WOW! :eek: I honestly understand all of your pain and suffering and wish everyone here a better quality of life than they are currently experiencing.

This is my first post (and first visit to this board tonight). I am completely overwhelmed to find so many others with similar conditions and symptoms as I am experiencing. Needless to say... when you are feeling down and out, there is probably someone else who has been in your shoes and can provide comfort in the form of experience. I am hoping someone here can help me or steer me in the right direction. Here is a quick summary for me:

37 year old male, no history of back/spine disorders, very active, healthy. Never had surgery of any kind; worst injury is probably a sprained ankle.
Woke up Monday 7/23/06 with burning pain in left bicep/shoulder and stiff neck. Symptoms progressed with numbness in left thumb/index finger, cramping forearm and shooting pains down my left shoulder into the bicep region. Went to family doctor and he found diminished reflexes in left arm and diagnosed me with a cervical strain. Family Doc then prescribed Vicodin and Valium for pain management and scheduled PT for me. Pain became considerably worse after PT sessions and night and in the morning were becoming unbearable. PT recommended MRI and doc agreed. MRI performed 8/14/06. Diagnosed with Cervical Stenosis.

Some quick notes from the radiology report... there is anterior posterior widening of the C5, C6 and C7 vertebrae and corresponding discs. There is a additional spondylosis present at these levels which appears to be comprised of both hard and soft disc. This is resulting in attenuation of the ventral and dorsal subarachnoid spaces at C5-6 and C6-7. There are spondylitic changes at C5-6 and C6-7 which is resulting in moderate central canal stenosis at these levels and moderate ventral cord flattening at C6-7.

So my next step is to see a Neurosurgeon, but my appointment isn't scheduled until 9/21. I consider myself to have a decent tolerance of pain and find this to be the worst pain I have ever experienced (especially at night and in the morning). I cannot sleep lying down, run, ride in the car, climb stairs, etc. without experiencing severe pain in my neck, shoulder and bicep. It honestly feels like my arm is broken. My thumb and index finger are still numb and reflexes are absent. Now... if you are still with me here, these are my questions;

1) Is this a degenerative disease, meaning I will only continue to get worse unless I opt for some form of surgery?
2) Is there anything they can do to widen the canal without surgery?
3) I am assuming my nerves are being pinched which is causing all of my pain... can this become permanent if I wait too long for surgery.
4) Has anyone heard of or had laser spine surgery to treat spinal stenosis? Is this a new technology?
5) Has anyone heard of the laser spine institute institute? I am very skeptical by nature and wonder if this is some sort of scam. http://www.laserspineinstitute.com/home.aspx

Don't mean to hijack this thread, but just looking for that one person out there that might provide me kwowledge and experience before my Neuro appt.
I honestly feel like I am too young for this to be happening to me (most cases appear at age 60 or so) and am terrified that i will never be the same as I was just one month ago. I have a two year old daughter that brings me to tears just thinking that I may not be able to enjoy normal activities with her as she ages. I am also tired of being on narcodics and feeling "loopy/tired" all the time.

Anyone?

Many of us here are in our 30's and 40's with no history of previous problems and no accidents, etc. - will write more later.

Hi Jimmy -
Welcome to the board, wish you didn't have to be here and all of that. You're in the right place.
First, it is overwhelming and you are doing the right thing to be asking a ton on questions and doing your own research! There are many, many treatments and surgical approaches and some are of VERY dubious credibility and even the very best specialists can disagree on what ought to be done in YOUR case.
Did I say 'specialist' ? That's Job #1 - it's great that you are getting diagnostics and seeing a neuro but once it comes to any invasive treatment options - you want a spine specialist. Could be a neuro or an ortho but someone who does nothing but spines and has completed at least 1 spine speciality fellowship. Call the office and ask or look it up on the web.
I'm 43. I'm 8 weeks post-op on a 2nd attempt to fuse my lumbar spine and during the last 3 years of that fun-filled journey I've developed an increasing amount of cervical spine trouble. I believe in knowing everything I can about my treatment and my personal experience has only underscored the ultimate importance of doing just that.
I'll just bet you are in a great deal of pain but I would seriously caution you from any quick decisions that include needles or knives!!!!! My left thumb and index fingere went comepletely numb on me back in March and I suffered greatly for about 2 weeks with the type of pain you describe. I began to get my feeling back in my fingers only after 6 weeks though the pain had subsided remarkably.
Be very sceptical.
Here's what I can do with your questions: stenosis does mean nerve impingement and that does sound like what your dealing with. There are several things that can be happening to pinch those nerves and some can and do heal with time (prime example: a disk may herniate and push into the canal space and often will recede and heal with time). Others don't heal and some do progress with age and if the problem is a degenerative disease the process can be speeded up considerably.
Unpinching those nerves is the basic quest and many methods are tried and some work. I am trying right now to learn whether epidural injections with steriods and/or nerve blocks and facet joint ablation-type treatments are worth the risks, the time off of work and so on. I, too, am getting pretty sceptical and wondering if all roads eventually lead to surgery and these 'less invasive' methods are just what the system does with us until enough time has passed to know that 1) it ain't going heal by itself, and 2) she ain't going to go away and leave us alone.
Be very cautious about what some of these 'centers' and 'institutes' claim. Check these health boards for people who have been there and done that. I just used a new product/technique in my surgery (BMP) that some people think of as being so new that it isn't well enough tested. I did a huge amount of research to convince myself that the FDA knew what it was doing in approving this product, found a surgeon who was experienced in using it, and traveled to do have it done. BUT I am learning that many other 'new' and cutting edge techniques don't seem to be standing up to the test of time despite intitial promising results. AND I'm not even discussing some methods that are generally seen by most as outright quackery.
I wish you the best of luck. Ice, pain meds on time, rest, and time will be your friends. Suzy-Q

