Cervical stenosis

Posted by billandri @billandri, Feb 3, 2019

I am a healthy and active 32 year old male. Last month I was diagnosed with cervical stenosis (C5-C6) after having morning finger numbness for 2 months. All 3 doctors I asked suggest surgery, either disk replacement or merging of spines. Has anyone dealt succesfully with such conditions via non surgical means? Thank you.

@collierga

I am a active 64 yr old with similar symptoms although my numbness has been going on for one year but does not limit my activity.
One doctor recommended 2 surgeries the other one did not..The thought of having the anterior approach scares me as heard it is very painful to swallow and talk after surgery. Does anyone have any experience with that?
Good luck with your decision. Your are young so as long as you have a good surgeon and hospital surgery should be uneventful. Do your research. i am in the medical profession and have learned a lot from this discussion group

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I've had 2 cervical surgeries through the anterior. I don't remember them being any more painful, than you would expect from a surgery. Yes it's a little hard to swallow for a few weeks, because they move your larinex during the surgery. But I had no pain with the swallowing itself.

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@collierga

Hi Jennifer
Could you also PM number of Dr. Fogelson's office i would like to send my imaging studies to him to review. i am very with Mayos as we have had my daughter there twice and my dad also went there years ago. Such a great place.
Thanks so much

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Hi @collierga You'll need to have Mayo set up a patient account for you first and give you the number. Then you will be able to send medical records and imaging studies in and ask them to be sent to Dr. Fogelson for review. The records office will input the information in the computer system so he will be able to view it when he logs in and they hold on to the imaging CDs. I got mine back long after my surgery, but you can ask how they handle returning discs if you need it back. You might ask for extra copies if case something is lost in the mail. You can contact Mayo online for this, and someone from triage calls you back. I will send you the triage phone number for neurosurgery privately, and they can set up the account for you and they will ask questions about your medical history.

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@miflowers

Bill I can tell you the surgery is not that big of a deal. I’m 35 and had a fusion done a year and a half ago on c4c5. It started as you said In fingers. Eventually both of my arms were numb. I was unable to wake them. I researched my surgeon and picked the best one in my opinion. Can honestly say I had a 100% improvement. I felt and was ready to go back to normal activities in two days. Honestly wish I’d had done it sooner. I understand not wanting to go the surgical route. But I definitely suggest you research all your options. And if you do surgery talk to a lot of people in your area n find a good surgeon.

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Did they do posterior or anterior approach with your surgery/
How much pain was involved and any difficulty in swallowing

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@jenniferhunter

Hi @collierga You'll need to have Mayo set up a patient account for you first and give you the number. Then you will be able to send medical records and imaging studies in and ask them to be sent to Dr. Fogelson for review. The records office will input the information in the computer system so he will be able to view it when he logs in and they hold on to the imaging CDs. I got mine back long after my surgery, but you can ask how they handle returning discs if you need it back. You might ask for extra copies if case something is lost in the mail. You can contact Mayo online for this, and someone from triage calls you back. I will send you the triage phone number for neurosurgery privately, and they can set up the account for you and they will ask questions about your medical history.

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Thank you

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@ww2valentine

Hello Jen: I just recently joined Mayo Clinic Connect. Tomorrow I'm having my first appointment at the Rehab Centre for atrophy in my left leg, numbness on the bottoms of my feet, and diabetic neuropathy. Even though I have kept my blood sugar low (5.2 – 5.8) in the past year or so, I'm just starting to experience neuropathy now. In the past couple of weeks, I have developed a rash on my shins and around the ankle area, which is as itchy as the devil and brings on a burning, stabbing pain. It's disturbing my sleep. Well, even with all these complaints, I at least felt as though I knew what was causing it — i.e., my Type 2 Diabetes. Then I joined Mayo Clinic Connect! Now I see posts and links to articles that seem to indicate statin drugs can cause neuropathy. Another post led me to what I had thought in the first place, which is that my cervical and spinal stenosis could be causing my problems. I've been taking statins on and off for years, my cervical MRI indicates "severe stenosis" and my lumbar problems have caused marked stenosis in that region. So here I am back to being puzzled as to what's causing this neuropathy. What questions do you think I should ask my rehab therapist tomorrow when I see her at my appointment?

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@ww2valentine I'm not sure if your question was directed to me. You can ask your rehab therapist about the pattern of muscle atrophy and weakness that you have, and if that matches what your imgaging and reports say about your stenosis and any nerve compression that you have. There can be multiple reasons for symptoms that overlap, so there may not just be one answer. Spine surgeons have to assess that as a "differential diagnosis" because they need to know if their surgery could help. If they do surgery, it may not fix a problem if there are multiple causes, and the surgery is to decompress something like a nerve or the spinal cord. From my own experience with muscle atrophy in my arms and shoulders, it was only after decompression surgery that my muscles began to recover and rebuild in physical therapy, and that takes a long time as the nerves heal. I don't have diabetes, and I don't know how much that will affect nerve function. It is possible that rehab is a test to see if you will improve before any spine surgery is considered. Often medical notes that state surgery is recommended also state that physical rehab had failed to improve the patient. I had central canal cervical stenosis with spinal cord compression, and physical therapy helped by realigning my spine and took a little bit of pressure off. The muscle spasms were pulling the normal neck curve out of alignment and twisting or turning the vertebrae and effectively making the spinal canal smaller. It was a temporary fix until the next spasms occurred. They also used electrical stimulation to calm the production of neurotransmitters which actually carry the pain impulses between nerve cells across the synapse (gap) between them.

