What is the treatment for severe cervical spinal stenosis?

Question

Hello doctor,

I am 51 years old. I have been diagnosed with very severe cervical stenosis. I currently have no neurological deficits or pain. However, I have intermittent light numbness and tingling to the head and neck. I am curious if I have more options. My imaging results are as follows:

1) Significant reversal normal lordosis that appears to be congenital and acquired spinal stenosis with severe degenerative disc disease at all levels.

2) There is severe stenosis from C-3 to 4 through C-6 to 7.

3) There is no signal or Chiari malformation. However, there is severe foraminal stenosis at all levels C-3 to 4 through C-6 to 7. Therefore, the current recommendation is to wait for symptoms, and the proposed procedure is second-level disc replacement with second level fusion or third level fusion with one disc replacement.

I was told surgery is not an option until I get symptoms and signs. Is there a risk in waiting? How long could I possibly go at this point before needing surgery? Are there other more successful procedures with the same or better benefit? Is fusion the only option? How much routine pain will you have to endure after the procedure? What is the overall quality of life for a patient with spinal second-level cervical fusion? How significant is a risk there for paralysis or permanent numbness and tingling? My BP is 126/86, P-86, R-18, and temperature is 97.6. I am taking Ritalin, Mobic, Tylenol, Robaxin, and Vitamin tablets. I have attached the report for your reference. Please guide me.

Answer 1

Hi,

Welcome to iclinq.com.

First of all, there is multi-level stenosis in radiology. And regarding the decision about surgery, we have to look at both radiology and the patient's clinical symptoms. At this moment, your radiology (attachments removed to protect the patient's identity) shows a problem, but your clinical symptoms are not bad. So we can wait for surgery.

How long these symptoms will last is purely patient-dependent. It varies from one patient to another. It may take six months to a year. It depends on your lifestyle and physical activity. Fusion is the only option to open the stenosed canal. The success rate of surgery is very good. Pain varies from patient to patient. All surgeries have pros and cons. And the risk is associated with it. But that risk is not as much as compared to the benefit.

I hope this was helpful.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

You must be very careful regarding sports and other activities. Avoid high-impact activities and too much stretching of the neck. You can do exercises under an adequately qualified physiotherapist, who will guide you regarding exercises. I hope this was helpful.