Cervical Stenosis

@otavares I am a spine surgery patient for cervical stenosis. Depending on where your stenosis is will determine how the surgeon will address it. If you have stenosis at the nerve roots between the vertebrae that are narrowed due to bone growth, a surgeon may use an ultra- sonic type scalpel for trimming bone to widen those areas. If you have stenosis in the central canal, and your spinal cord is being compressed, that is a lot more difficult to access, and usually there is a bad or collapsed disc involved that will be removed to allow access to the canal. That may be removed by a different tool that takes bites out of the disc. That leaves a space that must be filled with something such as a bone disc implant in a fusion or an artificial disc implant.

When you start consulting surgeons, you must keep an open mind and listen to their recommendations. They have their own ways of working and their own preferred tools and procedures. If you go in with an expectation of them using an ultra sonic cutting tool, and it isn't what they offer to you, you may be on a slippery slope. No surgeon wants to be told how to do their job because you found some information on the internet. You certainly can ask how they do their procedures. Keep in mind it is very easy for surgeons to back out of helping a patient for a lot of reasons. They don't want to get into a situation of getting bad online reviews over a disagreement with a patient and take a risk on surgery.

Sometimes surgeons do advertise a "miracle tool" claiming it makes them a better surgeon, but that is marketing. The best facilities will also have the latest in technology and tools, so they likely have the ultrasonic scalpel. I know Mayo does have it. Here is a discussion where the ultrasonic scalpel was talked about.
https://connect.mayoclinic.org/discussion/controversial-trends-in-spine-care/
The best reason to choose a surgeon is their reputation and skill and if their area of interest matches what you need. They all have statistics of their own person success rates with the procedures that they do. Also look at the reputation of the medical facility where they work. You can find a lot of information in their profiles about their training and awards. You'll find excellent surgeons teaching at spine surgeon conferences for doctors and publishing medical research papers.

We have many discussions about cervical stenosis. If you type those keywords in the search bar at the top of the screen, you will find many patents talking about their surgery experiences.

Jennifer

@otavares I have some questions for you if you don’t mind. It is related to the pressure in your neck and head that caught my eye. I have had pressure in the lower back of my head and neck and also once in the front of my neck from one side to the other. The pressure in the front of my neck was really bad. The pressure comes and goes. I had an MRI that showed I had moderate central canal stenosis C6-7 and severe bilateral foraminal stenosis. I have bulging discs in my neck. Even though I have bilateral C3-C4 severe foraminal stenosis a neurosurgeon said that those issues aren’t causing the pressures. He looked at the MRI and said my stenosis was not severe. When the pressure goes up so does my blood pressure. I don’t have dizziness but I am curious about your confusion. I am having some issues and I know the definition of confusion but would like to hear more from you about that . I am asking for a reason. I am sorry I don’t have feedback on spinal surgery. I have small nerve fiber with no known cause. When I tell the Doctors I have head pressure they call it a headache. I have had headaches years ago that were pounding until I threw up. That is a Headache to me not pressure. Appreciate anything you can tell me about those issues because I yet to have any answers regarding the pressure in my head.
@rnlorena

I'm losing partial use of my left hand due to this. I had a C5-C5 arthroplasty in Nov 2022, and a C6-C7 arthroplasty a few weeks ago. I'm not dissecting my situation in every way possible and hand-wringing about it; I just know stenosis was doing it. I can barely make a fist. This may be all I can get done. My point would be not to let this percolate; get stenosis dx'd if you suspect it ASAP. Mine went from mild/moderate to this point in less than 3 years.

Also get their rate of infection post procedure

Sounds like your doctor's are brushing you off. How about a second opinion and let your current doc know that you are not satisfied and do not feel heard. They work for you!

