What helps spinal stenosis besides surgery?

Posted by sakota9 (Joan) @sakota, Jul 17, 2020

I also suffer from bursitus in my hips so I go in for infections. The shots help both my hips and my back. Today, thought I would look for things on the internet and then discuss with my dr. I came across an article for a neuromd Its a device you wear on your back and helps with the pain. Its been FDA tested and approved. Has anyone checked this out. I don't know if insurance covers it or not ...... I am getting tired of the injections and those really are just a temporary solution. I'm 76 and don't think I want to go thru surgery and my dr said that doesn't really help. So if anyone has one of these things or know about them, would appreciate your input. Besides the back am also dealing with copd and lung cancer........Life is like a box of cherries......I just keep getting the sour ones......... Hope you all are doing ok......andhave God, family and friends as your everyday support...........

Interested in more discussions like this? Go to the Spine Health Support Group.

kaptainkat | @kaptainkat | Nov 18, 2022

My physical therapist and her team of techs have restored a life to me!

And I DID tell them so!

pablo81 | @pablo81 | Nov 19, 2022

In reply to @larryltaylor0490 "Can anyone tell me the pain After having Verta flex procedure without being put to sleep" + (show)

I had the Vertiflex installed at L2/L3 for severe stenosis in June 2022. It was done under light sedation. I could feel the surgeon hammering it in but no pain. Post surgery was similar to pre surgery. It did not give me the relief I hoped for and it may have exacerbated my adjacent L3/L4 stenosis which is somewhat logical.

pablo81 | @pablo81 | Nov 19, 2022

In reply to @jenniferhunter "@bazzinga1234 Spine damage can come WITH or WITHOUT pain, and what happens is that bone spurs..." + (show)

@jenniferhunter

@bazzinga1234 Spine damage can come WITH or WITHOUT pain, and what happens is that bone spurs grow because of uneven pressure, so when a disc bulges or compresses, if causes uneven pressure on the bones around it causing bone growth. A ruptured disc that spills the gooey contents causes inflammation, which in turn causes bone growth as the body tries to stabilize the spine. In my case, a disc ruptured into the space around my spinal cord in my neck. That causes compression of all the nerve tissue passing through the cord to other parts of the body. I had trouble walking and had leg weakness and changing pain all over my body. It can cause incontinence. With enough pressure, the nerves die and dissolve in the fluid inside the spinal canal and they do not regenerate resulting in permanent disability. The nerve roots that exit the spinal cord can also be compressed by bone growth there, and discs commonly rupture into the space around the nerve roots. If the bone growth continues unchecked, it strangles the nerves. There is also a ligament on the back side of the spine that can enlarge and cause compression of the spinal cord.

It's easier to understand traumatic injury from a vehicle collision that damages the spine or nerves. We do things to prevent injuries like that by wearing seat belts and having air bags in the cars. Think of spine deterioration as a slow motion injury that happens over years. It can have the same effect, and a patient may have a choice to alter their destiny with decompression surgery. Not everyone gets a choice about being disabled or not. Why wouldn't you consider it?

It is hard to function daily when you can't walk, and everything is difficult. Getting up from a chair or getting out of bed is hard when you don't have the muscle strength to bear your body weight. When nerves die, the muscles they innervated atrophy and disappear. Then there is the financial burden of having to hire caregivers when you can no longer take care of yourself. Will you also need to be able to help physically take care of a spouse or relative?

There are many things to consider when deciding to have spine surgery or not. You have to ask yourself what quality of life you want, how can that get better or worse, and how long you might live with the quality of life in your condition. Your current health state is also a factor in your ability to recover, and the skill of the surgeon is very important.

If fear is preventing a patient from making a decision about surgery, understand that it is still a decision that will affect the rest of your life. Don't let fear make your decision for you. There are ways to get past the fear and understand it, and deprogram it. Doctors can also help with that too. Surgeons can't always promise to take away pain. They improve function with their procedures. There will be pain from the surgical path, and it may not be horrible. When I had my cervical decompression surgery, I found I could tolerate it without pain medication, so I didn't take any after I left the hospital. The pain medicine nauseated me, and causes constipation, and I was better off without it. I was tired and slept a lot during my recovery. I have no regrets. I got my life back and had a great recovery.

