I am so thankful for this information. I was diagnosed of having severe cervical stenosis, severe arthritis, bone spurs, bone overgrowth with narrowing of the spine and calcification. I have been suffering since April 2024. My Family Health doctor looked at my mri and said all she seen was arthritis, threw me on pain meds and sent me to PT. I managed to get through PT with no improvement, had a nerve block injection with no improvement and next I am having to have a steroid injection. This has been a living hell! My chiropractor pushed for an MRI, it was sent for a 2nd opinion (my neurosurgeon) and was told to push through my PT and injections and if no relief, we will revisit surgery. I pray for anyone suffering with nerve pain.
@@JillyBean1968 look up prolotherapy with Dr. Hauser Caring Medical Group here on RUclips. I have cervical instability and 30 conditions. He has all the answers
Feel for you...., me too.... Is your cervical stenosis severe centtral canal or severe cervival foraminal stenosis? How are you doing now.... PT is not helping you still? Curious what caused the stenosis for you? Mine was a head injury as a child.
Dr. Su, you have to be the most informative doctor I have watched on some hundred videos. You have helped me to find the words to use when I speak to my Orthopaedic doctor/ Surgeon. Thank you for these videos that are so detailed. I am 81 and have had three lumbar injections, that have helped me immensely. I’m still going with the program. But now I feel so much more and better informed.Thank you again. Chet Marcotti, NH
I was diagnosed with myofascial fibromyalgia 20 years ago. As it turns out, it most likely was a cervical cord compression the whole time! In 2013 it advanced to the point where I lost all feeling from my shoulders to my feet. It took the VA several months to do an MRI & EMG in which they said I needed emergency ACDF. My spinal cord was actually smashed so flat that the surgeons didn't know how I was even able to walk, they'd never seen a cord that flat without paralysis! If one doctor had went over the myelopathy score 20 yrs ago, they would have realized it wasn't fibromyalgia. Just a tip for others w/ fibro- make sure they check your neck.
Thank u for sharing I was initially diagnosed with fibromyalgia . For 7 years drs did nothing now experiencing debilitating symptoms .finally will have MRI Friday
@Vegang Represent Thanks for asking. Most of the muscle fatigue is gone, still have neuropathy that varies with activity(usually directly related to neck movements), and I'm slowly gaining a little more sensations back. Let me know how things turn out for you.
Dr. Su - from the perspective of a retired cardiologist, GREAT presentation - very helpful in understanding why I need an ACDF. Your whole series on cervical myelopathy and radiculopathy has been excellent. Please keep up with the highly informative videos.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient, contact Dr.Ani John on RUclips channel now for help for Any kind of health issues.
You are absolutely amazing how you educate individuals. I had an MRI last week and I got the results without anyone explaining anything to me. I have so many things listed on my MRI that you have explained to me. Before watching your videos I figured that at any moment I was going to be paralyzed. Your videos have calmed my nerves and are keeping me sane as I wait to see a neurosurgeon. Thank you so much for what you are doing to educate people. You would definitely be my neurosurgeon if I lived in California. ❤️ 🙏
Thank you so much for putting the facts into plain English. So simple to understand, but when you only get 15 minutes in a doctors office it can be very confusing. You answered so many questions in 18 minutes. It is so hard to make a good decision, and be an advocate for yourself when you don't really understand what is happening to your spine. It is scary to begin with, not understanding adds a whole other level of uncertainty. Appreciate your information and for taking the time to reach people that need clarity.
Iam in the same situation.pain for 20 years and they no find nothing 7 diferent second opinion and nothing.i cant seat for long period of time and stand either i cant work I dont have quality of life
This man took a oath and has such honor to uphold it . DR TY. Still fighting the insurance company for my surgery. This helped me understand that I really need it .
I can't tell you enough how grateful I am for these videos. I found out I have congenital spinal stenosis and these videos have helped to clarify so much, give me the information I need to advocate for myself, and more importantly give me hope that I can live a normal, active life. Thank you!
I had a successful C5-6 fusion but had trauma during the healing process that caused me to have another neck surgery from C-4-C7. The Dr put hardware in me that was too big..I could actually feel a screw poking me but instead of fixing it then, he sent me to pain management which got me onto all sorts of drugs. 4yrs later, He then had to place a rod in the back of my neck in order to support another surgery to remove the too big hardware in the front. So 20yrs after my 1st initial fusion, my neck is in worse off shape then in the beginning. Instead of 2 surgeries, I had to have 4! I can't stretch my neck muscles & have muscle spasms throughout my shoulders, blades & even pain in the front of chest, cervical radicalopathy down left arm. Had to have 2 left shoulder operations & elbow as well due to the pain. In 2015, I quit my 20yr avaiation job & went thru the worse withdrawals from pain management meds but you know what? The radiating pain stopped the 1st week 😊 be careful taking meds!! I now manage my pain with heat, ice, tens unit & cbd & marijuana..replaced 4 medications with just that 😊
i'm a super healthy male, workout/bike racer, etc. I was pretty devastated to get a REALLY bad MRI - severe stenosis, spinal cord compression. They can't believe I'm mobile and walking, to be honest, based on the image (i mainly have some nerve pinch discomfort, but otherwise the myelopathy hasn't truly kicked in). I feel terrible having to severely cut back on my passion (cycling), but i do take comfort a bit, in this video, and your stats, Dr, about the danger of possible paralysis due to "minor trauma". I still don't really know my path forward here, but the spine surgeon i wento also did essentially take the "let your symptoms guide me" in terms of surgery approach. So similar to your thinking. He basically said "wait," but that he does believe surgery is all but a given, eventually. It's all such a huge bummer. I've kept myself in great shape all these years, but like with anything in life, there are no guarantees. We'll see what happens.
Very interesting watch. Love that you pointed out that the MRI is not what is being treated, the symptoms are. I had ACDR about a year ago and while my MRI did not appear nearly as severe as the one you showed with no symptoms, my symptoms were growing increasingly worse, to the point of dropping things and having to no reaction to grab them. The radiculopathy, hyperreflexia, positive Hoffman’s sign all improved immediately after surgery. Truly amazed and appreciative for doctors like yourself.
WOW Dr. Su! I am so thankful this video popped up on my youtube this morning. I was diagnosed with spinal stenosis 6 months ago after having tingling and numbness in my hands and feet. I've had two opinions from Neurosurgeons, one says surgery ASAP, the other says I don't need surgery. It left me wondering if I need a third opinion. I have been obsessed, full of anxiety and fear after hearing the possibility of paralysis. You have answered every question I have been wondering and I now I know (based on mJOA score) that I can relax and just watch my symptoms. I printed out the assessment to keep an eye on things. I'm considered mild at this time. Thank you so much for this video!
God bless you. Truly. It's a beautiful thing that you're doing by breaking this down and giving so freely of your expertise. I'm blessed enough to have a surgeon who took time to explain surgery versus non surgery, and who answered every question I had. However, some are not so fortunate - and in my case it's comforting to hear it explained so well again before I have surgery. Thank you, Dr. Su!
You are very good at what you do. Youd make a great professor at a university teaching upcoming doctors. You have the ability to explain difficult concepts with ease.
