A little background on me: I just turned 43, and will deliver baby #4 in March (Please God, not on April 1st...;-). I have a two and a half year old daughter, born when I was 40, and two grown sons, ages 21 and 18 (obviously born when I was in my uberfertile 20's!).
From the "It worked for me" file:
Don't go for IVF. It's super expensive, runs a high risk of multiples, and no guarantee, either, just like trying naturally. What seemed to work for me was getting the otc ovulation kits and finding out if I was even ovulating and if so, what was my cycle. I was ovulating, but it was on the days when I felt so crummy and out of sorts that I nearly made my Dh sleep on the couch! LOL It was good for me to recognise how my body was handling ovulation now as a "way grown up" as compared to how it did as a 20-something. What also helped us was to set a loose 12 month limit: Relax, enjoy ourselves, and be okay with the fact that it *may* not happen--we didn't want to force a situation artificially. (honestly, after 8 months of trying for our daughter, I looked at our spare room and started thinking "formal dining room..." and that's when I conceived our daughter. :-) Remember, when we're in our later childbearing years, things sometimes just move a little slower.
How is your back condition going to play into the stresses of pregnancy? Will the kids and Dh pitch in if you're laid up with pain? What does your surgeon think? Will the major surgery repair or just shore up a deteriorating area? Will you be healed in time to manage that toddler who's clamouring for "Upeez!"?
God bless you in your adventures. I am hoping it all works out as wonderfully for you as it has for me. *hugs*