My best friend is having spinal surgery at the end of January. 29 years ago he broke his back,with the surgical repair involving the thoracolumbar area all the way down to the sacrum. Has fusion from L3 to sacrum, and severe central stenosis(levels L3-4,L4-5)high grade foraminal stenosis bilateral (L4-5)ligamentous hypertrophy at L4-5,severe sclerosis involving endplates at level L3-4 with very large traction osteophytes and what appears to be a posterior fusion with pseudoarthrosis extending through L-2 level. There is Grade 2 anterolisthesis of L5 on S-1and disc protrusion present. There is also retrolisthesis of L2 on L3. He will undergo microscopically-assisted extensive lumbar laminectomy,with decompression of the L3-4,L4-5,and L5-S1 levels not only of the nerve roots with foraminotomies along with arthrodesis with attempted posterior and lateral interbody fusion, and pedicle screw fixation; as well as exploration and correction of fusion (L3to sacrum.) He has degenerative osteoarthritis. Other factors that need to be considered -he is a smoker(2+ packs per day), drinks two or three alcoholic drinks per day (usually beer), has hypertension (is on meds), has Hepatitis C - not active but diagnosed 25 yrs ago. In 2009 he had right hip replacement surgery and is scheduled for left hip replacement in July or August 2013. Despite his condition, he has remained physically active (gym, cycling) until the last 8 weeks-has to walk with a cane and cannot go very far without exhaustion from severe pain.And, almost forgot, has been on and also abusing opoids for years.