my best advice is research research research...and to utilized this board. the people on here are great and very informative. I took over two months before making my surgical decision...

explore every option short of surgery. it's different for everyone- a simple epidural or two may do it for you. traction may do it for you. a nerve root block may do it for you. once you've tried all that, surgery may be your only option- and then you STILL have options.

explore every surgical option short of fusion. I was recommended by 5 conventional neurosurgeons to have fusion at two levels. I am 38 w/a 2 year old and another on the way, and I had serious concerns about doing fusion at a "relatively" young age. once you've done it there's no turning back.

so I began focusing on NON fusion options, figuring that if they didn't work I'd still have fusion as an option. worse case, the minimally invasive option might buy me enough time until they had worked all the kinks out of the artificial disc option and it became commonplace.

plus I've heard that once you go down the fusion road, you're pretty much guaranteed future problems w/the above/below discs- the adjacent level theory. you put more stress on the remaining discs...

I just had a two level acd WITHOUT fusion yesterday down in Lake Worth Fla, with a Dr. Merril Reuter. Perhaps by the time you've explored the other non-surgical option- traction, epidurals etc- I'll be able to tell you if the non fusion route worked!!

YES I researched the LASER SPINE INSTITUTE. they don't take my insurance- United- and told me their procedure would cost $30,000 for the doctor alone. They have since sent me emails that they are now offering different financing options for patients, but that was too little too late for my wallet.

that seemed to be the case w/most of the non invasive facilites/dr's. most don't take insurance and are really expensive. one facility- Dr Jho in Pittsburgh I believe- takes insurance but it's 3-4 months before you can get into see him.

Dr. Reuter was one of the few that was in network with my insurance, and was a cheap flight on southwest away- I live in TN- plus his offices are 15 minutes from where my Aunt lives so I had a free place to stay. I was obviously also very impressed w/his credentials and his staff via emails and phone calls before deciding to come down. I'll let you know in the weeks to come if I still feel like it was worth it!

It sounds like you are still fairly early on in your journey, I would encourage traction and epidurals first. Good luck.

I agree with BW, do as much research as you can.

Although I've had other orthopedic surgeries and back problems, my neck problem is relatively similar to what you describe. I was 37 when the pain started - without any idea of any problmes I woke up one morning in 2003, did a typical light morning yawn/stretch and the next thing you know I had horrid burning pain in my neck, radiating down my left arm and into my thumb and forefinger. My primary care was awful and all he did was give me 100 percocet as a treatment plan. Becuase I couldn't get he or his staff to get me a referral to anyone I ended up going to a chiropractor which gave me some relief, but I was never comfortable with the cracking/stretching they did. Finally I found a new primary care who told me I needed an MRI immediately. It showed I had disc protrusions and stenosis, so I was referred to a neurosurgeon.

The neurosurgoen said at the time I was not a surgical candidate and reccomended a pain management physician. I saw the PM doc and he reccomended Epidural Steroid Injections (ESI) into the discs. It was a relatively easy thing to undergo. One injection every 2 weeks - a series of 3 injections. I would arrive early in the moring, they'd give me light sedation (demerol and versed) as I lay on a table. Before I knew it they had me up and walking into a recovery area with reclining chairs. They'd give me some juice and crackers and I'd go home. I would take it easy for the rest of the day (both due to the sedation and a little pain). I was very lucky that the first time I did the inejections in early 2004 they took away 99% of my pain and worked so well. And all it required was 3 days (I'd take the day off due to the sedation and need to take it easy).

