Cervical stenosis: Wait or treat?

@marilynnovak Hi Marilyn. Thank you. My spine surgeon told me the best way to prevent a need for further spine surgery is to maintain core strength. Riding my horse helps me do that because I need to compensate for his movements with my back, so I get a good workout just at a walk which is what I do. I also work with a physical therapist and she works on my neck and torso. I have thoracic outlet syndrome which is a tightness in the chest and shoulder/neck that pinches nerves that go to my arms, so I'm always working on something and I do home stretching too. Physical therapy can help maintain strength and with anything spine related, good posture is essential.

Thanks, Jennifer. My 2 MRI interpretations should be here any day now. It is difficult waiting! It is like a mystery story so far, but mysteries don't hurt.

85-year old male in reasonably good overall health - with the exception of recently diagnosed C4-5 central canal stenosis with severe bilateral foraminal stenoses. This affects certain neck and, possibly, lower-back movements, especially while in bed. Surprisingly, I have very little pain when moving around during the daytime. Currently, I'm not considering surgery. Has anyone else with a similar condition, had Cortisone injections and, if so, what have been the results?

@cjs4handgbear - Welcome to Mayo Clinic Connect. This is a great place to ask questions just like yours.

I had C4-7 (ACDF) 18 months ago. I was nearly 72 and in reasonable condition. I also had little direct pain so I never considered that an ACDF was on the table since I was really working to diagnose lower back pain which was much more painful and life-impactful. But, while digging to define my lumbar problems, the docs at Mayo took cervical images then showed me where the ACDF was necessary.

The good news is - The ACDF was fairly straightforward with a less than 24 hour hospital stay. I used very minor pain meds and I have felt fully recovered for some time. I'm only sharing this as - if an ACDF becomes the recommended treatment for you - that procedure and recovery can be quite tolerable.

Thanks for responding to my post. Your comments and input regarding ACDF, were helpful. I was not familiar with that term, so I researched it and found a good deal of information about the procedure and process. I have a Second Opinion appointment tomorrow with a Spine Specialist, to review the MRI video and Radiologist's notes.
Thanks, again.

Bilateral foraminal injections can be quite helpful where stenosis is compressing the exit nerves.
Because your pain is at night, I suspect that your pain is from central canal stenosis. You might find some relief from positioned your heat more forward during sleep. The more forward position opens lessens the normal curve at the neck in a lying down position. Epidural injections can also reduce pressure against the central canal.
I'm glad you are seeing a specialist tomorrow. They will be able to tell you exactly what is reducing the canal space--disc, vertebra, ligament.
https://my.clevelandclinic.org/health/treatments/22293-cervical-epidural-steroid-injection
The injections are outpatient. I've only seen them done with a local numbing agent . Usually done under fluroscopy (though I've seen them done with ultrasound) and take less than thirty minutes.

@cjs4handgbear
I had ACDF surgery on c5-c6 because I had cervical spondylotic myelopathy which is a central spinal cord compression injury. If you fall, you can be paralyzed from that level down. My surgeon suggested surgery to avoid permanent damage and progression/decline. I bought a cervical pillow to ensure my head/neck was properly aligned while sleeping which helped. I had daily headaches, neck/shoulder pain, weakness in arms/hands (dropping things and handwriting issues), bladder control problems and heaviness in legs when walking. This was all tied to my cervical spine. After the surgery, many symptoms improved but I do have residual weakness in arms/hands.

Good luck getting good doctors and diagnosis/treatment options. I never did injections in my neck and PT didn’t help.

I had C5-7 & C3/4 ACDF. I just wanted to comment that serious cord compression can lead to some permanent changes if left too long. But this will typically cause sensory and muscle weakness like others have mentioned. I felt forced into the surgery because my upper back shoulder pain was unbearable. I did have several epidural shots done under anesthesia as an OP, but that was while waiting for surgery. But they eased the pain temporarily. I'm glad to hear you're getting a second opinion. Knowing the level of cord compression would be important to know. Best of luck.

I have c4 5 6 7. Nerve compresseion in neck , burning. Im now going for my 3rd cervical epidural. I got about 30% better, hopefully the 3rd one will do the trick. You need a good pain management doctor. Try ice. helps a lot or the pain.

I have c4 5 6 7. Nerve compresseion in neck , burning. Im now going for my 3rd cervical epidural. I got about 30% better, hopefully the 3rd one will do the trick. You need a good pain management doctor. Try ice. helps a lot or the pain. yes the injections can help immensely