Has anyone dealt successfully with Cervical stenosis without surgery?

Hi, @jenniferhunter! It's great to hear from you again. I've not made up my mind yet about a second opinion. I know it's the smart thing to do––and I may very well look for one. I must say the surgeon with whom I met––and not only the surgeon but also his nurse––provided an amazing experience. Friends had cautioned me: Be careful, Ray! If he's a surgeon, he's going to try to sell you on surgery! Thanks to my friends' cautions, I went fully prepared. But both the doctor and the nurse were so detailed in their presentations, so seemingly caring (great listeners!), so patient in going over the specifics of my situation (my symptoms, history, MRIs, and X-rays) that I drove home believing I couldn't possibly be in more caring, competent hands. I say all that, and yet I may still seek a second opinion. (In fact, the surgeon said he'd fully understand if I were to solicit a second opinion.) So, we'll see. One day at a time. This Tuesday I'll get those neck flexion X-rays and the thoracic MRI. Then, I see the surgeon next on 9/8. Between now and then, I'll continue with my cervical PT. I remain in good spirits about all this. I'm looking forward to getting the proper thing done––once I've determined the "proper thing"! Ha! Thank you for your continued interest. Your messages are a great comfort! Best wishes, Ray

@ray666 Detail is good. Other opinions are useful in a few ways. You may get several opinions in agreement of the need for surgery, and you would know that you are getting an honest evaluation. You may get wildly different opinions that place blame on other diseases instead of your spine, and you can tell if a surgeon is paying attention or trying to dismiss you if their opinion doesn't make a lot of sense with what you know about your symptoms. I know in saying this it might conflict with a trained medical opinion, but surgeons do pick and choose their cases. I have been in that spot of being passed over and surgeons and staff not paying attention to real spine related symptoms and not connecting them to my imaging and making excuses why they can't help me. I had learned enough about spine issues that I knew when I was not getting a good opinion. The surgeons at the top of their game did not have trouble understanding my case, but it took an opinion with a 6th surgeon until I found a great surgeon and went forward with surgery.

You may get different solutions with different manufacturers of spinal hardware because different surgeons have different preferences. They have to be trained in the use of the products by the manufacturers. Some offer artificial disc replacement but only if you have good bone quality and do not have instability. Some have PEEK cages which is a type on inert plastic. Some are titanium. Some cages screw in with angled screws and do not require a plate to be placed on the front of the spine. Some surgeons prefer to use a bone graft because it heals better (according to mine) and for me the best choice of all was no hardware, just the bone graft and I was careful until it fused. Some place rods and do a "curve correction" but that also removes the ability to move. There is going to be a compromise, but there is a choice with the understanding that not every patient is a good candidate for every solution. In the end, you have to educate yourself as best you can, and make an educated choice as to which surgeon you wish to hire for the job.

Think of it that way. They must earn the job not by pressuring a patient, but by explaining the benefit of the solution they propose vs the risks. Getting other opinions is normal and expected, and if a surgeon objects to it, you could look elsewhere. If a surgeon does good work, they should not worry about peer reviews. They are reviewed by insurance companies and Medicare anyway as well as online patient reviews. In order to get insurance clearance for surgery, they must submit their plan for review and approval in order to get paid by health insurance companies. Some surgeons are in private practice in their own facilities for profit. I talked to a high pressure surgeon in a group of 11 doctors who owned a surgical center, and he ran out of the room to avoid answering my questions. Then he mistook my leg pain as being caused by something else and told me to go to rehab and fix that first, then come back for spine surgery. I got e mail solicitations posing as surveys about my health for 2 years that were sniffing for business. Of course I couldn't fix my leg pain because it was caused by the spine problem in my neck and the 6th surgeon who was at Mayo recognized this.

