Go to the Cockrane Report and do your research,you are getting out of date advice on your back. Some of what you are being told to do is not effective , no research to support some of those surgeries.
Stop the epidurals they are damaging , please remember clinicians(docs) treat as to what they learned in school and are usually 10 years behind the new research findings. They stick with what they know and have been trained to do. when it comes to many surgeries it is shocking that they are often not based on research, yes many surgical procedures are based on someones idea of what might work.
I work in a neurosurgeons office. I would do whatever I could to avoid the fusion. I have yet to see a patient go back to daily function that it would take to do stalls or horses. Even my surgeon says there is a chance it will help and a chance it won’t help at all. I would get a second opinion also as opinions seem to vary. If they only need to fuse one level there is a minimally invasive surgery that seems to have better results than a traditional fusion.
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I would go with the knee repair first. Get a solid base of support under your body, without pain in movement. It SHOULD dramatically reduce back pain just by keeping your body better aligned, weight bearing in balance on both legs.
I also am due for knee replacement, and have found that I will badly favor the poor knee, throwing much more weight on the good leg, causing body to carry itself crookedly. That certainly makes things MUCH worse for the whole body, pain intensified in other parts with misalignements. Even not in pain with my knee shots (which last me about 6 months), I may be “saving” the bad leg moving around. So I have to pay attention to my posture, stand straight, even shoulders, use my entire body in balanced walking to prevent making myself sore.
I would definitely get my knee fixed first, wait a little, see what the back is doing after knee surgery before fixing the back. You might have a lot of issues resolve once you are able to stand and walk with good, painfree support of your legs. Husband got a surgery done, found other places hurting badly once the first pain was gone! Amazing how one pain will mask another, you hear the loudest irritant, miss other things hurting. He got those other places fixed when healed from the first surgery. Life is much better for him now.
Also wondering if OP has done her back shots with a Pain Clinic? There are alternatives to cortisone, do help a great deal. My brother gets back pain shots at a Pain Clinic, a series of 3, done a month apart. They last him about 6 months, and greatly help his pain issues. He has fused vertebrae in lower back, disc issues. Not sure what meds they use for his shots, we are really grateful to have found such relief for him instead of pills. The pills were not helping much, causing other side effects that were bad.
Pain Clinics might be more current than individual Orthopedic Drs., have alternatives to the Cortisone. Of course this means you need a Prescription from the Orthopedic Dr. to be treated at all. Worth checking out though, could be a big help to you. Brother had been dealing with pill pushers for the last 10-15 years. NO ONE suggested pain shots as an aid to help the spine issues. My cousin is married to a man with a back problem, brought up the pain shots he gets instead of pills, to function, hold his job. It was a light bulb moment for me! I dragged brother to my favorite Ortho Doc, who was all in favor of pain shots after seeing brother and his medical history, x-rays. His pain is not entirely gone, but he can now function reasonably, not taking the heavy doses of pain meds with the awful side effects on his thinking, personality. He puts his back pain at a 4 when they ask about it, down from a 8-9 level when we went in the first time before shots. He can manage a level 4 with few problems, a pill at times during the day. Pills are also lower level meds than before, yet are all the help he needs now.
I would not jump into back surgery without doing a lot more research. Best of luck with your surgery.
I was referred by my ortho to a pain clinic, and have had the spinal epidurals through the pain clinic. Not an option to do them at an orthro’s office like cortisone shots in the knee because the spine shots have to be done on a fluoroscopy table.
They also prescribed gabapentin, which simply isn’t an option for me. In the dosage that makes a difference in the pain, the drug makes me stuporous.
The problem is that while the shots have given me a lot of relief short term, it’s not lasting. I had the third set in the series five weeks ago and the effects are diminishing. Not as bad as when I started the series, but certainly not fully functional. My layman’s interpretation of this outcome it that the shots relieved some underlying acute inflammation but haven’t done anything to resolve the chronic structural problems.
I do think I’ll go ahead and do the knee surgery first, and reevaluate where I am with my back after that.
Goodhors:. “There are alternatives to cortisone, do help a great deal. My brother gets back pain shots at a Pain Clinic, a series of 3, done a month apart.”
Can you please find out what he was injected with? That would be great. My guess, though, is that it was cortisione (which can have different names). The series of 3 shots, a month apart, is typically how cortisione (epidural) injections are given. Thanks.
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[QUOTE=AKB;8850687]
I wonder if getting the knee fixed will make the back better. Sometimes people are like horses. When one area, like the knee, is causing problems, it aggravate other areas. I would vote for getting the knee fixed first, and waiting on the back.[/QUOTE]
Just what I was thinking. Maybe in trying to compensate for the knee pain you are moving and carrying yourself in a way that aggravates your back? I would opt for the knee first.
Is it possible to ask your two doctors confer on which surgery should be done first? I would want an informed opinion (or two) before making any decisions
Definitely the knee. Back surgeries can be very unpredictable.
Good Luck
[QUOTE=AKB;8850687]
I wonder if getting the knee fixed will make the back better. Sometimes people are like horses. When one area, like the knee, is causing problems, it aggravate other areas. I would vote for getting the knee fixed first, and waiting on the back.[/QUOTE]
[QUOTE=McGurk;8853790]The back is mostly debilitating because of pain. I can’t stand or walk for very long at all without the epidural injections. I tend not to be riding much lately not because riding hurts, but that catching, bringing in, grooming and tacking is more than I can bear.
