Hello 👋

I have Cervical cord compression, and my neurosurgeon has recommended ACDF surgery.

I'm feeling pretty anxious, especially about the risk of adjacent segment disease (ASD). I've read a lot about it online, and it's honestly making me nervous.

If you've had ACDF, I'd really appreciate hearing about your experience.

- How was your recovery?

- How long did it take before you started feeling better?

- Did your symptoms improve after surgery?

- Have you developed ASD or any other long-term complications? If so, how long after your surgery?

- Is there anything you wish you had known before having ACDF?

I'm trying to make the best decision possible, and hearing real experiences from people who've been through it would really help.

Thank you so much for sharing your experience.

35M here.

History

At age 19 I once injured my lower back by trying to lift super heavy furniture. Since then I've had sciatica that has been mild / moderate and easily manageable. I mostly only had pain down the right leg and no back pain. About 3 years ago when I first did core exercises religiously for 2 weeks, my sciatica completely disappeared for the first time ever and it was great.

Current state

But about 8 months ago, the latest "flare-up" started which has been very persistent and only gotten a bit worse. I can't walk more than 2-3 mins without the pain really building. I could play pickleball great but as of lately that's been tough too and for the past week sleeping has been painful and I've been sleeping 2 hours less per night even with advil. In general flexion helps but lately I've had this mild to moderate pain sometimes even in flexion, particularly behind my knee or on the outer/back of thigh, so there may be an acute sciatica component or some new nerve irritaiton, idk. The MRI this week vs 6 months ago actually seem to be almost identical, no clear worsening (but symptoms have improved, then lately worsened even more).

MRI

https://preview.redd.it/058zbsky3cbh1.png?width=2354&format=png&auto=webp&s=f5a29cf0d161dc01121b46b4006150501385ce7c

https://preview.redd.it/c80hkmfe4cbh1.png?width=2348&format=png&auto=webp&s=63b267485f4d375fc98ab6b4d52e556f6cfa44ac

https://preview.redd.it/qwvebujv4cbh1.png?width=2348&format=png&auto=webp&s=293a3b9b4bb63508963c713e71cc517ccb8dc81e

https://preview.redd.it/yrlwa1gw4cbh1.png?width=2348&format=png&auto=webp&s=6127949f886e8a79953d1d32992f583f59ec81b0

What I tried

Meloxicam didn't do anything. Medrol pack reduced pain a lot but made the numbness much more apparently; I guess I'd call it an overall mild to moderate improvement. ESI might have resulted in partial improvement but not more than 30%. I did PT here and there but honestly didn't do it properly or religiously because of a) pain b) lack of motivation / signal that it'll help and c) possibly aggravated nerve in doing so. Inversion table also seemed to help the very first time I did it for 10 mins but since then I haven't exprienced that improvement and it seems to just aggravate the nerve. In fact in the past 2 weeks or so most things seem to aggravate my nerve very easily, even things that might otherwise help, like inversion table or PT.

What to do next?

I can:

a) Get an ESI again, go see this new PT who's supposed to be more of a spine expert, and give that a month. But honestly my life is miserable right now - extremely limited and eating a lot and inactive and putting on weight. I still go and play pickleball and push through some pain / take breaks / alter my stance etc and can cycle and can workout at the gym with care. But the limitation sucks. If there is a real chance I can get to much better function without surgery (say 15 mins walking tolerance) after a month or max two of PT, I'd treat that as a win. But if it's unlikely, I wouldn't want to waste my time.

b) Get the decompression surgery.

What do you think? Is there a good chance conservative care will help?

tl;dr - 35M, mild sciatica for 15 years, major walking intolerance for 6-8 months, some up and down in symptoms but nothing clearly helped including ESI (didn't do PT very religiously). Is there hope for conservative care? Or should I jump to decompression surgery?

Curious if anyone who has had a fusion can recommend any surgeons in northern Cali, specifically the Bay area or surrounding? I have
L5-S1 spondy that is only Grade 1 (they think) but i cannot stand
Or walk for even 10 minutes without major pain and foot and left pain and numbness. It's getting worse not better.
thanks:)

I had my MRI yesterday.

The MRI found two disc problems that are likely causing my symptoms:

\- L4-5 level: A disc is bulging/extruding out on the left side, which may be pressing on the nerve that runs down toward your left leg/groin (the L5 nerve).