Dr. Su thank you. I am a chiropractor who has very mild MJOa score. My left arm is weak. Progressed about a year and a half after a auto accident. I'm strengthening it and using PEMF therapy to help which is extraordinarily beneficial I fine however, I was told I need a laminoplasty to prevent it from getting worse. I also have some balance issues lately, but nothing involving dexterity yet thank goodness as I said, I am a chiropractor. So I will be going forward with the laminoplasty your videos. Terrific. Keep up the good work and thanks.
Thanks Dr. Su. Your video is very easy to follow yet very comprehensive. It has really helped my wife with her decision whether to have her ACDF surgery. You are definitely an asset to the medical profession!
Thank you. You explain things so well. Misdiagnosed for like a decade? The past 2-3 years.Yikes. Full blown symptomatic. Now here we are...🥳 Myasthenia gravis, as well?? Are the two tied together? Cuz me numbers came back high on that too, a month back. Was just sent for cervical mri this week. I think i fall into late stages. I have soooo much going on back there. Spine surgeons words. Makes me wonder if all these surgeries will be worth it. I/ll need many, they tell me. Yikes, man.... I wanna treat this holistically, so badly. Wish i could see you. Seems youre a great doctor.
This is good stuff. I just barely have numbness and shooting pain now and then and have lost a lot 17 pounds doing my exercises and my doctor told me today she still recommends surgery from an MRI taken 2 months ago.
This channel is a gift. You break things down and provide useful information that is easier to digest than when we are sitting in an austere doctor's office. It's hard to absorb what you're hearing sometimes, and hard to make decisions that are comfortable. Thank you so much
Thank you for explaining, I have compression of spine degenerative disease and have recently been diagnosed with OPLL. I’m very scared of operation but listening to you explain I am starting to understand better. Starting to realise I might not be able to avoid the operating table but feeling more confident in the decision making of this thanks to you
I have just been diagnosed with multiple level degenerative changes with a disc bulge pressing on the cord with no neurological symptoms and just neck pain. The diagnosis was given and I was so scared. I’m seeing a spine specialist (in the U.K.) in two weeks but this video has really helped my anxiety as my score states no myelopathy. I am so grateful for your clear concise and informative video. Amazing thank you
Tomorrow my brother will have surgery He has mild myelopathy .. with only neurological symtops is numbness on left little finger. Otherwise neurological examination is completely nrml. He has spinal cord compression at c4 and 5 and c5amd c6. I took opinion of best neurosurgeon in the town but nothing ws more satisfying than this video.
Big thank you to Dr. Su for his advice! I was very anxious about the diagnosis from the specialist I saw at Kaiser so am greatly relieved after talking to Dr. Su. He's the best!
I learned a lot from your video, I have two fusions and from watching this video I should not have gotten either one. the first one however was fine the second one set me on the path to becoming disabled and I have not worked since. Recently I fell and hit the back of my head on the ground. A few weeks later I had a cervical headache. Got an MRI and found my old fusion was fine in my neck however the disc above had compression. Really afraid to have another surgery,
I got an MRI and they found mild disc bulge and shallow superimposed central disc herniation in both L3-L4 and L4-L5. I am 43 years old and about to get my 3rd epidural and my pain is still the same. My pain management doctor and my PCP have not really explained what is going on with me as good as you do. Your videos have given me so much hope and information that I have not gotten yet from anywhere else. I am beyond stressed and anxious since I am a mother of little children and a teacher and dealing with this leg pain since February and I still dealing with chronic pain that will not go away. My whole life has been seriously impacted especially my mental health. I still wanted to thank you for your videos . Please do a video of what to do when you have severe spinal stenosis caused by disc herniation. (I had paramedics at my home once because of the severe symptoms and I thought I was having a heart attack!. ). Anything you can say to help me understand what I am going through will really help. BLESSINGS TO YOU! And thank you again.
Doctor I suffer from both moderate to severe myelopathy and severe cervical Radiculopathy and I have to say you are spot on with your approach and recommendations I wish these conditions were explained to me in this manner Thank you Doctor
Dr Su You make so much sense to me and your explanations are very thorough. I appreciate your expertise and your sharing through your channel. I am in my early 70’s and have suffered with spine problems for many years. This year I had my first spine surgery an ACDF , three level to address myelopathy and it seems to have been very successful. This video explains what was going on with me very well. Thank you again for sharing
Totally agree! It's like a free exam almost! Good to hear that you are feeling better. I have a low back problems and neck problems (dental hygienist) and as a second opinion this is where I "go". 😄
The best presentation and explanation that I have heard from many videos. Articulate, and Intelligent person presenting in a way that the lay can understand. Great job!
Best video I’ve seen regrading cervical surgery. I am planning on ACDF surgery. This video explained everything so well. Im trying to talk myself out of surgery, but all of my symptoms say I need it. I’m just scared. Dr Su is an amazing instructor. Such great information for such a scary decision to make. Thank you Dr. Su.
Dr Su I wanted to say thank you for replying to all my questions over the last few week. I know I've been asking you questions left and right. I really do appreciate you and your kindness and time. Happy Holidays to you 🥰
Hello! This is the most comprehensive and thorough video I have seen on this topic. I was diagnosed about 2 years ago... I am 59 years old, I also have ddd, arthritis and bone spurs. I have gotten 3 different opinions, 2, from orthopedic spine surgeons, 1, from a neurologist. I am very active and walk 5 miles daily, I do not smoke or drink, my BMI is 18-19 and my nutrition is excellent. My pain level is mild - uncomfortable, and intermittent, more of a stiffness. The 1st and 2cd surgeons graded it as moderate to severe - not based on the Japanese score, but on the MRI. I don't have muscular impairments except weak grip strength- worsening of discomfort when lifting arms for a few minutes. The 1st surgeon, said that I have myelopathy, based on the grip strength for my age, etc. The 2cd surgeon said I did not have myelopathy, the neurologist said to "watch and wait" - I am doing okay. I don't want surgery for personal reasons... My familiy, financial, and social circumstances are such that surgery and recovery would be very difficult and life altering for me. I had a car accident in my 30s and never even had issues until my mid- late 50s... When I was diagnosed by MRI because of the infrequent stiffness. I wonder what your opinion of all this is Dr? I do PT - decompression exercises. 1 surgeon wanted to do an ACDF immediately, the other recommended a laminectomy, the neurologist said I can go without surgery!
