Considering Laminectomy for Spinal Stenosis to relieve neuropathy pain

Did you have any back symptoms or just issues in feet?

@bttpe1961 - There are several related discussions started by members considering a laminectomy that you might find helpful. Here's a search link that lists the related discussions - https://connect.mayoclinic.org/search/discussions/?search=considering%20Laminectomy.

Your neuropathy is more likely due to nerve damage in your feet. Can you wiggle your toes? In my case I have nerve damage in my feet from being pre-diabetic and that was due to having hypercortisolism which went undiagnosed for years before it was discovered in a serendipitous fashion. I had growths on both adrenal glands which were producing cortisol. Had one adrenal gland removed last August, but I'm still producing more than I need. Excess cortisol can lead to diabetes, osteoporosis, high BP among other things.

@bttpe1961
I would hold off on surgery until you learn more.

Have you been to a neurologist? Did you get a skin punch biopsy of thigh/ankle to test for small fiber neuropathy? Did you get extensive neuropathy bloodwork to find the cause of your neuropathy (are you diabetic, do you have vitamin deficiencies or toxicities, do you drink alcohol, etc.)? Did you have EMG/nerve conduction studies done of your upper and lower limbs?

Have you had MRIs of brain, cervical spine and lumbar spine? What do they show in the report? Have you read them in detail? What levels did they do the spinal injections?

It would be good to get more updated testing/imaging and see a couple different doctors for 2nd and 3rd opinions before moving to surgery. I don’t like the way your orthopedic doctor is handling your case/condition from the dismissive response to your treatment options. I would fire him/her.

@bttpe1961
Have you tried taking alpha Lipoic acid and Acetyl l carnitine supplements for neuropathy pain? Have you tried capsaicin nerve pain cream? Have you tried lidocaine nerve pain patches like Salonpas brand?

Using compression socks and ice packs (covered in a cloth to protect skin) can help. Heat can aggravate nerves due to swelling of tissues around nerves.

Do you know what levels in your spine are pinched/compressed? Is your spinal cord flattened or are nerve roots pinched? Spinal cord flattening and compression causes different symptoms than pinched nerve roots/nerves (causing radiculopathy radiating pain down arms/legs).

Symptoms in both and I "think" these started at about the same time 12-15 years ago. It started with back pain when I played golf and pain in my big toe. Initially treated as gout and separately as spinal stenosis.

I've had comprehensive testing for the neuropathy both locally and at Mayo Clinic. The general diagnosis was "idiopathic neuropathy". I also have Parkinsons. I've had the full NCS and EMG multiple times that show the progression. I've also had a nerve biopsy (nerve removed from right calf). That showed demyelination and axon loss. I've has multiple MRI and images of the spine from hi to low and multiple images of the brain. The general report is spinal stenosis. I did rely on one Orthopedic Surgeon for many years (9+). Where surgery was "off the table - I was not a candidate for surgery" direct quote. TODAY - after the epidural lidocaine and demexatrose (spell) (injection three days ago) I am pain free in both feet but numb. I'm assume at this point that the problem was the stenosis. I should add that the NP called the stenosis moderate not severe. Also, my back has been treated with "facet" injections every year for 5 years and this past year they performed an ablation (10 points). My back is actually pain free < 3 on my scale. Without facet injections the pain in the back is >7 all the time and crippling on occasion.

You need to get bloodwork, MRI and EMG, go to Neurologist to determine large fiber neuropathy. Endocrinologist can determine small fiber. I had a L4/L5 pinched nerve with slight numbness near big toe, caught the original strain of Covid down the street from LAX, and three weeks after recovering, my Long Covid attacked the under nourished pinched nerve around my toe, and broke the nerve open above the ankle. I have both small and large fiber PN. Got worse this year, started vitamin regiment, looking into IVIG, stem cells, PRP but not holding out much hope. Make sure you need surgery by getting EMG which isolated which nerve(s) are having trouble

@bttpe1961
What levels of your spine do you have stenosis? Do you have disc bulges/herniations, bone spurs/osteophytes, hypertrophy (excess bone growth), ligament buckling, etc. that are pressing on your spinal cord/nerve roots?

Why did they tell you that you could not have spine surgery? Surgery should be an option if non-operative treatments do not help. If surgery can help address the source/cause of pain, I would think that would be an option. Non-operative treatment is only temporary relief. If there is a structural or mechanical issue, that needs to be addressed.