Feeling miserable, pain meds provide minimal relief

Join the club, what are we supposed to take from your long introductory paragraph?

Hi, @jeaniem - the title of your post tells me you are feeling kinda miserable and in pain. However, the rest of your post is not something we can interpret here on Mayo Clinic Connect, as we are not medical professionals.

I believe your report is saying you've had prior spinal surgery? If so, what's going on since then?

It would be helpful if you told us what pain meds you are on, dosage and frequency. And what is the nature of your prior spinal surgery? Have you had lower back nerve ablation and/or steroid epidurals? What does your doctor say your next step will be? Are you seeing a pain management specialist or an orthopedic specialist?

@laughlin1947 I had l5 s1 fused in 2022 due to congenital non-fusion at L5 with bilateral pars defects.
and right si joint fixation in 2025.
I have had multiple steroid injections at L5 S1 and in the right si joint before the fusions. I take tramadol, 50 mg every 6 hrs as needed, flexeril 10 mg, and 5% lidocaine patches. I also take tylenol arthritis ,650mg as needed. I do have a pinched nerve at C5-C6 and a cervical rib. Also a mild thoracic scoloiosis Pain management a few weeks ago suggested I could try a spinal cord stimulator. Thank you for any thoughts.

Jeaniem, hi. Sorry you are in pain.
The report advises a lumbar MRI. If that hasn't been ordered you might point the advice out to your primary care.
It looks as though you might want revision surgery at L5 S1 The uncovering of the disc at that level means that the vertebral body has slips forward leaving the disc uncovered, unprotected. Hardware may have loosened, but it could be that L5-S1 was fused in that slipped position for other anatomical reasons. Because the disc is uncovering and bulging the type of fusion you had seems to be was a PLF where they leave the disc and use hardware to support the vertebra.
There may be other sources of pain evident on specific imaging. Grade 2 anterolithesis doesn't always require surgery. But standing (instead of lying down for the image) can make the fusion unstable.
The facet joint space narrowing can be quite painful.
Could you describe your pain, give the location and tell us which activities are worse and which make it less painful.
If all these terms are unfamiliar let me know and I'll send video links.
First the MRI, then you might want to see an orthopedic surgeon. I like the idea of going back to the fusion surgeon from 2022, but I'd always want a second opinion.
When did the pain start. Was pain absent after the first surgery.
Gently

@gently
Agree with above completely.
The tricky part is to try to find what is generating the pain before doing more surgery.
Good luck, life sucks living with the constant pain.

@gently Sorry I should have noted the report posted above was from a lumbar mri a few weeks ago. I was told that the vertabrae shift was from bilateral pars defects and that my l5 never fused prenatally. I had back pain when I was younger but never bad enough for any imaging, at 60 I was just suddenly hit with pain that would make it very hard to walk or sleep. I had steroid injections that did not help , so was referred for mri, which found the problem. My brother had the same defect but his was found when he was 10 years younger. He did very well after surgery but died from a glioblastoma a few years later. The pain now is both si joints, ribs, mid back and burning nerve pain and weak legs. After the 2022 surgery I had worked back up to over 3mph walking pace and some light weight lifting, now the more I move the more I hurt and walks are about 2 mph with very weak weak legs. Mid back feels like something jabbing hard and lower is mostly a stinging sensation. Also get tingling in knees, feet and fingers.

Jeaniem, some of the confusion is because the radiologist was uncertain of the numbering in describing the lumbar segments. But with the prenatal information, the assignations must be correct. The L5, S1 segments fuse prenatally and then separate again with the growth of a disc. You must have had a partial disc that wasn't removed and is now bulging. It may be the pars fractures that led to your pain at 60 followed by the fusion.
If you haven't been referred to an orthopedic surgeon, you might do that first and let him order the dedicated Lumbar MRI with imaging techniques to reduce the problem of artifact.
I'm wondering if they corrected the vertebral alignment during the surgical . Sometimes they shouldn't, but I'm questioning if it is a new misalignment causing pressure consequently tingling, burning and weakness.
Your thoracic look so good that it may be muscular caused by the low back imbalance. I suspect that would cause pain in both SI joints.
The finger tingling may be caused by the low back imbalance affecting the neck.
Without any medical background, I think it is a surgical fix. And it sounds like being proactive is saving you from nerve damage.

@jlssurplus
Thank you.

@gently
No the aligment was not fixed, Surgeon told me he could not fix that without causing permanent nerve damage, basically just stabilizing. I did have relief for a while because nerves were decompressed.