Any Success Stories of Lumbar Stenosis Surgery?

@closer0043 - Welcome to Mayo Connect. This is a great place to ask the sort of questions you asked. I'll try to answer some of them.

I had 4-level ACDF at C4-7 in Feb 2023. Causation was degenerative arthritis. I was successfully managing decades of progressive neck, shoulder, and arm pain right up till I discovered I had even worse stenosis and spondy in both the thoracic and lumbar spine areas. Yup, that's just about everywhere.

First step was to address the cervical issues which is (in my opinion) the lesser of the two surgeries. Three months later, in May 2023, I had a 4-level discectomy and fusion at L2-5.

Some advice? Always get a second opinion before agreeing to extensive surgery. Always select the best medical facility you can find. (I used Mayo but there are other excellent hospitals out there.) Find the best neurosurgeon (not ortho) and consider consulting with a physiatrist. Those docs see lots of back problems plus they have no dog in the fight concerning surgery or not-surgery decisions...

Now the hard part: Only you can make the final decision as to surgery or deferral. It's a matter of personal risk management: which is worse? Having surgery with a known period of impactful recovery plus possible negative side effects? Or deferring the surgery which runs the risk of permanent nerve damage that cannot be fixed. This is a decision you are forced to make when it's impossible to know with certainty the ultimate outcome of each path.

All your symptoms could be caused by nerve pinching due to stenosis and/or spondy. Another suggestion? Until you sort this all out - seek hobbies other than playing basketball with a bunch of young bucks who can drag you up and down the court and other than power lifting. I went from golfing a lot to reading 2-3 books a week. It was an adjustment but what other choice is there?

Let us know how things are going...And what else I can assist with...

Thanks John, I play baseball not basketball, and most guys are in my age range. Some are 70 and still play which is amazing. I gave up basketball about 7 years ago. That’s a young mans game! I have already accepted my playing days are most likely over. I just want to enjoy my retirement with my active wife. I’m happy if I can enjoy a day at the beach or zoo with her. Also, walks and bike rides are getting tougher as my legs get weaker.

I have had 8 surgeries in the past 14 years to keep me playing, so I understand the surgery decision. All of them have worked out great for me. I had 2 resurfaced hips, 2 rotator cuff repairs, knee meniscus, ankle bone spur, double hernia, and partial knee replacement. All of my surgeries were performed at Rush in Chicago.

I only mentioned the severe spots on my MRI report. I think I also saw the word moderate 5 or 6 times. That’s what happens when you have 357 plate appearances in one year at the age of 53 with 2 metal hips. What was I thinking!

My biggest fear is that I waited too long for the surgery and my nerves are beyond repair even if the pressure is alleviated. That’s where the expert opinion is needed. No matter what the outcome, I’m happy my EMG was clean even if my NVC showed mild polyneuropathy. I hope your recovery goes well.

Sorry, I meant Phil.

@closer0043 I am a cervical spine surgery patient and had a ruptured C5/C6 causing spinal cord compression. I also have thoracic outlet syndrome (TOS). That caused compression of nerves and blood vessels to the arms which complicates a diagnosis when there are overlapping symptoms. TOS is most often missed and misunderstood by doctors. TOS can cause breathing problems and it does for me. One of the many compression points are between scalene muscles on the side of the neck very close to C5 and where the trapezius connects to the spine. TOS can be caused by an injury such as a whiplash or repetitive stress injury and I suspect that weightlifting may not be good. If I lift too much weight, it kicks up my symptoms. If I raise my arms or turn my head, that causes blood supply and my pulse to stop in my neck. That is some of what they do to test for it and a neurologist should know about it. If your neurologist did not consider TOS, you may not have an accurate diagnosis.

Did you get a new MRI after the weight lifting incident of your cervical spine? They can also look at the brachial plexus for TOS in that area. It sounds like that event may have been a disc rupture because of the burning or at least a nerve compression caused by the effort. Did that leave lingering symptoms?

