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spine fusion for adult scoliosis and stenosis

I am 65 years old and scheduled to have fusion surgery from T10 to S1. I started experiencing pain down my left leg about 4 years ago. The first MRI revealed I have severe lumbar stenosis. In the process I was also diagnosed with progressive spinal deformity (spondylolisthesis / scoliosis). The curvature has progressed to around 35 degrees and it is now quite visible. I cannot walk more than 1/2 a block or stand still for more than 15 minutes without starting to have severe pain all the way from my left hip to the foot. However, I NEVER have back pain!!! I almost always wear tennis shoes and a semisoft brace to reduce the daily onset of pain. I have been reading the forum and other web sites about all the possible complications including chronic pain after surgery. I wonder if it wouldn't be best to postpone the surgery. However I have been told that as I get older chances are that the curve will be greater and more difficult to correct / improve; being older I may then have to have this inevitable surgery when I already have other health issues; and also the curve may result in permanent nerve damage or damage to other organs (ie., lung and kidney). What do I do???? opinions please!


  • Welcome to Spine Health.
    As none of us are doctors we can't advise you as to what you should do.

    I do understand how difficult it is to decide whether to have spinal surgery or not as I went through that myself.

    The surgery that is being proposed for you is a very long fusion.
    Really the best person to ask questions of and to discuss this with is your surgeon. However, I do understand that our time with them is always very limited. Could you get a second and even a third opinion? If they all recommended the same surgery that would probably help you with your decision.

    I would want to ask each surgeon that I saw whether they felt that having surgery was inevitable.
    I would also ask what is likely to happen if I didn't have surgery at all and what about if I delayed it.
    I would want to know how great the chance of ending up with permanent nerve damage would be if I waited and delayed the surgery.

    It sounds like you have already been told that your curve is likely to become greater as time goes by and that would make it more difficult to correct. Spinal surgery is not to be taken lightly and having other health issues develop as you get older could make it much more difficult to recovery from.

    My experience was a fusion and laminectomy for a grade 2 spondylolisthesis which was from a fractured Pars defect. I didn't get a diagnosis until I was in my 50s although I was told that I had had the problem since I was a child/teenager. My spine has degenerated disc disease and I believe that the altered loading of my spine due to the spondylolisthesis didn't help this. Before my surgery I couldn't stand for more than about 5 minutes before I was in pain and my walking was limited to about 10 minutes. I had terrible sciatica in both legs that would have me in tears some days and lower back pain that would build until I couldn't bear to stand any longer.

    After my surgery the sciatica had gone and almost all the lower back pain had gone too.
    The recovery from a spinal fusion is long and not easy but I did cope with it. I did try to avoid my surgery for over two years but the pain got progressively worse and my life became more limited. Eventually I went to talk to a spine surgeon (orthopeadic) and he told me that I couldn't put off surgery any longer or I would end up in a wheelchair. He didn't know how I was managing to walk as my nerves were so compressed. That helped me to decide to go ahead with surgery and had it about 3 weeks later. Afterwards the relief was so good that I wished I hadn't put it off for so long.

    Good luck in making your decision. This is a good place to arm yourself with information but please do be aware that most of the good success stories are no longer here posting. They have got back to their busy lives again.

    The decision has to be yours but I know that being able to talk to others who have been through the process of decision making is very helpful.
    Something that someone said to me that helped was 'how much is your life being limited by the problem? Is your life shrinking?' That made me realise that I was slowly losing more and more of my life. Since having the surgery, my back is not perfect but it has given me back many of the things that I was losing.

  • inchwormiinchworm Posts: 719
    edited 08/25/2013 - 9:26 AM
    I am also 65 and just 5 1/2 weeks post-op fusion from T10-L4 for scoliosis, so we are very similar in those ways. My scoliosis wasn't progressing like yours is but I was in significant pain in right leg--from hip all the way down my leg--numbness, etc. The worst problem for me, however, was increasingly frequest muscle spasms in my thighs which were excruciating. I was unable to drive or ride more than 15 minutes in a car without the spasms occurring and I was unable to sleep on either side in because of pain in my hip area. My surgery extended down to meet the 2-level lumbar fusion I had 3 years ago--L4-S1. You will be fused in exactly the same vertebrae that I am, if you go ahead with the surgery. I feel SO MUCH better, already, even though I still have some remnants of pain/numbness which I'm quite certain are due to swelling/inflammation--they are improving by the day.

    If I were in your shoes and my scoliosis was advancing at the rate yours is, I wouldn't hesitate to have the surgery--the sooner the better--but this is a decision only you can make. The surgery will mean up to a week in the hospital, even without any complications, and will leave you unable to put on your socks or tie your shoes. I'm learning innovative ways to get things done and actually, my flexibility and range of motion are improving daily. My picture shows the hardware from this latest surgery--my surgeon did limited removal of the hardware from my first fusion so only part of the original hardware is visible in this x-ray.

    Let us know what you decide to do. We'll be here to cheer you on and I am happy to answer any questions you may have since I've been there already. :)

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
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