UKC

I've been offered a Lumbar Decompression operation to reduce my Spinal Stenosis. Current symptoms are numbness and tingling in both legs - from toes up to buttocks - which comes on when standing, walking or running. It's steadily getting worse and is now starting to affect my climbing too.

Just wondered if anyone else has had this operation, and what the outcomes were, particularly in regards to continuing to run and climb. Also anyone with the same condition who has found non-surgical therapies that work - eg exercise regimes.

Many thanks to anyone in a position to respond.

Martin

In reply to Martin Hore:
Well that's a coincidence, us oldies, eh? Yes, but as yet not operated.

Symptoms: Numbness in the left leg down the front of the thigh and down the front and outside of the lower leg in varying degrees. When it's bad it affects the knee as well and at this point I lose power in that leg and it gives way - difficult to step up or step down without support. This at first was brought on simply by standing or walking on the flat (washing up or wandering around a supermarket...!). Walking uphill or on varying terrain less so, but as it's progressed it's starting to happen on any terrain. It is the crural nerve that is affected. After a prolonged period of standing up, my lower back becomes stiff and painful around my waistline. Both these symptoms can be eased by sitting for a few minutes. The right leg remains unaffected as far as numbness is concerned though I do get a cramp like pain down into the gluteus medius though this could be a tendinitis but I'm now starting to suspect it's not. My climbing is largely unaffected and in fact I believe it's beneficial due to the twisting/stretching nature of it, and in fact I'm climbing better now than for the last ten years or so.

I've seen two surgeons.

The first told me: 'I you don't do anything about it pretty quick you'll no longer be able to walk. I propose fusing L 3,4 and 5 with screws and bars and stuff. I can do it in six weeks time. Sign here (and give me lots of money)'

The second disagreed a little with the first one's diagnosis and proposed simply enlarging the channel, no fusing and wasn't urgent.

This all happened about 2 1/2 years ago and while it is a bit worse I'm far from paralysed and unable to walk! I think eventually I'll have to bite the bullet and have it done, but it'll be with the second surgeon, not the first.

In reply to JTM:

Many thanks Jon. Yes, that is quite a co-incidence.

I've started to feel the symptoms when climbing, but only on easy stuff. As soon the climbing gets at all hard (that's VS and up for me) I concentrate on the climbing and forget the discomfort. Also the specialists I've seen concur that the bending and flexing of the back involved in climbing should relieve the symptoms. Right now it's the running (orienteering mostly for me) that is starting to be badly affected. Hill-walking also to an extent, but the heavier the pack the less the problem (so no problem taking all the gear to fill at least 7 gear loops!). Cycling is no problem at all. And, as you say, it's the washing up and shopping that's the worst! I'm also getting cramps more often and suspect there may be a link.

My surgeon is definitely in the same camp as your second one. But, worryingly, he doesn't seem to think the enlargement surgery will cure all the symptoms. I may leave it for another year and see how it develops, but it would be good to be rid of it if the surgery will achieve this.

I don't think the specialists I've seen get to see many fit over 60's with this condition. It's mostly people who can't walk to the shops at all.

Hoping someone will see the thread who's actually had the op.

Martin

In reply to Martin Hore:
I've had spinal problems since I was 13 which by the time I was 50 had become progressively worse leading to 4 spinal decompression operations at 2 levels L2/3 and T12. I was misdiagnosed before the first operation leading to a delay of 18 months during which time I suffered irreversible nerve damage leading to serious mobility problems and great pain. I would advise you to have the operation ASAP and avoid my complications. Delay could lead to paralysis from the waist down as it nearly did to me. Where do you live? There are neurological centres of excellence and I would advise you to check these out. I had mine done at Derriford Hospital in Plymouth and my excellent surgeon was Commander Smith RN. Exercise won't help, I was climbing at about E3 about 6 months before I began to deteriorate and then it got very quickly worse to the point that I couldn't walk properly..

In reply to pete osullivan:

Ooof, Pete that sounds bad. It's sort of the scenario that my first surgeon suggested, which frankly scared the shit out of me. I'd seen that you were selling some gear due to ill health... I'm really sorry. The main reason I delayed having the op offered by the second one was that I unfortunately had an intestine problem as well at the time that could only be resolved by surgery and it was a priority over the back problem. Indeed the surgeon refused to consider operating until it was resolved. Now in the middle of having a house built rules it out until at least next year.