I would follow the video and get your own mjoa score and based on that partner with the surgeon that you trust to make a decision. You can always make a virtual appointment with me at California orthopedics and spine
Dr. Su, great video with plain English Information. I have extensive Cervical Instabilities with Disc Bulges, stenosis at various levels, Military Neck, and Facet Joint arthritis as well Spondylosis throughout my spine, with OA on a number of vertebrae. Moreover, I suffer with Dextroscoliosis of 25 degrees, resulting from a 1 inch shorter right leg sustained from a fractured right Femur in 1966, playing HS Football. I'm 71 now, male, retired. The spinal issues wreak havoc with my well being, affecting my nervous system (no Reflexes), Peripheral nerve damage, and yes, radiculopathy form my neck into both arms (the left worse). I get numbness in my legs / feet. And, I have been battling On & Off (more on lately) Bladder Incontinence with leakage. On a few occasions, I could not hold the urine at all getting out of my car going to work - a very Embarrassing day!! . I've Seen and heard of Prolotherapy for Cervical Instability issues. I am willing to try that but cannot find a Prolotherapist near me in Suburbia NY. I have come to find doing personal research (that's why I'm here now), that Cervical Instabilities contribute to many maladies not fully disclosed here... Tinnitus, TMJ, Sinus problems, Throat problems, Occipital Headaches and even pain into the temples, even IBS/GERD and can affect The Vagus Nerve(s) [ one on each side]. I have been to 6 different Spinal /Neuro Surgeons for opinions since 2018-19. All said: No Surgery on your Lumbar spine , Maybe you are acandidate for Cervical Surgery , if it becomes Intolerable. I'm getting there!! In 2012, after my first cervical MRI was done, he reprt indicated that I had a More Narrow Than Normal Spinal Canal. I did not know this until about 6 onths ago reviewing same with my Pain Management doctor. What do think I should do?
Great video, thank you a lot. I have spinal cord stenosis It started from neck pain and a little numbness in two fingers but over 1 year I have neck pain less often and I don't have numbness but often have tingling in my fingers. I do PT and started with yoga several months ago. I am 33 years old, I used to do freeride skiing and bjj.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient, contact Dr.Ani John on RUclips channel now for help for Any kind of health issues.
Dr. Su, thank you so much for this very informative video. I am a 62 yo practicing (1/2 time) anesthesiologist who has been monitoring my cervical spine issues since 2009 when I had my first MRI for neck and arm pain. A C7-T1 disc herniation at that time was managed successfully with oral steroids and PT. A second herniation occurred in 2016 at C4-5. The MRI had worsened with multilevel congenital central canal stenosis and neuroforaminal narrowing in addition to the disc herniation compressing the nerve root and cord. A cervical ESI helped immensely with my symptoms but my neurosurgical colleagues stated it was only a matter of time before I would need surgical intervention. Since then I have been relatively symptom free with rare arm and foot tingling and neck pain. I have stayed quite active biking up to 75 miles/wk, strength training and playing competitive Pickleball and tennis. Over the past couple weeks, the symptoms are more frequent; some neck, shoulder pain and tingling but no weakness; my mJOA score is 18. I am concerned another herniation may be developing and it may be time to begin my search for a top rated neurospine surgeon in the event surgery becomes my best option. After viewing your video and excellent explanation on literature based indications for surgical intervention, I am a bit more reassured that there is no urgency in this matter until my symptoms begin to worsen. If you can recommend the top spine centers in the Midwest (I know Mayo has an excellent reputation) I would appreciate it. Thank you for time in producing this video for the general public; your contributions are greatly appreciated.
There are many great surgeons in the midwest. Instead of searching for an institution I would encourage you to search for specific surgeons whether it be private practice or academics. I'm always happy to do a virtual consult for you at California orthopedics and spine
I watched this video twice and it's very informative and useful to help decie if surgery should be considered. Talking to my surgeon today and hopefully I'll be better prepared.
You mentioned “Learning to live with the pain.” In some of your videos. Would you please do a video on what that may look like and what has helped your patients learn to do this? Thanks in advance and really appreciate your channel helping to educate our family on our son’s injury.
I have had c4-5, and c6-7 fused. Well, for the past 2 years i have needed c3-4, but with that surgery? i must retire (i am a dentist), and with 2 kids still in school, I just can't do that. So i live with the pain. Most days it's tolerable, but some days? I just don't know how much longer i can continue. I go to the gym, and I also have both lumbar and cervical traction units at home, that temporarily relieves som of the symptoms. My hope is to put off the surgery as long as possible, and maybe??? better technology will become available to treat my pain.
@@DrM1107 interesting comment. Do you think being a dentist caused you to develop the bad neck? I ask because I know dentists have to stay bent over in flexion a LOT while working on fixing teeth.
A family fiend was the healthiest person I’ve know. Always active, disciplined diet and maintained a healthy weight. He was an avid golfer and developed some nagging back pain. He had back surgery and almost immediately began having issues with gait and digestion. He began losing weight and saw several specialists. None could figure out what was causing this. He began to decline to when it was very apparent he had nerve damage and was diagnosed with ALS. Over two years he lost most functionality and he died yesterday. He was a good man. I can’t help but think his ALS was triggered or accelerated by the spinal surgery. It was like a light switch. Prior to surgery he was perfectly fine. After surgery he declined.
That's heartbreaking. My best friend had ACDF surgery a week ago and she is in a great deal of pain. I'm worried for her. They say this surgery is common but I'm sure there are complications too.
Watched several of videos since I just had sever flares of neck pain but only tingling on Left arm and leg but no pain, was told from x ray I have stenonis. I don't have other symptoms like urinal, strength loss, or stability issues. Will be consulting spine specialist soon. Learned a lot which has reduced my anxiety. Sincere thanks for the education, expertise and dedication.
I’ve been dealing with a neck and lumbar spine injury for years. Got a copy of the MRI report (basically my neck is a mess) and you’ve been able to explain to me clearly the decision process with surgery and why I have the symptoms that I do. I’m seeing a Rheumatologist at the end of October for a way forward with this. Thank you for your presentation.
Always love your videos! New MRI 16 months from last one definite deterioration.. nurosurgeon had case conference to discuss my case and I'm waiting for response C4/5 and C6/7 makes sense why I'm uncomfortable lie either side for long period.. your explanation are always so clear thank you!
A+ video in every respect. I saved it as a go to reference. My recent MRI indicates "moderate cervical myelopathy". I just did the MJOA eval and have a score of 16, mild myelopathy symptoms. Yesterday a neurosurgeon suggested surgery sooner rather than later. I'm 78 and dubious. Has anyone tried non surgical treatments that seemed to help? Thanks in advance.
Thank you so much for this very informative video. I’m currently waiting to see a neurosurgeon because I’ve been symptomatic and have cord compression on my MRI. I sort of went down a rabbit hole of worry not being able to ask anybody any questions while I wait. This answered so many questions for me. Thank you so so much.
You need to travel doc .i live on a small island we lack expertise in orthopedic!!!!!! Many ppl are suffering we also lack surgeons imo . If only you could come your explanation is well spoken , trustful and highly analysed . Well explained step wise .
Dr Brian, you really made my day, my week and my year. My score is 14 and only have little numbness and pain in my neck. In 8 weeks my pain has went from a 9 to 5 and your advise is gold. You sir are a very good person and I wish you all the succes in the world!
So very appreciative of this video. Our family is going thru really rough time. Booked an appointment with you but it’s not until December. I really need your help asap to make the decision.
Thanks for your video it’s been very helpful I was scheduled for neck surgery and after watching your videos I decided to get a second opinion and was told I don’t need surgery yet that’s been almost two years ago 😮😊. I now see my new Neurosurgeon once a year unless I feel something wrong.
