Has anyone dealt successfully with Cervical stenosis without surgery?

That is very reassuring as my symptoms are also numbness. Surgery is very worrisome to me.
Did they do the anterior or posterior approach for you surgery?

I have been diagnosed with multi-level cervical spine stenosis. I am seeking an experienced caring team that will discuss ALL treatment options, try least invasive first and considers me a member of the health team.

Would anyone be so kind as to share your reviews and experiences.

Also, I live in North Carolina so the Fla. facility would work best for me.

Thank you,
Victoria

Hello @victoriamb and welcome to Mayo Clinic Connect. At Mayo Clinic, you can expect a multidisciplinary team approach to care. This article may be helpful to you in considering Mayo Clinic for care.

Non-Surgical Treatments May Decrease Pain from Spinal Stenosis:
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-nonsurgical-treatments-may-decrease-pain-from-spinal-stenosis/
An excerpt from this article states:
Surgery usually isn’t necessary to treat spinal stenosis. Often a combination of lifestyle changes, physical therapy and medication can effectively decrease the pain and discomfort caused by this common back problem.

Can I ask if you were recommended surgery after your diagnosis?

@victoriamb My experience with surgery for cervical stenosis is at Mayo in Rochester with Dr. Jeremy Fogelson. He is an excellent surgeon and I had great results. You can read more about this in my patient story. I understand you want to stay closer to home and Mayo Jacksonville may be an option. Since you are traveling, you can go to any of the Mayo campuses if you so choose. Check the website or call to see if your health insurance is accepted. I tried to work with local Chicago surgeons, but none would help me, so I traveled to Rochester which is a 5 hour drive for me, and it was definitely worth it. Dr. Fogelson is often recommended by my physical therapist because of my experience with him and he has helped every patient she has sent to him. I liked that he had both neurosurgery and orthopedic spine fellowship training and he is highly regarded in his field, not just at Mayo, but also at spine conferences where he gives presentations and teaches.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Good morning, all! (I hope I'm placing this message on the correct board.) Only yesterday I received a cervical stenosis diagnosis as the result of a neck MRI. Today I'll be beginning to learn what's involved. In the days ahead I'll be starting neck PT, and also talking to a neurosurgeon. That's it for now. I look forward to reading all of your earlier posts and watching this board as I learn more and more about what the future has in store for me. Cheers! ––Ray

Hello all. I have been diagnosed with "severe stenosis" both in my cervical and lumber spine. My neurologist did all of the tests, then basically told me "you need to see a neurosurgeon" with literally no other explanation or discussion. Needless to say I am not too happy with him.

Still, I now have an appointment for a consultation with a neurosurgeon.

Here is my question: I have a pacemaker, and I cannot have an MRI. Has anyone here been in this same situation? How did your doctor(s) work around it in diagnosing your problems? Thanks, Mitch.

@birdman518 Hello, Mitch. I am a spine surgery patient for cervical stenosis and had my surgery at Mayo in Rochester. Your neurologist should have told you that stenosis means a narrowing, so when they refer to stenosis of the spinal canal, that means that the space where the spinal cord is has narrowed due to either a disc that is expanding into that space or bone growth into that space. Stenosis can also happen at the nerve roots which are the spaces between the vertebrae where the spinal nerves exit to go to the body. When you do see a surgeon, ask them to explain specifically what the issues are and explain any imaging. I had consults with surgeons who were unwilling to do this and viewed the imaging before they came into the room with me. The surgeon I hired for the job did explain everything on the imaging and took the time to answer my questions.

It is good to get consultations with several surgeons before you decide to have surgery. The surgeon usually orders imaging and since you can't have an MRI, they might ask for something like a CT scan which is a 3 dimensional image assembled from multiple X-rays. They also use X-rays to show if vertebrae are slipping past each other by having the patient bend the neck while taking the image. Ask for copies of your image studies on disc so that you can take them to appointments for other opinions.