Your rash should be evaluated, and it may not be related to diabetes. I know that shingles produces a rash that follows nerve pathways and is very painful. My mom had it, and she had dark red bumps in a line. Nerve pains can be burning, stabbing and like an electric shock. I have not had shingles myself. It's easy to assume something is related to something else, and make a mistake and go without treatment. A medical professional can intercept a problem before it gets serious, but only if they have a chance to evaluate it. I have made this mistake myself thinking I was having my normal allergy sinus problems, and in reality there was an infection in the root of a tooth causing the pain, and damaging jaw bone. I didn't recognize the problem until it had gone pretty far and then an oral surgeon cleaned out the infection and replaced the lost bone.

You might be interested in our Myofascial Release discussion. You can have compression of nerves and tissues from fascial tightness, and MFR therapy can help that if it is a physical problem. This helps neuropathy for some patients and there is mention of it in the neuropathy discussions here. Here is the link. https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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@collierga

I am a active 64 yr old with similar symptoms although my numbness has been going on for one year but does not limit my activity.
One doctor recommended 2 surgeries the other one did not..The thought of having the anterior approach scares me as heard it is very painful to swallow and talk after surgery. Does anyone have any experience with that?
Good luck with your decision. Your are young so as long as you have a good surgeon and hospital surgery should be uneventful. Do your research. i am in the medical profession and have learned a lot from this discussion group

Jump to this post

I had a 2-level anterior cervical spine fusion in April, 2019 at the Mayo Clinic at the age of 65. Dr. Ahmad Nassr did the surgery; several people working at the Clinic told me he has an excellent reputation. I had no problems with swallowing or speaking after the surgery. My only problem has been times when I am extremely fatigued but the fatigue is lessening.

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@miflowers

Bill I can tell you the surgery is not that big of a deal. I’m 35 and had a fusion done a year and a half ago on c4c5. It started as you said In fingers. Eventually both of my arms were numb. I was unable to wake them. I researched my surgeon and picked the best one in my opinion. Can honestly say I had a 100% improvement. I felt and was ready to go back to normal activities in two days. Honestly wish I’d had done it sooner. I understand not wanting to go the surgical route. But I definitely suggest you research all your options. And if you do surgery talk to a lot of people in your area n find a good surgeon.

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That is very reassuring as my symptoms are also numbness. Surgery is very worrisome to me.
Did they do the anterior or posterior approach for you surgery?

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I have been diagnosed with multi-level cervical spine stenosis. I am seeking an experienced caring team that will discuss ALL treatment options, try least invasive first and considers me a member of the health team.

Would anyone be so kind as to share your reviews and experiences.

Also, I live in North Carolina so the Fla. facility would work best for me.

Thank you,
Victoria

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@victoriamb

I have been diagnosed with multi-level cervical spine stenosis. I am seeking an experienced caring team that will discuss ALL treatment options, try least invasive first and considers me a member of the health team.

Would anyone be so kind as to share your reviews and experiences.

Also, I live in North Carolina so the Fla. facility would work best for me.

Thank you,
Victoria

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Hello @victoriamb and welcome to Mayo Clinic Connect. At Mayo Clinic, you can expect a multidisciplinary team approach to care. This article may be helpful to you in considering Mayo Clinic for care.

Non-Surgical Treatments May Decrease Pain from Spinal Stenosis:
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-nonsurgical-treatments-may-decrease-pain-from-spinal-stenosis/
An excerpt from this article states:
Surgery usually isn’t necessary to treat spinal stenosis. Often a combination of lifestyle changes, physical therapy and medication can effectively decrease the pain and discomfort caused by this common back problem.

Can I ask if you were recommended surgery after your diagnosis?

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@victoriamb

I have been diagnosed with multi-level cervical spine stenosis. I am seeking an experienced caring team that will discuss ALL treatment options, try least invasive first and considers me a member of the health team.

Would anyone be so kind as to share your reviews and experiences.

Also, I live in North Carolina so the Fla. facility would work best for me.

Thank you,
Victoria

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@victoriamb My experience with surgery for cervical stenosis is at Mayo in Rochester with Dr. Jeremy Fogelson. He is an excellent surgeon and I had great results. You can read more about this in my patient story. I understand you want to stay closer to home and Mayo Jacksonville may be an option. Since you are traveling, you can go to any of the Mayo campuses if you so choose. Check the website or call to see if your health insurance is accepted. I tried to work with local Chicago surgeons, but none would help me, so I traveled to Rochester which is a 5 hour drive for me, and it was definitely worth it. Dr. Fogelson is often recommended by my physical therapist because of my experience with him and he has helped every patient she has sent to him. I liked that he had both neurosurgery and orthopedic spine fellowship training and he is highly regarded in his field, not just at Mayo, but also at spine conferences where he gives presentations and teaches.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

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