Dizziness, ear ringing and nausea and head pressure are symptoms that may be related to TOS because of changes in circulation. Dizziness can be caused if C1 or C2 independently rotate (or lower C vertebrae to a lesser degree) because that stretches the vertebral artery inside them which lessens part of the blood supply to the brain. I had that happen, and it caused vertigo and I actually fell backward once because of this. TOS sets up this situation if one side is worse causing it to be tighter. A muscle spasm starts pulling on the spine rotating vertebrae it attaches. What concerns me is that a diagnosis of polyneuropathy will satisfy the doctor who doesn’t look for other possibilities in the diagnosis.

I know the moment my bulging C5/C6 ruptured. I was stretching my neck with a slight twist and I heard it pop, and my neck suddenly turned past the limit of the range of motion. It didn’t hurt, but felt strange and nauseating. It ruptured into the central canal and didn’t hit a spinal nerve. Sometimes a disc ruptures into the foramen between vertebral bodies where the nerve roots exit the spine.

I have some familiarity with Chicago spine surgeons because I saw 5 of them who missed my correct diagnosis before I came to Mayo. I did see one connected to Rush.

If you have questions or need to define your concerns for your surgeon, I will help if my experience is relevant to your situation.

Jennifer

Jennifer, you're awesome. I must have read 20 of your replies in the past month. I already have TOS on my list of questions to ask. I have suspected it for the past couple of years mostly due to the repetitive motions of throwing a baseball about 10,000 times a year.
My neurologist is Rezania. My neurosurgeon at U of C was Lee. My new appointment is with Fessler at Rush. All of my MRIs were after the incident. I have another appointment with my neurologist late June. I'm waiting on a call from Rush for an appointment this week after he reviews my records. I'll keep you updated. Thanks for your input.

Here are my MRI reports.

I have had 2 major back surgeries due to congenital stenosis, severe arthritis, and some other causes. I am a hundred percent better. No nerve problems. No radiculopathy any more. No falling because my legs gave out. I am strong, healthy and owe it all to the surgeons and guidance from Mayo Clinic Rochester, specifically Dr. Marsh, Dr Elder, and Dr. Colonel, -the later is the name I gave him, not his given name, so you'll not find him. I apologize for that because his name was more long than my arm, and/so I could never spell or pronounce it correctly. He was a Colonel in the US Army too, so I called him Dr. Colonel. He only does research now. He is retired from surgeries. I digress. My nerve conduction test went from junky to outstanding. I want to stray from your question, because I have a background in medicine, and a family history wrought with heart disease. You mentioned "finger tip edema," which sounds like what is called medically "clubbing" and almost all of your symptoms could also be due to cardiac problems. Your mri reports look pretty normal for a 50 year old guy. The body ages, no.matter how well we try to take care of it, or don't want it to, or think it shouldn't. Some of the best, Olympic, world class athletes, trained since they were old enough to talk, have had cardiac issues, and still some others, don't find out about a valve or other congenital heart issue until its too late. Part of the laypersons' interpretation of medical reports and medical information is that we lack the experience in order to put said information into the context of living on the planet for [enter number of years alive here,] which is normal for an aging body. In order to interpret medical information accurately, within the correct context, what is required is medical schooling, where the larger picture is matriculated. If not, we would all be Doctors and surgeons. The reason I am saying this is to hopefully gently ask you to go see a Cardiologist, and try to not diagnose yourself, because the latter causes so much unnecessary anxiety, which makes everything and pretty much anything worse than it already feels. Stay active like you are. Stay your best self advocate like you sound! Just maybe shift some of your trust to a your your Doctors if you have more than one, and maybe please, take all of this info to a cardiologist. I wish you the best! Baseball rocks!

Thank you so much Mary. I also wondered if I have a cardiac issue, but no doctor appears to think so. I did just have a normal EKG before my knee surgery in November. Wouldn’t that show something if there was a problem? I am worried that my legs are getting a little weaker, but the amount of nerve compression I have out my lower back through in the past 14 years has been phenomenal. I have been sprinting “not jogging” with 2 metal hips almost daily. No cartilage here to embrace some of that impact. I believe my back has taken the impact of every run, jump, dive, or slide. I’m truly surprised that my kidneys have held up so well with all of the ibuprofen I have injested.

