I had 2 separate decompression surgeries, the last in 2010 and then 10 years later I had a 2 level fusion. The decompression surgeries went very well and I am happy I had them. Disc herniations at L4 and L5 had compressed the nerve roots. I had a hemilaminectomy and hemilaminotomy. Hemi means one side of the spine, in my case, the left side. In a laminotomy, your doctor makes a hole in the lamina and removes a small piece of the bone to make room for the nerve root. In a laminectomy, your doctor removes most of the bone (lamina). A laminotomy removes less bone than a laminectomy. Since I only had compression of the nerve roots on one side of the vertebra, I only needed the decompression surgery. Your neurosurgeon should explain what he would remove and why. He should have a model of the spine in his office so he can explain the procedure clearly. When you see your surgeon, have a prepared list of questions and concerns. He won't be able to tell you exactly how much bone needs to be removed before the surgery but he should be able give you a good idea. He should also tell you what part of the surgery (if any) will make your spine unstable.

For my fusion of L4-S1, I needed the facets removed at both L4 and L5 on the left side. The facetectomy would make my spine unstable, requiring a fusion. I was very concerned about the fusion surgery, but I am glad I had the surgery. At the time, I was using a cane or wheelchair, my husband was doing our grocery shopping, and I was having trouble both rising from or sitting down on a chair. I wasn't sleeping at night and was in constant pain, worried that it would be permanent. During my consult with the surgeons, I expressed my concern about the possibility of pain after the surgery and they could not guarantee that I would be pain free. I told them that I felt the pain after the surgery would be easier to live with then the pain I was living with before the fusion and that I was willing to have the surgery. It has been almost four years now and although I do have pain at the L2-L3 level, it is controllable and not constant. I don't worry about when or if I might need another surgery and I have not been to my surgeon for 3 years. I do make sure I am kind to my spine and don't overstress it. I use grabbers to pick things up and avoid bending, I reorganized my cupboards to make things easier to reach. I am careful not to twist when I vacuum or sweep, etc. I also made the decision to avoid high impact sports which can be very hard on your degenerative spine. I have also had knee replacement surgery twice on the left knee. I would rather have the decompression surgery for my spine any day than a knee replacement.
Your quality of life is going to be the deciding factor for you. The longer you wait for surgery, the greater your disability and your recovery may also take longer. How much pain are you willing to tolerate? How many sleepless nights can you live with? Are you getting any relief from PT or injections or Cymbalta or any pain meds that aren't opiates? If you have a good doctor that you can trust, ask him your questions, then relax and have your surgery.