Opinions matter. I knew enough to know which doctor gave me the best option and I had been reading about spine surgery for a few years. I also looked for any disciplinary action, and on the positive side, I read the surgeon's research papers to see if their interests were a good match for my case. If you found a surgeon who is a good match and is respected by their peers and want to proceed with that doctor, it is your choice. If you need more opinions to be able make an informed choice, get them. You have one chance to make a good choice. Not all surgeons are trying to sell you on surgery, and I was very suspicious of one who did that toward me. The surgeon at Mayo made an offer to help me and he didn't need to convince me of anything. I knew he was giving an honest evaluation of my condition and he would not have financial gain because of doing surgery because Mayo surgeons are employees and are not paid extra for doing surgeries.

@billandri Sorry to hear about your diagnosis and numbness issues. I would highly recommend asking for physical therapy with a therapist that practices McKenzie techniques which are geared specifically for getting things moving in the spine properly. I am not surprised using a neck collar didn't help, most often restricting spinal movement will make things worse, as joints are meant to move. I would also recommend looking at spinal injections. Sometimes steroid injections at the site of the issue (in this case C5/6) can be helpful in reducing swelling associated with the constant irritation and may give you symptom relief. (Again, not a medical professional, this is just my personal experience)
I can understand your hesitation on surgery, as surgery can sometimes lead to other issues. Most insurance companies want to see 6 weeks of more conservative treatment first before going for surgery. It might be beneficial to see a PT to help figure out if the stenosis symptoms can be alleviated with strength and posture exercises while also trying the steroids for reduction in inflammation before the surgery. If symptoms subside, you may opt for continuing down the non-surgical route. If they do not subside, the you will have done due diligence in looking at other options as well as satisfied any resistance you might get from your insurance.
I have had two artificial disc replacements at C6/7 and C5/6. I had the two surgeries 2 years apart and they were after quite sometime from the original injury. The disc replacement seemed the best option to me as it does not inhibit natural range of motion in the neck especially at a younger age. I would recommend doing research on surgeons using these devices first and picking one that has experience with a variety of devices and has been properly trained. Most of the time you can look on the device websites for a list of trained doctors and find one in your area. Both neurosurgeons and orthopedic surgeons specializing in spine issues may be options for this procedure.

Bill I can tell you the surgery is not that big of a deal. I’m 35 and had a fusion done a year and a half ago on c4c5. It started as you said In fingers. Eventually both of my arms were numb. I was unable to wake them. I researched my surgeon and picked the best one in my opinion. Can honestly say I had a 100% improvement. I felt and was ready to go back to normal activities in two days. Honestly wish I’d had done it sooner. I understand not wanting to go the surgical route. But I definitely suggest you research all your options. And if you do surgery talk to a lot of people in your area n find a good surgeon.

@ray666 Detail is good. Other opinions are useful in a few ways. You may get several opinions in agreement of the need for surgery, and you would know that you are getting an honest evaluation. You may get wildly different opinions that place blame on other diseases instead of your spine, and you can tell if a surgeon is paying attention or trying to dismiss you if their opinion doesn't make a lot of sense with what you know about your symptoms. I know in saying this it might conflict with a trained medical opinion, but surgeons do pick and choose their cases. I have been in that spot of being passed over and surgeons and staff not paying attention to real spine related symptoms and not connecting them to my imaging and making excuses why they can't help me. I had learned enough about spine issues that I knew when I was not getting a good opinion. The surgeons at the top of their game did not have trouble understanding my case, but it took an opinion with a 6th surgeon until I found a great surgeon and went forward with surgery.

You may get different solutions with different manufacturers of spinal hardware because different surgeons have different preferences. They have to be trained in the use of the products by the manufacturers. Some offer artificial disc replacement but only if you have good bone quality and do not have instability. Some have PEEK cages which is a type on inert plastic. Some are titanium. Some cages screw in with angled screws and do not require a plate to be placed on the front of the spine. Some surgeons prefer to use a bone graft because it heals better (according to mine) and for me the best choice of all was no hardware, just the bone graft and I was careful until it fused. Some place rods and do a "curve correction" but that also removes the ability to move. There is going to be a compromise, but there is a choice with the understanding that not every patient is a good candidate for every solution. In the end, you have to educate yourself as best you can, and make an educated choice as to which surgeon you wish to hire for the job.

