Had my visit with the neurosurgeon yesterday, and to my surprise, he tells me I have two herniated discs, along with spinal stenosis. I thought I only had one disc herniated, but he showed me on my MRI where both are....lumbar region but I forget which level. We talked so much, I forget all the technical stuff. Also discussed my neck problems, too. He said he doesn't think I have any pinched nerves, but now wants me to have another MRI of the upper back area to determine why I am having the pain and burning in my right side. He tells me that if I have an operation, it will be "major" with a cage and fusion, and at least 6 months recuperation period. I was upset when I left there, and need to think about our conversation. Nice doc, though, who took the time to explain and answer questions. Thank goodness he is sending me a written report, because I honestly forget everything he said.

But, I am wondering what exactly a "cage" is and what is the purpose of it? Have a follow up appointment after my next MRI, but thought I would ask you all about the cage thing and also what do they do about the stenosis when they operate?

Thanks, all, and I know you will be great on helping me as I have learned so much on here from everyone.

Judy

Hi, Chablis. Not sure on the stenosis, but a cage is what they put between the 2 vertebrae. They fill it with bone material, either from you or from cadaver bone. Sometimes it is coated with something called BMP (bone morphogenic protein -- I think? You can look this up.) The cage is kind of like coral. It's to give structure to the bone to fuse. If you search for images of them on the internet, it might help you get the picture.

Got to go - cookies baking!

Yep..chatter explained the cage very well. Stenosis treatment depends on different things. If you have stenosis due to the canal it sits in (as your nerves run through the spinal column, then they would literally open up the bony space where the nerves were being squeezed. Think of a straw and a wire running through it. The straw being your skeletal spine, and the wire being your nerves. Well, that straw can build up plaque or calcium on the inside making the passageway more narrow in that build up area, and then the wire would not be free to move about there and may also be squeezed.

In order of the wire to be freed up, the straw would have to cleaned and honed out to it's more natural state to allow the wire to sit back into its normal position.

Hope that analogy helps some.

let us know how you are doing.

I was told that they really don't know until they are in if they can get the cage in -- sometimes the opening is too narrow and can cause major nerve damage. Sometimes it just is not worth the risk. I was supposed to have one this last surgery but my surgeon said it was just to risky.

Well, now I know what the heck a "cage" is, and what it does! It gives me the chills thinking of having something like that put into my back! This whole darn thing is making my nerves a wreck, but I guess you all know what I mean, as you guys have been through it. That's interesting, Diet, what you said about the cage and being risky sometimes. I guess the surgeon makes his decisions once he gets in there and sees what is going on.

Justoneofus, you explained the stenosis thing very well; now I understand about that....and Diet and Pepper, now I understand about the cage, although I am picturing this big square thing being put in my back.....like a real cage! Someone else had described it to me as like a "thimble"! Either way, it still makes me queasy.

I'll be back with more questions, I'm sure, but thanks for now!

Judy

That would be normal for you or anyone facing spinal surgery to be nervous and scared and if you weren't I would be worried about you. Just remember that despite all the tests that they run that they do not necessarily show everything. When they get in things may actually look better than they thought initially and you may not need a cage insertion. Your surgeon could get in and decide that you need spacers or more detailed nerve work than he anticipated. The key is that you feel confident in your surgeon and that you have total trust in him.

Don't hesitate to seek 2nd and 3rd opinions.

When you are sitting in the waiting room of his office, discretly chat with the people in the waiting room to find out more information about your doctor. When you are having tests run, talk to the medical personnel. You would be suprised at what you learn. If you are having PT, talk to the therapist find out who they would recommend for a second opinion - they might tell you you have the best or say so and so is really good.

Good luck and if you have any questions don't hesitate to ask - I must admit I love to chat sometimes. :D

Hi Judy

I was just reading your post. I won't go into to detail ( unless you ask ) I just wanted you to know that I have two cages and spacers in my back. I know how overwhelming it is going in and the doctor telling you all these diffrent things! I have tuned out myself hearing about what is going on in my back ect... I wish you the best of luck.

Hi All....hope everyone had a good Christmas; I said Ouch a lot during mine, and didn't sleep too well from all the work! Diet, I hope you are feeling much better and are on the road to recovery. Wanted to mention the neurosurgeon I went to is one of the top surgeons in Delaware, and was recommended by my neice who is an OR nurse. I do have a good feeling about him.....plus he is pretty darn handsome and has a good manner about him! What you said about once the doc gets in there makes sense; I guess things can change one they get a good look. I like to chat too, but fear I will get repremanded if I do it too much on here! Thanks for your advice; I have my MRI tomorrow of the neck and the middle back area, then my visit to the neuro next week. I'll keep you posted!

XZX, thanks for your reply! Gees, with you having 2 cages and spacers, I can get through it having one, huh!! I almost feel like tuning things out too, I sometimes think the less I know, the better off I will be! But yes, I want to ask.....do you feel better, and how are things going with you. Are you still having problems, or did the operation take care of things? I hope it took care of things, of course! Tell me your experience, it would be interesting to hear!

Thanks, and take care.

Judy

Hi Chablis

I had L4 - S1 fusion last Dec. With cages and spacers. I have disk degeneration disease, spinal stenosis in my lower lumbar. The reason for the cages is this: Titanium cages with genetically engineered protien ( also called BMP ) is placed in the lower back to help stablize the spine, also to help create new bone growth. My surgeon explained to me by putting the cages in my back, he would not need to do a bone graft harvest in the hip. So the recovery time is supposed to be reduced. Also, the cages act as structural support while bone grows. The BMP is to help bone grow faster, resulting in fusion faster. Justoneofus explained stenosis really well! during surgery the surgeon removes or adjusts the damaged parts of the spine to relieve the pressure on the nerves roots and or the spinal cord. My back where I had my fusion done does feel lot stronger, and the pain of those levels are mild. I have other problems going on in my back ( don't you just love back problems ) L3 is not good. I have some Thoratic problems going on. Also, I have some neck issues happening. I do understand how all of this can be overwhelming, just take the time to let it sink in and find out what you can about it. My heart goes out to you, I know how you are feeling. I hope that things go well for you. Hugs.

