Should I have scheduled back surgery?

[lateeda]

Fell from a horse in December of 2008.  I went to the ER because of horrible pain.  I ended up being diagnosed with fractures of the pediducles and transverse process.  6 months later, I was diagnosed with an annular tear in a disc space at L5-S1.  I had a lumbar fusion at l5-s1 in 2009, one week after the diagnosis.  

Now, I have times where I fall over and can't feel my left leg.  When I bend to the sides and especially the back, I get HORRIBLE pain in my back and have to come home after work to just lay down on ice, stretch, and try to wait to feel better.  I went from being an active 28 year old, to quickly being in lots of pain.  We have tried steroid injections, steroid blocks, etc.  We have done MRI's, CT scans etc.  I have been carefully examined for all neurologic issues-- nothing showed up.  I have been examined for back and spine issues- and the only thing the doctor can think of is facet joint issues.  My question is to have surgery to remove these facet joints (I am fairly young), or live with the pain??  My job requires a ton of bending and twisting.  I want to be sure I am my best and right now, this pain is debilitating down my left leg and I am living with horrific pain that takes my breath away.The doctor would put screws and a bridge into my back as a replacement for the facet joints being removed.  I think my pain is from this, but I need a second idea of go ahead with surgery, or wait.  THANKS!

[S. Kaul, MD]

Hi there!

I would not advise a surgery for the facet joints since the surgery would be high risk and would come with its own set of complications; besides the type of pain that you describe does not seem to be due to facet joint issues and hence it cannot be guaranteed if your pain would improve with the procedure. This might be an inappropriate comment since I do not have your clinical details, hence I would suggest discussing this in detail with your orthopedician. You may also try consulting pain management and physiotherapy for pain relief.
Hope this was useful.

Take care!

[lateeda]

Not asking for a second opinion of course, but I value another physician's ideas, as my sister is in the medical field and her advice is what scared me (technology is "not there yet") for this surgery. I just want to live again and be active!!  :)  I love my doctor and I am glad to be seeing him as a my physician.  It is just confusing since I keep hearing I am "so young" and "why now?"  In my opinion, 28 isn't that young when you fell from a horse and ruined your back.  I think it has aged so fast.  Anyways, thank you and blessings to you for any thoughts you may have pertaining to this.