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Cervical Spinal Stenosis

usnretuusnret Posts: 5
edited 06/11/2012 - 8:46 AM in Spinal Stenosis
I have been diagnosed with minimal grade listhesis at C3-4 and C4-5 with significant cervical spondylosis that also results in the central canal stenosis. At the C4-5 level demonstrates i have canal stenosis less than 10mm, measuring at least 9 mm if not smaller with evidence of cord signal changes suggestive of myelomalacia.
It has been recommended that I have a Cervical procedure called a cervical C3 laminectomy followed by a C4 to C7 laminoplasty. I was offered this because I am a very active and healthy 56 year old with no cervical neck pain.
I am a retired Naval Officer and this cervical problem is service related but the VA wants me to have a muililevel anterior cervical discectomy and fusion, which would most likely entail C3-4 C4-5, C5-6 and C7-7.
At my age this seem like a death sentence.
They will pay to fuse my neck but refuse to help me pay to preserve my mobility with the laminoplasty.
Can anyone help me here are they (VA) right or is the spine specalist correct?
I believe in the specalist!
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1

Comments

  • Steve, first of all thank you for your years of dedication in serving our country.My situation is almost a carbon copy of yours. In fact my neck looks lile a train wreck on an M.R.I.
    I have to ask why are they going to operate and fuse all those cervical vertebrea together if you are not in pain?
    For them to fuse all those cervical vertebrea together will give you almost zero range of motion in turning your neck. I do not see that as being a good deal long term. Anytime they fuse something together, the vertegrea up and down the line inherit the job of twisting and turning that they used to do.
    This does not sound like it is in your best intrest, can you give a little more back ground?
    Thanks Bill
  • Bill,
    Well here is the rest of the story. The VA only recognizes cervical fusions and that is all their neurosurgeons do. They do not practice nor do they try to learn newer techniques. I just went to the VA to talk to the neurosurgeon who originally disapproved my Laminoplasty operation. Once she saw me and did her tests she stated to me that NOW she understood why my doctor wanted to do the laminoplasty vise the fusion. I WAS TO YOUNG!!!
    I might add that it took Senator Bennet from Colorado to get them to see me. The VA agreed that my injuries were services connected but because their surgeons ONLY do fusions they would not approve my operation using a newer technique. The neurosurgeon agreed with my civilian doctor after seeing me and stated that I was to young to have a multi level fusion when there was a better way to do it.
    On Thursday 19 August I will have the proper operation done. Cross your fingers …
    I still have to weight to see if my military insurance will pay for the operation. I have severe headaches and I can’t wait any longer to get this over. I have no pain in my neck but have lost strength in my right hand and arm. I also have shooting pains down both legs. Do you have headaches also?
    My question was if they know my injuries were service connected why can't they help me pay for it?

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  • Fellow crapy neck type here! See sig. My fusion (last one) failed, and too it seems (doctor won't admit to it okay) that the different stresses between my hardware also caused my C6 vertebra to crack - thus screwing both fusions! I am now losing the C7/8 level from 'adjacent level' failure. I was told that if the crack doesn't resolve (there is movement there), and my symptoms continue to increase, they would recommend going back in and revising C5-7 and adding C8. My C2/3 has a 9mm "bulge" with 1/2 the disk space being occupied with a 'cluster' of moderate bone spurs. That would leave me with C1/2 and C3/4 left alone.

    Not happy. I know that alone will restrict the living snot out of my range of motion. I've been putting it off as I am NOT looking forward to all that mess, but the symptoms might be the decider's of my future.

    I've been to several Neurologists, still sticking with my original Neurosurgeon, but also had a consult with a Orthopedic Surgeon who specializes in spines - I should have just brought a 'rubber' stamp as they all seem in agreement. :( Now if it helps, and it's in-line a bit with Bills post. Unless you are getting where the pain is too much, or your day to day living is being adversely affected, I would have a hard time having that many levels fused!

