Severe Stenosis in Lumbar Region

Congratulations. My surgery is coming up, and it is encouraging to read about good outcomes.

I received toradol with Tylenol until fourth day. Day I was discharged. Had to wait until drain collection was down below 40 ml per day. The toradol work marvelously but it interferes with bone growth which is needed. So, I was left with Tylenol every six hours and methocarbamol (muscle relaxant) every 8 hours. Walking helped to keep pain down and laying down on my back every 2-3 hours. Sleep was very restful except for bladder needing to be emptied for a couple of days. The lower back felt fatigued periodically (every 2-3 hours) so I laid down to rest. Tylenol seems to help to keep the pain under control.

A positive success minded attitude goes a long way to aid recovery. Once you get your PT exercise program postop don’t ever stop doing it. Once you insult your back with surgery it never forgets. And you’ve had a few years with stenosis which didn’t help much either. I had the similar low back surgery in 1988 with SS bars and screws while yours will be titanium. The success rates for these procedures with a competent surgeon are great but the healing and long term effects are on you. I’m paying for not having titanium hardware but my surgery was a success.

My doctor is recommending Posterior Cervical Decompressive Laminectomy Instrumentation and Fusion, C3 - C6 with foraminotomy, with navigation and Neuromonitoring. In addition, to Posterior Lumbar Decompressive Laminectomy L2 - L5.
I've been in pain for quite some time. It's altered my way of life. I'm presently doing Pt, Acupuncture, massage therapy and chiropractic services. Not much relief. Anyone have any recommendations as I don't want to be too quick to have the recommended surgeries by the neurosurgeon?

@dbethel1 Welcome to Connect. I understand the hesitancy on decisions on recommendations for some extensive spine surgery. It would be helpful to get other surgical opinions. Sometimes surgeons have different ways to address the problems, and you will gain a better understanding of the issues and what your best outcome may be. If you are already in a condition where you no longer progress with physical therapy, have weakness, muscle wasting and pain, that may indicate limitations because of compression of nerves. The problem with compression is that if it goes on long enough, nerves may die and dissolve leaving a permanent disability for whatever those nerves were supposed to do. I have heard stories from patients in wheelchairs who could no longer walk and problems with control of bowel and bladder function.

I do know how that feels to have the weight of a decision like that. I had spinal cord compression at C5/C6, and had a fusion to free my spinal cord. It was frightening to be like that knowing that the only way out was spine surgery. Let me also tell you that my experience was not that bad. I don't know how yours would be and you have a lot more levels of involvement. It is not a decision to take lightly, but to take seriously after you are educated about your choices.

What questions do you have to ask your specialists?

How do you know if you have nerve damage beyond repair/surgery?

@dbethel1
Have you looked into 2nd and 3rd opinions from different orthopedic spine specialist surgeons or neurosurgeons?

What does your MRI show in your lumbar and cervical spine? Is your spinal cord compressed? Do you have bone spurs/osteophytes? Are nerve roots compressed?

Have you been to a neurologist for EMG/nerve conduction studies to narrow down which nerves are compressed?

What are your current symptoms? Are you dealing with pain, weakness and numbness? Is your bladder/bowel affected and are you having difficulty standing, walking, doing stairs and with balance?

@dbethel1
Usually, cervical spine decompression is prioritized over lumbar if you have spinal cord flattening/compression injury.

Do you notice any issues with dropping things or difficulty gripping objects? Do you notice any changes to your handwriting?

Have you been told you have degenerative cervical myelopathy?

Try practicing Gokhale Primal Posture method for awhile before resorting to surgery. A Mayo MD/PhD called it “The greatest contribution ever made to non-surgical back pain treatment.”

@dbethel1 I apologize for not seeing your post. I can find replies much easier if you tag me with my name like I did here on your post.

If a nerve is damaged and not functioning or dead can be tested by a neurologist who does nerve conduction studies. It is hard to determine when and if a nerve will die from compression. That can cut off the blood supply to the nerve. Mainly, I think you would be judged on the functioning of your body and muscles, etc and if there are any deficits as well as by where you are feeling pain. It's probably best to consult a spine surgeon because typically they have a neurologist they like to refer patients to for testing and evaluation.