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[|Human|] Central Canal Stenosis L-3 L-4 Moderate Stenosis Multifactorial but is Primarily Due to dorsal Epidural Lipomatosis. I had blocks for the pain & have had fusion done 2 l-45 & l5s1 years down the road the l23 & l34 now having problems from degeneration needing possible fusion at the l-23 & l-34
[|AI|]  Hi there, thanks for your question at Dorsal Epidural lipomatous, is one of the not so common conditions in lumbar spine. I am happy to know that you have done well for so many years after your first surgery(the results of surgery and general condition is usually not god in this condition). Regarding your current situation.  1. Stenosis need s decompression surgery if you significant claudication symptoms, that is numbness, tingling and pain radiating along any of your legs after walking for a distance (distance at which symptoms arise decreasing with time). 2. fusion is required if you have significant back pain and your radiography /MR I show signs an of instability. 3. Since you have already tried injections, PT and pin medicines surgery is the next logical step in the ladder of pain management.  R. Your daily activities are affected by your it would qualify as another reason to go under the knife again. Hope this helps. All the best. Regards.  Chat Doctor.