2nd appointment for injections for spinal stenosis

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Hi,

Going into hospital this week for a second round of spinal injections. Last time it worked really well and I was something like 80-90% down on pain levels for about 9-10 months. I was advised that they now only use a local anaesthetic but they told me that last time and I still went out like a light :-).

I'm hoping this time round it will work as well as last time but I wonder if I should push for the full operation to clear the blockage / narrowing of the spinal canal that's causing the problem?

I'd appreciate hearing from anyone who has had the full operation and, obviously, their outcome.

I suspect that my pain levels are probably not considered high enough for the operation but, even with self-assessed pain measuring 5-7 /10 and a gait like Stumpy in Rio Bravo, it's still causing mobility problems in everyday life. I would have thought that catching it early, i.e. before pain levels reach 10/10, would be a better use of the NHS's funds? Also less risk of nerves being permanently damaged?

I'm also suffering from mild arthritis in most joints and a specialist who reviewed my MRI results said I'd probably need my hips "doing" at some point :-( . He also said that they might do the spinal operation AND hip replacement at the same time!!

Cheers,

Stuart

PS, I made this mistake of watching hip replacement surgery on YouTube.......

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  • Posted

    Hello Stuart...............

    I had had some leg pain for a few months, check for rhuematism - not that.

    Then physio. and a sciatic pain started..............

    To get a quick result i went for a private diagnosis & a mri scan..............

    Neuro guy advised likely spinal stenosis which it is L3 L4 C but more significant - ' csm- cervical spondylotic myelopathy c5 c6 with spinal compression '

    This he advises urgent and a fusion of c5 c6 due in 3 weeks - but the micro keyhole surgery as to wait... this still leaves me only able to walk a few hundred yards and standing in a supermarket is awful - calf burning pain...........

    I knew nothing of the csm - although with research yes have the balance prob- slightly, clumsiness rare too, and handwriting a bit wobly!!

    I can sit though but fell my life is on hold- i am a keen walker and active... No idea waht the trav insurance will be afterwards !! as i like to travel- could you advise on that after your injections and i am sure trav ins will want to know!!!

    kind regards Ches guy - A.

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    • Posted

      Hi, I'll let you know how I get on this time round.

      I started with a diagnosis of sciatica and was told to take co-codamol (30mg codeine) 2x4 times a day "indefinately". In another post perhaps I'll explain where that led to before I decided to take myself off them after 4 years...

      After co-codamol and, pretty much, just trying to bear the pain (I did try a few others inclusing Tramadol and Amitriptyline)  I suddenly found the pain had reduced significantly but I developed an altered gait (a limp and unable to walk in a sttraight line!). It was a new GP and a new surgery who told me that he didn't like my symptoms and that's how I ended up having an MRI scan and seeing a specialist who diagnosed "a congenitally small spinal canal with a severe central and lateral recess stenosis at the L4/5 level. The right neural foramina is also significantly narrowed and the patient has a slightly dysplastic hip on the right side with large osteophytes and impingement in abduction, flexion and external rotation." Bit of a mouthfull!

      Although I have fairly constant pain, it is nothing like as bad as the pain I sometimes got from sciatica a few years back. I remeber not being able to drive to my daughter's wedding and the relief I got when I stood up to make my speech after sitting down for a couple of hours.

      I've had physio several times but it doesn't seem to have helped much. The only thing I've had to stop doing is cycling but I'm going to try that again after the injections take effect.

      Can't help on the travel insurance angle as I don't travel much although the last time I went to the US to do the Disney / Universal tour I declared everything and had no problems. Well, no problems insurance-wise, I wouldn't suggest that particular holiday to anyone suffering with sciatica though!

      Cheers

      Stuart

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    • Posted

      Thanks Stuart.. i have amitripyline and it certainly helps at night ( i went to a&e one weekend) as the pain was so great- the dr there knew exactly what i needed.... thanks for the info on travel- i had to cancel an italy trip in July - the insurance did pay out and the airline is allowing the full air ticket ££ to another next year which is good rather than claiming.

      Only when the specialist is happy with me will he do the spinal stenosis - no idea when, I have read up on the subjects and the cervical op could actually relieve & allieviate some of the spina lumbar conditions, if it does then that might make that i could walk a bit further and even stand for a bit longer.

      All this is so frustrating as do work although semi retired( but really enjoy the small job i have in retail ) and i go walking in a walking group !! so all this is on hold till both are fixed

      kind regards

      Cheshire guy- A

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    • Posted

      Stuart and Cheshire ~

      I'm not sure but if you haven't read the side effects on amitripyline one can be blurry vision.  I developed that and it gave me headaches...which amitripyline was supposed to help with the headaches.  So, if you haven't read the effects...just keep an eye out for that symptom (no pun intended) :P  Hope both are feeling well.

      Frustrated

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  • Posted

    Hi Stuart

    You didn't say what levels of your spine are effected.  I was in an auto accident breaking my back and injuries of the neck. I had the surgery for my back L2-S1 and the outcome of it was (according to the doctor)good.  According to me, not so much. I realized that I didn't have much choice but to have the surgery but it didn't get rid of my pain.  Not to say if you had it, the same would happen.  My surgery was classiified as "failed back surgery syndrome" meaning the surgery went well but the pain issue wasn't resolved.