\- L5-S1 level: A disc is extruding on the right side and is pressing on and pushing aside a nerve there (the S1 nerve).

There’s also mild wear and tear (disc degeneration, a small tear in one disc, and some joint arthritis) at those levels, plus mild narrowing of the spinal canal at L4-5 (nothing severe, apparently)

The report specifically flags disc extrusions and nerve compression as the “clinically significant” findings, meaning these are likely the actual source of my “radiculopathy” (nerve pain/numbness) symptoms, especially the left groin pain I’ve been having despite 5 months of physical therapy.

So….. I have two herniated (“extruded”) discs in my lower back that are pinching nearby nerves, (YAY) which explains the ongoing pain. Nothing on the scan suggests an emergency or trauma (no fracture, no severe stenosis), but since PT hasn’t resolved it, this is something I’ll need to talk with my doctor about. Not sure about next steps (such as injections, further specialist evaluation, or surgical options).

Hello

The last 4 months have been problematic to say the least. I am 60 yrs old, now retired & have had bouts of back/hip pain for years. In Feb this year I had a sudden onset of sciatica symptoms through left buttock down to my toes.

There has not been a pain free day in 4 months. I do take Celebrex, Pregabalin & Panadeine Forte. Trying to stay as active as possible. Finances are really tight so have not been to PT yet.

In your experience with stenosis, doe PT really help, or just aggravate your symptoms?

https://preview.redd.it/h8882lpxixah1.jpg?width=994&format=pjpg&auto=webp&s=3780228d068bbbe046bef777b12cba94ce6bfd31

I'm a 35-year-old male trying to decide whether to undergo cervical spine surgery now or continue monitoring. I've seen a spine surgeon and have had multiple discussions with him, but I'd really appreciate hearing from people who've been through something similar.

MRI Impression

• Congenital block vertebrae at C3–C4.
• Multilevel degenerative disc disease with spinal cord and nerve root compression.
• Severe cervical spinal canal stenosis, which becomes even more pronounced when my neck is extended.
• My surgeon told me that there is virtually no cerebrospinal fluid (CSF) left around my spinal cord at the most compressed level, meaning the cord is almost completely surrounded by bone/disc rather than its normal protective fluid.
• T2 hyperintensity within the spinal cord at C5/C5–6, consistent with compressive myelopathy.

My symptoms

• Most of my hand symptoms have been present for around 4 years.
• Constant numbness/tingling in my ring and little fingers on both hands.
• Clawing of my right hand with muscle wasting in the palm below my little finger (my doctors think this may also be related to a separate ulnar nerve issue).
• My left triceps muscle twitches/fasciculates if I bend my elbow to a certain angle and hold it there.
• Occasional knee buckling, which I've only noticed relatively recently, although I'm not sure exactly when it started.
• Leg stifness, feel rigid at times. Numbess if i stand in the same place for 5 minutes
• subtle balance changes on one leg that I'm not even sure are related. impossible to wear shoes using just 1 leg
• No major weakness.
• I can still work full-time, drive, go to the gym, and play badminton.
• I occasionally wake up from sleep because an entire hand (and sometimes the area below my wrist) becomes extremely numb. It usually improves after changing position or moving my arm.

Neurological examination

• Positive Hoffmann's sign.
• Positive Babinski response, more pronounced on the left.
• Other neurological examination findings were also more abnormal on the left side.

What my surgeon said

• This is not an emergency.
• I'll likely need surgery at some point in my life.
• I could choose surgery now or continue monitoring with follow-up every 6 months.
• Waiting carries the risk of further spinal cord damage, and any neurological deterioration may not be completely reversible.
• Surgery is intended to prevent further neurological decline, not necessarily reverse existing spinal cord damage.

He has left the decision to me because my symptoms are still relatively mild and I'm functioning well day to day.

My dilemma

This is one of the hardest decisions I've ever had to make.

On one hand, I'm only 35 and I'm still active. If surgery can preserve my current neurological function before things worsen, it seems like a good opportunity.

On the other hand, surgery has its own risks, and once a fusion is done there's no going back. Since this isn't considered an emergency, I wonder if I'm operating too early.

I feel caught between:

• having surgery before it's absolutely necessary, or
• waiting too long and missing the chance to prevent permanent spinal cord damage.