I have a follow up with my neurologist in a little over a month. Plus, I am waiting to get my thyroid biopsy in a couple of weeks due to a couple of suspicious nodules there. I guess the good news is my fatigue is getting better, but still concerned about the leg weakness. If it is just peripheral neuropathy like my neurologist says, maybe it still has a chance to heal since most of my symptoms started after my weightlifting injury.

These are my NCV / EMG results:

Hi Closer,
I’m with you as far as being OCD.
Yes stenosis definitely can cause sciatica and numbness in the legs and arms depending on where it is in the spine.
At 78 I still don’t want to give up skiing. Extreme stenosis in L345 and neurological claudation in the butt and legs. I stretch and walk through the pain, eventually it lessens and I walk more.
Not a Dr but it’s not that hard to see your drive for fitness is out of balance with what your body is telling you. It’s hard to back down when you’re an athelete accustomed to having a high performance body.
You will be happier if you make peace with Father Time.
Like you I have limiting factors (back), currently searching to find a solution other than fusion and decompression. Take your time and don’t jump into surgery. Surgery often leads to a lifetime of ongoing related problems.
Learn how to stretch and work your back muscles gently. Avoid things like dead lifts and squats. Replace them with leg presses and super man extensions on a big rubber ball. If it hurts stop. Walk intervals 3 minutes on and off fast and slow, excellent for your body and soul. If you can dance and like music, put on ear buds and go out walking and dancing. People think you are nuts but they wish they had your joy.
Good luck and god bless you.
Tony

Hi @closer0043 . Nope, not necessarily. Ekgs show cardiac rhythms. There are ranges for each person's 'normal.' I have had a longer q-t voltage than textbook normal my whole life. Stress tests, cardiac ultrasounds due to my familys' morbid, long history of sudden death cardiac disease lateron, and on repeat, and the cardiologists could see that that was simply how my heart beat, beat. Fingertip clubbing is usually a sign of vascular somethings or others, nerve issues, pituitary, thyroid, and or other glandular problems. Vascular problems, meaning what blood and lymph is pumped out to and through the body, has a more difficult time getting recirculated back, and picked up by veins going back to the heart, from the lymphatic system, so it can go back through the heart and pulmonary circuit again. I have venous damage from sports injuries, 3 pregnancies in a row, becoming overweight, bilateral total knee joint replacements to some extent, and so on. Living life basically. We dont go through life without some things simply happening no matter what we do or how proactive we are. The remedy to assist in my case, the lymph fluid that gets stuck in my legs occasionally, is a low dose diuretic, and drinking tons of water. Nerve damage can cause clubbing too, it depends on where said damage is. Ekgs cannot see or show coronary artery blockage, or as you stated, thyroid issues, which by the way, could also cause clubbing, and/or too much antidiuretic hormone, or the opposite not enough antidiuretic hormone, because though the regulator for that is the pituitary, the thyroid is like second in command pretty much and even benign nodules can cause one or the other glands to over produce or underregulate the messages to the kidneys to keep more water (urine) in the body, or, the opposite. If I were you, I would bring all of these up with the physician who did the thyroid biopsy. Maybe copy and paste all of this thread onto paper, or at least get it onto an iPad or something bigger than a phone screen, with your daily logs, (which I thought was/are just fantastic data for the correct Physician, and such smart thinking on your part, that I may steal that awesomeness of an idea for my own issues lol!,) schedule extra time with him or her, and share it all with them. No lie. Now that you mentioned thyroid, I am thinking that may be the root of most of it. And way to go with that self awareness, persistence, and consistency. Truly. Your self discipline from sports and activeness shone through. I have no worry about you. You will get to the bottom of it, and through anything. I believe that. -mary