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You have congenital stenosis (narrowing of the spinal canal from “birth”). On top of that, you have some degenerative changes of the discs. This causes further narrowing of the canal and cord compression. The terms used by the radiologist are moderate to severe stenosis. This is concerning for two reasons.

The first is the potential for spinal cord injury. The spinal canal in the neck narrows with bending the head backwards (extension). A fall onto the front of the head can cause this extension motion vector. This can lead to a central cord injury (see website for further information). If you participate in sports that can put your neck in jeopardy, you should curtail these sports (mtn biking, horseback riding, water and snow skiing, wrestling among others).

The other potential problem that could occur on a chronic basis is myelopathy, the dysfunction of the spinal cord from continued compression. See the website for symptoms of myelopathy.

It is unusual for a 32 year old to have this significant amount of stenosis. The neck pain that you complain of is not from cord compression as the cord compression is generally painless (has no pain receptors). Most likely, the neck pain originates from the degenerative changes of the discs or facets. The arm pain (down to the pinky and ring fingers) is most likely from nerve root compression in the foramen (see website).

It may be in your best interest to gain a second opinion. Remember however that modifiers (mild, moderate, severe) are in the eye of the beholder and the radiologist interpretation may be different than the spine surgeon.

Dr. Corenman

You had an anterior approach to the spine. An incision on the left requires cutting some abdominal muscles and these muscles will not heal and function as before the surgery. This abdominal wall weakness has two separate consequences.

One is that the opposite side muscle will continue to pull with regular strength and the surgical side muscles will have less “pull” (strength is diminished by the incision). This imbalance will pull the midline off center (as marked by the umbilicus or navel).

The second consequence is that the abdominal wall on that side will bulge somewhat with the complaint of “bloating”.

“Core” therapy work to try and rebalance the abdominal wall may yield some symptom relief. Make sure you have a consult with the original general surgeon who made the initial incision and approach to make sure there is nothing wrong (abdominal wall hernia).

Dr. Corenman

Post laminectomy syndrome is a catch-all term for failure of surgery to relieve pain. An open laminectomy with a large incision does not necessarily mean that the surgery was done improperly but that the surgeon is probably from the “old school” where the philosophy was “incisions heal side by side” and it did not matter how long the incision was.

A full laminectomy does not generally create instability of the spine. The spinous process is removed but the facets are generally left intact which are the main stabilizing processes (other than the disc). A microdiscectomy is a much “smaller” surgery with only a very small portion of the lamina removed (laminotomy) and the approach is from only one side. The laminectomy is performed from both sides.

Your spine could be unstable but that term is used for a number of different pathologies. True instability is the inability of the spine to maintain normal anatomical relationships with forces that cause shear, torsion and flexion/extension.

Pain generation could be from instability, foraminal stenosis, lateral recess stenosis, degenerative disc disease, isolated disc resorption, or chronic radiculopathy. See the website for description of each.

Spinal fusion- if needed, might be your answer but a thorough workup needs to be performed to determine the cause of your pain. As to complications of fusion, look to the website for “complications” for a good description.

Dr. Corenman