    Are you able to go to a civilian doctor with your insurance for the newer method (which you also seem more comfy with)? Another thing too, be it one level, 3 levels, all levels?!? I would sniff around and see what options are out there first - if you can handle that of course, or your insurance allows. Wow, that just sounds like a megga HUGE surgery. Please keep us posted on what you end up doing. *HUGZ*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Brenda,
    I’m going with the civilian doctor…He is a very strong believer in maintaining range of motion. That is why he recommends doing the Laminoplasty.
    It is actually called an open door laminoplasty. This will eliminate the stenosis and nerve pain. There in no fusion involved and my range of motion will be maintained.
    I live in Durango Co. and the doctor is with spine Colorado people come from all over the country to have these 2 doctors operate on the cervical spine and lumbar spine.
    After the operation they say I will be up and walking 1 hour after I get to my room. I will have to wear a soft collar for 6-8 weeks. I have met several of his neck patients and 5-6 weeks post op they are out hiking the Mtns.
    Cross your fingers!
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    I had my first 3 level fusion done @ age 44 - and had the entire procedure redone with four levels anterior and posterior @ age 46. Here's a link to where I started for contrast and compare purposes.

    http://www.spine-health.com/forum/neck-pain-cervical/my-bad-mri

    Don't you have insurance coverage through the VA system?? I wouldn't think it matters what the cause of your condition was - is. I thought we took care of our enlisted both during and after active duty.

    I think a lot of strange things though.

    Feel free to PM me with anything I maybe able to provide insight into, having been down the cervical fusion road a couple of times now.

    Warmest regards,


    D
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  • Steve,

    Congrats on your decision!!! :) Since this method is less 'aggressive' and you maintain a lot of your ROM, that is fantastic!! Please let us know when you are going to do this, and then we can shoot megga positive energy your way for the surgery and recovery!!!! Bravo! Thanks for the news. :) *HUGZ*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Metalneck said:
    I had my first 3 level fusion done @ age 44 - and had the entire procedure redone with four levels anterior and posterior @ age 46. Here's a link to where I started for contrast and compare purposes.

    http://www.spine-health.com/forum/neck-pain-cervical/my-bad-mri

    Don't you have insurance coverage through the VA system?? I wouldn't think it matters what the cause of your condition was - is. I thought we took care of our enlisted both during and after active duty.

    I think a lot of strange things though.

    Feel free to PM me with anything I maybe able to provide insight into, having been down the cervical fusion road a couple of times now.

    Warmest regards,


    D
    To Brenda. My operation in Aug 19th.
    D,
    I spent 10 years enlisted and the next 15 as an officer. When I retired I already had a 70% disability from the military. Because the VA only does fusions they will not pay to have a non fusion done. When I say too young I think they mean that because I don't have the neck pain only the stenosis and nerve pain that the fusion was way overboard.
    The VA and military doesn't take care of our vets at all. They opt for old technology and never bother to keep up with what else is available.
    With the VA it's a case of do it our way or do it yourself, even if it is a case of service connected enjurys.
    It took my Senator from Colorado to push the VA and military ins. enough to get them to consider my case. The jury is still out.
    Because of my case I have met several Vets with missing limbs and their relatives are going broke paying to get the proper health care they need.
    In deed we are not taken care of...

  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    That makes me sad and mad as an american that we treat those who have served us so dearly - so poorly.

    If respect was worth something beyond a genuine feeling of thanks, honor and awe - you would be a wealthy man indeed.

    Thank you for all you have done and best outcomes from your procedure. We will be around if and when we maybe able to provide support or a smile ... or (From Brenda)HUGZ.

    D
  • I will write when I get home and tell you what happened...
    This feels worse than being shot at right now.
  • Steve,

    *HUGZ* and ENERGY going your way for the day after tomorrow!! As to the VA (ex Army here), I stay clear here in South Florida. Our VA hospital has been in the news waaaayyy to much for unhealthy things (reusing caths for procedures for example - yuck!) and like you stated, they do things "this and only this way" only! In my former office (retired), we had 2 vets return from Iraq with major orthopedic issues, and too, they ended up using their federal government insurance. Sad huh?

    From what you've stated, your disks much be in pretty good shape. So they will clear out as much of the Stenosis and and back in business! My issues have all been disks and osteophytes (bone spurs) so my options were more limited. Glad to see open minded doctors are taking care of you - probably faster too than the VA can give? *HUGZ*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
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