In regards to farmwork; anything that involves sitting on the tractor is fine - bushhogging, harrowing, using the front end loader. Anything that involves standing - mucking, holding for the farrier, etc., is miserable and an endurance test.
I do think the knee factors into that equation, though - I can’t put all my weight on my right knee or it gives out. So if I want to rest my back I tend to lean forward onto something.
With my previous TKR, I was so diligent with the rehab that I gave myself bursitis in the new knee! I tend to overdo things. 
So - I can a lot of the knee rehab without standing/walking for long periods, and I’m pretty sure all the back rehab involves standing or walking. I think that’s the answer.[/QUOTE]
That really sounds like your knee is making your back sore to me. A doctor once told me that a nerve can be constricted and it won’t cause a problem unless it’s also inflamed. If you can alleviate the inflammation on your leg your back might get quite miraculously better.
I think it’s important that you stress your back problems and insist they handle you gently during surgery. I know two people who had mostly healed back issues greatly exacerbated by they way they were handled or posed during surgery.
My knee surgery is scheduled for next month and I am really, really ready. Haven’t ridden at all the last two months, and pulled shoes off the horses the last farrier appointment. Am going to ask that they do a spinal epidural as part of the anesthesia like they did for my last knee; I am hoping that it will make my back happier with the rehab and PT.
I made a big decision. I am hiring someone to put my horses back into work for me. This feels very, very strange. If you ever told me that I would pay someone else to ride regularly that wasn’t a BNT or didn’t have an Olympic medal around their neck, I would have laughed about it.
But the reality is, both the horses and I are fat, unfit and out of shape. Getting on either horse after a several month layoff, fresh, with a questionable knee and the rest of my medical history seems sketchy at best. So I am paying a very nice, very competent local rider/instructor to put them back in work for ~30 days before I get on. Expensive, but way cheaper than screwing up my new knee. And frankly, I’m probably going to enjoy that first ride more if I’m confident that the boys are going to be gentlemen about it.
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Thanks for the update. My knee replacement is doing very well, though not on any horses yet. Feels so much better with body aligned correctly again. Hiring a rider for the boys sounds good for everyone. Best of luck with the surgery.
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Good problem solving on your part…best of luck with your surgery
Best of luck with your surgery.
I had a L5-S1 fusion in June 2013 at age 30 due to a totally collapsed disc, was bone on bone. I was in the clamshell brace for 3 months, a hybrid for 2 months, and cleared to get on a horse in 7. The surgery was life changing for me. I was functioning previously, but was in constant pain.
Now, nearly 4 years out, I am still pleased with my surgery. I do all my farm work, ride, back babies. I’ve taken up dressage (still jump too) and can sit the trot without being bedridden for 2 days after.
I’m not saying that the surgery is to be taken lightly, but there are those of us out there who had good results. FWIW, I do think that the BoT brace helped accelerate healing, I wore it under my medical braces. I found that it brought me the most relief pre-surgery and felt that it couldn’t hurt post-.
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Soooooo…
A lot of things have changed since my last knee replacement, and they are good things.
One, the protocol is no longer nothing by mouth past midnight, as it used to be. You are allowed clear liquids, including black coffee, up until a couple hours before surgery. Bliss. Not starting out dehydrated and light headed is great.
Two, they now do a spinal block plus a local block. The local block, to the inside of the knee, is guided by ultrasound. This means that the rest of the sedation is truly very light twilight sedation - no breathing tube necessary, and very little pain. No anesthesia hangover either.
The local block makes getting up and walking the afternoon of surgery a snap.
Finally, the have a new type of waterproof dressing that means you can shower when you get home.
So I was in hospital less than 24 hours. Standard is 48, but I was feeling good and doing all the PT so they let me come home early. Home PT starts today.
I can’t tell you how much easier this was than last time. I rode the golf cart out to the chicken coop and gathered eggs with hubby this morning, using the cane to navigate.
The decision to have someone else keep my horses in work has been an excellent one; they are going well and I am really looking forward to getting back on.
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Good for you! 
So glad to hear everything went well and that you’re feeling okay - jingles for continued pain relief and a speedy recovery!
What bliss to be allowed coffee before surgery! I never have had an issue fasting, but the lack of coffee is horrible. Sounds like you are doing well, lots of healing jingles coming your way.
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Glad to hear you got the knee fixed and are progressing well. They told me to put cling plastic wrap over the cover on stitches for showering. Worked well, my protective cover never got wet. Has to be cling wrap because it seals better than plain plastic wrap in water.
Funny how each Dr and hospital have their own way of doing things! Such a variety!! But results are getting faster, better recoveries and doing normal things again.
My knee is doing very well after Nov replacement. I had a slow recovery in getting knee straight, then bending well. I had not had full range of motion before surgery and learned how wimpy I am about pain!! I just went for slower progress with minimal pain for straightening first. Doc was really huge on “get it straight first, we can bend it after”. So that is what we did in Therapy and daily exercises. I recently graduated out of Therapy with a straight leg and120 degrees of bend. Recent Dr visit made Doc happy wit those number aND seeing mE walk. She encouraged continued exercises, might gain more bend over time. Keep walking correctly, extend leg, step heel-toe so it gets ingrained and is my “normal” movement again to use both legs equally.
Back doing my stall chores and enjoying being outside.
