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Spinal Stenosis Surgery - 4 hours scheduled...normal?

DevonneDDevonne Posts: 3
edited 06/03/2015 - 3:33 AM in Back Surgery and Neck Surgery
Hi everyone,

my father (75) has been diagnosed with spinal stenosis and some other age-related signs of "wear and tear". The pain has been ok and he was still able to walk for several hours up until two months ago but it then got worse and after an MRI, the orthopedist suggested surgery. He got an early appointment at a renowned specialized clinic and the head surgeon even called him personally and made it sound like the surgery was not that big of a deal and he would schedule 75min for it.
He would have to stay a maximum of 10 days in hospital.

My parents went to the clinic on Monday for the pre-surgery discussion this week - two days before the planned surgery, but didn't have a meeting with the surgeon, only the anesthetist, who told them that it would be a 3-4 hour surgery and mentioned the care afterwards, with a catheter for the bladder and serveral ones for pain medication etc.
It sounded a lot scarier than what we thought it would be. I have heard about stenoses surgeries as something far eaiser.
My father cancelled the surgery for now because he really want to have an informative talk before and know exactly what will be done and if he does, what of these steps are necessary etc. He is waiting to get an apointment with the surgeon for real now...Hopefully soon!

I am really confused and worried now, if this might be a very complicated surgery or if scheduling 3/4 hours is still somewhat "normal"? Unfortunately I can't send you the info from the MRI results now and I know you don't have a crystal ball to guess what could be the problem or what the surgeon intends to do.
But maybe someone has experience or preferrably ;) - could tell me that it is still in the range of "normal" spince surgeries etc pp. I am just so impatient now because the srugery was scheduled for today and now it is waiting all over again.
This whole things makes me very nervous anyway.

My father is actually doing ok now considering. He takes two medium painkillers per day and does a lot of things in his office now, so pain is managable and his spirits are good.

Thanks in advance for any replies


  • SavageSavage United StatesPosts: 5,476

    Welcome to Spine-Health

    It would be very helpful if you could provide us with more details. So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong,

    Here are some questions that you should answer:

    - When did this first start?
    - Was it the result of an accident or trauma?
    - What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc)
    - What Conservative treatments have you had? Which ones?
    - What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc)
    - What medications are you currently using? (details, dosage, frequency, etc)
    - Has surgery been discussed as an option? (If so, what kind)
    - Is there any nerve pain/damage associated?
    - What is your doctor’s action plan for treating you?

    Providing answers to questions like this will give the member community here a better understanding
    of your situation and make it easier to respond.

    Please take a look at our forum rules: Forum Rules

    Please remember that no one at Spine-Health is a formally trained medical professional.
    Everything that is posted here is based on personal experiences and perhaps additional research.
    As such, no member is permitted to provide

    - Analysis or interpretation of any diagnostic test (ie MRI, CTscan, Xray, etc)
    - Medical advice of any kind
    - Recommendations in terms of Medications, Treatments, Exercises, etc

    What could be good for someone could spell disaster for another.
    You should also consult your doctor to better understand your condition and the do’s and don’t’s.
    It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have are
    I’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?

    Diagnosing spinal problems can be very difficult. In many ways its like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then its up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.

    Specific comments :

    Personal Opinion, not medical advice :

    --- Ron DiLauro, Spine-Health System Moderator :
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • SavageSavage United StatesPosts: 5,476
    I think your dad made wise decision to hold off on surgery until he had full knowledge of what to expect.
    If he doesn't have full understanding, I don't know how he can give his consent.

    You and your dad might want to talk with the doc about your dad's pain level now and how he is coping well with the medium pain medication that you mentioned.

    You might want to remind doctor that your dad is able to walk for several hours. Is that with cane or walker?
    It really doesn't matter much, I wouldn't think, as several hours is quite impressive, to me anyway. :)

    I would also ask the doctor if there is any risk that your father will have long term more pain after the surgery.
    Could the surgery cause stress or bother any other part of his spine?

    Something to think about anyway.

    Other members with more experience may drop by with their experiences.
    I wish you and your dad the very best
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • SukhreSSukhre San Diego, CAPosts: 181
    Is taking a second opinion an option? Is it Cervical or lumber?
    MRI shows C4-C7 severe steonosis. Pain in hand.
  • He's right- spinal surgery is serious and if he's not ready, it's a good thing that he stopped the train. I also was not ready when my surgeon wanted to operate. I was scared and I wanted to try every last non-surgical option first. So I postponed surgery and threw myself headfirst into some pretty strenuous procedures, physical therapy and kept a pain log for months to help myself better understand my pain.

    After 9 months of hydrotherapy, bilateral rhizotomies, a discogram and three sessions of disc injections, I decided to get a new MRI due to increased pain and nerve issues. My surgeon told me what I already knew; my discs were completely collapsed and I needed surgery. So I did it, but this time around I felt like I truly had tried every other option and it was under my terms. This helped calm my fears.

    My two level 360 fusion at L4-S1 was scheduled to take 5 hours. I had an iliac crest bone graft. Because I am slender and did not bleed much, my surgery went faster than expected. I was out in three hours. Recovery was HARD. The pain was intense. But I knew I needed the surgery so I powered through it.