My questions

1. Did anyone here have surgery while their symptoms were still considered mild?
2. Looking back, are you glad you had surgery early?
3. Did anyone decide to wait? If so, how did that work out?
4. If your MRI looked much worse than your symptoms, what ultimately influenced your decision?
5. Has anyone regretted either having surgery too early or waiting too long?

I'm not looking for medical advice instead of my surgeon's opinion. I'm simply hoping to hear real experiences from people who've faced a similar decision, because it's been mentally exhausting trying to figure out the right path.

Thank you for taking the time to read this.

Is there anyone else on this thread with congenital lumbar stenosis? Has anything helped alleviate your pain? I’ve seen multiple surgeons who say there isn’t a fix for my particular issue, so I currently manage with pain medication. The last surgeon suggested a spinal cord stimulator implant. I also have psoriatic arthritis which causes joint inflammation and increases my back pain.

I feel so hopeless.

I had my follow up with an orthopedic doctor to go over my MRI this morning. MRI report said I have bulging discs at c5-c7, including an annular tear, and broad based osteophyte complex at c6-c7 causing moderate cord deformity and significant central stenosis, effacement of CFS, and moderate foraminal stenosis. Looking at the images in the office, the problem area has minimal CSF space all around, and a top view section shows only a tiny sliver of it on one side, and none on the other, where the cord is being compressed. The cord compression in that image looks like a full quarter of the spinal cord is missing because it's being pressed in.

I've been having symptoms like frequent headaches (some orthostatic), severe fatigue and brain fog for several years now. 4-5 months ago, my arms and hands started feeling tingly, which has progressed to feeling tingly 24/7, shooting pain, clumsiness in my hands, and major weakness. I've recently developed double vision (eye doctor confirmed cause is not from my eyes), and balance issues. I've actually fallen a couple times.

According to my doctor, the only problem caused by the stenosis and cord compression is the arm/hand issues. She said the loss of balance can't be from it, because the cord is only compressed and not "damaged", since there is no color change to the area. She said the debilitating fatigue and brain fog aren't from it, either, but maybe from meds or POTS.

She also said that the double vision is something else, because those nerves are higher up. I asked if the reduced CSF flow could cause it, and she insisted that since CSF flow isn't COMPLETELY blocked, it can't cause a problem.

This goes against everything I have read on these issues, but I'm not a doctor, so I don't know if I'm being ridiculous, or if she is. I do have a consult with a surgeon, but I'm worried that will also get me nowhere if the doctor is right about everything.

I cannot continue to live like this, and I need to know if my symptoms really are caused by something else, or if surgery for this could improve my quality of life. Is there still hope, or do I just give up and assume this is my life now? Hoping to hear from people who have experienced these issues.

Hello I’m 22 and I was diagnosed with cervical spinal stenosis when I was 16. Pain has always been chronic throughout most of my life sometimes it’s better while other times it’s much worse but the pain has never fully gone away. I’ve been able to manage the pain for a while but the past couple years have been rough and I’m sick of the pain and the flare ups. I tried to go to a spine surgeon but he told me to get a recent MRI and my pcp told me I have to get PT to get an MRI I went 3 times recently but was unable to continue due to my work schedule and lack of transportation. I asked my doctor if I could be directly referred to a neurosurgeon and I’m still waiting on a response. If that doesn’t work then what else can I do since I’m unable to continue pt at least for now and it didn’t help at all anyways nor has it in the past? This is mostly a rant but if you have any answers for me go for it. I’m just sick of being in pain all of time and having trouble moving around. I’m in my 20s I should not be struggling as much as I am.

I'm a 35-year-old male trying to decide whether to undergo cervical spine surgery now or continue monitoring. I've seen a spine surgeon and have had multiple discussions with him, but I'd really appreciate hearing from people who've been through something similar.

MRI Impression

• Congenital block vertebrae at C3–C4.
• Multilevel degenerative disc disease with spinal cord and nerve root compression.
• Severe cervical spinal canal stenosis, which becomes even more pronounced when my neck is extended.
• My surgeon told me that there is virtually no cerebrospinal fluid (CSF) left around my spinal cord at the most compressed level, meaning the cord is almost completely surrounded by bone/disc rather than its normal protective fluid.
• T2 hyperintensity within the spinal cord at C5/C5–6, consistent with compressive myelopathy.

