Cervical Spinal Stenois

HI Laura - I'm so sorry your DH is going through this, it's so scary. My bf's mom had spinal stenosis in her 80's - so bad she couldn't walk - and the surgery "cured" her - even at the age of 80! It's good your DH caught this early! That said - be sure to get a second opinion from other specialists (I'm assuming you've seen a neurologist)........I also have spinal stenosis, and numbing of two toes, but the orthopedic doctor I saw said it wasn't very severe and I wouldn't need surgery. Fortunately I have no back or neck pain - I think all the swimming all these years really has helped with that. Still, I worry that it could get worse - but reassure myself that I've had "baseline" MRI's done which will make it easier to watch.

I'll be praying for your DH and you - hope you are comfortable with whatever decisions you make - and that God's angels will watch over you!

I had a prophylactic  ACDF C5-7 (anterior cervical discectomy with fixation).  In English this means they went through the front of my throat (anterior), took out the 2 discs, drilled out a boney growth inside my spinal column, did a Roto-Rooter job on my nerves at that level as they exited the spinal column, fused them together, and put in a titanium plate.

I had never heard of this surgery before.  I went to a 2nd opinion and he recommended having it done too.  My neurosurgeon said that he was concerned I would have a spinal cord injury if I fell on my chin.  That's because of the boney growth inside my spinal column.  I would have had a minimal surgery (my surgeon specialized in minimal techniques), but my discs were too shot.

I have carpal tunnel too, so I had other issues.  

I had physical therapy after for a few months.  I was out for 6 weeks with a no-drive clause and a 2 pound lift restriction.  (That's about 1 quart of fluid.)  Since I live alone, that meant multiple trips to the grocery store and to take out the garbage.  I couldn't take the 5 pound jar of flour out of the cupboard.

I don't know if it was necessary or not, but I'm glad I don't have to worry about a spinal cord injury.  I knew I'd never have the expertise to decide whether or not I really needed one.

Here's what the Mayo says about spinal stenosis. http://www.mayoclinic.com/health/spinal-stenosis/DS00515 It lists nonsurgical options.

Best wishes to your hubby!

Hi,

Long story short -- I had cervical stenosis and other problems in my neck and had ACDF (anterior cervical discectomy with fusion) for C4-6 in January 2008.  It was an overnight stay in the hospital and a few weeks of being very careful afterward.  The pain was gone as soon as I woke up from the surgery.  Unfortunately, now a year and a half later, C3-4 and C6-7 are both giving me problems -- achy shoulders and some numbness in my arms and hands.  I'm going to put off surgery as long as possible because it is just too soon after breast cancer treatment to think about another procedure.  I would definitely encourage your DH to see a neurosurgeon that specializes in spines for this type of surgery and get at least 2 opinions.  Best wishes...

Bonnie  

Laura, I do not have any input for you. I am not knowledgeable in back problems, tho, I am beginning to have very bad pain in my lower back. I just want to offer you my hugs and support that your husband gets better soon.

Hugs and prayers

Wow, what timeing for you to bring this up.  I am going for a 3rd opinion for severe stenosis at Lumbar 3.  First neurosurg. wanted to do 3 levels with rods and fusion due to slipping of the spine sideways and toward the back, besides the laminectomies.  then he backed out saying he'd only done one surgery with that many levels--at least with the minimally invasive technique.  He referred me to Memphis to the guy who taught him the procedure.  I 'll see him in 3 weeks.

In the meantime, I consulted a neurosurg who doesn't do min. invasive(read up on this: it's like laproscopy for tying tubes and removing gallbladders, and the surgeon has to be very careful, but the recovery is very fast(muscles are not stipped from the spine--surgery is done thru a scope) and if just for stenosis, can be done outpatient)  Anyway, he said I'd need only one and no rods or fusions.

So---more x-rays and I have an appt next week with an ortho who does only spine, as did the first neurosurgeon).  I have all my studies: MRI, bone scan, EMG/NCS, flexion/extension and standing/supine plain xrays.  I'm hoping to get TWO  recommendations that match.  LOL and then decide who I'll let do it.

It's a little money maker for the simple stenosis surgery, a "lazer" spine center in Fl. does the workup, surg. and teaches PT all in 5 days.  The docs accept insurance and medicare, but the facility --hospital,etc, do not accept any.  So, you go there and cough up at least $18,000.00 (not a typo) to get it done.  If you have reg. ins. with out of network avability, you can get a little of it back.  I'm on medicare, so I'd just be out 18 grand,  Yeah, right!

I have arthritis in the back( lifted too many patients in  my career, I guess) and other stuff, but the stenosis began to really get bad in Feb. and I am able to stand or walk for no more than 10-20 min. without sitting to relieve the pain.  I have increased my pain meds from 2 tylenol #3 to percocet, but try to only take that at night and keep with the codine in the day. 

