[Jerry6416]

I have had lower back pain for many years. I have had been treated by the VA (Vet with disabled rating). In late October 2011 I had progressive symptoms -- pain down backside to right leg to foot, buttocks, to foot and weakness, contacted VA Doc and they ordered MRI, had MRI in early Feb but no appointment.

On Feb 28th symptoms increased and now include numbness most of time in right foot and some in left, right drop foot and no reflexes with weakness in right leg. The burning and weakness has progressed to the left leg at this time. I went to local ER (NOT the VA). In the past I have been there a few times and they would always say no back emergency give me meds and send me on. This time they were able to get my MRI right away electronically from the VA.

The ER came in and said you have a major problem and kept me in ER until Neurosurgery came and talked to me and problems are from MRI and the Neurorsurgeon:

-- L2-3 and L3-4 severe canal stenosis with narrowing to 4mm and L3-4 has severe forminal stenosis, L4-5 has moderate to severe canal stenosis and forminal stenosis. L1-4 there is broad based bulging and L2-3 has right paracentral superimposed disk protrusion, Aslo advanced DDD and Disk Desiccation. The neurosurgeon stated at this time conservative treatment is not indicated and surgery should be done soon.

I was unsure of this because no conservative treatment offered, though PT in past and I am not a candidate for ESI and then I said lets see what happens and then got a some other opinions from both neurosurgeons and primary care, concurred with above.

I tried putting off but my symptoms have increased to where my right foot is numb quite a bit, increased pain in back and symptoms now increasing in the left leg. Yesterday I made the choice to have surgery due to PC saying my symptoms and weakness have increased in just the last few weeks. So I have scheduled another consult with original neurosurgeon I spoke to. Surgery will be MISS at at 3 levels for Central and Forminal Stenosis (Microdiskectomy).
Mind you I am fearful of surgery (greatly) mostly due to anesthesia due to high blood pressure (controlled) and I have been a smoker over 30 years, so any if you have any information, support, and information to offer would be appreciated. I will see the neurosurgeon again on April 24th to re-evaluate and reschedule surgery (I chickened out the first time) unless the surgery is earlier, my PC said my symptoms are increasing fairly quickly.

I have consulted with 2 internal medicine doctors (My VA and my "civilian" doctor and have had 2 neurosurgeons) and basically they all concur.

Thanks a lot for any help I have been lurking here for a few weeks and saw lots of good stuff and I done a lot of internet research.
Jerry
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[Dr. Smith]

Originally Posted by Jerry6416

Surgery will be MISS at at 3 levels for Central and Forminal Stenosis (Microdiskectomy).

Welcome Jerry,

If that's the same as Endoscopic Microdiscectomy (aka Micro Endoscopic Discectomy) then it's the gold standard, and the least risky of the three procedures I know of. Lumbar surgery is also less complicated/risky than, say... cervical, though that doesn't mean it's without risk - ALL surgery involves risk.

The way I see it, the choice appears to be either do nothing and continue to deteriorate (with all that entails), or take the chance. No-one can decide that for you. Something to remember is that online, you see mostly the bad outcomes, because the good outcomes don't need support groups, don't tend to post about their successes, and are out getting on with/living their lives.

It IS important to know the track record of the surgeon you choose with the exact (or as close the exact) same procedure.

If you haven't, google: questions before lumbar surgery (and similar terms) and failed back surgery syndrome.

Best wishes,

Doc

[Leesa]

Hi Jerry ~ It DOES sound like your symptoms are progressing rather quickly. I'm surprised that NO ONE offered ANY conservative treatment for you. But, surgeons don't like to do that -- they like to cut. I can't say whether or not it would have slowed down the progression of the symptoms or not.

The fact that you have some severe stenosis obviously suggests that conservative care won't work. So surgery is the only route to go at this time. If you wait too long, you could end up with permanent nerve damage among other things. So don't put this off any longer.

I'm also a smoker, and I've had several surgeries, including 2 open surgeries (not micro) on the spine. The anesthesiologist will talk to you prior to surgery and will answer any questions you may have about your surgery, and will help to calm your concerns. Don't be afraid to ask him ANY questions you may have.

I wish you the very best! PLEASE let us know as soon as you can how your surgery went and how you're doing, okay? We REALLY do care. Others will want to know too, who might be facing the same surgery. God bless and please take care. Hugs, Lee

[Jerry6416]

Thanks to both for the reply I much appreciate your answers. I have done a lot of on line research on this over the last few weeks. I guess in the past I was putting it off not just trying to play out the fact just arthritis or something.

I have done research on the surgeon and he specializes in micro endoscopic disectomies and and from what I hear is one of the best at this in the Northwest.

In the past there has been some conservative treatment done, it is that the different doctors do not feel it would work. The neurosurgeon that I got my second opinion from stated "your back is not in good shape" and said I could have conservative therapy but gave it on 20% chande of working.

Anyway I will be seeing the original neurosurgeon on the 24th of April to go over final questions and go ahead a reschedule the surgery. Also I will ask to see the anesthesiologist to talk over my situation.

Again thanks and I am sure I will continue to post, I have learned much from this forum and sure I will have questions prior to the surgery AND I will let you all know how it goes. I am looking forward to getting better, as are my grand kids, they have to suffer my irratibiltiy almost daily (due to pain and stress), and they have been troopers about it all, and what my grandson did to help me the other day to help me (he is only 5) made me realize I probably have to go with this. Will be talking to you, again thanks.