This has been so in depth, I really appreciate it. I feel like Im in purgatory at the moment and Ive been sedentary in bed almost 2 mos. After uterine surgery at the end of August- 2 weeks later I felt like what was a muscle knot in my shoulder that would not go away and I could not put my head back or look up. It got worse and eventually was excruciating pain day and night into my left shoulder, my elbow and my wrist and arm and fingers. MRI showed severe ossification between c6-7 with a reversed-c and impingement. Im on 900mg of gabapentin 3x's a day, muscle relaxants and oxycodone Im trying to not take but I cant even see the neurosurgeon for another 2 1/2 mos. So Im just rotting away waiting. Its a horrible place to be in.
Hi Dr Su how are you? I re-watched this video today. Since I last posted, my left sided neck pain has got worse and since in the last 7 days (as of 10/4/2023), I feel that there is a lot of extreme tightness, pain inside the left of the neck base where it meets the SCM muscle roughly. This has kept me awake all night despite strong pain medication when lying down. I am also feeling referred pain to my left index finger mainly and sometimes the thumb, middle, ring, little fingers as I move my head. As of 1 and half months ago I developed some numbness, tightness, pain in my groin and feet. Standing improves the situation, sitting and lying down make it worse. I have done nothing to make it worse. I was manipulated by an osteopath towards the end of February 2023 and this is when things started getting worse. I don't think that I have myelopathy because I used your mJOA chart to score myself. The sum came up to 17. I can still walk despite some right nerve impingement in the lumbar spine, I can control my bladder with very slight difficulty due to an existing mild prostate enlargement (I am 66), no numbness in the arms yet, but some pain on and off.. Can you please explain the meaning of the following statements in simple terms? Mild to moderate C4/5 and mild C5/6 central canal stenosis. Right C4/5, left C5/6 and right C6/7 neural compressive foraminal stenosis. Some disc degenerative activity at C4/5, C5/6 and C6/7 Thoracic upper and mid facet joint degenerative change as well as costovertebral degenerative Also, since I live in AUS, how do I arrange a zoom appointment with you? Do I do this online or do I have to call? Thank you. Best regards Alfred
You can call California orthopedics and spine and request a zoom appointment with me. They know how to deal with my international patients. I have seen a few people from Australia and have had some come over for surgery as well.
I had chiari decompression at age 42. Six months later C3-to-T1 was fused. The surgeon wanted to also fuse C1-C2 because there was so much rotation in the bones. I have bad neuropathy throughout my entire body and have had difficulty walking since 2013. Not sure what would help. 🥺
Congratulations Ashley on your Gold Metal!!! (If you see this) Thank goodness you didn't get sent down the surgery rabbit hole!! 🙌👊👍👍🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇
Thank you for sharing these videos they are very helpful. Currently I am researching everything I possibly can about the spinal cord. A recent MRI shows herniated discs (c5/c6) , stenosis, and a severely damaged spinal cord. Surgeons are recommending disc replacement or fusion to project the spinal cord. Unsure if I should go the route of surgery or try to rehabilitate my neck on my own. Open to thoughts or insights.
Thank you for teaching about the spine. It’s something I took for granted so many years. You are a generous and kind person. Would be interested to hear what research is being done on disc replacement. Thanks again!!
Thank you Dr. Su for this very thorough video. I have spinal compression that is just as bad as the example MRI’s that you depict in the video but I would score an 18 on the mJOA score. I have no numbness, no degradation of motor skills, etc. None of the symptoms in the mJOA test. I do, however, have a lot of neck pain and stiffness. My doctor is telling me I risk permanent paralysis in the event of an accident and that surgery is inevitable. He does agree that with the “treat the symptoms not the MRI” philosophy. My neck pain had been kept in check with Aleve but over the last couple of months it is getting noticeably worse. Physical therapy didn’t really help at all. What do you recommend for 67 year old patients like me that really don’t want to jump into surgery but need to get the neck pain solved to get back to leading an active life.
Thanks for the very helpful presentation. BTW, I'm over 65 and deteriorated over several weeks after a misjudged (5 ft, not 2) backward jump from a wall with akward heel landing. I thought I might be ok as my jaw, knees and joints seemed to improve, despite a clear spinal concussion (1-2 sec. paralysis) and hearing what sounded like several disc crushes, but after a week of trying to return to regular activities, I started with severe neck spasms and electrical shocks to moderate myeolopathy. An Xray and the PA at the walk in clinic dx'd bad DJD, radiculopathy, sent me to PT exercises and dry needling and I deteriorated over 4+ more weeks. The surgeon I saw said continue PT but ordered an MRI which his office bungled for weeks and when I got to the ER they found multiple hreniated discs with one halfway wrapped around my cord in a stenotic canal. After posterior C3-T2 fixation with laminectomy, I got everything back immediately after surgery, but then had some return of para/hyperestesia on one side and both hands (at least numbed my arthritis) after my 2 post surgical neck spasms. That is clearing nicely since surgery 5 weeks ago. I am a pretty healthy, athletic 68yo non smoker, light drinker who has always healed quickly and apparently auto fused a factured c3-c4 after a diving accident (spinal concussion in the water with 45 sec paralysis) for which I never got treatment (except for advil) at age 21; I did have neck spasms for around 5 years. Anyway, my surgeon suggested possibly some return over the first year for my surgery, but underestimated me. You mentioned in your video that quick onset is associated with better outcome, so I think that was my case, along with being resilient. Again, thanks for the great vid!
Thanks for the detailed and easy to understand videos. I have been experiencing muscle wasting of the hands arms and chest over the last five years. But my strength is still good and I have no pain. I've had many many headaches that always start with pain in the neck usually when I wake up in the morning. But I have found that physical therapy and exercise have really helped with the headaches. But have had no effect on the muscle wasting. I have been to several spinal surgeons and I've been told I do not need surgery and there is no clear explanation for the muscle wasting. I have had both ulnar nerves released and one carpal release.
Thank you, for making this video. Dr. Brian Su, you are helping us understand what we are dealing with after a year of trying to find answer. ER 9/11 pain shoot to back head from the spine. CTscan with & without contrast. Later I saw my Neurology he order MRA MRI Head & spine Have Multi- Aneurysm He listens on 9/21/2022 after seeing the results Diagnosis: Cervical Stenosis Of Spinal Canal At C5-6, there is a broad-based disc osteophyte complex with more focal right paracentral components. Severe central spinal stenosis with anterior cord compression. Facet and uncovertebral hypertrophy. Moderate bilateral neural foraminal stenoses. At C6-7, there is a central disc osteophyte complex with mild superior and inferior migration. Moderate to severe central spinal stenosis with mild anterior cord compression. Facet and uncovertebral hypertrophy. Moderate bilateral neural foraminal stenoses. Other multilevel degenerative changes with congenitally short pedicles. There are varying degrees of central spinal and neural foraminal stenoses. Please see above for the remainder of the individual-level details. My neck started to lock up morning sometime can't lift myself out of bed my husband has to help me. Dr has been saying is Rheumatoid arthritis. but it came back Neg for Rheum & positive for Oth. Arthritis in the spine. Then I fall and things go worst. Seeing a Spine Dr. Monday 9/26/2022 thank you, I'm less worried.
Thanks so much for providing this information. I have pinched cervical nerves and my imaging shows spinal cord impingement but not the symptoms. I do have radiculopathy and will be having epidural shots. Crossing my fingers it improves my condition. I’m disappointed my doctor didn’t either take time to explain all the details or provide me with information like this.
