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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@pthaley

I have had 5 cervical fusions and getting ready for my 7th on C7 - T1. I have had great results with them all but I am afraid I have waited too long with this last one. I have been going to a pain clinic for 3 years and have had multiple injections. At first they helped but after a while they had no effect. The pain has gotten to the point where I can't hardly stand it. On February 8th I will have a discectomy/fusion ....severe spinal stenosis. Once I recover from that, I will have the same done on L3 -L4. Then hip replacement. This will be my 3rd surgery on my lumbar spine.
The best advise that I can give you is don't wait too long. I have nerve damage that can't be reversed. I will be 67 in March and have always worked and stayed active. I have come to a complete stop. Don't wait too long.

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@pthaley I see that you are a new member, welcome! You do have a list of surgeries in your future and months of recovery ahead for sure. Will your cervical fusion be an anterior or a posterior approach? I have heard surgeons say they would do a posterior if there already was an anterior surgery to avoid extra scar tissue in the area of the prior surgery.

Did you find recovery from lumbar surgery to be more difficult than cervical surgeries? I hope will get relief and improvement from your procedures.

Jennifer

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@elizaolson

I have Spinal Stenosis at L4 and L5. My orthopedic surgeon gave me two choices: surgery with no guarantee or stay on my pills Tramadol and Gabapentin. I have chosen surgery. I figure that even if it doesn't work, I've tried my best.

I checked on my surgeon's reputation. There were 4 comments; two raved about him and two thought he was terrible. It was mainly about his attitude and professionalism. Nothing about his quality of surgery.
I am in Canada and due to COVID-19, surgeries are backed up. Another reason is that suddenly, we have had a lot of shootings and the hospital that my surgeon works is responsible for looking after them.

He even warned me that I could be cancelled at any time. I replied, "Oh, I know another Surrey shooting." He was silent. I will report on my experience.

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Can you come to Mayo Clinic in Rochester, MN? I came here with an emergency room dr in Georgia, USA. He was most confident with Dr Bydon and he is happy I have same doctor. Two weeks ago I had surgery for a lateral herniated disk and severe stenosis at L5/S1. Surgery went excellent. Be careful with after care. Follow directions to a tee.
You have to call number listed, have tests sent requested. If approved will be on a waiting list. I had a phone appointment then came for testing and surgery, all within 3 days.
If you come stay at a hotel within a 5 min walk from hospital if you can, especially if you don’t have a car.

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@jenniferhunter

@pthaley I see that you are a new member, welcome! You do have a list of surgeries in your future and months of recovery ahead for sure. Will your cervical fusion be an anterior or a posterior approach? I have heard surgeons say they would do a posterior if there already was an anterior surgery to avoid extra scar tissue in the area of the prior surgery.

Did you find recovery from lumbar surgery to be more difficult than cervical surgeries? I hope will get relief and improvement from your procedures.

Jennifer

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Good morning. My cervical fusion will be a anterior. I seem to do well with the cervical fusions as well as the lumbar. The recovery on the lumbar is more difficult and is longer. Of course my mobility will never be the same, but I have learned to live with it. It just seems like for me, everything is wearing out at the same time.

I hope you have a good day,
Patti

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@eviggiano

I have been watching this blog and find it very helpful. My question is: ortho vs. neuro surgeon for spinal stenosis? My MRI shows a very narrow spinal canal that causes severe pain. There is literally no space in the spinal canal (L4 region). Thus far, I have 2 opinions, and I am 2 for 0 (suggesting surgery). One is from an ortho surgeon (who spent very little time with me to review the surgery and its outcome), and the other was a neuro (who spent a good deal of time with me). The problem I face is that the ortho MD is with a highly regarded bone specialty hospital in NYC, and the neuro is with a Community hospital in my state. I also am working through the Mayo Clinic's Spinal Center; however, this will mean an airline trip in-and-out, and a hotel stay. How much pain is expected post-op?

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I would first pursue minimally invasive surgery beginning with MILD treatment (85% of stenosis comes from inflamed ligament I have read)..and/or interspinous spacer that opens up the canal. Both are done locally under mild sedation and very quick. They are also low risk.

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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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Have you considered MILD treatment?

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@melinda7

Can you come to Mayo Clinic in Rochester, MN? I came here with an emergency room dr in Georgia, USA. He was most confident with Dr Bydon and he is happy I have same doctor. Two weeks ago I had surgery for a lateral herniated disk and severe stenosis at L5/S1. Surgery went excellent. Be careful with after care. Follow directions to a tee.
You have to call number listed, have tests sent requested. If approved will be on a waiting list. I had a phone appointment then came for testing and surgery, all within 3 days.
If you come stay at a hotel within a 5 min walk from hospital if you can, especially if you don’t have a car.

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Going to the Mayo Clinic at this time is out of the question. But thanks for the advice, especially about following recovery instructions to the "t".

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@eviggiano

I have been watching this blog and find it very helpful. My question is: ortho vs. neuro surgeon for spinal stenosis? My MRI shows a very narrow spinal canal that causes severe pain. There is literally no space in the spinal canal (L4 region). Thus far, I have 2 opinions, and I am 2 for 0 (suggesting surgery). One is from an ortho surgeon (who spent very little time with me to review the surgery and its outcome), and the other was a neuro (who spent a good deal of time with me). The problem I face is that the ortho MD is with a highly regarded bone specialty hospital in NYC, and the neuro is with a Community hospital in my state. I also am working through the Mayo Clinic's Spinal Center; however, this will mean an airline trip in-and-out, and a hotel stay. How much pain is expected post-op?

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Do both by having one assist the other. It done all the time and there’s even a special code docs use to bill as assistant to surgeon.

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I had ACDF surgery in October of this year. I had severe cord compression so basically had no choice. But my symptoms have not gone away, still have severe numbness in my hands and my balance way off. So i guess to answer the question unless you will have permanent spine damage like me surgery not worth it in my opinion.

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Why do people have to suffer with extreme pain from spinal stenosis? If you have a damaged heart, there are remedies. If you have cancer, there is surgery and treatment.
Doctors can replace lungs, livers and kidneys. Knee replacement, hip replacement, but there is no fix for spinal stenosis. Most people have more pain after disc surgery.
More research is needed to
make the surgery less dangerous and have better results post surgery so the patient can have a better quality of life.

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@bazzinga1234

Why do people have to suffer with extreme pain from spinal stenosis? If you have a damaged heart, there are remedies. If you have cancer, there is surgery and treatment.
Doctors can replace lungs, livers and kidneys. Knee replacement, hip replacement, but there is no fix for spinal stenosis. Most people have more pain after disc surgery.
More research is needed to
make the surgery less dangerous and have better results post surgery so the patient can have a better quality of life.

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I am not sure what information you have. Three weeks ago I had surgery mainly for a lumbar lateral herniated disk. At same time surgery for severe spinal stenosis was also addressed. You have to do research to find the doctor you want. You can get in sooner with some doctors. I waited 5 months but worth it to me.

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