Severe spinal stenosis: Would you do surgery?

Posted by collierga @collierga, Jan 15, 2020

Hi there
I am new to this group. I am a 64 yr old female, in basically good health. Hip replacement 10/2018 with no complications.. Currently have no pain only bilateral finger numbness with minor lower left arm numbness. For the most part does not interfere with my daily living activities
Diagnosed with severe cervical stenosis via MRI in 8/2019,C-3-4 shows severe disc degeneration, moderate to severe bilateral formalin narrowing due to uncinate spurs/C4-5 same as 3-4 but with broad based disc bulge/5-7 C7-T-1 Degenerative anterolisthesisBroad based disc/osteophytic ridge causing severe central canal narrowing. i have gone to 2 different Neuro surgeons they both say complete opposite treatment plans. One says observe see him if symptoms get worse. The other doctor wants to do 2 surgeries, first through the front, #2 through the back to stabilize. I am leaning towards no surgery but am looking for someone to tell me they had this surgery and are happy t hey had it done. So far when i talk to people with back/neck issues they say they would never again go through surgery.
Thank you all in advance for you opinions..

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Hey Jen, nothing scheduled yet in regard to my severe canal stenosis. I have to wait until my brachial artery stenosis is treated. I see vascular surgeon on October 12th. More to be determined. Same stuff different day! I hope you're having some victory over your pain and your thought life. You're in my prayers, Sunny flower

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@sunnyflower please keep me posted on what vascular surgeon says. You have so many serious issues. If this isn’t too personal, how do you deal with it financially?

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Hi Jen, well, I have Kaiser Permanente Medicare Advantage plan. I have no yearly deductable except for the part D, prescriptions. I pay $349 per month premium but that includes dental. Regular office visits are $10, specialists are $20, sometimes $30. Spinal injections with anesthesia/OR/anesthesiologists and doctor is $100. If no anesthesia, cheaper. MRIs, Bone Scans, DEXA scans, CTs and other diagnostics are I think $40. Could be $50 or $60 by now? I need to look but it's not much more. X-Rays, mammograms and labs and more are free. Everything under one roof except for some diagnostics but some sites have everything such as nuclear medicine. I have a co-pay but no co-insurance. Medications are the most expensive it seems. I'm in the "Catastrophic" stage now, finally so meds are very cheap now. Some of my meds are off the charts expensive. Yes, it's a financial strain and can be a hardship for certain. I am very happy w/ my plan and thankful for it too. Thankfull we can afford it! My husband is still working and he has me covered under his dental so for example, I am having to have a new crown and I pay zero b/c I have double coverage. We're very blessed. Hope you are ok today? I know that's a subjective question! Warm hugs, Sunny

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As well as my hip problems which will mean a replacement of my hip on the left side I had my right side replaced a year ago my consultant says some of my problems are to do do with spinal stenosis which causes pain tingling and forces me to bend forward has anyone else experienced this and what if anything can be done about it

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@lotsofpain

As well as my hip problems which will mean a replacement of my hip on the left side I had my right side replaced a year ago my consultant says some of my problems are to do do with spinal stenosis which causes pain tingling and forces me to bend forward has anyone else experienced this and what if anything can be done about it

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Hi @lotsofpain, you'll notice that I moved your message to this existing discussion about spinal stenosis. I did this so you can connect with @jenniferhunter @collierga @bernese53 and others who have experience dealing with this issue.

This is another good discussion to review:
- What helps spinal stenosis besides surgery? https://connect.mayoclinic.org/discussion/i-came-in-here-because-i-suffer-from-spinal-stenosis/

What treatment or therapy did your doctor suggest? Was it suggested that treating the spinal stenosis would mean you wouldn't have to have hip surgery?

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@colleenyoung

Hi @lotsofpain, you'll notice that I moved your message to this existing discussion about spinal stenosis. I did this so you can connect with @jenniferhunter @collierga @bernese53 and others who have experience dealing with this issue.

This is another good discussion to review:
- What helps spinal stenosis besides surgery? https://connect.mayoclinic.org/discussion/i-came-in-here-because-i-suffer-from-spinal-stenosis/

What treatment or therapy did your doctor suggest? Was it suggested that treating the spinal stenosis would mean you wouldn't have to have hip surgery?

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Thank you the doctor I saw is a hip surgeon specialist and the hip replacement will go ahead but he is made the point that that it will not solve all the problems so so he has referred me back to my GP for her to do a referral to a spinal specialist who will decide what sort of action to take I already had an injection in my spine but it did no good and arguably made things worse

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@colleenyoung

Hi @lotsofpain, you'll notice that I moved your message to this existing discussion about spinal stenosis. I did this so you can connect with @jenniferhunter @collierga @bernese53 and others who have experience dealing with this issue.