In reply to JTM:

I'm sorry if the post sounded a bit doom laden but it is unlikely that the nerve damage will be reversed and will only get worse so I think you have to make a difficult decision. The sooner the better is my hard earned advice.

In reply to pete osullivan:

Thanks Pete - really helpful. Definitely a vote for early surgery.

You don't really say what the eventual outcome was for you though I guess it wasn't too positive given Jon's observation that you advertised gear for sale. Very sorry if that's the case.

Martin

In reply to Martin Hore:
I forgot to mention that a positive aspect of the surgery is that the recovery time is very short, a couple of weeks at most. The keyhole surgery leaves a small wound and does not affect any muscle groups unless the stenosis has affected your posture in which case it might hurt for the time it takes for the muscles to recover their correct function as it did for me after my first operation (about a week) of the 2 weeks. I can't climb anymore but I had a fair crack of the whip and other interests have opened up for me.

In reply to Martin Hore:
To the people who have this condition, is there anything which brought it on, to do with posture or a physical job or is it something which is more random in who it affects?

Just curious about whether it can be avoided at all really, since I currently have a healthy back (as far as I know).

In reply to Timmd:

I've not asked the specialists I've seen what might have caused it, though I've always had a spine that curves the wrong way in the lower back (a bit like a stegosaurus) and there is a history of osteoarthritis in the family (which I'm beginning to notice in my fingers). So it could be linked to one of those.

Martin

In reply to Martin Hore:

I've had surgery for spinal stenosis caused by spondylolisthesis. It started with similar syptoms of numbness creeping up the legs and quite quickly deteriorated to the point where I had to stop for a rest walking down the corridor at work - a bit of a come down from walking 30 miles or more a week (although I'd moved on to more paddling than walking by the time this hit). Oddly scrambling remained easier than "easy" walking or standing.

The GP referred me to the physio who promptly referred me to the Walton Centre, where I was lucky to wind up in the hands of a surgeon whose special interest this was. Exercise was not remotely likely to fix it, it was deteriorating quite fast and I was warned of the risk of nerve damage becoming permanent if left too long. I seem to have wiped the exact terminology from my memory but I was given options involving fusion and metalwork, or a non-metal option involving taking the misplaced vertebra apart, clearing space for the nerves, and jigsawing it back together again. The latter is the option I chose.

Apparently many people take only a day or two before walking normally - it took a little longer for me and the few days after the operation were very painful indeed. But the day I went home I could walk a mile without even thinking about stopping for the first time in over a year. I'd had no idea how handicapped I'd been until I suddenly wasn't.

Don't know how the recovery would have gone if I hadn't overreached and pulled something while stretching, which led to more painful days. Nearly three years on I'm not in the same state I was before it started going wrong, but infinitely better than I was just before the operation. Things I particularly noticed: I seemed to have lost a lot of shock absorption so running really jarred; heavy rucksacks were not sensible; the fine control I needed for balancing a racing kayak was definitely diminished and I lost some flexibility. The irony is that before the operation my back didn't hurt at all, but now it does - on the other hand, I was not functional at all but now I'm almost back to normal and hopefully still improving.

As you remarked, they did find it unusual to have a young(ish) active patient. The physio was very sympathetic to my wish to get right back into activity, though not to the extent of putting it in writing that I needed to paddle every day...Joking apart, though, the paddling does help keep my back loose and I notice if I don't do it a while. Flexibillity is coming back if I remember to stretch, running begins to seem possible again (if my knees let me), cross-country skiing no problem, climbing no problem apart from the wretched knees (but I'm not a hard climber anyway), and I'm getting back to carrying heavier weights. The one thing that still makes me ache is standing for any length of time.

Anyway, I guess the short message from this long ramble is that for me surgery was definitely the right choice, done sooner rather than later. The non-metalwork non-fusion option has worked well for me too. One of the hardest lessons to learn was that it would take so long to get back towards normal - but that it is getting there however slowly. The other hard lesson is to listen to my back and ease off or rest it if I've been pushing too hard.

Hope this helps, and good luck with your decision.

In reply to kamala:

Many thanks for taking the time to give such a detailed and helpful reply. Looks like another vote for the surgery - earlier rather than later.

Martin

In reply to Martin Hore:

Many thanks to those who have responded to my OP, both here and by email. Still deciding whether to go for the operation. I'll come back with a report in a few months time.

Martin