I have little activity other than TV, the boards and reading.  My gardens are a mess and I can only work on the parts that I can sit on my garden cart and still reach them.  So, quality  of life is in the pits. 

I had sworn all my life that I'd NEVER allow back surgery, but at this stage, I'm begging someone to fix this.  I worked with a huge number of back patients (but before the new min.invasive) and outcomes were less than optimal and scared the sh** out of me to do it to myself. 

I still work out at the pool at least 3xwk--about an hour. laps, streaching, and strengthening, esp upper body and abdomen.

I totally AGREE; get opinions!  At least 3, and only see a doc, either neurosurg or orth who does only spines.  And make sure they do the procedure they recommend several tiimes a week and have done so for at least 5 years.  At least those were my criteria for breast recon and my spine is certainly as important at recon.

Probably, TMI, but I'm worn out with frustratiion, waiting for appts,  and continued pain.  At least I'm retired and can stay home.  My dh has been a jewel, goes to the back of the house (we have a Long house,) to keep me from having to walk it if not necessary.  He does the grocery ---I can go in, but can't make it thru the store and back to the car.  I cook in "shifts" of 10 min., sit, 10 more min., etc. 

I got a tiny bit of relief from epi injection for 48 hour , so it was not worth doing it again.  I just want to get back to something like normal.  I was so good before this crap started. 

So---ck out the min. invasive surgery and watch out for rip offs, and stay with docs who do only spine surgery.

My heart goes out to you both, bless you and I pray for great results if he chooses surgery.

Laura,

I have spinal problems, including stenosis, degenerative disc disease and bulging and herniated disc problems (between L3, L4 and L5-L5-S1).   The pain varies between the back, hip and legs.  I feel the worse part of this is the radicular pain (nerve root pain).  The pain travels down my legs...into my feet.   The radicular pain bothers me the most because of the inability to sit, sleep, stand, etc.  This can lead to the loss of bladder, etc. control.

I spent a sleepless night last night due to the radicular pain in both legs.  I have good days and nights and bad days and nights.

Please get another medical opinion.   The specialist I see is very conservative and we are trying to stay away from any surgery.   We discuss all possible treatment options.  I have 3 levels that are unstable and repairing one may cause problems to the other levels. 

There are many individuals who respond to physical therapy, cortisone shots (I've had 3 of these) and other therapies.   Sometimes surgery may be the only option because of nerve damage.

Having said all the above.....I do know that each individual must evaluate the pros and cons of any treatment plan with their doctor.     You and your DH are doing the right thing by researching the problem.    There are many, many websites that advocate surgery (mostly private doctor/medical facilities).   The best information will be from medical sites like WebMD, etc.   

Laura, send me a PM if you would like to talk.     

Well, the ortho agrees that fusion is needed.  at least that part is settled.  He doesn't do min. invasive, so I'll see the guru of min. invasive surgery next week in Memphis.  Then I'll have to make a decision according to what he recommends.

There are alternatives to using splinters of your hip bone for grafting for fusion.  I forget the name of the stuff, but it is supposed to work well.  (I just call it fairy dust) LOL  Grafting/or other  is necessary if you need the area stabalized with fusion.

Dottie,

I'll be thinking about you. Start looking into pain managers in your area if you haven't already. I know too many orthopedic surgeons who cut off their fusion patients from meds at the 6 week post-op point. And the reality is, you made need narcotic support for a while after that...

In the meantime, swim like a fish, drop a few pounds, strengthen your core and everything you can.

Will you be in a hard brace for the time that you can'tbend or turn?

Anne

Thanks for the recommendation Anne.  I am going to a neuro and my post op info/detail sheep notes that they want me off meds as soon as possible to prevent addiction.

Now the problem is: I won';t see this guy again after surgery,I hope to  be followed by another doc closer to me and who was trained by this neuro and actually referred me to him.  So the operating surgeon has no stake in my pain management since he won't have to listen to me bitch.   LOL

I have a teriffic ortho here who believes in good pain management and feel she will be available to me -- have known her for years and she and dh are very friendly.   She knows I don't take a lot of meds and I sure want to get off these narcotics.  The drugs and continued pain is depressing me and I'm already on anti depressant.  She offered percocet last year for much less pain and seemed relieved when I finally accepted it a couple of months ago.

Her pain mgt. program includes a urine test on demand---I was really impressed.  She also has patients bring in left over pain meds if they ask for a change in meds and  she he keeps these narcotics locked up in her safe.  Smart gal.  That way she's comfortable giving meds as needed and appropriate for the patient.  Then I have a pcp who is a surgeon and very aware of my aversion to narcotics.

I can hardly wait to be able to walk more than a few yards and cook a full dinner with having to take breaks---and work in my flowers next spring.  Oh, wait, I'll be getting a hip or knee replacement then---according to my back recovery.  Here comes Darthene Vader.  LOL

Laura, glad you have a decision made.  It's such a pain to keep going over and over what one should choose.  ANd such a relief to get going.