Diagnosed with severe spondylosis & stenosis: Treatment options?

Posted by rodturner @rodturner, Oct 6 8:39pm

Greetings all. I have just been diagnosed with Cervical Spondylosis and Stenosis, stemming from many years of Infantry and other heavy physical training. I have led a super-physical life and now, at 69, I am paying the price. But I have no regrets. I just want to be pain free for my remaining years. Trying physical therapy and OTC meds now, waiting to see if it works. My major symptoms are occipital pain and vertigo, which I hate. I'm looking for a place to find support and perhaps discuss treatment options.

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@gently

besmith57, I hope you have luck with the pain specialist.
There are so many procedures that can address the pressure on your nerves that causes your pain.
It may be the disc bulge squeezing nerves in the foramen.
They may start with injection to reduce swelling impinging on the nerve. It helps locate the exact source of pain and can provide relief.
The goal is to increase the space so the nerves can exit freely.
They can reduce swelling, remove the extruding part of the disc, reduce ligament size, remove a tiny part of the foramenal bone. Sometimes they ablate the medial branch nerve that sends pain signals.
After you see your pain specialist post their suggestions. And we will weigh in.
If you create a new post, you'll get more responses.

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I'm not sure how to start a new post. LOL The pain specialist suggested radiofrequency ablation first. If that doesn't work, she wants me to try Sprint. It's an implanted device I would wear for 60 days. I was really wishing for a permanent solution. I even told her I would have surgery again, but she said that wasn't an option. Pray the ablation works. I was pretty depressed after my appointment, Guess if I can get pain relief for 3 months with 4 procedures a year I will give it a try. Fifteen minutes without pain would be nice. LOL

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@gently

rodturner,
similarly I have spondylosis and stenosis though not from any years of Infantry or heavy physical training. Cervical spondylosis can have many meanings or sources. It can involve painful bone spurs osteocytes and/ or disc degradation. Mine are osteocytes and some central canal stenosis from a disc bulge.
Someday I'll have surgical removal of the spurs and likely minimally invasive disc reduction.
I'm staving it off by chiropractic care. Occipital pain, vertigo and subsequent nausea are all at bay for a period of time after adjustments. If I wait after initial symptoms, I get pain in my shoulder and arm.
Chiropractics isn't for everyone, as I hope you will soon hear. The word usually excites some response.
I do recommend that you look at surgical options, even while not considering them. Some things are best treated early on.
Welcome, Rod.

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I appreciate your “some things are best treated early on.” I was just told by pain doc that once the nerve pain reaches the leg from severe stenosis, ablation won’t work. I will admit, since I’ve had this problem for probably 25 years and only done epidurals sporatically, NEVER were other suggestions given to me besides the epidurals. I’ve been pretty good about core work over the years, but I think the compression and leg pain I have is leading me to a fusion or two. Last couple epidurals did not last too long.

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@besmith57

I see my pain specialist today. I hope they can give me some answers. If not, I do think I will get a second opinion. Thanks for replying,

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I will have a radiofrequency ablation trial on the 24th. I pray it will work.

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@besmith57

I will have a radiofrequency ablation trial on the 24th. I pray it will work.

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By trial, are you referring to lidocaine injection to identify the nerve? I was actually scheduled for Cervical Radio Frequency Ablation (RFA) this morning on C1-4 but postponed it. A recent Oct 10 MRI noted "extremely severe" right and "severe" left foraminal narrowing with severe AP canal stenosis at C5-6. I want to now first have my MRI reviewed with an Orthopedic Surgeon consultation. At L-4, I also had some issues with a compromised right L4 nerve root. Lots of unfamiliar terminology, Some good Mayo Clinic Spinal Stenosis videos on Youtube.

@jenniferhunter provided me with some very excellent on topic discussion and links to some Mayo Clinic Videos that help with the terminology and visual understanding of Cervical Spinal Stenosis. I did postpone the Ablation even though the Pain Management Dr said I should proceed. I am assuming that if I have C5-6 surgery, the Orthopedic Surgeon will address any C1-4 issues,

Have you seen RFA success rates? What I found was 20% to 25% full pain relief, 60% to 65% partial pain relief. It can take 4 to 6 weeks to realize these, and it may only work for 6 to 12 months. My Oncologist during my recent 6-month MGUS even cited the 60% to 65% success rate. Please do your own research though, obtain a current MRI and if warranted see an Orthopedic Surgeon for a consultation.

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@dstone501957

By trial, are you referring to lidocaine injection to identify the nerve? I was actually scheduled for Cervical Radio Frequency Ablation (RFA) this morning on C1-4 but postponed it. A recent Oct 10 MRI noted "extremely severe" right and "severe" left foraminal narrowing with severe AP canal stenosis at C5-6. I want to now first have my MRI reviewed with an Orthopedic Surgeon consultation. At L-4, I also had some issues with a compromised right L4 nerve root. Lots of unfamiliar terminology, Some good Mayo Clinic Spinal Stenosis videos on Youtube.

@jenniferhunter provided me with some very excellent on topic discussion and links to some Mayo Clinic Videos that help with the terminology and visual understanding of Cervical Spinal Stenosis. I did postpone the Ablation even though the Pain Management Dr said I should proceed. I am assuming that if I have C5-6 surgery, the Orthopedic Surgeon will address any C1-4 issues,

Have you seen RFA success rates? What I found was 20% to 25% full pain relief, 60% to 65% partial pain relief. It can take 4 to 6 weeks to realize these, and it may only work for 6 to 12 months. My Oncologist during my recent 6-month MGUS even cited the 60% to 65% success rate. Please do your own research though, obtain a current MRI and if warranted see an Orthopedic Surgeon for a consultation.

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I just had an MRI which showed multiple issues.
Yes, this will be the lidocaine injection. I pray it works. My neighbor had it done and it worked for him. I have googled RFA numerous times. I have constant pain especially when standing or walking. If the injection doesn't work they will try an implant called sprint. These procedures seem to be my only options. If they fail I will see another doctor. I need my life back.
Thank you for your advice.

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