Think of it that way. They must earn the job not by pressuring a patient, but by explaining the benefit of the solution they propose vs the risks. Getting other opinions is normal and expected, and if a surgeon objects to it, you could look elsewhere. If a surgeon does good work, they should not worry about peer reviews. They are reviewed by insurance companies and Medicare anyway as well as online patient reviews. In order to get insurance clearance for surgery, they must submit their plan for review and approval in order to get paid by health insurance companies. Some surgeons are in private practice in their own facilities for profit. I talked to a high pressure surgeon in a group of 11 doctors who owned a surgical center, and he ran out of the room to avoid answering my questions. Then he mistook my leg pain as being caused by something else and told me to go to rehab and fix that first, then come back for spine surgery. I got e mail solicitations posing as surveys about my health for 2 years that were sniffing for business. Of course I couldn't fix my leg pain because it was caused by the spine problem in my neck and the 6th surgeon who was at Mayo recognized this.

Opinions matter. I knew enough to know which doctor gave me the best option and I had been reading about spine surgery for a few years. I also looked for any disciplinary action, and on the positive side, I read the surgeon's research papers to see if their interests were a good match for my case. If you found a surgeon who is a good match and is respected by their peers and want to proceed with that doctor, it is your choice. If you need more opinions to be able make an informed choice, get them. You have one chance to make a good choice. Not all surgeons are trying to sell you on surgery, and I was very suspicious of one who did that toward me. The surgeon at Mayo made an offer to help me and he didn't need to convince me of anything. I knew he was giving an honest evaluation of my condition and he would not have financial gain because of doing surgery because Mayo surgeons are employees and are not paid extra for doing surgeries.

Hi, @jenniferhunter! It's great to hear from you again. I've not made up my mind yet about a second opinion. I know it's the smart thing to do––and I may very well look for one. I must say the surgeon with whom I met––and not only the surgeon but also his nurse––provided an amazing experience. Friends had cautioned me: Be careful, Ray! If he's a surgeon, he's going to try to sell you on surgery! Thanks to my friends' cautions, I went fully prepared. But both the doctor and the nurse were so detailed in their presentations, so seemingly caring (great listeners!), so patient in going over the specifics of my situation (my symptoms, history, MRIs, and X-rays) that I drove home believing I couldn't possibly be in more caring, competent hands. I say all that, and yet I may still seek a second opinion. (In fact, the surgeon said he'd fully understand if I were to solicit a second opinion.) So, we'll see. One day at a time. This Tuesday I'll get those neck flexion X-rays and the thoracic MRI. Then, I see the surgeon next on 9/8. Between now and then, I'll continue with my cervical PT. I remain in good spirits about all this. I'm looking forward to getting the proper thing done––once I've determined the "proper thing"! Ha! Thank you for your continued interest. Your messages are a great comfort! Best wishes, Ray

I was diagnosed with stenosis (2 places) and herniated discs some years ago. I was in extreme pain. Surgical evaluation said 10% chance of success. Solution seemed to be many years of pain meds. I then went to Mayo and they referred me to one of the PTs who put me on an exercise and aqua therapy plan. That was 2 years ago and I have pain free since then. No meds, no surgery, no more numbness. There are alternative to meds and surgery. It worked for me. The only downside is that regular visits to gym are required.

@jenniferhunter

Thank you for your detailed post. I was recently told my X-rays show severe cervical Foraminal stenosis. The next step is an MRI. My issues have been mostly arm and hand pain I’ve had on and off for years. X-rays show worsening since 2019.

I will know more after the MRI results. Surgery is scary but I don’t want to discount it if it ends up being necessary.

One thing I’d like to know is are there things we can do to either avoid or prolong the need for surgery without risking permanent damage.

I wonder if there are special pillows that are recommended. Also if there are helpful stretches and exercises that can help without causing harm.