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Severe spinal stenosis: Would you do surgery?
Spine Health | Last Active: Jul 27 8:04pm | Replies (207)Comment receiving replies
"I was in a position of going from surgeon to surgeon and none would help me because they misunderstood my condition and were afraid of an inflammatory problem like MS."
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What was the inflammatory problem if it wasn't MS?
I'm not in a rush to have a lumbar fusion done. The surgeons I have seen aren't in a rush to do surgery because of the medications I take to control my inflammatory conditions. They were concerned about infections, delayed healing and osteoporosis from long term prednisone use.
I'm off Prednisone now and on a biologic. Now a surgeon is ready to do the fusion when I'm ready. My inflammatory pain is well controlled but I would have to pause the biologic I take to control inflammation. I might be ready to do surgery but first I need to overcome my fear that the inflammation will resume on top of surgical pain.
At one time, I was told to never have surgery again. Being advised to never have surgery was because of heterotopic ossification (HO) after knee replacements. My understanding of heterotopic ossification is that it is abnormal healing because of excessive and dysregulated inflammation. What of the chances of developing heterotopic ossification after a lumbar fusion?
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@dadcue That's a good question Mike. I didn't have an inflammatory problem and that was just a guess by the surgeon without any diagnostic procedures to come to that conclusion. I had an epidural injection that took away all of the pain that I had. My pain was everywhere, in my trunk, arms and legs and feet and arms. The surgeon expected that I would only have arm pain and scapular pain because of the bad disc at C5/C6. He was not considering that some compression of the spinal cord was affecting nerves that were going lots of places, and that changed with my body position. He suggested a spinal tap to check for MS which was kind of radical. There was no indication of MS lesions in any of my MRIs that showed spinal cord and brain stem. He ignored the results of the spinal injection because he couldn't explain why it resolved all pain temporarily. It may have been meant to weed me out of his consideration.
After the spinal injection, I charted my pain as it returned on body diagrams and it showed up in every dermatome. Dermatomes are a map on the surface of the body that correlate with each spinal nerve and where it goes. He refused surgery because he didn't know if it would make me worse and he said it would resolve very little of the problem. What he missed is a condition called "funicular pain" that is caused by spinal cord compression. It wasn't as well known then, and even now, surgeons miss this. Because the spinal cord floats in spinal fluid and is supposed to move, it changes position and changes where compression might happen hitting different nerve cells in that big bundle. My surgery resolved all that pain by decompressing the spinal cord.
Surgery does cause inflammation in healing, and I don't know what your answer is. I did find some information from Mayo about this. You may want to contact the author listed at Mayo and see if you could consult about this, or have your surgeon consult on your behalf.
https://www.mayoclinic.org/medical-professionals/endocrinology/news/diagnostic-approach-to-disorders-of-extraskeletal-bone-formation/mac-20429760
Here is the author's bio.
https://www.mayo.edu/research/faculty/pignolo-robert-j-m-d-ph-d/bio-20246127