Hey, Chablis:

I have a plastic cage actually filled with bone I donated to myself (from my hip). I couldn't even conceive of what it was when my doc told me about it, but I'm happy to report the cage is doing just fine and before my surgery I visualized a monkey in it just to make myself laugh (sure beats crying, eh?). If you search on line you can probably find a pic of it. Good luck with your decision!

Schragie-girl

Hi XZX and Schragie, Good information from both of you; thanks! It seems that there are so many diffferent ways to do these operations from what I have been reading, like plastic cages and titanium ones, donar bone and cadaver bone, etc. It gets very confusing trying to keep it all in my head. I did go and have my MRI today (neurosurgeon ordered it) of my upper back and my neck. Next step is to go back to talk to the surgeon and then decision time! Glad to hear your back is feeling better, XZX, and hope you get those other problems straightened out. I have the double problem as well....lower back and neck issues.

Schragie, that is funny about the monkey! That's good to hear that your doing well; I like to hear that from people. Hope you continue to do well.

Thanks for all the good information, both of you! I wish I could print this all out so I could file all this info; I have a hard time trying to remember where I posted what sometimes!

Take care,
Judy

Hey Chablis:
We're just a bunch of painiacs hanging out on the boards on a Friday night. I was invited to a b-day party for a good friend but I had an epidural steroid injection this afternoon and am following doc's orders to rest for 24 hours. I am really really really hoping this one lasts for me. I am managing my probs with nerve meds and muscle relaxants these days, and things are looking up.

I was told that if you're relatively healthy it's good to use your own bone. It really depends on the doc though. I had cadaver bone (ew!) for my cervical fusion at age 30 and it healed fine. I used my own hip bone for the lumbar last year and still have some pain problems. By the way, everyone says the ileac crest bone harvest is more painful than the surgery, but that wasn't the case for me and mine healed okay after a few months. I can't even remember which side they took it from unless I poke myself.

The double-whammy of cervical and lumbar problems is a tough cross to bear. I found the back issue much more debilitating because it hurt to sit, sneeze, or even tie my shoes. I became one of those people who drops change on the street and has to let it go because I can't bend to pick it up. WIth the neck, at least I was still mobile, though hurting. (As an aside, my husband's parrot starting saying "oh, my neck" after a while so I must have been complaining an awful lot).

Feel better,
Schragie-girl

Hi Judy, your from Delaware, Oh my!, I'm not that far from you, you definitely need to give me the name of your neuro-surgeon, I'm sure you've read my nightmare with mine on my last visit on the 19th. Your surgeon sounds wonderful. Keep him.

I too agree with you having neck and lumbar issues are so different, and the lumbar issues are more debilitating, I thought when I had neck problems that was bad, boy!, was I wrong, lumbar problems are worse, but then having both problems at the same time is no picnic either.

I would really love to have the name of your surgeon, as I am willing to travel up to DEL if I have it.

Thanks, and you take care, and hope the holidays weren't too hard on you. I know for myself I paid dearly for it for two days after everyone left, and now I have more family coming in for the New Years Eve and Day.
Tulip15

Chablis,

Glad you found the information helpful. You are right, there are quite a few ways to do fusion. My bone came from chips the surgeon took off my spine ( eww ). Good luck in making a decision! Shragie, you made me laugh thinking about the monkey in the cage! I guess I have two in my cages! lol. Hope the epidural brings you some relief! Yeah, the lower back and neck issue's are not fun!
Tulip, sorry you are dealing with a doctor that is not helpful. I hope you find someone who treats you like you deserve to be treated. Take it easy with the company coming in! I know the extra strain on the back during the holidays is hard, some people don't get it either. Just take care of yourself.

Hello Everyone. Just read all the nice posts, and the good information! Gees, 10 years ago I would have never thought I would be sitting here complaining about back and neck problems; how things do change! Schargie, glad your feeling better with the meds and muscle relaxers, that's good news! I love what your hubby's parrot says!! I received one of those massage cushions, has heat and massages up and down your back like fingers. My daughter got it for me for Christmas. I find it really helps relax my back and if I use it before bedtime, I can get to sleep a lot better. Still wake up during the night and have to pop a pill or use pain rub, but the cushion is nice!

Yes, Tulip, I am in Newark, DE. I only had one visit with this surgeon, but I did like him right away because he spent the time talking to me and explaining things, and answered all my questions. Am I allowed to post his name on here? If it is ok, let me know, and I will give it to you on my next post. He is in with a group of surgeons. As I said, my neice knows a lot about the doctors being an OR nurse, so I was comfy going to him. I didn't read about your visit with yours, but I am going to.

XZX, hope your well and I will make a decision after my appointment on the 21st of this month. I am glad the holidays are over; all that extra work hurt!!

Take care everyone, and see you all again soon.

Judy

Judy you may post his name, city and town of the doctor. No telephone numbers.

When is your next appt with the neurosurgeon?

Thanks Pepper, I did finally read the rules of posting; I should have done that long ago! I posted a note to Tulip telling her the name of my surgeon, but I can't find it now! I will have to look again and see if it is there. My follow up appointment is January 21. He will go over my MRI results and let me know what he thinks...and then comes the time for me to do my deep thinking on what to do. That's going to be sooo hard as you and many on here know.

Hope your feeling better and getting along well. Take care of yourself.

Judy