Spinal stenosis and ablations

Posted by kris27 @kris27, Aug 15, 2023

Hello, I have been having ablations for years with good luck but lately they are not lasting as long and they are not relieving as much pain. Have any of you experienced this? If so, what else have you tried besides surgery?
Thank you
Kris

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Profile picture for jenatsky @jenatsky

Ablations are not a cure all as you know. I don’t believe there is a sure fire cure that instantly cures neuropathy. Those of us with disk narrowing, spine issues causing pinched nerves leading to neuropathy, etc. don’t expect any magic bullets but we keep searching like you are. Back injections help but again only temporarily and too many can cause bone destruction. At some point I have found you must come to terms with your physicality and learn to cope as best you can.

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Is surgery not an option? Just curious.

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Profile picture for jbr @jbr

I (75) had lumbar surgery in 2015 for stenosis. My spinal cord was so narrow that the surgery was considered urgent or I would lose the use of my legs. The following few years I was better, but the surgeon warned that I would need more future surgeries, and that has proven to be true as I now have sciatica and weakness in my left leg. Shots and ablations have not helped at all.
Upon moving and visiting a new doctor it was discovered that I needed neck surgery for the same reason. The stenosis was affecting my balance. (The poor balance caused me to fall down some stairs and my quadricep tendon was severed and I spent a year recovering from that surgery). The neck surgery was completed 7 weeks ago and my balance issues are almost gone.
The next surgery will be lumbar to try to fix my very weak left leg.
My point is that depending on your personal diagnosis surgery is necessary and helpful in many cases. Several friends of mine have had several surgeries and they are now able to go hiking without pain. That is my ultimate goal.
It is essential to search for reputable surgeons first!

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Did you first have to go through PT, injections, etc before surgery could be considered?

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Profile picture for denman55 @denman55

I've had foraminal lumbar spinal stenosis for over 10-years. I've had numerous ablations and epidural steroid injections. Nothing helped. Nothing was effective. This past March I had the MILD procedure. It also was not effective. Then I had another Epidural Steroid injection. That didn't help the pain either. Now I've been told the only option for me is the Spinal Cord Stimulator. I've been in pain for well over 10-years and it's getting worse. Now my legs are effected and I can barely walk without pain. I just don't see my life changing and I think I'll be in pain for the rest of my life.

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Surgery isn't an option?

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Not for me since it would be temporary. I’ve accepted that my back will continue to deteriorate and my scoliosis will continue to twist my spine. It makes no sense to inflict more pain on myself than I normally have.

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Profile picture for tdukerryder @tdukerryder

Did you first have to go through PT, injections, etc before surgery could be considered?

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Yes, all of the above!
My spine surgeon is one of the best in the country, with UVA teaching hospital in Charlottesville. I am still holding off the surgery for other reasons.

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Profile picture for jenatsky @jenatsky

Not for me since it would be temporary. I’ve accepted that my back will continue to deteriorate and my scoliosis will continue to twist my spine. It makes no sense to inflict more pain on myself than I normally have.

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I suffered for 20 years until I met the best orthopedic surgeon! Had surgery immediately. (7 years ago). I got my life back and my pain disappeared. But what is best is my nerve roots were no longer being crushed. If you don't consider your nerve roots you may be causing irreparable damage. I have that and its unfortunate because I would have done the surgery earlier if I wasn't at a neurologist who was inappropriate for my needs. My scoliosis IS continuing to degenerate along with the rest of my spine. I had a double cervical spine surgery two years ago. I am super happy with my choices because I can continue to exercise and keep my body strong. I am looking at another surgery around the lumbar one, in the next few years, "but bring it!" the right doctor is key. I am 68. Waiting too long may not be in your best interests so you should talk about it with your surgeon as much as you need to to make a decision best suites your body and lifestyle.

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@loriscorsone if I was in significant pain I might consider another surgery but I’m not. I keep myself active and moving walking 2 miles daily and gym 2x weekly. I was once offered by a Jefferson neurosurgeon to replace my stainless steel bars with titanium so I’d be able to have an MRI if ever it was necessary. I said no then and still say no. As a former nurse and medical coder I’m not a fan of over doing surgery on myself. I’m managed to only have the one fusion surgery in 1990 and I’ve had no others since that time.

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Hi, I had a spinal fusion 6 years ago, but unfortunately the surgeon chipped a bone when putting in metal cage. The chip was removed 4 days later with another surgery. This has all led to permanent nerve damage to L5 on my left side. Many spinal fusions can work! Got to research the surgeon. I have a very good pain specialist, we have tried pain injections, (what everyone is calling Ablations - we call Lumbar Pulsed RF Rhizotomy + Root Sleeve Injection) every 5months or so, I did get relief, but not for long maybe 6 weeks to 8 weeks. I also take Lyrica and Physeptone which does help a lot. I have just trialed a Neural pain Stimulator Implant for the past 4 weeks, this is called 'Saluda', made in Australia, and it has worked! At least 60 - 70% decrease of pain. I am going to now have the permanent implant done. I did trial a device called Boston 2 years ago that didn't work at all. So everyone, keep searching, keep positive and try new things.!

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I am getting my first epidural steroid injection tomorrow so will ask my doc about the Lumbar Pulsed RD Rhizptomy (aka Ablation?) that you mentioned. He said Medicare approves injections up to 5 (I think!) times a year, but I am hoping just to need one.

I have used Lyrica at night but if I take more than 25 mg it gaves me terrible foot and calf cramps at night. I have not heard about Physeptone- yikes, I just looked it up, it's methadone, an opioid. But if it works and nothing else does, good to know. I tried tramadol with absolutely no effect.

However the comments from others on potential permanent nerve damage from crushed lumbar nerve exits is of interest. I will discuss with my back doctor.

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I see on the internet one small study about ablasion and neuropathy. It seemed to help those with neuropathy tremendously. Does anyone know anything more about the possibility of ablasion for this condition?

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