I was recommended fusion of l4-5 and l5-s1

@reidy Why was this fusion recommended? I had my L5-S1 fused nine years ago for supposed spondylolisthesis. It was not a pleasant experience. Plus, it did nothing to help relieve my pain. If I could go back, I would not do it. Be very careful when making this decision. It would be a good idea to get a second opinion.. I wish you well.

Yes spondylitis,was told would not relieve back pain but would relieve my right sided sciatica?

@reidy you didn’t mention whether it is going to be open or minimally invasive? If you’re debilitated before surgery recovery will be more challenging and you’ll still have some degree of pain, you indicated. It’s certainly your choice but consider who will be caring for you in recovery? Will the surgery increase your quality of life enough? I’d be asking a lot of questions and honestly after my surgery in 1990 I’d be hesitant doing same surgery again and I’m 73.

I have found most surgeons optimistic.

They can fix the structure and that is a success, but can't guarantee the pain will improve to the point you are expecting or wanting.
If he is telling you that you would still have back pain that would beg the question of why not.

My wife has been through 6 fusions and I have taken care of her through all of them including 3 in a little over a year, It is not an easy recovery the older you get.
The better shape you are in the easier the recovery.

Have you tried other treatments for the sciatica?
There are a lot of non surgical and surgical options.
It really depends on exactly the problem, everybody's is a different case.

Best thing is to research, research and then research some more, you can't go backwards from a fusion once it is done.

I am in the same boat as you age 64 minus the back pain. For me a 3 level fusion is the next step. I am choosing to tolerate the pain and find ways deal with it until i can't

Hi Reidy,

Sorry for what you're dealing with. I'm 71 and have scoliosis, stenosis, listhesis, and disc degeneration in my lumbar spine. Nothing fused yet thankfully and my surgeon has said my strong core muscles are protecting my spine, and at least for now, making fusion unnecessary. (I am in the gym everyday and work with a personal trainer. I'm very fortunate to still be this active.)

About 12 years ago it was recommended that I have the S1 through L5 fused, just like you. The first surgeon I saw would only do a fusion.

Well I found a second surgeon, and he did confirm a fusion would be recommended, but tried something else first, a laminotomy. I had this procedure done at S1, L5, and L4. The surgeon drilled a hole in the back of these verterbrae, and this gave the sciatic nerve more room. He also removed some disc material from L5/S1 that had ruptured and was in my spinal canal.

That was 12 years ago and I haven't needed fusion surgery. I'd at least ask your surgeon about the procedure I had. It helped a lot with the unbearable stbbing pain I had on the back of my right leg. And before surgery, I couldn't stand up for more than 30 seconds. Recovery from the laminotomies was short, less than a week and the incision didn't require stitches.

I hope this helps. Please let us know how you proceed and all the best to you!

Joe

@jlssurplus

Good for you for taking such great care of your wife. I can't imagine going through 6 fusions.

I'm 71 and my lumbar spine is a disaster area. I am active in the gym, everyday, and that has helped develop a strong core that then supports my lumbar spine.

Please see my reply to Reidy re: lamintomy to relieve pressure on the sciatic nerve without fusion. It worked well for me. I haven't had a bout of sciatica since the surgery. Although 12 years later, I wake up with a lot of lower back stiffness that clears up in about 15-30 minutes.

I've had both hips, right knee and left shoulder replaced, all with great, pain-relieving results. I truly want to avoid fusion surgery. From what I've heard, it's a long recovery and doesn't provide as much pain relief as joint replacement.

All the best to you and your wife (or husband).

Joe

@reidy
I just had spinal decompression and fusion of l4-l5 -Feb 3, 2026.
At 60 this surgery has been very easy to recover from. I had not walked properly for at least 3 years prior due to spinal and laminal stenosis as well as degenerative disc disease; had butt, thigh shin pain and numbness in toes. Since the surgery I only have the toe numbness ( which is supposed to resolve), no pain and am walking much better. I have been doing stairs a week after surgery when I went home and while I needed help for the first 2 weeks at home I am now able to be self sufficient.
This may not be everyone’s experience, it has worked for me …

@heisenberg34
So sorry you didn't get relief from this fusion. I also have spondylolisthesis, stenosis at l34 and foraminal stenosis at 4-5. I have gotten many opinions, some of them want to do three level fusion from l3 to s1 and a couple would only do two levels. I certainly don't want to go through it if it's not going to help with my pain which they say is not typical at all. My main pain is that my calf muscles throb and spasm after I walk even if it's just a few steps. It is making my life miserable cuz you have to walk to do anything even just go to the bathroom. I want to decide soon though because I don't want to be recovering from surgery in the middle of the summer when I like to go to the beach and bike. I was wondering also even though they're saying the recovery would only be 3 months how soon I could go on an airplane somewhere or ride my bike. Most of the surgeons are saying I could ride my bike in 4 months which is a long time for me cuz biking is my freedom since walking hurts me. Anyway sorry for the long winded comment but any feedback is welcome.

@heyjoe415
You are so lucky. I had a laminotomy at L 3 4 after almost 6 years of stenosis when all the surgeons were saying I needed fusion I refused and finally found one that would do the laminotomy only. The only problem is that it didn't last. In fact the pain I had only went away for about 2 months. Then came back. Now they're saying I have to do the fusion to get rid of this atypical pain which is throbbing in my calf muscles after I walk even if it's very short distance like from the kitchen to the window. I am afraid of the fusion still but just throbbing is driving me crazy. The only thing that helps me is oxycodone and I don't know if I could stay on that the rest of my life. Any feedback? I'm fairly strong in my core but I don't actually spend that much time on it every day. I go swimming once or twice a week and do physical therapy once a week. I don't know if good compression I have would be helped at this point even if I did core exercises 3 hours a day.

Hi Annie,

Sounds like you went through what I went through. Although my laminotomies are still holding, thankfully.

I'm so sorry for the pain you are experiencing, likely due to your sciatic nerve beng squeezed from the stenosis you mentioned.

As for whether a stronger core would help alleviate the pain, I suggest asking your surgeon and if possible, getting a referral to a PT.

My surgeon tells me my strong core muscles are all that stands between me and lumbar fusion. The laminotomies worked once but can't be repeated. If I developed sciatica now, I'd need fusion surgery, and I'd like to avoid that.

And chronic use of oxycodone comes with its own set of problems, including tolerance and constipation.

See if your surgeon believes you can be helped by PT. I'm sorry I don't have more encouraging news for you Annie. As for me, as much as I'd like to avoid fusion, I'd do it if it meant relieving chronic sciatica pain. I've been there, as you are now, and it is very painful.

Please let me know what you do. (In the meantime, I'd try applying ice to your lower back, not heat. The cold could temporarily relieve some of the inflammation around your sciatic nerves. Has your surgeon suggested an epidural, an injection of cortisone into the affected area? This usually helps with a bulging disc. It likely would not help with stenosis.)

All the best Annie.

Joe