Foraminal narrowing: Destined for surgery? Anyone manage this without?

@jenniferhunter
Thank you jennifer. My pain is very consistent though in that it's always in my calf muscles and sometimes upper hamstrings. And I don't know if fusion will help that. I'm going to look up your surgeon at Mayo. Did you have fusion though for that compression? Is that the standard way they deal with spinal cord compression?

@dsonderhouse unfortunately I will not be seen by a neurosurgeon for a month. In the mean time I need to be doing something to help myself but I’m afraid to move practically for fear of making something worse.

Please try acupuncture. It's a great temporary central nervous system reset. Also maybe muscle relaxing or nsaid meds with PT until your appointment

Hi y'all, before I comment I want to make sure you understand that I'm not a surgeon but I'm a retired board certified surgical first assistant 30 years of experience and neurosurgery and orthopedic surgery. During my career I participated in only three of these types of decompressive and stabilization surgeries as they are or at least were when I was in practice fairly rare. I was diagnosed about 3 yrs ago with cervical stenosis at C2-C3. At this time my stenosis classification is between grade two and grade 3 grade two meaning that spinal cord compression is apparent on CT scan. Grade 3 is the same except grade 3 means that there is signal change coming from that level of the cord. On my scan my spinal cord is now pinned against the anterior or front wall of the spinal canal. This causes several problems. Firstly the signal change of course and additionally can place traction on the vagus nerves both left and right which interupts their communication with the systems that they govern. The left vagus controls heart rate, rhythm, circulatory tone (i.e. how relaxed both the veins and arteries are) blood pressure and breathing. The right vagus controls all organ systems below the diaphragm (i.e. all of the digestive organs including metabolic function, reproductive system etc) for instance when I change position say I lay down and I put some traction on the right vagus my heart rate increases immediately and eventually the slows down to a normal rate but it takes time for the vagus to re-establish proper communication with what it's supposed to be controlling. Disturbances in the right Vegas system will cause things like diarrhea, diabetes type II, slowed digestion, incontinence of both kinds(!!), disturbances in liver function among others. As far as when one should seriously consider having surgery to stabilize your neck the Hallmark for surgery is when muscle wasting begins. That is you begin to lose muscle mass. As I recall once that happens that's not going to come back. If you have grade two cervical stenosis you need to see a neurosurgeon to evaluate it and you need to see one who does many of these or has a lot of experience doing it. A lot. I want to emphasize that it is very very critical that you find one with a great deal of these cases under their belt. You've heard the saying if you're a hammer everything looks like a nail and if you're a surgeon sometimes everyone looks like a surgical procedure. But there are very specific criteria that have been established in the last 20 years or so to give you a solid point in time where you should think about it. I've waited as long as I have because putting rods in your neck limits or completely eliminate motion in your neck (plus the fact that I'm an old man now) which fixes the problem of course but you can't move your neck anymore I didn't like that idea but I'm getting to the point where I think I'm probably going to have to do it. There are surgeries that will decompress your spinal cord without using rods that limit motion but very few surgeons have experience doing this but there are some. It's called cervical laminoplasty and involves hardware but does not interfere with motion and at the same time decompresses the cord. I would check out ( and this isn't a plug for him because I don't know him personally} Dr. Brian Su who is Co-Director of Spine Surgery at the Marin Heath Medical Center. I believe that's in the Los Angeles California area. He has an excellent YT channel that is excellent for both layperson's and providers. When you find his channel look at his vid titled 'Cervical Laminoplasty-Into the Operating Room" it gives a thorough explanation of the surgery complete with excellent graphical representations of it and descriptions as well as a colleague of his doing the actual surgery. Dr Su does these however not everyone with our problem is a candidate. He also offers video consultations. His contact info is in the video description. Just do a search for Brian Su M.D. on YT and you will learn all you need to know and more. I wish you all the best. Peace.

@tjb7dee Welcome to Connect. Thank you for your excellent explanation of spine function. I can relate my own experience which was a fusion of C5/C6 that was done at Mayo and without hardware. I did have the beginning of spinal cord compression and some muscle wasting on the back of my shoulders. Some of that muscle did come back, but I did loose some. I do also have heart rate changes with neck position sometimes. I was loosing the coordination and strength in my arms and I did get that back from this surgery. I’m approaching the 10th anniversary this year and have not had further issues. One thing that is different, is that I chose to do this with no hardware. I only have a donor bone disc and I lived in a neck brace until fused. The surgery was successful and resolved all my pain. I do have neck stiffness and tightness that I keep working on.

Are you at a point where you are considering surgery?

I had severe foraminal narrowing at c5-c6. Had single level fusion. Didn't go well. Now have advanced arthrosis of the facet c7-t1 and large anterior bone spurs above the plate. Lots of pain and minimum relief. THC gummies help me sleep. Hot tub helps a little. Stretching is important. Hard to find a surgeon who is willing to help because of the ACDF. Due diligence pays off dividends in my opinion. Could be worse and could be better. The struggle is real.

@livininthestix I went through several surgeons before I found one that would help. Have you considered Mayo? They are known for taking cases that other doctors refuse. You need to have insurance they accept, and that can be a roadblock to getting help anywhere. If your C7-T1 disc is loosing height, it will put more pressure on the facet joints. Also, uneven pressure at the end plates can cause bone spurs as the spine remodels. If the spinal cord is getting compressed in the central canal, it can cause myelopathy and dysfunction. Nerves can be permanently damaged.

Are you planning to seek a consultation with a spine surgeon?

@jenniferhunter I would like to talk to a Mayo surgeon because something isn't right in the neck. I have been referred multiple times and they deny each time. I have great insurance and was seen by internal medicine, infectious disease, and ent for another issue. They wanted a new MRI because mine was over a year old. They referred me to Duluth which is closer to home and had the results sent to Rochester. The report said the spurs are causing swallowing issues as well as arthrosis and a bunch of other stuff. I never heard back from Mayo about any of it so I just left it be. You should see how bad my toes and fingers curl. Its crazy. I seem to be a mystery. My primary literally said I dont know what to do or where to send you. Thanks for replying. I don't mean to sound negative but if I could go back I would never of had the ACDF.

@livininthestix I would make an inquiry just for the spine issues and I recommend that you send any spine imaging you have to be reviewed by Dr Jeremy Fogelson at Rochester Mayo. He was my spine surgeon who took my case after 5 others turned me down. You can self refer. Do call the billing and insurance department first to make sure your insurance is accepted at Mayo. Forget all the stuff you have been through and start fresh. You will need to have imaging on discs to be able to send into Mayo. What happens at Mayo is the first doctor you see becomes the one who refers you to other specialists there. Tell them you want to start over and ask that Dr Fogelson review your case. Don’t give up and live with it. Put yourself into a position of making an educated choice.

You can request an appointment online from the Mayo website and someone at Mayo returns the call. Then you ask for Dr Fogelson to review your imaging. There is a long wait to get in, but it’s worth it.

I had pinched nerves caused by stenosis of C5-L1 or so.
I had one spinal injection so far back in 4/2026 and I am okay so far.
Is it something that you would consider again, if you had already done it already once?
VJ