Hello and welcome to MH. I am sorry to hear of the back problems and pain that you are experiencing. In my opinion, surgery is a must ! Left untreated could lead to permanent paralysis. You spine is a complex region of nerves and muscles that provide function to many areas of the body so it is important that if a Doctor recommends immediate surgery then do not hesitate.
It sounds like the Neurosurgeon would most likely Fuse the area at L4-5 and then use a decompression technique for the narrowing of the spine (Stenosis).
I highly recommend that you visit a web site by the name of :
Spinehealth.com -or- Spineuniverse.com
These sites go into great depth on different back problems and surgerys and can answer many of the questions you might have. Also, Med Help has a forum on backs as well. You might want to check that out too.
Take care and good luck in the future. Let us know how your doing.
PS- I have included some information that I thought might be helpful for you.
A herniated disc is described as an "uncontained" disc problem, meaning that the soft interior of the disc (the nucleus pulposus) has leaked out of its covering and no longer provides cushioning for the vertebrae above and below it. Additionally, the ruptured matter may become lodged in the spinal canal, where it can irritate nerves. A bulging disc, by contrast, is still within its casing, and is called a "contained" disc condition.
Symptoms of herniated discs in the lumbar region (the most common site of herniation) include serious pain in the lower back with pain radiating out to the legs, feet, and buttocks. This pain often intensifies with certain activities such as coughing or laughing. Herniated discs can also cause numbness or tingling sensations in the feet and legs. Left untreated, a herniated disc may cause muscles to weaken and atrophy. Herniated discs are also associated with muscle spasms.
Welcome to the Pain Management Forum of MedHelp. I am glad you found us. Mollyrae has done a good of providing you with information.
Your question was surgery or not? In my opinion the response is yes. I do not know how you can avoid it. You have tried all the normal procedures to avoid surgery or to treat a less severe herniation. The herniation (severe) is pressing against the serves in your spinal canal. This is what is causing the stenosis or narrowing which in turn is causing your pain and weakness.
An elderly family member had stenosis in the lumbar area of her spine. She had severe pain and weakness and had difficultly walking. A neurosurgeon performed surgery and she has had no further pain. It was like a miracle. I was sure she would be left with some residual pain and/or limitations but she has not.
Your MRI also reveals prominent degeneration of inter-vertebral disc. So you have several areas of disease that need the attention of a surgeon. I know this may be a bit scary for you but there are some absolutely great neurosurgeons out there. Your pain should be reduced and your strength should return. There are multiple articles on the web, indeed Mollyrae has provided you with a few. Most are full of a lot of medical jargon to wade through and for the layperson they can be difficult to understand. I encourage you to make a list of written questions for your surgeon and take them with you. Be prepared to obtain the answers to your concerns. You should feel so much better after your surgery.
Please let us know how you are doing. I will look forward to your updates. Take Care, Tuck
Surgery is not really an option for some but necessary. I would get a second opinion though. Ask your Dr if he can recommend someone for a second opinion. Explain you do trust him you would just feel better getting a second opinion to relax your mind that your doing the right thing.
Getting second opinions when surgery is involved is fairly standard.
I agree with Sandee. She offers you a very god idea. It never hurts to get a second opinion and it may make you feel better about the procedure. I would ask each surgeon the same questions and you will be in a better position to compare them. That will give you good material in which to make your decision and/or select your surgeon if need be.
Again take care and please keep us posted. Tuck