This is another good discussion to review:
- What helps spinal stenosis besides surgery? https://connect.mayoclinic.org/discussion/i-came-in-here-because-i-suffer-from-spinal-stenosis/

What treatment or therapy did your doctor suggest? Was it suggested that treating the spinal stenosis would mean you wouldn't have to have hip surgery?

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Hello. đŸ˜€ The term spinal stenosis was never mentioned to me. Originally back in 1982 I had Spondylolisthesis. That is what the Harrington rods were for. Then in 1993, it was determined that the rods were useless and by this time I had advanced scoliosis, osteoarthritis, osteoporosis, and Spondy in another location - that is when the 6 screws were put in. Through genetic testing, I was found to also have Ehler's-Danlos Syndrome. That involves collagen. (To make a dreadfully long story short, all tissue in my body is too lax - muscles, tendons, ligaments, even skin. I can intentionally dislocate shoulders, wrists, fingers, knees, ankles, toes, and can turn my neck to see directly behind me. I could probably fold myself into a box.) 3 years ago I had a total right hip replacement. I don't really know the cause of that, but my hip slipped & slid all the time. It was suggested that the combo of EDS and severe scoliosis (side-to-side AND front-to-back) was the culprit.

I have had many injections in my spine, none of them helped. I was told one should last 6 months, another should help for a year, but none of these helped. Now I have the SCS device implanted and tho it was so recent, I know it will block the pain because the trial worked beautifully. Probably reduced pain by 75-80%. We are doing small adjustments on my implant and I'm feeling better.

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Bless you, you poor darling.

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@lotsofpain

As well as my hip problems which will mean a replacement of my hip on the left side I had my right side replaced a year ago my consultant says some of my problems are to do do with spinal stenosis which causes pain tingling and forces me to bend forward has anyone else experienced this and what if anything can be done about it

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@lotsofpain I presume you are talking about stenosis in the central spinal canal. Commonly when discs rupture, the jelly like material inside invades a space it doesn't belong, and that causes inflammation. It creates uneven pressure on the end plates of the vertebral body, and that causes bone remodeling and growth of bone spurs. For me, that created a disc osteophyte complex of disc material and bone spurs that was pressing into my spinal cord. Sometimes stenosis happens in the spaces between the vertebrae where the nerve roots exit the spinal cord. It then compromises that nerve specifically. Sometimes surgeons can do a foraminotomy to address issues at the nerve roots. This link explains a foraminotomy.
https://www.spineuniverse.com/treatments/surgery/foraminotomy-taking-pressure-spinal-nerves

If the problem is in the central spinal canal, surgery to get there needs to go through a disc space after a bad disc is removed, or discectomy. That is what I had, a removal of the C5/C6 disc, a clean out of the bone spurs and a fusion with a bone graft to replace the disc. These problems tend to keep getting worse and the spinal cord is easily damaged which can cause permanent disability, so it is important to get a surgical intervention before that happens. Spinal stenosis is measured on the x-rays and classified according to how much the fluid space within the spinal canal has narrowed. On an MRI, spinal cord damage can show up as a whitish area within the spinal cord where the individual nerve fibers have degenerated (myelopathy). Sometimes this damage can be mild and not show changes on the MRI in the initial stages.

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@lotsofpain

Lumbar stenosis can make it difficult to walk and often feels better when you lean forward and relieve the pressure on your lower vertebrae.. This describes me to a T, I am severely bent forward . I had an injection which if anything mad things worse.I need something that will physically pull me upright like a belt or brace in the hope ir will force my muscles to learn to support a more upright posture. ANY IDEAS Complicated by the fact that I am waiting for a 2nd hip replacement as my hip has no movement my other hip was replaced 16 months ago

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I am in your shoes! Do you know the position you're in when putting clothes in a top-load washing machine? Or standing at the sink washing dishes? I cannot stand like that at all, I have to lean forward on my forearms. If I don't, I have to sit on a stool, and am then also on my forearms. I too had a right hip replacement 2 years ago and it's well, but put an additional "quirk" in my stance. To look at me you would thing I'm about to fall on my face. I have found that it does get me to the front of waiting lines tho! Have had many injections, none worked. As far as standing straight, I don't know of any device that will do that. I'm afraid they'll tell you to strengthen muscles in PT.

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