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Thread: Spinal canal stenosis and severe neural foraminal narrowing. Should I do surgery???

  1. #1

    Spinal canal stenosis and severe neural foraminal narrowing. Should I do surgery???

    Within the last six months or so I've been experiencing arm numbness and tingling with a very slight reduction in arm strength and sensation when I turn my head to the left or look up in the sky. So I had an MRI done in April, and the results are below. I visited my neurosurgeon at Stanford (Dr. Larry Shuerer) and the only solution is surgery.

    Anyone else with this problem, what was your decision and was the surgery successful?

    Also, can anyone recommend a neurosurgeon at UCSF for a second opinion?

    My main concern is;

    C3-C4: Posterior disc osteophyte complex, uncovertebral hypertrophy and facet arthrosis resulting in moderate spinal canal stenosis, contacting and mildly flattening the spinal cord, and moderate right with severe left neural foraminal narrowing, progressed from the previous exam.

    C5-C6: Posterior disc osteophyte complex, uncovertebral hypertrophy and facet arthrosis resulting in moderate spinal canal stenosis and severe bilateral neural foraminal narrowing, progressed from previous exam.

    Narrative[/h]MRI CERVICAL SPINE WITHOUT CONTRAST: 4/11/2018 13:30

    CLINICAL HISTORY: 44 years of age, Male, with history of quadriplegia following spinal cord injury.

    COMPARISON: MRI cervical spine on 9/12/2012

    PROCEDURE COMMENTS: MRI of the cervical spine was performed without intravenous contrast at 3 Tesla. The following MR sequences were obtained: 3 plane localizer SSFSE, sagittal T2, sagittal T1, sagittal STIR, axial T2, and axial MERGE.

    FINDINGS:

    Alignment: Redemonstrated postsurgical changes of C4-C5 anterior cervical discectomy and fixation. Reversal of normal cervical lordotic curvature in the upper cervical spine.

    Bone marrow: Normal for age.

    Vertebrae: The vertebral body heights are maintained. Multilevel degenerative changes, as follows:

    C2-C3: Minimal posterior disc osteophyte complex mildly effacing the ventral CSF space without significant spinal canal stenosis or neural foraminal narrowing.

    C3-C4: Posterior disc osteophyte complex, uncovertebral hypertrophy and facet arthrosis resulting in moderate spinal canal stenosis, contacting and mildly flattening the spinal cord, and moderate right with severe left neural foraminal narrowing, progressed from the previous exam.

    C4-C5: Small posterior disc osteophyte complex and uncovertebral hypertrophy mildly effacing the ventral CSF space and resulting in mild bilateral neural foraminal narrowing without significant spinal canal stenosis.

    C5-C6: Posterior disc osteophyte complex, uncovertebral hypertrophy and facet arthrosis resulting in moderate spinal canal stenosis and severe bilateral neural foraminal narrowing, progressed from previous exam.

    C6-C7: Minimal uncovertebral hypertrophy and facet arthrosis without significant spinal canal stenosis or neural foraminal narrowing.

    C7-T1: No significant spinal canal stenosis or neural foraminal narrowing.

    Cord: Small syrinx with myelomalacia at the C4-C5 level, similar to the previous exam.

    Extra-vertebral soft tissues: Normal.



  2. #2
    Member BRIDGET77's Avatar
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    Yes, I have stenosis similar to your diagnosis. My Neurosurgeon at Barrow's Neurological Center in Phoenix told me the same thing your Physicians said. Surgery is the only answer. If you hear of any alternatives, please let me know. I wear a collar to help keep my neck from moving too much, up or down. My Physician also trained at UCSF. I wish they used stem cells in their surgeries to prevent scar tissue and help speed up the recovery.
    As always, my best wishes for everyone.

    BRIDGET77

  3. #3
    Look up myelomalacia. You have degenerative disc disease and most surgeons wouldn’t touch you . It says you are Quadra parry ic. Did you get return function after the last surgery? I think you are taking a big chance and you have isteophytes pressing on your cord. Don’t worry about the neural foramina, that won’t paralyze you , just cause pain/numbness. You sure are young to have such an involved spine. UCSF has neurosurgeons that only operate on the spine. Sorry I don’t know the names. CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  4. #4
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    I had a similar diagnosis, controversial because it was based on my measurements and symptoms; My cord was atrophied and no active impingement was visible. I was doing a lot better after the surgery (suboccipital craniectomy and aminectomy through C7), but it left me very vulnerable to damage from every little insult. I wish more than anything that I had asked my surgeon to put in some protective instrumentation. It is not easy surgery, but I think it helped a lot until I fell. I’d gone from wheelchair to forearm crutches until they encountered a wet floor.

  5. #5
    Quote Originally Posted by BRIDGET77 View Post
    Yes, I have stenosis similar to your diagnosis. My Neurosurgeon at Barrow's Neurological Center in Phoenix told me the same thing your Physicians said. Surgery is the only answer. If you hear of any alternatives, please let me know. I wear a collar to help keep my neck from moving too much, up or down. My Physician also trained at UCSF. I wish they used stem cells in their surgeries to prevent scar tissue and help speed up the recovery.
    the neck collar is a great idea, I will certainly pick one up ASAP. And I will certainly let you know by hear of any other alternatives.

    Quote Originally Posted by SCI-Nurse View Post
    Look up myelomalacia. You have degenerative disc disease and most surgeons wouldn’t touch you . It says you are Quadra parry ic. Did you get return function after the last surgery? I think you are taking a big chance and you have isteophytes pressing on your cord. Don’t worry about the neural foramina, that won’t paralyze you , just cause pain/numbness. You sure are young to have such an involved spine. UCSF has neurosurgeons that only operate on the spine. Sorry I don’t know the names. CWO
    Thank you for your input SCI nurse, the only surgery I've had performed was at the time of my injury which is an anterior plate securing my c4-c5 vertebrae. I will definitely avoid any surgery at all cost, but it is pretty frightening to hear that most surgeons will not touch me. Year after year it slowly gets worse......SCI life, ugh!

  6. #6
    Quote Originally Posted by Random View Post
    I had a similar diagnosis, controversial because it was based on my measurements and symptoms; My cord was atrophied and no active impingement was visible. I was doing a lot better after the surgery (suboccipital craniectomy and aminectomy through C7), but it left me very vulnerable to damage from every little insult. I wish more than anything that I had asked my surgeon to put in some protective instrumentation. It is not easy surgery, but I think it helped a lot until I fell. I’d gone from wheelchair to forearm crutches until they encountered a wet floor.
    Hi random, do you mind if I ask how long ago you had the surgery? Also, what sort of protective instrumentation would you have asked for?

  7. #7
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    I’m so sorry for the delay. I had the surgery election day 2000, woke up to what would become the long process that ended with the outcome that resulted in the tragic limitation on stem cell research.

    I’m not sure what could’ve been used, but they must implant some kind of flexible protective thing that would have protected my cord from pressure injuries (where I lacked bone) and tortured injuries. Those are categories I just making up as I try to describe what I imagine. Or what do they use for fusions?

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