Spinal Stenosis
Have my first appointment coming up in Rochester in mid may. Being a Paramedic I research medical procedures extensively and most doctors don't like it when I question them. I'm trying Mayo as they are supposed to be the best of the best. I'm from Des Moines, IA and it seems all the docs around here just want to fuse the C-Spine.
I'm trying to avoid that if I can, kind of seems barbaric. In researching I've found several doctors that will use Ultrasonic scalpels to remove bone growth, thus relieving pain! (reducing recovery time) and installing new pads in between the joints. Has anyone been to Mayo to have this done? I've spoken to others that have had the fusion and they are doing fine but reading this group I hear alot of issues people are having after fusion.
Interested in more discussions like this? Go to the Spine Health Support Group.
@matthewpreston Hello Matthew and welcome to Connect. Ultrasonic scalpels have been discussed as being another tool a surgeon can use. It all depends on what needs to be done and where the issues are. I had a disc that was collapsed 50% (herniated) and that caused bone spur growth adjacent to the disc and it was pushing into my spinal cord. The disc had to be removed and there needs to be something placed in that space. I considered an artificial disc, but I was not a great candidate for it because of slight laxity that allowed the vertebrae to slip past each other a little bit. My surgery was at Mayo Rochester, and I chose fusion over disc replacement. I had concerns about immune responses to foreign materials, and I could have a fusion without hardware for one level C5/C6. It was done only with a bone bank spacer disc. I still have full range of motion because C5/C6 does not do much for turning the head. I lost a minimal amount of tucking my chin to my chest. I was in a neck brace for 3 months until fused.
It is major surgery and has a long recovery time, but in 6 weeks, I wasn't in any pain. After 3 months of a neck brace, muscles are weak, and I needed some physical therapy. Everyone is concerned about other levels going bad after a fusion, and I have had no trouble and I am 8 years past this surgery. I do myofascial release that I learned from my physical therapist. It helps to loosen tight tissue, and reduce tightness of surgical scar tissue. I think that helps a lot, because it takes the extra tension off. Tension and pressure can affect other discs. Hardware can play a role in increasing the risks of adjacent segment disease, for example the plates surgeons use on the front of he spine can rub if they are longer as in multilevel fusions. My surgeon told me a fusion shrinks a little bit as it heals and bone is absorbed and rebuilt.
You may be interested in this discussion
Spine Health - "Answers about Controversial Trends in Spine Care"
https://connect.mayoclinic.org/discussion/controversial-trends-in-spine-care/
Here s our discussion about Myofascial Release
Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
My surgery was life changing in a good way. I was very pleased with my spine care at Mayo. I had seen 5 surgeons prior to coming to Mayo and none would help me because they didn't understand my case and connecting my unusual symptoms to it. I did a lot of research and found medical literature with cases like mine, and with that, requested an appointment at Mayo and found a surgeon who understood. Basically I had referred pain all over my body from spinal cord compression. I did not have any nerve root compression. I was losing my ability to control my arms, and my Mayo surgeon gave that back to me.
Jennifer
Thank you and good for you. I too have seen multiple doctors here in Des Moines and not impressed with many of them. My neighbor just had his neck fused in December and said it was life changing. Mayo will be the last opinion I get as I need something done. The pain and degrading of motor skills is too much. Been dealing with this for 10 plus years. If mayo wants to just fuse the c spine then I'll probably have it done locally.
Thanks for the info
Matt
Hello Matt,
Had an MRI several months back.
MRI should moderate/severe stenosis C1-C7.
Spinal canal looks fine, its the nerve openings pinching nerves creating issues, weakness, tingling especially right arm/wrist.
Wanted to ask regarding your motor skills, what exactly did you mean ?
I feel my dizziness and lack of balance has been brought on by my stenosis diagnosis.
But my primary care Doctor is telling, absolutely no way (reason for me asking).
Thank You, Oly
@otavares Oly, Cervical spine problems can cause dizziness. This was happening to me. I had muscle spasms related to my cervical stenosis problem and also a shoulder issue (thoracic outlet syndrome) that causes neck tightness. Because of that, one side of my neck is tighter, and when I get a neck spasm, it can independently twist my cervical vertebrae. There is an artery, the Vertebral artery, that runs inside the cervical vertebrae, and it is part of the blood supply to the brain. If the vertebrae get twisted, it stretches that artery and closes down some of the blood supply. This causes vertigo and dizziness. I worked with my physical therapist, and realigning the spine solved the dizziness. It doesn't happen so much now since I have had spine surgery to correct the central canal stenosis.
