@annie1 I can appreciate how stressed you are and I was there too myself a few years ago. Keep communicating with your surgeon and get as many other opinions as you need. That is normal before making an important decision like this. Like you, I don't want to do another spine surgery. I was planning on just one and being done, and I do what I can to maintain mobility and stretching out any muscle kinks that crop up. Per my surgeon, I try to maintain good core strength and my horse helps with that when I trail ride. It's nothing crazy, and just walking, but that makes me compensate for the horse's movement while I sit up with good posture.

You need to know the reason that the spinal canal is smaller creating stenosis. That may be a thickened ligament, it may be a bulging or herniated disc into the spinal canal, it may be bone spurs growing in the spinal canal or it may be vertebrae slipping past each other a bit and essentially making the spinal canal smaller by being offset. Some people have a congenitally small spinal canal if it is under a certain measurement. Knowing this information may help you know what other questions to ask and that can help with your decision. Keep an open mind when you discuss how to manage the details of your condition.

Stenosis can also occur at the nerve roots because of disc herniations and bone spurs growing out there, and that would affect specific nerves at that level. Stenosis in the central canal has a broader affect of what it can affect.

Lumbar surgery is more difficult than cervical. That is what doctors told me because the lumbar spine is bearing most of your body weight as opposed to cervical bearing the weight of the head, but being more mobile. Loosing flexibility in the lumbar spine would probably affect walking a bit because the patient would move differently. I don't have that experience, but it would have to change it somehow. I have watched surgeons in videos from spine conferences talking and they say L5 S1 is a difficult level to fuse.

Adjacent segment disease also happens in spines that have not had surgery. It happens after spinal disc replacement and after fusion, although there are statistics to show that generally it happens at a lesser rate for artificial discs that preserve motion to a degree. Sometimes the body grows bone around an artificial disc implant in an attempt to stabilize it. Surgeons will take out the artificial disc implant and fuse that level instead. The best way for a spine to exist is the have the body weight evenly loaded and the spine stacked in line. When an injury happens and discs start to bulge they begin to shift the weight one way or another, and that can affect the rest of the spine as it compensates for this change. Bone spurs grow and bone remodels in response to pressure, so it is very common to have bone spurs grow next to a bulging or ruptured disc because there is more pressure there and inflammation there also affects it favoring bone spurs.

Your experience may be different. Some people have good experiences and some do not, but you do need to accept that with surgery, changes will be made and do your best to embrace that change and work toward success. Personally, I'm not worried about my fusion or a future fusion. It's already been over 7 years and I'm fine. There is a bit more neck cracking now and occasionally a twinge of pain at a facet joint that has some arthritis, but I can do everything that I want to do. I've made choices not to do sports that will cause pounding on my joints or spine so I don't add more wear and tear. Surgery was a choice I made when it was obvious I would be headed for some real disability without an intervention. Every choice you can make has some drawbacks, and you have to figure out which of these to accept. Even avoiding surgery is a choice and may have some drawbacks too. Sometimes there is a time limit on when a problem can be operated on safely given the age and overall health of the patient. If I had to do it again or do a lumbar spine surgery, I would get all the information I could before making a decision. I do have a bulging lumbar disc that cracks when I twist, and someday, that could become a problem, but for now, I am doing OK. I had a great surgeon, and he will be the one I consult in the future if I need him.

Jennifer