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Surgery VS Injections

So I've gotten some great feedback from folks on different forums on this site concerning surgery, injections vs oral steroids, conservative care options, etc. I have another question.

Background: Age 33. Work a desk job. Recent MRI showed bilateral pars defects of L5, Spondylolysis, Grade 1 4mm Spondylolisthesis. Severe bilateral neural foraminal stenosis at L5/S1. All other levels are normal for age. MRI did NOT show any spurs, herniated discs, thickened ligaments, etc.

I have an appointment with a neurosurgeon Monday morning. The only non-surgical option that I haven't tried yet (nothing has worked so far) is spinal injections. My question is this: if I know that injections are only providing temporary relief and that to truly fix the problem I will eventually need surgery, is there really a point in delaying the inevitable? Is there a reason to subject myself to the injections now and still have to go through surgery later? Of course the final decision has be to between my surgeon and myself, but I'm trying to figure out, if he gives me the option, would it even be worth considering something that's not really fixing the problem. Would love to hear your thoughts/experiences. Thanks to all, you're a great group of people and have been a real encouragement!


  • have you tried physical therapy? iwould try that first.
    some people on this site love spine injections, some hate them. my advice is to educate yourself heavily. i am not a dr, but my opinion is that they have high risks. there are many people who develop arachnoiditus or parallysis(and many who don't). but the epidural space is so close to the dura..and once the dura is breached, problems may occur.

    from what i understand, epidurals ultimately are temporary, and if anything make the condition worse because the steroids are corrosive to the bone.

    i would in my non professional opinion, try a facet injection because the risk is lower.
  • horselady21hhorselady21 Posts: 191
    edited 04/30/2015 - 10:43 PM
    I have had many, many injections. Some helped, some did not. Assuming that your surgery will be a fusion, you must understand that a fusion doesn't guarantee a pain free life. Yes, it can improve. But I am over 2 years out, and even though I consider my surgery a success, I am, and most likely always will be, on pain medication. Of course, that is because I choose to be active.

    There are some on here who have had better success, and then others who have been less fortunate. It is, in essence, a roll of the dice. The Dr using factor for me was quality of life. I knew , and the Dr who was giving me I injections at the time told me, that he could no longer help me. If a nerve is totally improved by total loss of disc, you can inject it all you want and it will make no difference.

    So in my case, I felt I had no choice. I am glad that I got it behind me, but it was the most painful and long recovery I have ever experienced. Only you can decide, like you said.
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  • I have had 5 lumbar transforaminal epidurals and 1 facet joint injection. All took place within a 9 month period. I honestly wish I would have stopped after the first two. I am by no means a Doctor or a Nurse, but have been a MA at 2 ortho groups. From my husbands experience, mine and research, I can honestly tell you if the first and the second don't give you at least 60% relief then stop. Talk to your Doctor and voice your concerns. Keep a pain journal. Listen to your body. Good luck :)
  • Saw my neurosurgeon this morning. Surgery is scheduled for June 10th. The L5 is cracked and they will be removing part of the back portion, along with any tissue that might cause nerve compression. Then they will put in hardware and do an L5/S1 fusion. He tells me 2-3 days in the hospital, minimum of 6 weeks off work, and 18 months before I can get back to running/rigorous exercise. Having a particularly hard time with that last one. :-/
  • Hopefully everything will go well post fusion. Listen to doctor's order's and don't over do it! Be careful with anything "Rigorous" after fusion.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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