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Has anyone dealt successfully with Cervical stenosis without surgery?
Spine Health | Last Active: Feb 13 3:16pm | Replies (139)Comment receiving replies
I had an injury to the the C5-C6 & C6-C7 levels in 2014 exacerbated by herniated discs due to 25 years of using a laptop computer.
Starting in January of 2025, I started having pain in my right shoulder radiating down my right bicep and arm. An MRI was ordered by the Pain Management Specialist. Based on the findings in the radiology report below, is surgery imperative or can it be elective?
Findings: The cervical vertebral bodies are normal in height and alignment with normal marrow signal. There is partial straightening of the cervical spine. No prevertebral soft tissue swelling is noted. There is no evidence of a cervical cord mass, syrinx or Chiari malformation. There is desiccation of the cervical disks.
At C2-C3, there is mild posterior bulging of the disc. No spinal or neuroforaminal stenosis is noted.
At C3-C4, there is disc osteophyte complex with broad-based posterior bulging of the disc. There is flattening of the ventral surfaces of the thecal sac and the cervical cord. Mild central spinal stenosis is noted. There is moderate to severe bilateral neuroforaminal narrowing secondary to bony hypertrophy.
At C4-C5, there is central posterior bulging of the disc with focal effacement of the ventral surfaces of the thecal sac and the cervical cord. No overt spinal stenosis is noted. There is moderate narrowing of the left neuroforamen secondary to bony hypertrophy.
At C5-C6, there is posterior disc osteophyte complex with effacement of the ventral surfaces of the thecal sac and the cervical cord with significant narrowing of the central canal. Moderate to severe neuroforaminal stenosis is noted secondary to combination of the disc and facet hypertrophy. Disc height is diminished.
At C6-C7, there is posterior disc osteophyte complex with asymmetric narrowing of the central canal. Moderate to severe bilateral neuroforaminal stenosis is noted. Disc height is markedly diminished.
At C7-T1 there is posterior bulging of the disc. No spinal stenosis is noted. Severe neuroforaminal narrowing is noted. There is loss of disc height.
Impression: Degenerative disc disease involving the cervical spine. Multilevel disc bulging with spinal and neuroforaminal stenoses at C3-C4, C5-C6 and C6-C7. Neuroforaminal narrowing at the other levels as described above. Partial straightening of the cervical spine which may be secondary to muscle spasm.
Replies to "I had an injury to the the C5-C6 & C6-C7 levels in 2014 exacerbated by herniated..."
It really depends on you and your level of pain tolerance you’re willing to put up with. You certainly have a mess in your neck. I believe Colleen Young one of the mentors may address this as a fellow C-spine surgery patient.
@dwlandi Welcome to Connect. I am a cervical spine surgical patient. After reading your post, I would think that you must be living with a lot of related symptoms. Perhaps symptoms haven't yet been connected to the structural condition of your spine. In answer to your question, spine surgery is elective in that it must be your choice to proceed. In the years since your injury, your condition has gotten worse, and you can relate that to those 11 years of change. Aging affects it too in that discs naturally dry out and shrink as we age which can also open up cracks in the fibrous outer part of the disc causing bulges or herniations. Your report is describing the slow collapse of several disks. If the collapse is complete, it is possible for the extra bone spurs and remodeling that is happening to start to fuse the spine. Already, there are several places of spinal cord compression and significant nerve root compression from bone growths. That will likely continue to happen, and at some point, when the compression is too great, it kills the nerves cells causing permanent damage. In the spinal cord on MRI imaging, loss of nerve cells may show up as a whitish usually mottled appearance. Your best opportunity to have a good result from surgery will be before permanent damage happens, however, it is hard to know when that will happen.
No one wants to go through spine surgery, and we tend to try to bargain with ourselves to talk us out of it. There are risks for sure, but there are also very significant risks to avoiding surgery that may prevent paralysis or disability.
At this point, I'm guessing you have not had a follow up with your specialist yet who ordered the imaging. I would predict that surgery will be discussed and recommended. Obviously, you've lived with some related pain for several years from this. I did too. My surgery timeline was a bit longer and it may have been about 18 years after the whiplash from a traffic accident. I lived in denial too for a long time because I was afraid. Eventually, I had to come to terms with my fear, make friends with it and understand it before I could move forward. My situation was just one level C5/C6 and not as advanced as yours is; I have no regrets, this surgery gave me my life back, and without it, I would have lost the coordination of my arms among other things. Not everyone gets a choice on if they want to become disabled, but the choice to avoid disability was a gift.
