Mother has had two surgeries for spinal stenosis. They both worked for a while but then her back and leg pain seem to come back. The surgeon is talking about another surgery but Mom seems unable to make the decision and wants us kids to tell her what to do. This is very unusual for her. She's always been such a strong-minded, decisive person. What should we tell her?
Spinal stenosis is a narrowing of the spinal canal and/or openings for the spinal nerve roots to pass out of the spinal column and down the arms or legs. This narrowing can come about as a natural result of aging and degenerative processes. Bone spurs, thickening of the spinal ligaments, changes in the spinal joints are just a couple things that contribute to the development of spinal stenosis. Surgery can be done to decompress the nerve tissue. The surgeon removes bone from around these sensitive tissues. Spinal fusion may be offered as a second approach for some patients. Fusion limits the amount of spinal motion, particularly at the segment where the fusion was done. It stabilizes the spine and protects the nerve tissue. Your mother's indecisiveness is understandable. After all, two spine surgeries is considerable. If she did not get the expected results (pain relief, improved function) then there may not be the motivatoin needed to face a third surgery. There could be another reason and that's depression. Your mother may not seem sad or experience bouts of crying but the inability to make important decisions like this one could be a symptom of depression. In fact, studies show that psychologic problems such as anxiety or depression can have an affect on patient results after spinal surgery. It's possible that the poor results your mother has had may be directly linked with depression. Before deciding on another surgery, it might be appropriate for your mother to be tested for depression. There are several reliable and accurate self-study surveys available for this kind of assessment. If she will let you, go with her to her next appointment and talk with her doctor about your concerns and her questions. The more you can sort through the whys and wherefores of her thinking, the better chances she has for a good treatment result.