    I think your dad is wise and he is lucky to have such a caring person like you helping out. Things will work out.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • Thank you all for your replies!
    In the meantime I know that the surgeon scheduled a fusion. In the MRI report it says that he does have pseudospondolythesis, of L4/L5 of around 4mm and there are also some other degenarative wears and tears:
    Spondyloarthropathy, Hypertrohpy of Ligamenta flava resulting in spinal stenosis (canal 5mm), neuroforaminal stenosis, osteochondrosis and retrospondylosis.

    So...looks like his back is pretty damaged. Then again, he is almost 76, so I guess some of these problems are maybe not all that shocking?
    The thing is, how do we know what has to be done and what hasn't? Maybe the pain doesn't come from all listed issues, but only from a portion?
    We wil lstart again from scratch and have an appointment for a second opionion. It is a neurosurgeon this time. Who was recommended from another neurosurgeon who wrote a very interesting article and back surgery etc.
    He will also go to a neurologist so maybe it can be determined where the main pain is or what nerves are affected?

    I really hope we will find a good way to get him better. I am so scared that he will suddenly deal with chronic pain and not be able to enjoy life anymore. He was always active and healthy and happy and is dealing so well with the situaion now.
    But I am really worried and have a hard time being optimistic.

    "You might want to remind doctor that your dad is able to walk for several hours. Is that with cane or walker?
    It really doesn't matter much, I wouldn't think, as several hours is quite impressive, to me anyway."
    That was until a few months ago, without a cane etc.
    But now, he can only walk a few minutes. Or let's say maybe 20mins, but with the mild pain med.
    So it has definitely gotten worse and something has to be done.

    @SarahLindeau: Thanks for your insighsts. I hope you are feeling better now and I admire you for your strength!

  • dilaurodilauro ConnecticutPosts: 9,859
    edited 06/15/2015 - 5:08 AM
    But please keep a few things in mind. As you stated, at 76, you would expect some problems with the spine. This happens to everyone. Degenerative Disc Disease along with Annular Tears in discs are essential the Aging of our Spines Most people will show sings of this by the time they are 30.

    Then there comes a time when the doctors have to evaluate if surgery is really the proper action to take. Is it ethically correct.

    What I mean by this, is at his age, everyone must consider the overall impact of ANY surgery. There are associated risks with any type of surgery when the patient is older. The risks are greater for a 60 year old than for a 30 year old, so for someone like 76, you need to consider everything.

    A surgery to correct a back situation may be successful, but there may be other impacts. One of my neighbors had a situation where their mother (82) went in for surgery for It was successful, but overall it was too much strain on her heart. So while her diverticulosis condition was corrected, her heart was weaken so that she had several strokes which eventually lead to her passing away 1 year later.

    I am ot saying this to scare you, I just want you and your father to approach this looking at all aspects.

    Will the surgery give him enough pain relief so as that he can walk again without pain and doing other things.

    I've had 15 surgeries, ( 7 spinal, 4 total joint replacements, 1 Achilles tendon reconstructive surgery, plus others) I had one hip replaced in 2011 and the next in 2013. In just those two years, the recovery from the second hip surgery was much more difficult. I am talking about being 61 then 63. That made a difference.

    I would look for options that would be conservative and provide your father with relief.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Thank you dilauro.
    And exactly, no one can expect to have a perfect spine at the age of 76 and I have also heard that it is really normal to see degenarative changes in an MRI of people of a certain age.
    So this is why I also think "don't take the maximum surgery to fix it all", rather than "find out what exactly causes the problem - if possible, and fix this".
    Maybe some orthopedic surgeons do have the tendency to fix everything they see...no idea, just felt like it with this one.
    So I am glad we will get a second opinion.

    As for the risk of a surgery due to age, I agree and thanks for pointing that out again.
    Luckily, my father is of very good health overall. No heart, blood pressure issues and no other problems.
    This back thing is really the first time he has something bigger going on.
    I know surgery is always a risk and that even though he is healthy, it could be a big strain on him - but he really shows no signs of any "weakness" in his vital functions. He already had a check-up at the clinic (where they wanted to do the procedure) and everything was fine.
    I think at this point, he is willing to take the risk. Especially because he feels still so healthy and strong, he would like to get some mobility back.

    He had his first surgery two years ago, for a hernia, and had no problems at all.
    I know this can could be different now of course - but like I said: the worry is more how his back can be fixed and if a fusion is necessary or if a simple decompression for the stenosis would be ok.

  • Devonne,

    You've got a lot of great advice here for you to digest and talk over with your dad. Dilauro is very right about age and those considerations on how he tolerates a massive surgery. A good surgeon would also consider all these things. The next time you see a neuro or spine surgeon, ask these questions. Bring a list of anything you want to talk about and go through them one by one. Take time to either take notes or record your surgeon's answers on an iPhone memo recorder. Trust me, it will help with your decision to have ALL of the notes in front of you. Ask tough questions. Be thorough. This is the life and wellbeing of someone very dear to you. Good luck!
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
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