Should I get back surgery?

jeem1

I hope someone has the time to read this and gives me their opinion and advise.

Would you get back surgery?

I started having back issues seven years ago after I started going to the gym.

I would get right sided back pain each time I would get up that lasted for the first 5 steps, it then would go away.

I went to the doctor and they took an X-ray and said I had advanced arthritis for my age.

Four years ago, the pain got worse. I would wake up with a sore back and needed to walked hunched down for the first few minutes. Eventually, it would go away and only hurt after I carried something heavyish or walked long distances.

My back pain, I’d say has gotten better since 2018 but about a year ago, my right leg started to lose strength after about 20 minutes of standing. It seems as long as I walk, it takes longer for my leg to lose strength.

Sometimes, when I'm sitting down, I have what I think is nerve pain down my crotch area.

As long as I have a sedentary lifestyle, I have no back or leg pain. Sometimes I’ll feel some soreness but nothing bad. I limit myself to lifting anything heavy. I’ve only had to take ibuprofen 3x in the last 4 years.

The reason I’m seriously contemplating back surgery is because I have tinnitus and having an office job (which I typically would have) is very challenging. I think I would do better in a blue collar job, but I need a healthy back for that.

I’ve had 3 MRIs done since 2018.

These are the findings:

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DATE OF SERVICE: 10/01/2018

MRI Lumbar Spine s/ Contrast

IMPRESSION:

1. Small to moderate right foraminal and lateral disc spur complex at L4-L5 with right greater left facet arthrosis and resultant moderate right-sided foraminal encroachment with contact of the exiting right L4 nerve root.

2. Moderate facet arthrosis L5-S1.

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DATE OF SERVICE: 12/07/2018

MRI Lumbar Spine without Contrast

IMPRESSION:

1. No significant interval change.

2. Minor right-sided L4-L5 foraminal encroachment with disc osteophyte complex contacting the exiting right L4 nerve root.

3. No findings to account for left-sided neuropathy.

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I went to see a specialist at Cedars-Sinai Medical Center in July 2019.

Within 10 seconds of reviewing the CD of my images, he diagnosed me with something else, with Parse Defect. He wanted to do surgery, then he changed his mind and said I should tried steroids first for the pain, which I never did. He told me to follow up with him every three months but I never did that either.

He asked the image center that first reviewed my first MRIs to do a second review.

This is what they came back with:

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DATE: 10/16/2019

ADDENDUM: The pars interarticularis defects present at the L4 level are a chronic finding and in retrospect are evident on prior MRIs from October 2018 and December 2018.

IMPRESSIONS:

1. Pars interarticularis defect bilaterally at the L4-L5 level with some bony hypertrophic changes and partial healing.

2. Right foraminal stenosis at the L4-L5 level due to hypertrophic changes from endplates and from pars interarticularis defect.

—---------------------------------------------------------------

I had another MRI performed last month -

DATE OF SERVICE: March 25, 2022

MRI, Lumbar Spine s/Contrast

IMPRESSION:

1. Stable degenerative changes including facet arthritis L5-S1

2. Since prior, new right exiting nerve root displacement L4-L5.

***THEY MISSED THE PARSE DEFECT AGAIN.

chiarieds

Hi @jeem1 - & welcome to the community. Good to see someone from the USA. Unfortunately we would be unable to advise as we're not Drs. However, I hope you seek further advice from your neurosurgeon at Cedars-Sinai Medical Center, as it has an excellent reputation in this field (& also  neurology)

As with many disorders, considering your back pain, it's how it impacts your Quality of Life (QoL), & yours doesn't seem to be severely impacted. Again this is a discussion to be had with your neurosurgeon, & if they would now recommend surgery, or not. My impression is that most good neurosurgeons would discuss other options rather than surgery initially. You really need to discuss the pros & cons with your specialist taking into consideration your thoughts about a career change.