Your primary care doctor may not think about this situation. Will you be consulting a spine specialist?
Jennifer
Thank You Jennifer!
@matthewpreston - I had an ACDF on C4-7 in Feb 2023 at Mayo JAX. The surgery went smoothly, I spent less than 24 hours in the hospital, post-surgery was uncomfortable for a time but by 2 1/2 months I was quite literally dancing at my daughter's wedding. Because this was a four-vertebrae surgery - fusion was required for stabilization. But I have felt no negatives associated with the "F" part of the ACDF.
Docs get frustrated by patients who bombard them with random questions. I always went to an appointment with (1) A pre-thought list of questions - questions that also indicated to the doc that I had already invested my time in researching the medical issue. (2) A second set of ears to help me grapple with what can be an avalanche of medical input.
I'm certainly biased - but I am a super Mayo fan. Been a patient there for well over 30 years. Good luck!
Thanks, I frankly don't care if they get irritated with my questions after watching my mother die unnecessarily at the hands of incompetent doctors and being a medic for 18 years.
I have questions they will either answer or I'll go somewhere else. Some of the surgeons around Des Moines think they are God and shouldn't be questioned, but it's my health and life we are talking about.
I'm also a woodworker so I want to be able to maintain that hobby. I have heard nothing but good things about MAYO, so we'll see what they say. I preferably would like the less invasive "repair" of my C-Spine but if the only course for correction is Fusion, then so be it!
I'm also concerned about the three-hour ride back to Des Moines from Rochester and how I'll tolerate that.
@matthewpreston I'm writing my response for you and the community as well. I had my fusion at Mayo and stayed a couple extra days in case of complications. It was a 6 hour ride back home. They will tell you to stop every 2 hours and get out of the car to walk. After surgery, you have a risk of blood clots, and this reduces the risk, and there may be excess phlegm in the lungs from anesthesia, and walking helps clear the lungs. Likely, you would be sent home in a neck brace. I just put my head on a pillow support and leaned back into the headrest. It was fine. I wasn't more uncomfortable because of the car ride home. I was just tired and wanted to sleep, but the car movement kept me awake. You'll probably leave with pain pills that help a bit.
I'm sorry about your mom and I understand why you are an advocate. Ask educated questions. You probably already know answers to many questions that patients ask. At Mayo, my surgeon explained the imaging saying, you've probably already seen this, but let's go over it. I knew to ask if I could have a fusion without hardware because I had read a medical paper that mentioned it, and I worried about immune reactions to metals, so I asked. My surgeon agreed on a no hardware fusion if I agreed to stay in a neck brace 24/7 for 3 months or until it fused. That is what I chose. There are different ways to address spine problems and your goal is to find the best one for your situation and why the surgeon recommends it over other solutions. Every procedure has risks and possible failed outcomes, and it helps to understand why it can fail, and how you can best prevent that from happening.
Surgeons can back out of helping if they sense you would be an unsatisfied patient and they worry about their ratings for successful procedures. I was refused 5 times because they didn't understand how to connect my case to my symptoms. They can cherry pick their cases and increase their statistics of success which affects their income potential. That being said, Mayo is known for taking more difficult surgical cases, and everyone at Mayo is an employee of Mayo, so that removes the financial bias to perform surgery. The surgeon receives the same salary if he/she operates or not. I can say that at Mayo, I found the best, and all my questions were answered. There is a set amount of time for a consult which was more generous than other places I went. Ask the most important questions first because time is a factor.
I am on the same journey as you. My first appt is on the 14th. This will be my second surgical consult and I am hoping for better news. The first one I seen wants to do a fusion on one day, let me rest for the next day and then back in surgery to place 6 pins in my back. To say the least I was mortified!!! You want to do what???
Good luck at your appt.
@matthewpreston - first off - listen to Jennifer. She’s a great source.
I drove 7 hours from Mayo JAX to my home about 60 hours post surgery. I was a little groggy and napped - but road bumps and such were very tolerable and I was only using Tylenol.
Good luck!