The pain came back in Dec 2005 and I saw the PM doctor again who suggested a second set of injections. He explained that I could do the series of 3 injections twice in a 12 month period. This time the injections "took the edge off" the pain but did not releive the majority of my symptoms. So my Primary Care sent me to an outstanding orhtopedic spine surgeon. I had thought he'd send me to a neurosurgeon but my PCP said that the OSS he was reccomending was great, and would be the only OSS he'd have work in his neck if it was needed. I saw him in April, had an MRI so they could compare it to the one in 2003. The OSS said that I now had bone spurring which was likely the reason that the injections alone weren't going to provide me enough relief. I wanted to put the surgery off until July (I could get a higher level of Short Term Disability pay after being with my employer one year, which would be July of 2006). But, I was having significant pain and numbness in the arm and neck along with numbness in the fingers. So, as the OSS said "You can either have 100% of your pay on STD if you wait until July or you can have 100% of the use of your arm if we operate sooner".

I had a C5-C7 ACDF on 5/18/06. I've had significant pain relief (though not yet 100% of what I'd like to see). But now if I have pain it is relatively brief and not as severe (and my OSS said this is normal since I'm only 3 mo post op and the fusion continues each day). I was in the hosptial 2 nights and out of work 6 weeks.

I guess it was meant to be as 6 weeks after the surgery I was offered a great job. If I had put off the surgery until July I would have been out of commission at the time they wanted me to take the job!

Let me know if I can give you any more information.

Karin
C5-C7 ADCF
5/18/06

Thank you all very much for sharing your personal experiences and information with me. For some strange reason, it calms me knowing there are others out there going through the same (or very similar) struggles that I am. You could probably classify me as one of those typical "take my health for granted" people, but now I have deeper sympathy and understanding for those in constant pain.

Suzy, I absolutely agree with you on making sure "going under the knife" is the last resort to achieving a desired quality of life you seek. Believe me... I will investigate any and all other non-surgical alternatives for making my condition more comfortable before I would ever consider surgery. "Unpinching the nerves is my quest" as you stated and I am anxious to find the best way possible for my own body to recover from the condition that it is currently in.

bw, wow - thanks so much for responding the day after your ACD surgery. I wish you the best recovery and hope this brings you pain free living from here on out. I will investigate more on your suggestion of epidural and traction treatment. I would be extremely interested in the progress of your surgical recovery if there is any way you can keep me updated???

Karin, your scenario seems to resemble mine closer than anyone elses, although I do not have any disc protrusions like yourself... just stenosis. Whether or not that is a good or bad thing, I have no idea. Either way, I need to be able to relieve the cause of my pain, which is pinching of the nerves (more than likely through the C-6 root). Sounds like the epidural worked great for you until the spurs started appearing. This sounds more and more like a promising option for me. Now it also sounds like the surgery has been successfull for you as well:) Like bw, I would be interested in hearing the progress of your recovery too if there is any way you can keep me updated. Couple of quick questions 1) Did you have to wear a brace post op? 2) When you say you had an ACDF, what exactly did they remove to give you relief? Was it just the bony spurs you mentioned or did they remove anything else from the cervical spine area? Sounds like your life is going well and things are working themselves out. Great news on the new job !!!

Many of us here are in our 30's and 40's with no history of previous problems and no accidents, etc. - will write more later.
Yes, sunshine I do see that many here are my age, however many seem to have disc related injuries, spurs, protrusions, etc. rather than just a plain narrowing condition of the spinal canal leading to the same symptoms I am having. With all I have read, most cases of significant degeneration or arthritis appear in older persons rather than someone my age. This may have been something I was born with or my canal just never reached its maximum growth like a normal persons. Seems with all I know so far, I will try every non-surgical route to stop the nerve root pinching which is causing my pain, however if surgery ever becomes an option I am wondering what they could possibly do to offset the narrowing. Perhaps a laminectomy??? Probably to early to worry about stuff like that, especially since I haven't even been to my Neuro appt yet.

Well, all the best to everyone. I will continue my quest for knowledge and check this board frequently. I will also share any information I learn with the people on this board and try to help any newbies with questions I am comfortable answering. Thanks for the inspiration.

- Jimmy B.

jimmy-

happy to try and help. checking my e's and this board is helping to pass the time, Tiger has made the golf tourney today pretty ho hum.

day 2 1/2 update. the brace is driving me CRAZY, mainly because of not being able to shave. the post surgery instructions say I can shower after 48 hours, but neither my wife or I can determine if that means WITH or W/OUT the collar, and whether or not I can shave. Of course it's the w-end so I can't call the doctor's office to ask. So I guess we're both going to put up w/it one more night and call the doctor in the morning to confirm...don't want to risk it.

the vicodan instructions say 6-8 hours, but I'm a fairly big guy and i'm finding the pain starts to kick back in every 5 1/2 hours...

