Can anyone advise of trying pain management to put fusion surgery off

@augal91 What you are experiencing is a disc that is collapsing, and you must have some sense of how fast that is changing because you have had 2 micro-discectomies. As the vertebrae bones get closer together it is closing down the space between the vertebrae where the nerve roots exit the spinal cord.

I do understand wanting to put off major surgery. What does your surgeon say about when is the right time for surgery? What surgeons can't predict is precisely when permanent nerve damage will happen if decompression surgery is not done. There is usually a wait to get on the surgery schedule that can be a couple months. I waited 5 or 6 weeks from my consultation for surgery, but it also took 2 years for me to find a surgeon who wanted the job. My surgery was a cervical fusion and my disc had collapsed 50%. Yours is L5S1 where you are bearing most of your body weight on the spine. That complicates the procedure and the recovery.

If you make the choice now to go forward with surgery, you are in control of that decision. If you wait, and your condition deteriorates rapidly, you may be headed to emergency surgery and not have choices as to what surgeon performs the procedure. These are questions to ask of your surgeon as to how that would be handled if you choose to wait and get into some serious pain. Pain management injections also come with some serious risks like cauda equina syndrome that leaves patients in permanent pain because of inflammation around the nerves.

This link from Medical News Today describes Cauda equina
"What is cauda equina syndrome (CES)?"
https://www.medicalnewstoday.com/articles/cauda-equina-syndrome

Here are some discussions in the Spine Health Group about cauda equina which is also called arachnoiditis. In the first discussion, a member describes this as the result of a spinal injection that was placed incorrectly.

"Arachnoiditis: Trying to find a specialist"
https://connect.mayoclinic.org/discussion/i-am-looking-for-a-doctor-in-nc-that-treats-patients-arachnoiditis/

"Anyone been diagnosed with arachnoiditis after spine surgery?"
https://connect.mayoclinic.org/discussion/arachnoiditis-2/

"Cauda equina syndrome (CES)"
https://connect.mayoclinic.org/discussion/my-story-in-short/

You'll have to weigh the risks of waiting and the risks of spine injections. I had one cervical spine injection that caused me to have new nerve pain that went on for months and I had cold sensitivity for over a year. It did eventually resolve. I think in my case, it was an inflammatory reaction to the injection itself because it happened immediately during the injection. I was having burning electrical shooting nerve pain that wasn't controlled and I said never again on spine injections. Some people are helped by them, but they don't fix anything.

Will you discuss the risks with your surgeon as you decide if you should schedule surgery sooner or if it is OK to wait?

Thank you so much for your insight and sharing your experience. So much has happened in exactly one year and just extremely frustrated. The first epidural and then microdisectomy was due to extreme herniation at L5S1 and I recovered completely from that surgery and was back 100% for a few months until I simply had an extreme cough and re herniated the same disk. I tried epidurals before each surgery as insurance required but none helped in any form, if anything I believe they made it worse. Then the second micro on same area. No pain but left with tingling and numbness on portions of left side from hip to toe. Then 2 months ago began feeling tightness and went to the Dr. and he advised another epidural and PT. I did all of these and the PT even made reference that my pelvis was tilted but didn't think that was the issue with my back. So now here we are with things getting worse. All of the above was done under the care of my Ortho which is a spine specialist and I like but his recommendation is anterior fusion.
Those close to me, many in the hospitals in this area have highly suggested seeking a neurosurgeons opinion. I met with a recommended one last week and have an MRI set in 10 days and then will immediately meet with him to read it and decide next steps.
The questions you mentioned are exactly ones I have down. I want to know how many of these has done and the risks if I delay.
I refuse to get another epidural and am curious as to what other "pain management" options there might be and chances of prolonging surgery... I will NOT do this though if he advises that long term damage is higher.
I would appreciate input as well on ortho vs. neuro....I'm leaning toward my issues being so nerve related to neuro but this is all so overwhelming and I want to choose wisely, not just quickly.
I have an international trip that is important to me in October and my ortho said traveling wouldn't be possible if I did the surgery. A local neurosurgeon told me I would be able to if I felt up for it....
But everything I'm reading says otherwise. I"m curious as to what this new neurosurgeon advises, I will also be in the middle of a home move Oct/Nov. Of course, if after counsel and prayer, we feel we must go ahead and do the surgery I will have to adjust as necessary. I"ve missed out on so much already but understand if I don't choose wisely, can miss out on so much more.
A year ago I was an active 53 yr old taking cate of my grandson, running 3 miles 3x a week and enjoying life. Now I can no longer even pick up my grandson....
I know a lot of info but wanted to be open as to what I'm working with as this is uncharted territory for me, I seek wisdom from those who've gone before me....

