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Severe spinal stenosis: Would you do surgery?
Spine Health | Last Active: 1 hour ago | Replies (189)Comment receiving replies
Hello, @collierga! Hello again, @jenniferhunter! Mind if I join in? I'm finding this exchange most interesting, mostly because my No.1 complaint is an uncomfortable gait. I have no pain, and no numbness, unless it's so slight I'm unawares. A neck MRI showed cervical stenosis in a number of places and in varying degrees of severity. Up until now, I've been meeting with a very knowledgeable neurology PA. In light of my MRI, she has advised I begin neck PT (next week) and meet with a neurosurgeon (week after next). Like others posting here, I'm furiously learning all I can about cervical stenosis, my chief aim is to have a full set of questions ready for when I meet with the neurosurgeon. In the meantime, I'm doing modest neck exercises (gleaned from YouTube stenosis sites) and am looking forward to beginning neck PT. The last few years, whenever a physician has asked me what's the No. 1 quality of good health I'd like to recover, I answer: to be able to enjoy walking again! ––Ray
Replies to "Hello, @collierga! Hello again, @jenniferhunter! Mind if I join in? I'm finding this exchange most interesting,..."
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@ray666 Hi Ray. I had gait issues too. Those were intermittent and happened when muscle spasms moved my vertebrae a little bit which essentially made the spinal canal a little smaller and put some pressure on the spinal cord. When my physical therapist realigned my neck, I walked normally again. My PT was buying me some time and reducing my symptoms. That was during the time that I was having trouble getting a surgeon interested in my case.
During my research prior to my spine surgery, I compiled a list of possible questions to ask. Surgeons don't have time to answer all of these, and you may choose what is most important. What other questions would you add?
1. What type of surgery are you recommending? Why? What is the specific anatomic lesion being addressed?
2. What is the natural course of my condition if it is not surgically addressed?
3. Why does the surgeon recommend this specific procedure? What are the potential results for this surgery? Why am I a good candidate for this surgery?
4. What is the source of the pain that is being addressed? How do you know this?
5. Please explain the procedure in great detail.
6.What products and implants are used? Is everything to be used FDA approved for this application?
7. What are the chances that the osteophytes will regrow? If so, what will minimize that chance?
8. What are my non-surgical options?
9. What are the different surgical procedures that can address my problem?
10. What would you recommend if I was your friend, wife, sister, or daughter?
12. How long will the surgery take?
13. What are the side effects, potential risks, and potential complications?
14. Please explain the risks and how they relate to me personally.
15. Reactions to implants, metal sensitivities, plastic sensitivities, toxicities?
16. Can there be lingering problems with dysphagea (swallowing) or dysphonia (speaking) due to procedure or implant? Breathing?-- asthma, swelling in neck?
15. What happens to an artificial disk as it wears? How long would it last? Any not made of metals?
Are the metals used the same or different within the implant?
16. How great is risk of adjacent segment disk degeneration with a fusion? Are there other discs that show degeneration now that could become problematic in the future? Do you think I will have a problem in the future on adjacent levels?
17. Do I have to have a metal plate or hardware on my spine? Is there another way to stabilize the spine?
18. What if, during my surgery, you encounter a different spine issue than you expected?
19. What is the risk/benefit ratio (the chance of a bad outcome as weighed against the chance of a good outcome)?
Do any of the materials used increase my chances of getting cancer?
20. What are the standard safety procedures to insure my safety during the surgery?
What are the safety cross check procedures during surgery?
21.What kind of imaging is used during the procedure and how does it tell you what you need to know?
22. Do you use neuro-monitoring during surgery? Are there electrodes on extremities making sure the nerves are functioning?
23. Are you using robotic assistance or free-handing?
21. Do I need to donate my own blood? If yes, why?
22. Do you perform the whole procedure? Will any students and/or other surgeons be doing any parts of the operation? If yes, What are their background and qualifications?
23. Can I talk to other patients who have had a similar procedure? ( Yes you can on Connect.)
24. What are the long-term consequences of the proposed procedure?
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Questions about the surgeon
1. How many times have you done this procedure?
2. Are you fellowship trained in spine surgery?
This is more important if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.
3. If I want to get a second opinion, who would you recommend?
4. Statistically, what is the success rate for this type of surgery? What is your personal success rate, and how many of this type of surgery have you done?