@@DrBrianSuTheSpineGuy Thank you for letting me know it is there. I was going to look through your videos to see what you have on my issues. Outstanding of you!!
Thank you for making things simple. I had cervical cord compression due to opll and had pcdf surgery but it still didn't help with pain in my thoracic spine like the dr hoped it would.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient, contact Dr.Ani John on RUclips channel now for help for Any kind of health issues.
Thank you for the valuable information. I discovered I have cervical and thoracic spinal stenosis from speed walking which rapidly turned into unbearable pain. Of course my PCP wanted to send me for surgery. I insisted on PT which took me from pain to returned full activity. I had setback again at age 61. PT helped again. But as of recently I'm having pain in my right neck down my arm with numbness to my hand and a minimal amount even up the side of my face to my brow. I'm 100% sure it's not a stroke. I'm beyond annoyed at how the symptoms are keeping me from living my life and surely getting worse. What surgeries do you perform?
Always, you are a great Doctor for what you do. You have been helping me understand my back issues and know understanding my neck which I had a car wreck 21 years ago and had 2 clean breaks on C5 and 6. Have no issues now, but understanding helps and people that understand can make better desicions. Thank you again. Just love you for what you do Sir!
WOW! I HOPE YOU’RE GETTING BETTER! I’M CONSIDERING SURGERY! LIKE YOU, I WAS IN A CAR ACCIDENT 22 YEARS AGO. HOWEVER, NO FRACTURES OR DIRECT INJURY TO MY C5,C6 TO MY KNOWLEDGE!
I am at a 16 on the mJOA (thank you God), was hit by a car on my ebike, found myself on the concrete, not sure if I was dying or living. Luckily, after my ER visit, all tested normal for my CT of my thoracic, blood work, sent home. Working with a Personal attorney, bike was replaced, but my chiropracter found on MRI, multiple disc herniations, stenosis, all kinds of commotion on my C-S spine, L-S Spine (Wondering why they didn't check my T-Spine, Inquiring minds asking.). Your video was on point, spot on, what I needed. Learning a lot, from your videos, I am a past Physician Assistant but didn't spend much time with Neurology (did about 2 years), so your knowledge and teaching method is amazingly comforting. Do you do long distance consultations on Zoom? :) I want to of course do non invasive, but I don't want to risk my full function. My goals was to restart skiing, and maybe running in a 5 k by next year. I am fine if not possible, because I understand biking is coolio if we stay on smooth pavement.
So! Brilliant talk!! I have cervical cord compression and am scheduled for ACDF in about 6 weeks. I have all the myelopathy symptoms. Yet my findings on MRI report only describe moderate to severe stenosis. I am 57 and have had spasticity issues in my left leg, and am not able to walk without a walker. It’s been 3 years living this way…oh, I also have MS. My question is could my symptoms be associated with the cervical stenosis? I’m thinking my diagnosis is getting lost due to pre-existing MS diagnosis. Am I crazy??
That's a good question and I think that's going to be my next video because I get a lot of questions about it. When you really look at the evidence PRP injections in the spine do not work except when there is a dark disc with a posterior high intensity zone. It does not work for degenerative change and cartilage loss and it does not work for nerve root compression even though many doctors do it.
The thing I struggle with is: I have a herniated disc at C6/C7. I was in unrelenting pain for about 2 months, my pain was at a 10, cut me open now and fix it type pain. But after waiting those 2 months my pain is probably a 4, I still have some numbness in my forefinger and get tingling/burning in my arm if I lay in the right position. But is that enough to say I should be cut open and my spine changed forever? That’s what I struggle with. Do I feel fragile? Yes. Do I live in fear of flaring it up again? Yes. Still, is that a good reason to operate? I can’t decide.
I am so thankful for this information. I was diagnosed of having severe cervical stenosis, severe arthritis, bone spurs, bone overgrowth with narrowing of the spine and calcification. I have been suffering since April 2024. My Family Health doctor looked at my mri and said all she seen was arthritis, threw me on pain meds and sent me to PT. I managed to get through PT with no improvement, had a nerve block injection with no improvement and next I am having to have a steroid injection. This has been a living hell! My chiropractor pushed for an MRI, it was sent for a 2nd opinion (my neurosurgeon) and was told to push through my PT and injections and if no relief, we will revisit surgery. I pray for anyone suffering with nerve pain.
@@JillyBean1968 look up prolotherapy with Dr. Hauser Caring Medical Group here on RUclips. I have cervical instability and 30 conditions. He has all the answers
Feel for you...., me too.... Is your cervical stenosis severe centtral canal or severe cervival foraminal stenosis? How are you doing now.... PT is not helping you still? Curious what caused the stenosis for you? Mine was a head injury as a child.
@@JillyBean1968 I feel for you and anyone else suffering like this it’s horrible just not feeling yourself anymore is scary
Dr. Su, you have to be the most informative doctor I have watched on some hundred videos. You have helped me to find the words to use when I speak to my Orthopaedic doctor/ Surgeon. Thank you for these videos that are so detailed.
I am 81 and have had three lumbar injections, that have helped me immensely. I’m still going with the program. But now I feel so much more and better informed.Thank you again. Chet Marcotti, NH
I love your "first and most do no harm" approach. We need more docs thinking like you. Thanks for your work. Dr. Mo
Dr Su performed surgery on my cervical spine 5 years ago and I am so much better. Dr Su and his staff are very professional.
Thank you,
Steve Hunter
I was diagnosed with myofascial fibromyalgia 20 years ago. As it turns out, it most likely was a cervical cord compression the whole time! In 2013 it advanced to the point where I lost all feeling from my shoulders to my feet. It took the VA several months to do an MRI & EMG in which they said I needed emergency ACDF. My spinal cord was actually smashed so flat that the surgeons didn't know how I was even able to walk, they'd never seen a cord that flat without paralysis!
If one doctor had went over the myelopathy score 20 yrs ago, they would have realized it wasn't fibromyalgia. Just a tip for others w/ fibro- make sure they check your neck.
Hello Julia
Thank u for sharing I was initially diagnosed with fibromyalgia . For 7 years drs did nothing now experiencing debilitating symptoms .finally will have MRI Friday
How are you doing now?,
@Vegang Represent Thanks for asking. Most of the muscle fatigue is gone, still have neuropathy that varies with activity(usually directly related to neck movements), and I'm slowly gaining a little more sensations back.
Let me know how things turn out for you.
Surgery?
Dr. Su - from the perspective of a retired cardiologist, GREAT presentation - very helpful in understanding why I need an ACDF. Your whole series on cervical myelopathy and radiculopathy has been excellent. Please keep up with the highly informative videos.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on RUclips channel now for help for Any kind of health issues.
You are absolutely amazing how you educate individuals. I had an MRI last week and I got the results without anyone explaining anything to me. I have so many things listed on my MRI that you have explained to me. Before watching your videos I figured that at any moment I was going to be paralyzed. Your videos have calmed my nerves and are keeping me sane as I wait to see a neurosurgeon. Thank you so much for what you are doing to educate people. You would definitely be my neurosurgeon if I lived in California. ❤️ 🙏
You can always make a zoom appointment by calling California orthopedics and spine
@@DrBrianSuTheSpineGuyHow do I get a second opinion?