I had pain all over my body from the spinal cord compression at one level, and I did not have nerve root compression. I did have problems emptying my bladder when muscle spasms were moving my neck around, effectively making the spinal canal smaller. It also caused me to walk with a limp. If my PT realigned the curve in my neck, that all got better and only because it was in an early stage of being affected, and my gait returned to being normal and equal. It was causing weakness, so when I limped, I couldn't walk normally at all if I tried. The bladder functioning could have progressed to incontinence that could become permanent.
What are your thoughts and concerns? What symptoms are you experiencing that you think are related to your spinal condition? How soon will you be seeing a specialist?
Thank you for your input. All information is helpful in making a decision. I see a neurosurgeon on Thursday, Aprii 10, 2025. It was my pain management specialist who wrote the Rx for the MRI and is suggesting that I see a surgeon. @dwlandi
@dlydailyhope
@julese
@jenniferhunter
All --
Your comments, experiences, and feedback are greatly appreciated! I saw the Neurosurgeon (one of the best in South Florida) on Thursday, April 10, 2025. After reviewing the MRIs from 2014 and 2025, he is suggesting conservative treatments before recommending surgery. See his notes below...
After clinical exam, and review of the radiographic findings, and history, I do believe that Doug is presenting with some intermittent right C6 and C7 nerve root symptoms. His MRI from 2014 appeared much worse and in fact had left-sided disc osteophyte complexes. On the 2025 MRI, this appears much improved. I do believe that his current symptoms are more of a sensory radiculopathy. He has excellent strength and no upper motor neuron findings.
I would trial a right C5-C6 and C6/C7 epidural steroid injection to see if this can provide him with even more relief. So far he has had an added benefit with PT, cervical traction, and at least the first injection. I think there is still room to continue with conservative treatments. Should his symptoms fail to improve or progress, I think he would make an excellent candidate for C5-C7 ACDF.
I reviewed the imaging findings with him. We discussed some the details of the surgery involved if needed down the road.
@dwlandi
I am so glad you were able to meet with your neurosurgeon and get some good input for treatment options and next steps.
Happy Easter!
From spine X-rays, MRI, lumbar nerve test and a few shots in lumbar they could not confirm Radiculopothy.
It was the Orthopedic that confirmed Spinal Stenosis and mild Scoliosis and sent me to Physical Therapy where the Physical Therapist noted Radiculopothy.
Because I have had this numbing, burning, stabbing aching in my left thigh for 10+ years but has no idea what it was-I trusted those medically to tell me I was anxious to do the Physical Therapy but it just causes more discomfort as far as numbness, stabbing and burning.
Is it possible to get rid of the left thigh pain with surgery after 10+ years?
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@dwlandi
I am in my mid 50s and if I had your MRI results, I would get surgery.
Your MRI shows that you have multiple levels of disc issues and bony growths that are compressing/flattening and injuring your spinal cord. If surgery is not done to decompress your spinal cord/nerve roots, there could be worsening symptoms and permanent damage. This is called degenerative cervical myelopathy (DCM) also called cervical spondylotic myelopathy (CSM). Definitely look this up to understand your condition. I really wish doctors did a better job communicating imaging/test results with their patients using terms people understand. You may also have radiculopathy if you have symptoms affecting arms/hands/fingers. Do you have headaches, neck shoulder/shoulder blade pain/tension/knots, weakness in arms/hands which impacts writing and notice you are dropping things, bladder/bowel control issues, and heaviness in legs when walking with balance issues?
I know this from experience. I was misdiagnosed for over 5 years and now have permanent spinal cord injury due to DCM. I was born with a congenitally narrow spinal canal and worked on a computer/desk job for over 30 years. I have straightening of my cervical spine, degenerative disc disease, spinal stenosis, myelopathy, osteoarthritis, etc. My spinal cord was flattened at C5-C6 and finally had a 3rd orthopedic spine specialist finally diagnose me properly (felt validated and heard for the first time in a long time) and recommended surgery right away to stop the worsening of my symptoms and permanent damage. I had ACDF surgery on C5-C6 in 2022 (helped with bladder control and walking) and now need to get C6-C7 done in May 2025 (symptoms worsened in 2024). I may have permanent damage at C5-C6 which affects arm/hand strength and I’ll need to see if surgery on C6-C7 regains better control of my bladder and walking/balance.
Have you seen a neurologist for EMG/nerve conduction studies of your upper and lower limbs and reviewed the results with your orthopedic spine specialist?