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Anterior Lumbar Fusion, how do you know when it is time?

I have always had back pain off and on for as long as i can remember. It just get worse as I get older. I was diaganosed with Spondylothesis on the L5-S1. He said this is something I have had for a very long time and I have been in pain for a long time. We have tried the physical therapy no luck, done the MRI and on Monday I will go back to see the dr. to see if he thinks the shots will work or if I just go to surgery. When I went and saw him 2 weeks ago, he said this is as bad as it gets and told me that he would do the Anterior Lumbar Fusion and told me a few things about it, but wanted me to do the MRI to see if the shots would work. He said that it would only bide me some time.
My question is, how do you know you are ready for surgery? I can't say I am in terrible pain all the time, it is hard for me to get comfortable in bed and sometimes don't sleep well, I can't stand for a long period of time, and I do have some weekness in my legs, and the hamstrings on the back of my leg get really tight. So tight sometimes that when I lie in bed I can't straighten my leg out it hurts too bad. But pain seems to come and go. I have good days and bad. But when it does flare up it it hurts! I have flare ups about every other month or so.
So when did you know you were ready?


  • I have similiar situation as you, spondylolysis with foraminal stenosis at L5-S1. I had about once a month flareup up until last August, then I either did something at the gym or just timing, since I'm 41 now, that the area finally became chronic. Everyday, not disabling pain, but very aggrivating pain/spasm/discomfort. I've done the PT, ice, heat, stretches, 2 ESI's and nothing gets rid of it. The only thing allowing me to manage it is muscle relaxers, and anti-imflammatory's. I've had to give up things I use to love to do, golf, skiing, bowling. I've worked hard on my ergonomics and posture to not provoke anything further, but I also have a physical job, and I really can't do all of my work without leaning on coworkers for certain tasks.

    How do you know when??? My neurosurgeon told me, don't have the surgery for pain relief, have it when you quality of live is gone, then you'll know it's time. I can't be any more conservative than I have been just to try and keep a paycheck coming in. I tried to put in for a desk job promotion but was turned down partly because the amount of sick time I have had to take off because of my back last year. It's frustrating, I feel like I'm getting backed into a corner here and the only option gonna be left is a TLIF fusion, which could end my career, permanently make me unable to golf, ski, bowl, so on and so forth.

    So, I guess look at the big picture, and ask yourself, have you given up about everything except breathing and still have pain, if so, then you will know it's time and right for you. Of course finding a good surgeon is paramount too...
  • I waited until I have numbness and tingling and weakness down both arms. Basically it is the last minute and I have tried EVERYTHING else. Surgery is a last resort, and if I can keep from doing it, I would. Wait til' you cannot bare the pain anymore. Many times surgery can make things worse. The surgery will not take away the pain. The big thing is the nerve damage. I must now have the procedure because of pinched nerves. Otherwise I would just live with the pain, as the surgery will not help that because I have arthritis
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