's IT band ?

@kdks99
This is an old thread, but I hope you get this message. I only have leg pain and I don't know if I have instability based on what that means. Also, how would I know where to go in Europe to get surgery if all the surgeons here will do fusion even if I don't really need it ?