Severe Right Foraminal Stenosis at C5-C6 with large broad bulge osteophyte in foramen & laterally

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My MRI report says severe foraminal stenosis at C5-C6 with a large broad bulge-osteophyte in the foramen and laterally, mild right foraminal stenosis C4-C5, small central protrusions at C6-C7 and T1-T2 without central stenosis. I have severe pain in my right arm, elbow, and hand, along with right side neck pain. I have been losing my balance, feeling dizzy, and (so embarassing) losing bowel and bladder control. Should I have surgery or do I have other non-surgical options? Neurotin, steroids, and vicodin do nothing to ease the constant pain. I have taken 2 weeks off from work hoping that the pain would ease off. I have been an upholstery/leather sewer for 32 years. The time off has not helped at all. The pain is worsening everday. I will be honest, I have researche some of the different websites and forums and have read that the loss of my bladder and bowel control is the last symptom before paralysis. Is this true? Should I have the surgery and will it prevent the incontinence and (if true), possible paralysis? I am so scared of any type of surgery involving my spine.

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  • Posted

    So so sorry to hear about your condition getting worse.   What you report is bad news, and you seem to know that already.  Like you, I have a similar condition but not as severe, and have researched it to the nines, as we say, to know all I can about it.  From what I have read, you no longer just have CS with radiculopathy (nerve pain radiating down your arms is radiculopathy), but have progressed to CS with myelopathy, which means that your spinal cord itself is being impinged upon.   This is a more serious condition.

    So, that if the injections and Prednisone does not phase it, that surgery is your only option, but I am not a doctor or a neurosurgeon.  However, everything I have read indicates that once you have bowel or incontinence issues that you have an urgent situation that needs immediate surgery.  That's the bad news.

    The good news is that the surgery should resolve the myelopathy.  Others can tell you their story, as I am still in the radiculopathy-putting-off-surgery-as-long-as-possible category.  But, I understand that most surgeries work well for this problem.

    It's certainly very, very frightening.   I am scared most of the time now and I am not as bad as you....

    If it is any comfort, the US football player Peyton Manning had 3 neck surgeries, and even played pro football after the first two (although that makes no sense to me).  A friend had the surgery you will likely have and is doing fine several years now with his only post surgery issue being minor irritation when swallowing food or drink.

    The bottom line is I dont think you have a choice now, given what you describe.

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    • Posted

      I am checking out all the neurosurgeons in my area and I have finally found one that I may allow to operate on me. He has a wonderful reputation as a surgeon. I am afraid to have the the surgery but I am afraid not to have it, too. The incontinence really bothers me and I am just 50 years old. I really don't want to end up in a nursing home no earlier than I have to. Thank you for your encouragement and your time to reply to my post. It has been really helpful.
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  • Posted

    I would second the above reply from J91297.  I believe fusion surgery for stenosis is more straightforward than foraminal surgery,  and probably carries less risk in terms of further nerve injury.  Your consultant should be able to determine outcomes and risks before you make your choice.  
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  • Posted

    Hi, I have every sympathy and understand how you feel. I too had all that you describe although I had an operation before I reached the incontinence problem.

    The MRI revealed spinal cord stenosis and osteophytes in the foramen. My mobility was decreasing to the point where a wheelchair would be required. 

    I was told 60% have a good outcome 20% no change or no more deterioration and 20% no improvement. For me logic dictated that not having the operation had two possible outcomes it would either stablise and remain the same or get worse. So a 60% chance of improvement was good enough to justify the operation.

    A posterior cervical laminectomy with screws on 4 1/2 vertebrae was performed in November 2014.  The surgeon also cleared out the foramen spaces. It was done in the back of the neck. I believe they can also do something else from the front. The wound took about two weeks to heal. The immediate impact was relief from some the the pain but not all and my gait is still poor. I have been told it will be 12 ~18 months before I can expect substantial improvement and hopefully it won't deteriorate any further, I will soon start some physiotherapy.

    The point is that it is not nessecarily a quick fix and delay could mean the cord bruising will take longer to heal. I have no doubt that everyones story is different and some will heal quicker than others. I wish you well whatever you decide. 

     

     

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    • Posted

      It's good to read an un-biased appraisal of the surgery.  More often than not,  people tend to talk it up and conveniently, perhaps hopefully, tend towards overlooking the downsides.....when really that's exactly what they should be assessing before any decisions.  My approach would be,  in terms of achieving a balanced prediction, to add 10% extra to any advised downside risk assessment....that might help cancel out any misjudgments based on over-optimistic advise.  It's good to be optimistic about possible outcomes,  but not at the expense of good risk assessment. 
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    • Posted

      Yes one has to make the judgement somehow, but when faced with incontinence, mobility issues, possibly a wheelchair, need for care and help dressing and reaching into the larder etc. One can only hope that the straw you are reaching for is actually sticking out from a life raft !

      Please excuse the cliche.    

       

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