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Posted by Gary
In Reply to: Stenosis / Back Surgery - What type of physician to use... neurosurgeons vs. orthopedic surgeons posted by ohaya
Hi Ohaya (for lack of a better name),
Deciding on surgery is a most difficult decision, particularly when it
involves the spine.
It should be a last desperate measure at resolving a problem.
Stenosis is the progressive closure of passageways, in your case(and mine),
in the vertebrate. It is abnormal bone growth inwards toward the nerves.
This closure strangles the nerves and prevents thier function. Once the
nerves are damaged there is no going back-it is a done deal. If this growth
occurs in the spinal column it troubles the spinal cord and affects all
function below that point. If it occurs in the foraminal openings ( the
holes through which segments of nerves pass to body parts from the spinal
cord), then problems occur to those particular parts. Generally, before
surgery is recommended, some testing will be performed to try to determine
the extent of nerve invovement.
Physical therapy is an opening attempt to resolve the problem and with
stenosis I don't see how it would be of any help. Steroids can be of some
use, I have read, if the stenosis is not too severe. I have a manager at
work who resolved his problem in this manner and has been fine since(years).
The steroids "melt" the bone to create a larger opening. Obviously, much
less invasive than surgery.
Which type of surgeon is best? Someone who "specializes" in back surgery and
is very competent at that specialty. I was referred to a neuro by a general
surgeon (not an ortho). Why? Don't know, I assumed because my spine was
involved. He was a real jerk, but turned out to be an excellant craftsman.
He even impressed himself with me (he didn't think I was going to come out
in one piece from the surgery). I am happy I had it done.
If your opening is almost completely closed, I suspect he is trying to be
easy on you recommending surgery. Do you trust this guy? Do you know him?
Regardless, get a second opinion (maybe from a neuro), then compare the
options you are presented.
In my case, they removed a couple of discs, cleaned out the stenosis, and
fused the vertebrate to stabilize the spine. I assume that is to prevent
further development of the stenosis and also because there is no more disc
material. I read stenosis is a progressive disease. My neuro claims that the
surgery halts the progression. I don't know.
All this said......I am not a physician, just someone who has gone through
this. I am not an expert. Your doctors are. Listen to them carefully. All
surgery carrys much risk and anything can happen.
Gary
P.S. I am 50 yrs old (if that helps)