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Hi Jennifer. I am 81 years old and have lived with spinal stenosis since 1996. It began with L2/L3 bulging disc that has gotten progressively worse over time and is considered severe. At L3/L4 a botched discogram in early 2000's created stenosis that was moderate until recently (this year) when I had Vertiflex installed at L2/L3 that made L3/L4 go from moderate to severe. Other 3 low back discs are mild to moderate. Latest recommendation is laminectomy at 3 discs starting with L1/L2, L2/L3 and L3/L4 leaving muscle support only. I have lost trust as no doc wants to spend time discussing at depth what the issues are and since last recommendation was preceded with threat of permanent damage if nothing is done.. Trying to look in to MILD treatment for L2/L3 at this point. My biggest concern is permanent damage because of inaction. I can function ok and tolerate the pain. I do 45 minute workout daily and am in fairly decent shape physically. I have "shopping cart" syndrome pain and mild to moderate thigh pain in both legs after sleeping 6+ hours in prone position. Suggestions and perspective appreciated. Fear is defintely a factor.

Jennifer, Volunteer Mentor | @jenniferhunter | Nov 19, 2022

In reply to @pablo81 "Hi Jennifer. I am 81 years old and have lived with spinal stenosis since 1996. It..." + (show)

@pablo81 My 80 year old cousin just had a laminectomy on his lumbar spine. That does not remove any disks, but instead opens up space for the spinal cord by opening up the bone around it. The discs remain in place between the vertebrae. He did very well, and was up and around right away, and stopped pain medication after a week. He was pretty active and golfed for many years. I think he stopped that because of knee problems.

You may want to get some other opinions. What is it that worries you so much about surgery? Believe me, I have been there, but I learned how to face my fears and in doing that, I changed my life and built resilience.

migizii | @migizii | Nov 19, 2022

In reply to @jenniferhunter "@migizii It would be advantageous to get several surgical opinions from different doctors. Recovery from lumbar..." + (show)

In reply to @jenniferhunter …. Thank you so much for these suggestions….if you know a list of specific questions to ask or resources of surgeons this would be wonderful….I live in MN and have to travel a great distance for all opinions…..Mayo Clinic was not interested in pursuing any options other than conservative treatment, which I shared previously….I could try again, but have been frustrated with my current physician there as I have been doing all the treatments faithfully for over a year, with little improvement and not even an injection was offered. I had to call Medicare, personally, to learn that injections are routinely approved for my spinal issue as the physician had told me they were not available through Medicare.
If you know anyone on this forum who has my specific issue, perhaps I could learn from them, too. Thanks again and have the best day possible💕

Jennifer, Volunteer Mentor | @jenniferhunter | Nov 19, 2022

In reply to @migizii "In reply to @jenniferhunter …. Thank you so much for these suggestions….if you know a list..." + (show)

@migizii Am I understanding you correctly, that you saw an orthopedic spine surgeon at Mayo for a collapsed L3/L4 disc and they said no to surgery, but another surgeon since then recommends surgery if conservative treatment fails? It sounds like you have not improved with physical therapy, etc. Have you seen a spine neurosurgeon? Both otho and neuro can be spine surgeons. Do you have other health issues that would make you a poor surgical candidate? One problem of being on "Medicare", if you are not on genuine Medicare, and are on a "Medicare Advantage" plan is that Mayo might not accept that. A patient I know just ran into that. Not all Mayo campuses take original Medicare (if I'm not mistaken). I think Rochester does take original Medicare. I called them and asked that question and I chose a Mutual of Omaha Medigap policy to go with it so I could be sure I would be covered if I needed further treatment at Mayo. It's time to sign up for next year's insurance, and perhaps you can change it so it is acceptable at Mayo.... worth a phone call anyway. I think you probably could get other opinions at Mayo if the insurance coverage was not an issue. Also in MN, you can see Mayo trained surgeons at the Mayo Clinic Health System in some other towns.

Here is a large question list I compiled about spine surgery, and not all may be pertinent to your case.

~ QUESTIONS ABOUT SPINE SURGERY ~

What type of surgery are you recommending? Why? What is the specific anatomic lesion being addressed?

What is the natural course of my condition if it is not surgically addressed?

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?

What is the source of the pain that is being addressed? How do you know this?

Please explain the procedure in great detail.

What products and implants are used? Is everything to be used FDA approved for this application?

What are the chances that the osteophytes will regrow? If so, what will minimize that chance?

What are my non-surgical options?

What are the different surgical procedures that can address my problem?

Can the disc be saved?

What would you recommend if I was your friend, wife, sister, or daughter?

How long will the surgery take?

What are the side effects, potential risks, and potential complications?

Please explain the risks and how they relate to me personally.

Reactions to implants, metal sensitivities, plastic sensitivities, toxicities?

