spinal stenosis with subluxation at L-4,L-5

[Nettie105]

I have been to see a neurosurgeon and and orthopedic surgeon about my back.  Began with pain in hip and radiation down legs three years ago.  I had a myelogram done and it showed spinal stenosis with complete block at L-4, L-5.  The orthopedic surgeon felt I should have surgery soon due to risk for cauda equina syndrome.  I am worried (swore I would never have back surgery) about the upcoming surgery.  I need surgery on my c-spine, too, because of spinal and foraminal stenosis.  The neurosurgeon feels I should have the c-spine surgery first.  Have any of you had both?  Which did you do first? How are you doing  now?  Thanks.

[kittyluv1]

Good luck!  Having both the surgeons talk with you (and your family?) regarding the planned procedures will be very helpful.  Whether you proceed with cervical or lumbar surgery first, you will probably need the other procedure done as well.
Let us know how the conference goes and what decisions have been made.
My thoughts are with you ----

[Nettie105]

Thank you for your reply.  The complete block at L-4,L-5 is due to subluxation and showed on myelogram as a complete block.  The orthopedic surgeon felt this should be done first due to the risk of cauda equina syndrome.   The neurosurgeon said the c-spine should be done because the canal is so tight due to spinal stenosis that a minor injury could cause permanent damage.  The two surgeons are in different practices, but do the spine surgeries together if a fusion is needed.  I have a surgery conference today to talk about all the specifics.  

[kittyluv1]

The extent of your degenerative disc changes involving your neck and back do present significant issues that need to be addressed.  I have only had cervical spine surgery (discectomy and fusion C4-C7), but my recovery was very good with minimal postop pain.  It did relieve all of the neck, shoulder and arm pain I had prior to the surgery.
My concern is that you are seeing both an orthopedic surgeon and a neurosurgeon who are offering two different approaches to treating your condition.
By "Complete block at L4-L5" are you referencing spinal stenosis which is affecting the spinal cord itself?  That would seem like an indication for doing the lumbar surgery first to prevent significant chances of permanent damage such as cauda equina syndrome.
Have the orthopedist and neurosurgeon discussed your situation together?  An agreement between the two of them needs to be reached so that the appropriate actions are taken in a reasonable time frame.
My neurosurgeon did state that cervical spine surgery is more easily tolerated and the recovery is easier than lumbar surgery, so that may also be a consideration for you.
Having two surgeries involving your spine can seem daunting and I hope that you are able to obtain good outcomes with any surgery you elect to pursue.
Best wishes ---