Would you come back and share how your doctors complete your diagnosis while working around your pacemaker? That would be valuable for other patients to know as well. Stop back in if you would like to discuss what you learn and your decisions about treatment options.

@ray666 Hi Ray, I just wanted to say how good it is to have a positive attitude as you go through this process. It really helps you as a patient stay focus on healing and decision making. Since we had already corresponding on this topic on another post, I'll just say Cheers to you too!

@jenniferhunter
Thanks for your reply! I am familiar with the basics of what stenosis is... but your suggestions about speaking with different surgeons is good advice. The best surgeon I found near me was not accepting new patients, but the one I got an appointment with has a very good background and many good reviews.
I already have the results from my lumbar and cervical CT scans.
E.g. this is from my lumber CT:

L3-L4: Disc bulge in combination with posterior ligamentous and facet
hypertrophy results in severe spinal stenosis. Facet and ligamentous
hypertrophy and disc bulge contribute to moderate left and mild to
moderate right neuroforaminal narrowing.

L4-L5: Disc bulge in combination with posterior ligamentous and facet
hypertrophy contribute to severe spinal stenosis. There is also mild
posterior epidural lipomatosis. Disc bulge and facet hypertrophy
contribute to severe right and moderate left neuroforaminal narrowing.

Here is the worst part from the cervical:

C4-C5: Broad posterior disc osteophyte complex with bilateral
uncovertebral spurs can triggering to moderately severe to severe
central spinal canal stenosis with probable ventral cord compression
and effacement of the CSF space at this level. Severe right neural
foraminal encroachment and moderate left neural foraminal
encroachment.

As I said, my neurologist did not go over *any* of this with me.

I will definitely keep this forum up to date as I continue my journey.
It is getting harder even to type this with the numbness in my right
thumb and hand.. 🙁

@birdman518 You did type a lot. You don't have to go overboard, I understand what you are dealing with. I do like to respond in a way that also lets others know and understand the issues. In that way, our discussion helps others too. Sorry about your neurologist. Sometimes they have a different opinion anyway from the surgeon, and what counts is the surgeon's opinion.

I can explain a few terms. The foramen are the spaces between the vertebrae when the pair of nerve roots exits the spine one on each side. The facet joints slide when you twist your spine because the discs don't move; they are shock absorbers. There is a ligament up the center back of the spine. You can find that at the base of the skull when you bent your head forward. This ligament can bulge into the spinal canal and press on the spinal cord.

The discs are named for the numbered vertebrae. C4-C5 means the disc between cervical vertebrae C4 and C5. There are 7 cervical vertebrae (neck), 12 thoracic (connected to ribs), and 5 lumbar (low back). C7 is the one that has the spine that sticks out farthest behind between your neck and back (thoracic area).

Your reports states foraminal narrowing around the nerve roots at L3-L4, L4-L5 and C4-C5, severe narrowing of the spinal canal at L3 through L5, and severe cervical stenosis (narrowing) at C4-C5 with spinal cord compression.

CT scans and MRIs show the body in slices and to understand them in 3 dimensions you have to scroll through them and watch how they change and remember what was next to the current sliced view. They take slices like a loaf of sandwich bread head to tail, and a sagital plane that divides the body lengthwise in half, and a front to back slicing. These view let the doctor understand in 3 dimensions. They look at the spacing where discs are, and everything else. This video shows an explanation of a spinal CT scan, but it is meant for medical professionals, but you can see how it looks. The first 2 cervical vertebrae are unique in that C2 has a post that extends up toward the skull, and C1 forms a ring that sits on top of it. If you really want to understand how the spine works, you can boil a chicken or turkey neck that comes as giblets. The meat falls off when it has boiled long enough so you can take it apart. That may be a lot more involved than you want to be, but I find it interesting.

Was this helpful for understanding the spine? I know... it is complicated!

This link also explains:
https://coreem.net/core/the-abcs-of-reading-c-spine-cts/