What happens to 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?

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?

Do I have to have a metal plate on my spine? Is there another way to stabilize the spine?

What if, during my surgery, you encounter a different spine issue than you expected?

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?

What are the standard safety procedures to insure my safety during the surgery?

What are the safety cross check procedures during surgery?

What kind of imaging is used during the procedure and how does it tell you what you need to know?

Are there electrodes on extremities (neuro monitoring) making sure the nerves are functioning?

Do I need to donate my own blood? If yes, why?

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?

Can I talk to other patients who have had a similar procedure?

Who else will assist you in the operation? What are their background and qualifications?

What are the long-term consequences of the proposed procedure?

~ QUESTIONS ABOUT THE SURGEON ~

How many times have you done this procedure?

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.

If I want to get a second opinion, who would you recommend?

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?

~ QUESTIONS ABOUT WHAT TO EXPECT AFTER SURGERY ~

What kind of pain should I expect after the surgery and for how long?

How long is the hospital stay?

May a family member spend the night with me in the hospital?

How do you manage the pain in the hospital?

Which pain medications will I be sent home with? What are possible side effects of these prescriptions (e.g. constipation, drowsiness, etc.)?

Who can I call if I have questions after the surgery? What is the process for communication?

How often will I see you after my surgery?

What symptoms would warrant a call to your office?

What symptoms would warrant immediate medical attention?

What limitations will I have after surgery and for how long?

How long should I wait to bathe?

How long will I be out of work? School?

What kind of help will I need when I return home?

When can I drive again?

When can I resume normal (light) household chores?

What expectations do you have for my recovery?

How soon after the surgery can I start physical therapy?

So that was a lot of questions.
Here are some other discussions to check out:

Podcast about Spinal Stenosis
https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/spinal-stenosis-1/
Spine Lumbar Fusion Surgery
https://connect.mayoclinic.org/discussion/spine-lumbar-fusion-surgery/
Are you considering getting some other surgical opinions?

theparrottrooper | @theparrottrooper | Nov 20, 2022

Hello Joan 🙂
I also suffer with spinal stenosis. Over the years I’ve tried a chiropractor, oral meds, steroid injections, “RFA” (Radio Frequency Ablation), a few other types of injections as well, and I just continue to become more & more crippled. Yes, most of the injections in the past gave me relief, some gave me a years relief but in time the shot that gave me a years relief now only gives me 2-4 weeks of relief. I did have a Spinal pain Neurostimulator installed in my lower right hip. It definitely works wonders in my lower back but now my pain doctor plans to put Interspinous spacers in my spinal canal. This new approach is supposed to work wonders w/spinal stenosis. These spacers gently open the spinal canal, creating room and reduce pressure on crowded nerves. From what I’ve read and heard from others is that this is a wonderful option and I will be having this surgery hopefully before “2023”.

theparrottrooper | @theparrottrooper | Nov 20, 2022

In reply to @theparrottrooper "Hello Joan :) I also suffer with spinal stenosis. Over the years I’ve tried a chiropractor,..." + (show)

If you do end up having Interspinous spacers installed, be sure that your doctor orders images verifying that your spine is strong enough to withstand the installment of these titanium spacers.

theparrottrooper | @theparrottrooper | Nov 20, 2022

In reply to @pablo81 "I had the Vertiflex installed at L2/L3 for severe stenosis in June 2022. It was done..." + (show)

Oh! No! My doctors are talking to me about the Vertiflex installment 🙁 I was hoping it would be the answer. Thank you for the heads up.

eviggiano | @eviggiano | Nov 20, 2022

In reply to @migizii "In reply to @jenniferhunter …. Thank you so much for these suggestions….if you know a list..." + (show)

Hello, I am also on this journey to seek different MDs to get answers to my severe spinal stenosis. I saw a neurosurgeon, and he suggested a Pain Management doctor, who set a treatment plan that included a spinal injection of cortisone and lidocaine, along with a regimen of oral pain medications. PT was also set up, but did not help much. And, yes, all of this IS covered by Medicare plus your supplemental insurance. Thus far, this regimen has helped with the daily management of my pain; however, it seems to be only about 30% effective. I saw my neurosurgeon again, and he is now suggesting surgery. I am actively seeking other medical opinions; only one neurosurgeon has responded, and I am still waiting for the second neurosurgeon to set an appt (FYI, the surgeons that are in most demand will NOT just allow the patient to schedule an appt; rather, the MD will screen the patient to determine if the patient fulfills their requirements to even be seen). So my journey continues.