Thank you so much for putting the facts into plain English. So simple to understand, but when you only get 15 minutes in a doctors office it can be very confusing. You answered so many questions in 18 minutes. It is so hard to make a good decision, and be an advocate for yourself when you don't really understand what is happening to your spine. It is scary to begin with, not understanding adds a whole other level of uncertainty. Appreciate your information and for taking the time to reach people that need clarity.
Iam in the same situation.pain for 20 years and they no find nothing 7 diferent second opinion and nothing.i cant seat for long period of time and stand either i cant work
I dont have quality of life
This man took a oath and has such honor to uphold it . DR TY. Still fighting the insurance company for my surgery. This helped me understand that I really need it .
I can't tell you enough how grateful I am for these videos. I found out I have congenital spinal stenosis and these videos have helped to clarify so much, give me the information I need to advocate for myself, and more importantly give me hope that I can live a normal, active life. Thank you!
I had a successful C5-6 fusion but had trauma during the healing process that caused me to have another neck surgery from C-4-C7. The Dr put hardware in me that was too big..I could actually feel a screw poking me but instead of fixing it then, he sent me to pain management which got me onto all sorts of drugs. 4yrs later, He then had to place a rod in the back of my neck in order to support another surgery to remove the too big hardware in the front. So 20yrs after my 1st initial fusion, my neck is in worse off shape then in the beginning. Instead of 2 surgeries, I had to have 4! I can't stretch my neck muscles & have muscle spasms throughout my shoulders, blades & even pain in the front of chest, cervical radicalopathy down left arm. Had to have 2 left shoulder operations & elbow as well due to the pain. In 2015, I quit my 20yr avaiation job & went thru the worse withdrawals from pain management meds but you know what? The radiating pain stopped the 1st week 😊 be careful taking meds!! I now manage my pain with heat, ice, tens unit & cbd & marijuana..replaced 4 medications with just that 😊
i'm a super healthy male, workout/bike racer, etc. I was pretty devastated to get a REALLY bad MRI - severe stenosis, spinal cord compression. They can't believe I'm mobile and walking, to be honest, based on the image (i mainly have some nerve pinch discomfort, but otherwise the myelopathy hasn't truly kicked in). I feel terrible having to severely cut back on my passion (cycling), but i do take comfort a bit, in this video, and your stats, Dr, about the danger of possible paralysis due to "minor trauma". I still don't really know my path forward here, but the spine surgeon i wento also did essentially take the "let your symptoms guide me" in terms of surgery approach. So similar to your thinking. He basically said "wait," but that he does believe surgery is all but a given, eventually. It's all such a huge bummer. I've kept myself in great shape all these years, but like with anything in life, there are no guarantees. We'll see what happens.
Very interesting watch. Love that you pointed out that the MRI is not what is being treated, the symptoms are. I had ACDR about a year ago and while my MRI did not appear nearly as severe as the one you showed with no symptoms, my symptoms were growing increasingly worse, to the point of dropping things and having to no reaction to grab them. The radiculopathy, hyperreflexia, positive Hoffman’s sign all improved immediately after surgery. Truly amazed and appreciative for doctors like yourself.
Your explanation is the best I have ever heard. Been suffering with this topic for years.
Thank you, thank you so much 🙏
WOW Dr. Su! I am so thankful this video popped up on my youtube this morning. I was diagnosed with spinal stenosis 6 months ago after having tingling and numbness in my hands and feet. I've had two opinions from Neurosurgeons, one says surgery ASAP, the other says I don't need surgery. It left me wondering if I need a third opinion. I have been obsessed, full of anxiety and fear after hearing the possibility of paralysis. You have answered every question I have been wondering and I now I know (based on mJOA score) that I can relax and just watch my symptoms. I printed out the assessment to keep an eye on things. I'm considered mild at this time. Thank you so much for this video!
God bless you. Truly. It's a beautiful thing that you're doing by breaking this down and giving so freely of your expertise. I'm blessed enough to have a surgeon who took time to explain surgery versus non surgery, and who answered every question I had. However, some are not so fortunate - and in my case it's comforting to hear it explained so well again before I have surgery. Thank you, Dr. Su!
You are very good at what you do. Youd make a great professor at a university teaching upcoming doctors. You have the ability to explain difficult concepts with ease.
Dr. Su thank you. I am a chiropractor who has very mild MJOa score. My left arm is weak. Progressed about a year and a half after a auto accident. I'm strengthening it and using PEMF therapy to help which is extraordinarily beneficial I fine however, I was told I need a laminoplasty to prevent it from getting worse. I also have some balance issues lately, but nothing involving dexterity yet thank goodness as I said, I am a chiropractor. So I will be going forward with the laminoplasty your videos. Terrific. Keep up the good work and thanks.
I watched many videos about this subject ... but nothing like this, clear, organized and helpful Thaaaanks
This video was so well structured and clear. It just put all pieces of the puzzle together. Thank you for explaining it.
You're the BEST dr.su! I could listen to you all day.learning from someone like you is precious.thank you dr. Su.😊
I concur 🙂👍
Thanks Dr. Su. Your video is very easy to follow yet very comprehensive. It has really helped my wife with her decision whether to have her ACDF surgery. You are definitely an asset to the medical profession!
Excellent video. Reasoned, sensible, and not alarmist. Every moment of it was informative.
Thank you.
You explain things so well.
Misdiagnosed for like a decade?
The past 2-3 years.Yikes.
Full blown symptomatic.
Now here we are...🥳
Myasthenia gravis, as well??
Are the two tied together?
Cuz me numbers came back high on that too, a month back.
Was just sent for cervical mri this week.
I think i fall into late stages.
I have soooo much going on back there.
Spine surgeons words.
Makes me wonder if all these surgeries will be worth it.
I/ll need many, they tell me.
Yikes, man....
I wanna treat this holistically, so badly.
Wish i could see you.
Seems youre a great doctor.
the best "consultation" i ever had...thanks doc
best explanation I've heard in 15 years, thank you Doctor Su.
I had all 4 symptoms
No neck pain.
C3 - C7 ACDF in May.
Doing well!
Got c5-c6 hernia servere stenosis
Dr. Su and his team changed my life. The cervical fusion he performed on me immediately gave me my life back.
This is good stuff. I just barely have numbness and shooting pain now and then and have lost a lot 17 pounds doing my exercises and my doctor told me today she still recommends surgery from an MRI taken 2 months ago.
You're an incredible teacher. Great video. I got acute radiculopathy after chiropractic manipulation.
This channel is a gift. You break things down and provide useful information that is easier to digest than when we are sitting in an austere doctor's office. It's hard to absorb what you're hearing sometimes, and hard to make decisions that are comfortable. Thank you so much
Thank you for explaining, I have compression of spine degenerative disease and have recently been diagnosed with OPLL. I’m very scared of operation but listening to you explain I am starting to understand better. Starting to realise I might not be able to avoid the operating table but feeling more confident in the decision making of this thanks to you
Hello Cheryl
I have just been diagnosed with multiple level degenerative changes with a disc bulge pressing on the cord with no neurological symptoms and just neck pain. The diagnosis was given and I was so scared. I’m seeing a spine specialist (in the U.K.) in two weeks but this video has really helped my anxiety as my score states no myelopathy.