My symptoms

• Most of my hand symptoms have been present for around 4 years.
• Constant numbness/tingling in my ring and little fingers on both hands.
• Clawing of my right hand with muscle wasting in the palm below my little finger (my doctors think this may also be related to a separate ulnar nerve issue).
• My left triceps muscle twitches/fasciculates if I bend my elbow to a certain angle and hold it there.
• Occasional knee buckling, which I've only noticed relatively recently, although I'm not sure exactly when it started.
• Leg stifness, feel rigid at times. Numbess if i stand in the same place for 5 minutes
• subtle balance changes on one leg that I'm not even sure are related. impossible to wear shoes using just 1 leg
• No major weakness.
• I can still work full-time, drive, go to the gym, and play badminton.
• I occasionally wake up from sleep because an entire hand (and sometimes the area below my wrist) becomes extremely numb. It usually improves after changing position or moving my arm.

Neurological examination

• Positive Hoffmann's sign.
• Positive Babinski response, more pronounced on the left.
• Other neurological examination findings were also more abnormal on the left side.

What my surgeon said

• This is not an emergency.
• I'll likely need surgery at some point in my life.
• I could choose surgery now or continue monitoring with follow-up every 6 months.
• Waiting carries the risk of further spinal cord damage, and any neurological deterioration may not be completely reversible.
• Surgery is intended to prevent further neurological decline, not necessarily reverse existing spinal cord damage.

He has left the decision to me because my symptoms are still relatively mild and I'm functioning well day to day.

My dilemma

This is one of the hardest decisions I've ever had to make.

On one hand, I'm only 35 and I'm still active. If surgery can preserve my current neurological function before things worsen, it seems like a good opportunity.

On the other hand, surgery has its own risks, and once a fusion is done there's no going back. Since this isn't considered an emergency, I wonder if I'm operating too early.

I feel caught between:

• having surgery before it's absolutely necessary, or
• waiting too long and missing the chance to prevent permanent spinal cord damage.

My questions

1. Did anyone here have surgery while their symptoms were still considered mild?
2. Looking back, are you glad you had surgery early?
3. Did anyone decide to wait? If so, how did that work out?
4. If your MRI looked much worse than your symptoms, what ultimately influenced your decision?
5. Has anyone regretted either having surgery too early or waiting too long?

I'm not looking for medical advice instead of my surgeon's opinion. I'm simply hoping to hear real experiences from people who've faced a similar decision, because it's been mentally exhausting trying to figure out the right path.

Thank you for taking the time to read this.

I had an hip MRI yesterday. Because of the position I had to lie in, an inflamed nerve was painfully compressed for over 20 minutes. I am suffering today as a consequence.

I have a lumbar MRI tomorrow. Is there anything that can be done to help make it less painful?

Osteophytes involved,too..

this is where I am headed to stop the neck pain..

How brutal of an operation is this?

How long is the recovery..?

Can bad thing happen making things worse?

Please advise.

Thanks

I have lumbar stenosis with some nerve damage I also have 2 fractures in my spine. My legs are pretty weak. I am also unstable when I walk like I could fall any moment. Climbing up and down stairs are not easy for me. When I climb up stairs, I have to grab the railing sometimes with both of my hands on a bad day and pull myself up. I am scheduled for surgery the first week of August. I have two large breed dogs and last week our sliding back door broke so I can't get it open anymore. Our backyard is gated so when the back door opens, I can just let my dogs run no issues. But since it broke, I have been getting my dad to take them out. But over the fourth of July weekend my dad is leaving town so if our door is not fixed my then it is on me to take them out. I attempted to take one of them out the day our door broke but it is physically impossible to climb up and down the stairs to my house with a dog in tow especially since they not listening once we are outside and they pull. Honestly, I am scared to try to climb down the stairs will a dog again, I don't want to get pulled down the stairs. Do anyone have any advice how to safely take dogs outside with this condition?

Looking for any advice. My mom is 85 and has stenosis and sciatic nerve problems. She is not a candidate for surgery. She's had injections and nerve blocks. Nothing helps. She's on pain management, but even the pills don't do much. Is there something out there that's new or we have not been told about yet?

Ok so after going thru a few hospitals in Massachusetts and getting no response to a response of “Dr is not taking on complicated cases “ I tried a dr in New York with a social media follow and have followed for the past year . Got call yesterday that Dr Riew has accepted my case! So, besides after surgery care, what else do I need to worry about being out of state?