Some background info: Mom is 84 and is probably in Stage 5, lives at home with the help of home health aides on a daily basis, meals on wheels, and care from her gentleman friend and me. She has pain in her right leg. My mom has a shifted couple of disks at the L3 and L4 level of her lower back. There are bone spurs that are contributing to the pinching of the nerve to her lower right leg. We've had all the scans and MRIs done to determine what is the cause of her pain, and the treatment recommended by her back specialist is a surgery that would take about 30 minutes, remove the spurs and use them to fuse the vertabrae to prevent the shifting of the vertabrae again, and then a probable one night stay in the hospital. I would stay with her at home after the surgery is done. I am concerned about the effects of the anesthesia on her already weakened brain, and what the surgery might do to set her back even farther. She suffers greatly from the pain, but not every day. Her primary care physician recommends it, but my brother is totally against it. Any experiences out there with this type of decision?

There are a number of different threads on this very topic, perhaps not back surgery specifically. There are also some threads on anesthesia with dementia. Do a find (located on the bar at the top of the box on this page) in order to find those very helpful discussions.

In the end, you have to make the decision based on your superior knowledge of your mother. But definitely take into consideration the possible effects.

I guess the question that we all ask ourselves when these things happen is "will it improve her quality of life?" If the answer is yes, it will significantly improve it, then you might want to talk to her doctor further. If not, then perhaps some other pain management techniques. Can the sugery be performed using a spinal instead of a general? Can she be referred to a pain management doctor? Is she going to be able to do the physical therapy required? Will she understand it?

If it were my dad, I'd seek other options and they are about the same age and stage. I don't think it would benefit him as much as it would hurt him in the long run.

It's a personal choice.

About 8 years ago, my Mom was in constant pain caused by ruptured disks and degenerative disk disease and they wanted to do surgery. I had been going to a chiropractor for years, so I told her she should at least try especially since the three epidurals she had did nothing for her pain, and the pain pills made her extremely constipated. She was scheduled for surgery, but after a few weeks of chiropractic treatment, she got better and never needed surgery. She kept going for many years, two or three times a week and medicare paid for most of it. The surgeon told us she would be back for surgery, that it wouldn't help...but he was wrong.

After watching my Mom decline this last year after having 3 major surgeries for colectomy, ostomy and kidney stones, I would say "NO, Don't have surgery"! But, that is just because of my experience...not necessarily that this will happen to your Mom. I believe my Mom was in a late stage 5, but after each surgery, she lost some cognitive skills, and when they're already in an advanced stage, putting them into the next stage is a HUGE loss of quality of life. After her first surgery a year ago, she lost her ability to walk on her own, she had strength, but absolutely no balance. Other pain management would be my choice if it was my Mom, but if other methods don't work then of course opt for the surgery since she can't live with pain either. My Mom's last surgery was for Kidney stones...we had to get rid of them since they were blocking her kidney, and they are very painful. I wish there was another way, but we didn't know of any.

There are always so many risks and choices...and if everything doesn't go "perfect" we tend to second guess all of our choices. You do what you think is best for your Mom, that's all you can do.

I believe the most trouble comes from the anesthesia (not yet proven) so if they can use a local that would be the best option if surgery is necessary. In my opinion!

Best wishes,

Felicia

All of this is what I would do, not what you should necessarily do
I'd try a good chiropractor first and if it doesn't help and her quality of life is decreased due to the pain, if pain meds aren't helping enough- then I'd probably do it. I'd ask to speak to the anesthesiologist before surgery and see if it were at all possible to do it without any inhaled anesthetics and without propofol because these seem to speed up the decline. You should also plan to spend the night in the hospital as well or have someone stay with her in the hospital in her room.

Does your mother have a Neurologist? It might be worth it to speak to a neuroulogist who sees dementia patients as a routine part of his/her practice and discuss the stage of dementia, the health condition she has and the recommended surgery.

After discussion with Neuro, making such a decision may be easier. Neuro may also recommend against certain anesthesias and certain medications and recommend "for" specific types. In any case, if you decide to move forward with a surgical procedure, do speak face to face with the anesthesiologist prior to the surgery and inform him/her of the dementia and your concerns.

Sometimes they choose to perform some procedures with a spinal anesthesia depending on the problem and the patient's condition.

There is no way to tell with any degree of certainty what the outcome will absolutely be, so you are very wise in researching this and weighing the options carefully. I think it all boils down to risk versus benefits. Doing your due diligence as you are doing will help in making such an assessment.

Let us know how you are doing. I wish you the very best.

Johanna C.

Could you consult another doctor and see if another type of surgery which is less invasive? You'd be surprised how many new types of surgery are offered without being so much on side of "opening up" and cutting.

Or...as someone else suggested chiropractic or therapy?

Best to you and glad you're here as you'll find great advice.