I am so grateful for your clear concise and informative video.
Amazing thank you
How are you
Do you have burning sensation??
Tomorrow my brother will have surgery
He has mild myelopathy .. with only neurological symtops is numbness on left little finger.
Otherwise neurological examination is completely nrml.
He has spinal cord compression at c4 and 5 and c5amd c6.
I took opinion of best neurosurgeon in the town but nothing ws more satisfying than this video.
Big thank you to Dr. Su for his advice! I was very anxious about the diagnosis from the specialist I saw at Kaiser so am greatly relieved after talking to Dr. Su. He's the best!
I learned a lot from your video, I have two fusions and from watching this video I should not have gotten either one. the first one however was fine the second one set me on the path to becoming disabled and I have not worked since. Recently I fell and hit the back of my head on the ground. A few weeks later I had a cervical headache. Got an MRI and found my old fusion was fine in my neck however the disc above had compression. Really afraid to have another surgery,
I got an MRI and they found mild disc bulge and shallow superimposed central disc herniation in both L3-L4 and L4-L5. I am 43 years old and about to get my 3rd epidural and my pain is still the same. My pain management doctor and my PCP have not really explained what is going on with me as good as you do. Your videos have given me so much hope and information that I have not gotten yet from anywhere else. I am beyond stressed and anxious since I am a mother of little children and a teacher and dealing with this leg pain since February and I still dealing with chronic pain that will not go away. My whole life has been seriously impacted especially my mental health. I still wanted to thank you for your videos . Please do a video of what to do when you have severe spinal stenosis caused by disc herniation. (I had paramedics at my home once because of the severe symptoms and I thought I was having a heart attack!. ). Anything you can say to help me understand what I am going through will really help. BLESSINGS TO YOU! And thank you again.
Please watch the lumbar spinal stenosis playlist
Hi 👋
How are you doing now?
#Epidural = #Nightmare long term!
I’m exactly the same 23years on pain meds , going for my 4th surgery tomorrow
Amazing doctor. Thank you. God bless you
Doctor I suffer from both moderate to severe myelopathy and severe cervical Radiculopathy and I have to say you are spot on with your approach and recommendations I wish these conditions were explained to me in this manner
Thank you Doctor
Dr Su
You make so much sense to me and your explanations are very thorough. I appreciate your expertise and your sharing through your channel. I am in my early 70’s and have suffered with spine problems for many years. This year I had my first spine surgery an
ACDF , three level to address myelopathy and it seems to have been very successful.
This video explains what was going on with me very well. Thank you again for sharing
Totally agree! It's like a free exam almost! Good to hear that you are feeling better. I have a low back problems and neck problems (dental hygienist) and as a second opinion this is where I "go". 😄
This is new to me waiting for my neurosurgeon appointment, this video is so wonderful .Thank you I now understand when surgery is necessary !!!
The best presentation and explanation that I have heard from many videos. Articulate, and Intelligent person presenting in a way that the lay can understand. Great job!
Best video I’ve seen regrading cervical surgery. I am planning on ACDF surgery. This video explained everything so well. Im trying to talk myself out of surgery, but all of my symptoms say I need it. I’m just scared. Dr Su is an amazing instructor. Such great information for such a scary decision to make. Thank you Dr. Su.
Mata: Did you have the Surgery? Hopefully, you got good results.
Dr Su I wanted to say thank you for replying to all my questions over the last few week. I know I've been asking you questions left and right. I really do appreciate you and your kindness and time. Happy Holidays to you 🥰
Hello! This is the most comprehensive and thorough video I have seen on this topic. I was diagnosed about 2 years ago... I am 59 years old, I also have ddd, arthritis and bone spurs. I have gotten 3 different opinions, 2, from orthopedic spine surgeons, 1, from a neurologist. I am very active and walk 5 miles daily, I do not smoke or drink, my BMI is 18-19 and my nutrition is excellent. My pain level is mild - uncomfortable, and intermittent, more of a stiffness. The 1st and 2cd surgeons graded it as moderate to severe - not based on the Japanese score, but on the MRI. I don't have muscular impairments except weak grip strength- worsening of discomfort when lifting arms for a few minutes. The 1st surgeon, said that I have myelopathy, based on the grip strength for my age, etc. The 2cd surgeon said I did not have myelopathy, the neurologist said to "watch and wait" - I am doing okay. I don't want surgery for personal reasons... My familiy, financial, and social circumstances are such that surgery and recovery would be very difficult and life altering for me. I had a car accident in my 30s and never even had issues until my mid- late 50s... When I was diagnosed by MRI because of the infrequent stiffness. I wonder what your opinion of all this is Dr? I do PT - decompression exercises. 1 surgeon wanted to do an ACDF immediately, the other recommended a laminectomy, the neurologist said I can go without surgery!
I would follow the video and get your own mjoa score and based on that partner with the surgeon that you trust to make a decision. You can always make a virtual appointment with me at California orthopedics and spine
I agree. Try to avoid surgery.
Dr. Su, great video with plain English Information. I have extensive Cervical Instabilities with Disc Bulges, stenosis at various levels, Military Neck, and Facet Joint arthritis as well Spondylosis throughout my spine, with OA on a number of vertebrae. Moreover, I suffer with Dextroscoliosis of 25 degrees, resulting from a 1 inch shorter right leg sustained from a fractured right Femur in 1966, playing HS Football. I'm 71 now, male, retired. The spinal issues wreak havoc with my well being, affecting my nervous system (no Reflexes), Peripheral nerve damage, and yes, radiculopathy form my neck into both arms (the left worse). I get numbness in my legs / feet. And, I have been battling On & Off (more on lately) Bladder Incontinence with leakage. On a few occasions, I could not hold the urine at all getting out of my car going to work - a very Embarrassing day!! . I've Seen and heard of Prolotherapy for Cervical Instability issues. I am willing to try that but cannot find a Prolotherapist near me in Suburbia NY. I have come to find doing personal research (that's why I'm here now), that Cervical Instabilities contribute to many maladies not fully disclosed here... Tinnitus, TMJ, Sinus problems, Throat problems, Occipital Headaches and even pain into the temples, even IBS/GERD and can affect The Vagus Nerve(s) [ one on each side]. I have been to 6 different Spinal /Neuro Surgeons for opinions since 2018-19. All said: No Surgery on your Lumbar spine , Maybe you are acandidate for Cervical Surgery , if it becomes Intolerable.
I'm getting there!! In 2012, after my first cervical MRI was done, he reprt indicated that I had a More Narrow Than Normal Spinal Canal. I did not know this until about 6 onths ago reviewing same with my Pain Management doctor. What do think I should do?
It's hard to say without looking at the imaging. You can make a virtual appointment with me through zoom if you call California orthopedics and spine
Great video, thank you a lot.
