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Spinal Stenosis
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Spinal Stenosis

I have spinal stenosis.  Most lumbar levels are involved according to my last MRI.  I have had a laminectomy L5-S1 (left), but the scar tissue left some artifacts.

I have shin pain, thigh pain, ankle pain and leg weakness  - all on BOTH legs.

The local neurosurgeon says surgery is no called for.  I have seen a neurosurgeon in Florida who says surgery is in fact called for and recommend operation on almost all levels.

I am sure that any surgery would leave some residual pain - the surgeon in Florida does a laminotomy and it seems as though having this done on all lumbar levels is dangerous.

I am looking for guidance - not a FIRM answer.  At what point should a patient decide to seek surgery?  I realize this is difficult.  The pain and weakness is affecting my life severely (I am 65).  I trust the local doctor who says "not now'.  I am unsure if the Florida doctor is just holding out hope, or can really deliver and if so, why suffer any longer.
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Welcome to the Back and Neck Community.  Members are here to provide assistance and support to individuals experiencing symptoms related to possible abnormal conditions of the spine.  Advice given is non-professional and is primarily based on personal experiences.

Surgery is a very difficult decision to make.  You need to evaluate the potential outcomes, including possible residuals (ie pain is perhaps decreased, but is still felt) with the current intensity of your symptoms and how your quality of life has been affected by them.
Having differing opinions from two professional practitioners may make the issue even more confusing.  You need to weigh the differences between the two options and use a pro and con checklist to assist you.  For instance:
Pro:  The pain will diminish and my symptoms will be manageable and allow improvement in my activity level.  I will be better able to function and I will benefit more than any possible residuals will affect me. The severity of my symptoms makes everything much more difficult and I find myself unable to participate in activities that I want to perform. I have noticed a progression of my symptoms and I feel that I will continue to get worse with no relief.
Con:  The surgery is not guaranteed to relieve all my symptoms.  The residuals will not enable me to function better than I am right now.  The severity of my symptoms is manageable most of the time and the acute flares that I experience are not longterm.
  You can modify the above issues to your present condition, and add any essential points that I have not listed.
Additional information regarding the causes and treatment options for lumbar spinal stenosis can be found at this web site:
    www.spine-health/conditions/spinal-stenosis
There are other links within this web site and it provides video documentation regarding the condition and its treatment. (See Lumbar Decompression Surgery)
   I recently had anterior cervical discectomy and fusion C4-C7 and surgery was my only real alternative as my cervical stenosis and degenerative disc disease was causing pressure on my spinal cord and the risk of permanent damage and even paralysis was too great.  Those events are not likely with lumbar spinal stenosis as the spinal cord is not present in the lumbar region.  The primary source of pain for you is the compression of the spinal nerve roots and the structural changes in the spinal column.
   After reviewing the material given and you have additional questions and/or concerns, feel free to post again and we may be able to assist.
Best wishes ----
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Dave, I have similar issues and have been to every kind of specialist one can go to. All of them have told me that I am NOT a candidate for surgery. My orthopedic surgeon is the Chairman of the Board of a huge medical university - he's pretty good. He sent me to a pain management specialist who implanted a Spinal Cord Stimulator (made by Medtronics) in my back. The SCS has helped tremendously. I would recommend you look into that option before having such extensive and drastic surgery. Good luck.
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