Laminectomy/Laminotomy or discectomy??

[Michael_J]

I was diagnosed 6 years ago with congenital cervical spinal stenosis C4-C6. I saw 3 neurosurgeons and 2 orthopeodic surgeons. They all wanted to operate but I went with the neuro who wanted to "watch" the condition & see how it progressed. Have had MRI's each year and a myelogram last year. Hit my head 5 weeks ago, had BIG problems for about 3 weeks, now feeling ok. New MRI shows less than 2mm space from C3-C6 and Neuro wants to take immediate action. Here is my dilemma. He (and his orthopedic) want to take out all 3 disks, fuse the spine and install titanium rods (anterior approach). I had seen another Orthopoedic at Washington U here in St Louis and liked him a lot. He vehemently disagreed with this course of action, citing my age (52) and recommends I undergo a laminectomy or laminotomy. He said that if I were to follow the other course of action that I would eventually have the balance of the disks in my cervical spine fail and I would be dealing with pain meds the rest of my life AND future surgeries due to the compromising of the spine. He says that the only way to make space for the cord is with the laminectomy/otomy, becasue the disks aren't totally "bulging" into the spinal column, he says the problem is a congenitally narrow canal exacerbated by aging issues. I have been putting this off becasue of this difference of opinion and am frozen in what to do. can anyone offer me sound advice on what I need to do?? Also, for note, I do not tolerate pain medications well at all. Appreciate some sound advice that may help me decide which course of acxtion to undertake. Until then, I am sitting on my hands.

[abhijeet v ghosh]

hi friend,
follow your st loius doctor's advice.
He is the best one you can have.

regards

[Michael_J]

I have parathesia in both arms and recently weakness in my right arm. Lifting my arm above my head has recently become difficult. I have even worse issues with my legs, but they can't figure out what is causing that parathesia and weakness. I only get 3-4 hours of interuppted sleep a night due to the leg parethesia-cramping and pain.
Regarding my cervical spine, the issue is whether I go with the on doctor who wants to perform the multi-level discectomy and fusion-rods-etc Or the doctor who wants to perform the laminectomy/laminotomy. The Laminectomy doctor thinks that discectomy is the wrong choice, since it will not (a) provide enough space in the spinal canal and (b) will eventually lead to disk failure at other spinal levels due to.compromising the function of the spine by removal of the disks. The doctors who want to perform the discectomy have not made any mention to me at al about the discectomy compromising the cervical spine. I am so confused. What I fear is if the laminectomy team is right, then even after having a 3 level fusion, I may end up having to have future discectomies when other disks fail AND possibly a laminectomy to address continued encroachment of the spinal canal. I wish someone could set me straight. This has me so confused

[abhijeet v ghosh]

hello Michael,
congenital cervical spine stenosis patients have very good adaptability to adjust to the small space. i also agree with your St Loius doctor who adviced you for Laminectomy,laminotomy.
The main point is - what are your symptoms and how grave is your problem?
Do you have numbness, paresthesia,weakness in your upper limbs or it's just tolerable pain.
So go with your St loius doctor's advice.
regards