Hi Augal,
Your words "I've missed out on so much already" will resonate with so many of us here. It is a trademark response to any life-impacting situation, and a process that leads us to the wisdom needed in making these major decisions. It is sometimes a long and frustrating journey, but it is a necessary part of these challenges.
We have all been there and you will end up with the right answers.
Getting the best expert advise is key. Balancing the resulting life impact needs courage! You can borrow strength from others. Do you have a spiritual dimension? This too gives support and direction as well as comfort in these times of rough/tough decision-making.
Your own words have wisdom.."if I don't choose wisely, I can miss out on so much more". So true!
I feel for you and those around you who also are impacted by these Challenges.
Be kind to yourself; resist despair, focus on positive outcomes. Involve others in your decision-making process... which you are doing.
Sending you best wishes. We are on the sidelines cheering you on to the goal!!

I don’t know if my comment will help, but I do understand the frustration. Have been living with spondylolysis(fractured pars)and spondylolysthesis(11mm slippage) for 15 years.
A recent car wreck, caused by the other driver, made it even worse and the disc between L5/S1 is now obliterated and the endplates are inflammed(modic changes). The neurosurgeon won’t recommend surguery yet because I stay strong(became a trainer to address my condition) and I still function. Eventually, the bones may fuse naturally, which I might prefer, but there is a risk of nerve impingement, and the obvious misalignment.
I just got my first cortisone injection in the facet joints, last week. Am still waiting for it to work, and one side is still tender at the facet joint.
It is all so worrisome, I know, but I can only recommend talking to your doctor, ice for pain, and whatever exercises are safe for you. Stay strong.

You can look up somatic therapy a new way to deal with pain. Very interesting. Or try lin.com

It sounds like you have tried all reasonable conservative treatments and will need the fusion in order to get lasting relief. Only you know if using pain management to delay the surgery will allow you to do all the things you want to do in the meantime. Keep in mind that a home move and an international trip will both put a lot of stress on your low back. It's good to get a second opinion when considering a major surgery like this. Ortho and neuro docs are both qualified to perform this surgery, so go with the doc you feel more comfortable with.

Thank you so much for the input. The MRI showed another severe herniation on the same disk so basically no other option than fusion. We felt extremely confidant and at peace with the neuro surgeon and have surgery scheduled for next Thursday, Aug 3.
Will be in hospiyfor 3-4 days and will wear a back brace for 8 weeks.
I am ready. Understanding that this might not relieve all of the issues with the nerve but praying for as much relief as possible so I can get back to LIFE.
Thank you, again!!

Look into MEDX program and see if you can find one in your area, even a bit of a drive might be worth it. I was approved for 2 disc replacements and that program saved me from needing it. Maybe disc replacement would work too.

Prayers as you move forward with your scheduled surgery on August 3! I will be praying for you as I know what is ahead for you since I had 2 back surgeries 8-weeks ago-a double fusion (L3-4, L5-S1) and a revision at L4-5. In preparation for your surgery, please keep in mind that the healing process is slow. At my 6-week post op appointment the Neurosurgeon reviewed X-rays for the process of the fusion and decided I was not ready to transition out of the back braces until probably 12-weeks post-op. At 12 weeks I hopefully will have enough fusion happening that I can begin the 9-week transition out of the back braces. Hopefully, by November I will be able to break free from the braces--I wear 2, one is a soft wrap brace which I wear 100% of the time and the other is a hard "turtle" shell brace that is worn when I am out of bed moving around. Not sure you mentioned what approach the surgeon will perform for your surgery?? As I said, I actually had two surgeries...the first was an ALIF (anterior-frontal approach) to fuse the top & bottom and the second surgery was PLIF (posterior-rear) for the revision/fusion & spinal stabilization rod.
In preparation for post-op clothing I purchased soft, stretchy pants/skirts with elastic or draw-string waste bands. Bras were not comfortable prior to surgery and certainly not after either so I opted for soft tanks with built-in shelf bras. Most important, you will most likely be instructed to not BEND, LIFT or TWIST (BLT!!) after surgery. Therefore, be ready to have good walking shoes as walking will be your #1 therapy as you begin to heal. Have shoes which you can just easily slip into...I have loved my Skechers slip-ins but there are many other shoes to try. It might be helpful to purchase a LONG shoehorn to help with those special shoes that you need help getting into. Another very handy tool is a grabber stick...actually, I have four of them and have put them in my kitchen, bathroom, laundry room and in the garage/car. You will not believe how many times you drop things and a grabber is a must to avoid the no bending requirement for necessary healing & fusion. Lastly, organize & rearrange your home to make things easily accessible...this is a no-brainer but you need to do it ahead of time so you avoid doing any BLTs. I've also hired a cleaning person during my recovery and it has been a real lifesaver. Grocery shopping online & delivery is a must. I coordinate grocery deliveries so someone is with me when they arrive to help put away.
In conclusion, I hope some of these small tips will help you with your recovery. I am ever grateful for a significant reduction in my pain and pray that you will find the same as we want to get our lives BACK in control and not vice versa have our backs in control of our lives.
Jesus said, “Those who are well have no need of a physician, but those who are sick.” Mark 2:17

Haven't had much luck with Pain Mgt. Specialists. Have had better results working with my GP.