    I still have to go for injections to relieve some of the pain.  I have an excellent pain management doctor and he goes right to the source.  I am always under sedation as I couldn't handle 7-9 injections w/o it. 

    All I can suggest is, follow what you and your doctor agree on.  I do agree with you that getting to the source before permanent damage to the nerves is a good thing.  Ask your doctor how many operations ended up with "failed back surgery syndrome".  That may help you decide which doctor to go with and if in fact you want to have the surgery.  Whatever you do, do not get the "laser treatment" that's supposedly "noevasive".  What it does is shaves away the bone making that area subject to breakage, it actually thins that area of bone...ie: my back in the auto accident was fragile (unbeknownst to me) and that's why it broke so easily.  The doctor I use was one of the doctors that invented (lack of a better word) that system and he said to me they do not use that lazer treatment anymore for the reasons I stated.  I had the lazer surgery by a different surgeon. 

    Anyway, I sure wish you well.  let us know what you've decided and what the outcome is.  I didn't want to put fear into your mind...just wanted to give you some things to ask your doctor.

    Good luck

    Frustrated

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    • Posted

      One more thing.  I also had surgery six months later on my cervical C4-5 &6.  That outcome was better and I only have mild pain and mild stiffness.  Again, good luck. 

      cheshireguy   ~ as far as travel insurance, my health insurance takes care of travel injuries but they have to be notified w/i 48 hours prior to any surgeries unless it's deemend life threatening.  I guess each policy is different. You may just want to phone the insurance carrier and ask them what it covers during travel, if any.  And if they don't, what they suggest you do with travel insurance. 

      Good luck to both of you!

      Frustrated         

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    • Posted

      Hi frustrated,

      As it happens I put my full diagnosis in a reply above (probably after you posted and before I read it!). Thanks for the info, no mention of non-invasive laser surgery so far but I'll make a note to avoid that!

      My wife counted 12 injection sites last time and I don't remember a thing although the nurse told me I'd be awake throughout the procedure but only just. Last thing I remember is being asked to roll onto the operating table from the gurney, my gown being opened and that was it until the recovery room and hour or so later. I was rather hoping for the same this time but I'll soon find out!

      Stuart

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    • Posted

      Hi Stuart ~

      Are you able to request sedation during your procedures?  My hopes is that you are given it as why add more stress to a uncomfy situation you're currently in.  In the very least, you'll have a good sleep :P  I mentioned that because sometimes I cannot sleep and almost look forward to being sedated for that extra bonus.

      Take care and be well

      Frustrated

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    • Posted

      HI Stuart ~

      Once I was established with the pain doctor and decided to go with him all the time, their office took care of the referrals along with the sedation.  Check with the office and see if they provide that service to you as well.  Would save a lot of headaches on your part!

      Good luck

      Frustrated

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  • Posted

    Hi Stuart,

    I have a long post here and maybe you can read that so you'll know my situation. If you don't see it, let me know and I'll paste in again. I live in the US. 

    I had L4, 5, S1 surgery done. Spondylolisthesis L5. I can tell you that my surgery was done when my average pain was 5 or 6 but I had episodes of 8 to 10 intermittently. Stenosis can be dangerous if it narrows too much of your spinal cord. Surgery is probably your best option. I had the full incision. My neurosurgeon said he doesn't do non-invasive for lumbar surgery involving three vertebrae. He said they need to see all the nerves and have room to work with the screws and rods.

    At three months postop, I'm doing pretty well, but have more pain on my left side than right. Muscles in the left buttock and then aches in the left leg. Intermittent and spotty… Anywhere from the hip into the foot. This is the leg that I suffered so much with sciatic pain with, So I'm pretty concerned about that. It's not stabbing pain, and I'm hopeful this will diminish. I see my doctor September 11.

    Good luck and do let us know how you're doing.

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    • Posted

      Hi Donna ~

      I agree with you regarding not doing non-evasive surgery for the lumbar...I initially had the "non evasive" surgery for one foreman opening.  It was because of that surgery that my back problem became worse when I had the auto accident.  That required surgery to the L4-S1.  After a few years, the L3 became a problem requiring surgery as the foreman became very narrow pressing down causing excruciating pain down my left leg.  The surgeon had to undo the L4 level to brace the L3 to L2 and L4.  I'm still in a lot of pain but it's being treated with pain injections.  They help but not for a long period of time. 

      Don't know what's next as I was in another auto accident this past 2013 and my right groin area is involved.  That sypmtom is being problematic because of the L1 &2.  I just hope it can be taken care of.  After having surgery on the L2, it seemed to take care of the problem of chronic leg pain in my left leg...however the L4-S1 and S1joints are causing a great deal of pain.  I too have nerve pain in my left leg and buttock along with downt he side of my leg to the knee then it stops and picks back up on the ankle to the baby toe through to the middle toe.  I'm confusing myself  lol.

      Anyway, take care!

      Frustrated

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