@gravity3 I can't help but be negative. I try to be positive but it has been very hard. I was surprised to finally find someone who has head and neck pressure. I am not a Dr. but I am a retired nurse. I know medical terms. I do not know everything. I have an excellent cardiologist but other than that it is not good with Doctors. After I went to the neurosurgeon he looked at the disc of the MRI of my neck. I read the paper. According to the radiologist that read my MRI I have some severe bilateral foraminal stenosis. The neurosurgeon said my stenosis is very minimal and it's not causing the pressure in the lower back of my head, neck or front of my neck. When I say pressure it is pressure. Some people ask me about my headaches. So I say this: When I got a root canal I had a pounding headache when I threw up it went away. When I had a virus I had a pounding headache. When I threw up it went away. I just don't know anymore. I did have a pounding headache related to blood pressure once. When I relaxed and got my pressure down my headache went away. I am going to a new neurologist and the questions will be numerous.

I hope that the new doc can help you get the answers that you need.

@rnlorena Your spine condition may be generating spasms in your neck muscles that are attached to each vertebrae. That is pretty common and the spasms can twist or tilt the vertebrae and change the curvature in your neck. I had this happening to me because my vertebrae would twist and stay like that, and because the muscles on the opposite side were getting stretched, it generated pain. The uppermost muscles connect to your skull on the back of your head. These are occipital headaches. A physical therapist can help with these. The ultimate solution is fixing the spine problem that you have. Since my single level fusion of C5/C6, I don't get occiptal headaches unless I do something weird with my neck position in sleep for example that can trigger it. You may be able to lay on your back and feel with your fingers if the spineous processes that stick out to the side of your spine are lined up. They have muscle attachments covering them, but you should be able to feel them.

Jennifer

Jennifer I'm wondering if you use a special pillow.
Thank you, Janet

@jenniferhunter MRI cervical spine with and w/o contrast. Posterior disc bulge at C6-7 slightly flattens the ventral cord with moderate central canal stenosis. There is severe bilateral foraminal stenosis. Posterior disc bulge at C5-6 slightly flattens the ventral cord with mild central canal stenosis. Mild bilateral foraminal stenosis. Bulging disc at C3-4 without canal stenosis. Right-sided uncovertebral spurring and facet arthropathy results in severe right foraminal stenosis. Range of motion in my neck is not great. MRI Thoracic spine- Axial images show multilevel disc spur complexes in the lower cervical spine producing slight effacement of CSF along the ventral margin of the thoracic cord substance. X-rays Lumbosacral. Patient has advanced degenerative disc disease at L4-5 and minimally L5-S1. Mild lumbar curvature apex to the right L4. Bilateral facet arthrosis L5-S1. He said perhaps I have a slight spondylolisthesis. So the Neurosurgeon that I saw looked at my MRI cervical spine. He said no evidence of spinal canal stenosis that significant surgically. He calls what I say is pressure a sub occipital headache. I get pressure in the lower back of head, neck and front of neck. The pressure in the front of my neck was from one side to the other. It was the worst. The Orthopedist who did the X-rays wanted me to take Mobic. I declined. I have other things that have come up and I don’t need anything else right now. I understand that side effects don’t happen to everyone but I don’t feel good about taking Mobic. I spoke with the pharmacist. He put it this way: you won’t know till you take it. I already knew that but a side effect can be a hole in the intestine or stomach. The MRI of the thoracic spine will not be talked about till my appt in April. I was in England in October and I had a pain in the upper part of my right breast. It was just sitting there hurting. Not moving anywhere. When I went up to go to bed I dropped something on the floor and bent over to pick it up. Pain shot down my breast. Since I have been back I have felt like something was moving underneath my right arm. Just a little feeling. Since then I have felt little things around my chest and underarms. I was diagnosed with small nerve fiber idiopathic. I don’t know if that is related. My regular Dr. shoved it off to the neuro Dr. what is he gonna do about it? I am gonna tell my Dr I want an Order for a diagnostic mammogram with an ultrasound. When I go I ask questions about what is happening (symptoms). I asked my new neurologist if he had any patients who woke up with full onset of pinpricks including eyes. He said that’s weird. He said maybe something similar. The first neurologist said none it’s rare. I am kinda fed up with this really. @rnlorena