@cwbf

Thanks for the suggestion. I would have consented to something minimally invasive. My original spine surgeon said surgery would be "extensive" and my entire lumbar spine would need to be fused. There was so much "bad bone" that should be removed that the surgeon was worried that there wouldn't be enough "good bone" left to hold all the hardware needed to fuse my spine. The surgeon was very worried that I was on prednisone and decided I wasn't a good candidate for major spine surgery.

I had so much radiating leg pain at the time that I would have settled for a leg amputation. I took a big dose of prednisone because I could not stand the pain any longer. The pain stopped after I took the large dose of prednisone. It was a very traumatic experience for me that happened about 10 years ago. I still remember my rheumatologist looking up from my MRI scan and saying she was happy the pain stopped but she wouldn't have recommended so much prednisone. She didn't elaborate on what she would have done.

The whole ordeal was revisited a few years later. I wasn't in as much pain but a surgeon said a less extensive surgery could be done to relieve some pain. She said some nerves were being "crushed" so paralysis was a possibility. I have some nerve damage but my gait was still "functional" according to that spine surgeon. That spine surgeon left surgery pending for whenever I'm ready.

I'm going with what another neurosurgeon told me. He was the surgeon who did my microvascular decompression (MVD) surgery for trigeminal neuralgia. He said "let pain be the deciding factor" for doing the lumbar fusion. I don't have too much back pain currently as long as I stay on a biologic called Actemra (tocilizumab). My back problem is one reason why my rheumatologist doesn't want to discontinue Actemra and says it is better than taking prednisone for the rest of my life.

The other problem was a complication I had after my knees were replaced . I had an aberrant healing process called heterotopic ossification (HO) after my knees were replaced. HO is called bone formation in soft tissues where bone isn't supposed to exist. This was called a healing process gone awry likely caused by too much inflammation.

That orthopedic surgeon told me never to have any surgery ever again.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6715128/