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Severe spinal stenosis - Surgery vs other options

Couple months ago, I was diagnosed with severe cervical spinal stenosis from C5-6 disk herniation (based on MRI). My symptoms included neck/right shoulder pain, tingling in right forefinger and thumb, and stabbing pain in my right rib cage. I was recommended surgery. I resorted to conservative means including physical therapy and acupuncture. I am seeing significant and progressive improvement in my symptoms since then. I feel I should continue with these conservative options and dismiss surgery but would like to seek opinion from others who may have been through similar condition. 

Thanks,

Jay

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Comments

  • dilaurodilauro ConnecticutPosts: 13,284

    Stenosis is nothing to take lightly.  If anything once you are diagnosed with stenosis (cervical or lumbar), it will get worse over time

    Most surgeons will let their patients know when the narrowing of the nerves gets too low that surgery is the only answer.   Left undone, you could have future problems of larger proportions.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • I tend to agree with dilauro but understand your hesitancy in having surgery.  I'd just suggest you be keenly aware of increased arm weakness and neck pain.  Some of this is also age related and involves osteoarthritis which takes it's toll as we age.

    Hope this is helpful

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  • What dilauro said as well.  It is conventional wisdom to avoid surgery until you cannot.  

    I had not only bulging disks, but also such severe stenosis with spinal cord flattening both anteriorly and posteriorly that the neurosurgeon warned me I was at a high risk for total paralysis or death if I was rear-ended in a car or fell down a few steps and bumped my head. I opted to go for the C3-C7 ACDF he recommended, and have not regretted the decision. My head and neck aches have abated, and the compromised grip strength in my left hand has improved as well.  If I had waited, I would have risked a catastrophic end result.  Mild stenosis and a little disk bulging might warrant alternative modes of treatment, but one should closely monitor one's situation continuously and be prepared to take a neurosurgeon's advice to fix the problem if the situation deteriorates.

  • I'm not a doctor.  

    When I was younger I herniated a disc in my neck and the pain was excrutuating - extreme spasms in my right arm, numbness in my fingers.  I wasn't able to do anything for six weeks.  A friend brought me iced buns and audiobooks and took me to the doctor and physio.

    A surgeon recommended surgery but my own doctor recommended I hold off until the disc had time to heal on its own.  She said I should start to feel a bit better in six weeks.  I wasn't entirely better until about a year had elapsed.  I've had no problems with it since.

    I've recently had surgery for a lumbar stenosis (central canal and lateral).  If the stenosis had been entirely caused by a herniated disc I probably would have waited longer before going with the surgery.  The soft gunk in discs slips out in a herniation, but usually dries over time and shrinks back. Having said, that, I was told by the surgeon that the herniated lumbar disc I had removed as part of my recent surgery wasn't so much herniated as "demolished".  That's not a medical term so I don't know what the difference is.

    Whatever you decide I wish you all the best.

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