Stenosis neck and back?
This is a very interesting gentleman, who comes to me to see if he really needs surgery for both his neck and his back. It was recommended by two spine surgeons, and he wants my opinion. As you’ll hear and see, this man looks like he has congenital stenosis of his low back and now he’s acquired additional degenerative changes that have severely narrowed his canal, probably making surgical treatment necessary at some point, if not now. As for his neck, it doesn’t look very stenotic to me, but it is kyphotic, and the surgeons may think that surgery is a good idea to protect his spinal cord from future injury. That can be a very reasonable recommendation, but since I don’t think his spinal canal is very narrow, nor his cord compressed, nor his reflexes, and gait indicative of cord pathology, I am going to suggest that he see a third neurosurgeon, someone I’ve known for 17 years, to see if he concurs. There are occasions when I will provide my opinion regarding surgery, without deferring to a surgeon, but this case isn’t one of them. As for his low back, I think he probably needs surgical decompression, but we can decide that after we address the neck surgery question. The reason is that the spinal cord travels down the neck and thoracic region, but ends at the bottom of L1. And the spinal cord is more important than the low back and its nerve roots. So we always
prioritize the neck over the low back in these matters.
In this video, I’ll also address the issue of stenosis. We can use the term in an almost trivial manner to describe any narrowing anywhere in the spine. Or we can use it in a more relevant way to describe a clinical picture in the neck or back, which is potentially surgical. And then, there is also the matter of congenital vs. acquired stenosis, and the combination of both.
Stenosis neck and back?
If I can help you with your neck or back problem, please call me at 404-558-4015.
