Cervical DDD/Spinal Stenosis Pinched Thecal sac- Surgery vs. Meds

[PerdidoKeyFlorida]

Recently been diagnosed with CDDD/Spinal Stenosis - see neurosurgeon 5/1.  MRI results:  Major abnormality - "asymmetric impingement of the osteophytes at the level of the neural foramina on the left at the level of the C5-C6 and C6-C7 is slightly more prominent than C5-C6.  The canal, though narrowed, there does not appear to be any evidence of significant deformity of the cord but the pinching of the thecal sac is well demonstrated."

Symptoms/meds:  Constant burning pain between shoulder blades,pins/needles in hands/feet.  Involuntary body jerks (mostly at night), creepy crawlies (sensations of crawling bugs), lower back pain, pain shooting down right leg, constant stiffness/aching, white hot pain from neck into head, headaches, incapcitating attacks that are EXCRUTIATING and that last 5-10 min and render my arms and hands dead weight.  Some trubs w/ left hand fingers working and slight gait difference.  Meds: Flexiril (10 mg 3x/day since Feb), vioxx (1 mo), Ultram (didn't work), percocet.  Flexiril/vioxx alone don't help.  Percs do a little - I hoard them (5/325mg)and take only when I'm in tears - which is often by 7pm.  Haven't been pain free in 8 months and restful sleep is a distant memory.

My question:  Must I have surgery?  I want to find some combo of therapy/meds that eliminate/prolong need for surgery/give me my life back.

[Claire631]

A related discussion, surgery was started.

[CCF-Neuro-M.D.-JT]

As I have not personally reviewed your MRI, I cannot give an accurate medical opinion regarding your case.  BUt based on what you report in your post, it sounds like there is some narrowing of the bony canal in which the nerves to your arm pass through.  This is probably the cause of your pain, weakness and numbness in the left arm.  The leg symptoms may be caused by a concomitant problem in the lower back but is not fully explained by what you've provided in the MRI report.  With the degree of pain you're having, the presence of weakness and sensory deficits, and the fact that it's gone on for 8 months without significant relief despite multiple med regimens and conservative therapy, if the MRI really does show severe narrowing or compromise of the cord/nerves, it is likely that surgery may be a very strong consideration at this time.  Again, if the nerve is significantly being compromised, the longer you wait, the higher the chance that neurological damage may be irreversible.  I can certainly understand your concerns about undergoing surgery, but if it's affecting your life without any help from meds or physical therapy then it may be time to start thinking about surgery  which could potentially make you feel better. Talk to the neurosurgeon about your concerns at the upcoming appointment. Ask him/her about the risks of surgery and what can be expected postop in terms of pain and neurological symptoms based on his/her personal experience with this type of surgery.  As for now, don't lift anything heavier than a gallon of milk, no contact sports, use meds as needed, and take it easy over all until you get in to see your surgeon. Good luck.

[tpayton]

A related discussion, unstable angina was started.

[JLC]

HAD SLIGHT STROKE ON 05/08/03 ON 05/01/03 HAD MRI L3 L4-5 EFFACING THE THECAL SAC CAUSING MILD SPINAL STENOSIS AT L4-5 THERE IS BILATERAL NEURAL FORAMINAL NARROWING SECONDARY TO SUPERIMPOSED CIRCUMFERENTIAL DISK BULGING AND MILD BILATERAL FACET JOINT HYPERTROPHY.ON 05/10/03 WHILE IN HOSPITAL MRI ON CERVICAL HAVE COMPRESSION AND NARROWING.TWO HOURS BEFORE STROKE   HAD SEVERE PAIN IN LOWER BACK AND RIGHT LEG.PAIN LEVEL 10 NO HISTORY OF HIGH BLOOD PRESSURE AT TIME OF STROKE VERY WARM SENSATION STARTING AT NECK FACE AND HEAD LASTED A FEW SECONDS.AT THAT MOMENT HAD NO PAIN AT ALL OTHER THAN RIGHT LEG BEHIND KNEE FELT LIKE A KNOT MOVING DOWN LEG.STROKE IS ON RIGHT SIDE OF BRAIN MY PROBLEM NOW HARD TIME WALKING,JERKING AND TWITCHING.WAS TOLD AT HOSPITAL THE JERKING WAS MEDS.AND WOULD GO AWAY.IT's been TWO WEEKS I AM STILL JERKING I CAN'T SLEEP SIT ON SIDE OF BED AND FALL OVER AND WAKE UP IN ABOUT ONE HOUR JERKING. PLEASE HELP.THANK YOU

[ERIK T]

Had cervical surgery on c4-5 and c5-6 with cages,plates,and screws.I had DDD and thought surgery was the answer and now i
just found out that i have three hernated disc's c2-3 c3-4 c6-7
and also have  minamal spodylosis.So think twice before you have surgery.Waiting to see what nuero wants to do with me.