### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I originally had a partial L3 laminectomy, complete L-4 laminectomy and L3-4 discectomy in 1995 and at the time a CT scan showed mild degenerative change to the facet joints @ L 4-5 with prominent right sided facet OA @ L5-S1. In 2000 I had bilateral decompressive laminectomies at L4 and L5; also lysis of adhesions and discectomies @ previous L3-4, L4-5 as well as L5-S1.. I have had ongoing problems since then but it has gotten worse.  An xray in 2007 showed some facet joint changes. A CT scan in 2011 shows some left sided L2-3 disc herniation. What was disturbing was that the scan also shows I have had a fusion at the L2-3 level; but I never have as I was told in 2000 to try to hold off for as long as possible. It also shows facet osteoarthritis and degenerative disc disease at L2-3, L3-4 and L4-5 and mild degenerative disc disease and osteo at L5-S1; where the osteoarthritis was originally found in 1995. The 2011 report also shows a fracture through the L4-5 right pars interarticularis. What I would like to understand is: could prior surgeries have any impact on the formation or speeding up of the osteoarthritis? Could the perceived fusion be caused by the osteoarthritis, and could the fusion have caused more pressure on adjoining joints causing the fracture and/or the L2-3 herniation, because of issues with other joints is one of the reasons I didnt have a fusion upon advice from my neurosurgeon. The next question, where do I go from here? It seems like my entire lower back is in a bad way and i am afraid I may have to go through another operation, only more extensive than previous ones and the chance for more problems in the future.

### output:

Hi and thank you for posting your question to Chat Doctor. Sorry to hear that about your back .in clinical practice the repeated surgeries are possible causes of formation of adhesions and development of spondylosis. Yes the severe spondylosis can lead to fused vertebrae .my advice is not to get anymore in surgeries as it is going to destroy the whole thing. Physical therapy and chiropractic doctors are the best choice now even if it takes more time to get better. Speedy recovery wishes