@ray666 I think you are in a situation where it is hard to know what problem is causing your symptoms or if it may be a combination of things. Cervical stenosis does cause problems like balance issues, dizziness and vertigo, lower body pain and actually pain anywhere in the body, weakness in legs, uneven gait and problems with incontinence or normal emptying of the bladder or bowel and many surgeons miss that connection. That is the problem I had in finding a surgeon to help me, because they didn't understand that connection until I found this described in medical literature and came to Mayo. Have you thought about the possibility that the cervical stenosis may be the cause of the neuropathy? It also may not be. How did this develop? Was there a spine injury like a whiplash? Did a spine injury happen before the lower body pain began?

The surgeon doesn't know for sure, so he can't make any promises, but that's OK. My surgeon didn't promise to cure my pain either, but cervical spinal cord decompression did solve the problem. The big clue I had was that I had an epidural injection that stopped all the pain I had all over my body temporarily, and then it slowly came back as that wore off over a few weeks, but there were 5 or 6 totally pain free days. I also had a lot of details on how this developed for me over a few years. I knew the all over body pain was connected to my cervical stenosis even though there is no diagnostic test for this. My fusion at C5/C6 did solve all of the pain I was experiencing which proved that it was generated by spinal cord compression.

My other question is about the about the wait and see approach. Will the neuropathy obscure worsening of the symptoms that are coming from the spine? If these are separate problems, neuropathy could prevent the normal warnings that would come from pain if there were no peripheral neuropathy. When damage shows up on an MRI, it may not be reversible with surgery. Surgery can prevent something from getting worse and it can also leave you in more pain than before surgery. It is a big decision and you need to know from your surgeon an accurate assessment of your condition. Surgeons cannot tell you exactly when permanent nerve damage will occur if the spine is not decompressed. What if there is no change in symptoms, but the MRI imaging starts to show nerve damage within the spinal cord? Would that be the indicator to proceed with decompression? Is that really worth waiting for? For a patient who does not have dignosed idopathic neuropathy, waiting for damage to occur just doesn't make sense. I know in my case, an earlier intervention gave me the best chance to not have lingering nerve pain after surgery. That is the result I have with a very successful recovery. I also had surgery with out hardware, and I know from a later experience with a fractured ankle, that metals inside my body were causing additional pain, so that was a good choice on my part and my surgeon made that solution available to me.