I re-read my first post and realized I didn't really explain my condition. I had disc herniations with bone spurs at C5-6 and C6-7. my main problem was at C6-7- the herniation was hitting the nerve and causing intense pain down my right arm- especially my elbow- whenever I would sit/drive/stand for too long.

the operation was done endoscopically- they went in through the right front of my neck- the hole is barrrrely pinky size in diameter- and removed the nucleus of the two discs- they decided to take care of C5-6 too while they were in there. it's the nucleus that leaks out as I understand it. they injected a gel made from my platelets into the spaces. I guess the idea is that if they remove the part that's herniated the disc will heal and pretty much return to normal. I felt this was a better option for me at this time than fusion.

the doctors didn't feel that my SPURS were the cause of my pain. I guess time will tell.

again though, in my opinion you're a long way from making any surgical decisions...

you'll have to let me know if any of this is making sense, the vicodan has definitely kicked in!

bw

Jimmy:

I did have to wear an aspen cervical collar for 6 weeks after the surgery. My surgeon admitted that this is considered very conservative treatment by some, as some physicians don't require any bracing. But, I'm now actually glad I had the brace. I was limited from moving in ways that may be painful and, in addition, I felt it kept the levels above and below my fusion in better condition and put less stress on them (discs above and below the level of fusioin are always at risk since they begin to take responsbility for more of the flexion and movement of the neck).

An ACDF is an Anterior Cervical Discecomy and Fusion. The surgeon made an incision on the front of my neck (anterior) and removed the discs between vertebrae C5-C6 and C6-C7 (discectomyy). In doing so he then placed bone in the place where the discs had been. He finished off with two plates and four screws (the fusion).

A neurosurgeon or orthopedic spine surgeon will examine you carefully and review the MRI results. I was very happy with my OSS as he led me though the findings with the films in front of us so I could see what was happening and why a fusion would help. I have seen fusion done for some people with stenosis, and I think it will depend in part on any other findings or nerve impingements you are experiencing.

I had hoped that my doctor would be able to do a posterior cervical foraminotomy to relieve pressure but he said I was not a good candidate. There are a variety of procedures out there so hopefully your doctor can discuss all the options with you.

And yes, the ESI's were well worth it while they worked. If they had continued to work I would have done the series of injection 2x a year for as long as I could as it is less invasive than surgery. But, in my case, the surgery was the right move.

Let me know if there's anything else I can answer for you.

Best of Luck

Karin
C5-C7 ACDF 5/18/06

Does Dr. Reuter do the same surgical procedures as Dr. Jho?

I just came across this thread tonight- I haven't been on this board as much lately. I am over one year post op with Dr. Reuter and a minimally invasive procedure for C5/6 and C6/7 herniations, and I am happy to report that I am still doing great....

It's been so long since I did my research, I can't recall the differences/similarities b/w Dr Jho and Dr. Reuter's procedures...

if you search some of my old posts- NON FUSION OPTION, or NON FUSION UPDATE and STILL LOVING NON-FUSION, they go into detail as to what I had done. I guess the best way to find out is to contact those dr's facilities and talk to someone there...

best of luck

bw

bw,

I don't really understand the non-fusion route? Did you have the disk removed? If so, what is keeping this area stable? I'm sure there is something I am missing here. I will need this surgery eventually and am still trying to find a better method than fusion. Thanks for keeping my thread alive !!

bw,

I don't really understand the non-fusion route? Did you have the disk removed? If so, what is keeping this area stable? I'm sure there is something I am missing here. I will need this surgery eventually and am still trying to find a better method than fusion. Thanks for keeping my thread alive !!

hi,i am like you i have many question and i posted them but noone would answer,anyways,i also have cervical stenosis and went to neursurg 2 years ago and he told me the same as you,now my problem is alot worst read my post,but little info i have many hern and bulging and protrding disc,many one the thecal sac and some right one the spinal cord causing deformity(with a large protrusion on central disk)i have to see 2 different neuosurg now cause i have this problom and now i have another one in my right hand bad wrist drop,i have seen the ns about this and he says therpy and come back in 6 weeks and said i had a poor prognois,i was also told the same thing about both problem by my neologist,so i am scared i feel like my life is turned upside down,anyways about the stensois i was born with it and had a wreck that made t worst,they said there is no cure for it not even surgry,because it would keep comming back,so i don't know what the ns is going to say now but i have done the shot no help and therhpy and chiro no help,and look how much worst it got in 2 years i say it time to control this i need some surgry now my stnosis is bad,good luck sorry for spelling i only have 1 hand,keep in touch ,kelsey