I have spinal cord stenosis It started from neck pain and a little numbness in two fingers but over 1 year I have neck pain less often and I don't have numbness but often have tingling in my fingers. I do PT and started with yoga several months ago. I am 33 years old, I used to do freeride skiing and bjj.
Thank you for this video. You have explained to me my situation in a much better way than my my doctors have in three years.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on RUclips channel now for help for Any kind of health issues.
Dr. Su, thank you so much for this very informative video. I am a 62 yo practicing (1/2 time) anesthesiologist who has been monitoring my cervical spine issues since 2009 when I had my first MRI for neck and arm pain. A C7-T1 disc herniation at that time was managed successfully with oral steroids and PT. A second herniation occurred in 2016 at C4-5. The MRI had worsened with multilevel congenital central canal stenosis and neuroforaminal narrowing in addition to the disc herniation compressing the nerve root and cord. A cervical ESI helped immensely with my symptoms but my neurosurgical colleagues stated it was only a matter of time before I would need surgical intervention. Since then I have been relatively symptom free with rare arm and foot tingling and neck pain. I have stayed quite active biking up to 75 miles/wk, strength training and playing competitive Pickleball and tennis. Over the past couple weeks, the symptoms are more frequent; some neck, shoulder pain and tingling but no weakness; my mJOA score is 18. I am concerned another herniation may be developing and it may be time to begin my search for a top rated neurospine surgeon in the event surgery becomes my best option. After viewing your video and excellent explanation on literature based indications for surgical intervention, I am a bit more reassured that there is no urgency in this matter until my symptoms begin to worsen. If you can recommend the top spine centers in the Midwest (I know Mayo has an excellent reputation) I would appreciate it. Thank you for time in producing this video for the general public; your contributions are greatly appreciated.
There are many great surgeons in the midwest. Instead of searching for an institution I would encourage you to search for specific surgeons whether it be private practice or academics. I'm always happy to do a virtual consult for you at California orthopedics and spine
Every video you produce is so informative and easy to understand. I'm always so excited to watch your videos. Thank you for all you do. So awesome.
Truly appreciate this video. Hope we can have more doctors thinking the way you do. More power
👍Very informative, thanks !
此處所謂 [#有CordCompression 是說：#在MRI影像上看來 有壓迫]#並不等於 臨床上已顯現客觀理學檢查徵象和患者主觀感受。
🔯MYELOPATHY 症狀:
1.🌹3:23 easy dropping things off hands 在手上的東西發生掉落現象(抓握等精細動作變差)
2.🌹 3:27 wide-base gait pattern, failed in Tandem gait ( 執行走直線測試，發現有困難）
3.🌹 3:50 Hand/ Foot numbness ( 上或下肢出現麻感，但不必一定持續感覺)
4:04 Arm/ Leg
weakness 自覺上下肢無力感
4.🌹 4:18 Bladder dysfunction 排便控制有困難
⚠️1/5 有myelopathy 者其Upper Neuron Signs却仍為陰性徵
Hoffmann sign 4:57
Increased DTR 5:03
🟣mJOA score
#modifiedJapaneseOrthopedicAssociation score 5:27 分數越高 越好
15-17分 界定為輕度
💔🆘#15分以下應考慮手術，但不必然立刻緊急手術，但多建議在近數月內安排手術，除非症狀變化很大。
🥸8:28
🥸9:56
🥸11:38 有cord compression尚無myelopathy者 第一年內8%機會出現myelopathy; 4年內出現的機會為約25%
🥸13:54 EMG有神經根病變証據者，發生myelopathy的機會較高。
🥸14:31 已有myelopathy症狀者 中有5%其myelopathy病情會快速惡化，20%會慢慢惡化，另75%則表現為階梯式的惡化。
🥸16:47 Myelopathy 手術減壓只能避免惡化但無法再回復比術前更好！
17:10 17:30 閱讀定格文字敘述
I watched this video twice and it's very informative and useful to help decie if surgery should be considered. Talking to my surgeon today and hopefully I'll be better prepared.
You mentioned “Learning to live with the pain.” In some of your videos. Would you please do a video on what that may look like and what has helped your patients learn to do this?
Thanks in advance and really appreciate your channel helping to educate our family on our son’s injury.
I have severe stenosis and I'm learning to live with pain. If you dm me ide be happy to share some tips.
This is self explanatory. What do you expect him to say?
@@pbufh yeah my shoulder neck and back hurt all the time. I just went to a doctor and told her and she looked at me and said "WELCOME TO YOUR 40s!"
I have had c4-5, and c6-7 fused. Well, for the past 2 years i have needed c3-4, but with that surgery? i must retire (i am a dentist), and with 2 kids still in school, I just can't do that. So i live with the pain. Most days it's tolerable, but some days? I just don't know how much longer i can continue. I go to the gym, and I also have both lumbar and cervical traction units at home, that temporarily relieves som of the symptoms. My hope is to put off the surgery as long as possible, and maybe??? better technology will become available to treat my pain.
@@DrM1107 interesting comment. Do you think being a dentist caused you to develop the bad neck? I ask because I know dentists have to stay bent over in flexion a LOT while working on fixing teeth.
Thank you ! People need a step by step understanding.
really great, clear, direct and straightforward video. very helpful. thanks!
Your videos are so helpful and easy to follow for a layman. Thank you!
Thank you doctor. A fantastic material for lay people with questions on the subject. Clear and reassuring. 🙏🏼
A family fiend was the healthiest person I’ve know. Always active, disciplined diet and maintained a healthy weight. He was an avid golfer and developed some nagging back pain. He had back surgery and almost immediately began having issues with gait and digestion. He began losing weight and saw several specialists. None could figure out what was causing this. He began to decline to when it was very apparent he had nerve damage and was diagnosed with ALS. Over two years he lost most functionality and he died yesterday. He was a good man. I can’t help but think his ALS was triggered or accelerated by the spinal surgery. It was like a light switch. Prior to surgery he was perfectly fine. After surgery he declined.
He also could have had Lyme. It’s closely related to ALS.
That's heartbreaking. My best friend had ACDF surgery a week ago and she is in a great deal of pain. I'm worried for her. They say this surgery is common but I'm sure there are complications too.
@@susanl10 Best wishes for her full recovery
Condolences man i hope your doing well🙏😔❤️
@@PH-x thank you for your kind words
Thank you for a very clear explanation of cervical myelopathy. I was just referred to a spine surgeon. Lots of myelopathy symptoms.
Watched several of videos since I just had sever flares of neck pain but only tingling on Left arm and leg but no pain, was told from x ray I have stenonis. I don't have other symptoms like urinal, strength loss, or stability issues. Will be consulting spine specialist soon. Learned a lot which has reduced my anxiety. Sincere thanks for the education, expertise and dedication.
Watch the cervical radiculopathy videos
I did watch Dr. Thank you.@@DrBrianSuTheSpineGuy
I’ve been dealing with a neck and lumbar spine injury for years. Got a copy of the MRI report (basically my neck is a mess) and you’ve been able to explain to me clearly the decision process with surgery and why I have the symptoms that I do. I’m seeing a Rheumatologist at the end of October for a way forward with this. Thank you for your presentation.
How old are you?
Always love your videos! New MRI 16 months from last one definite deterioration.. nurosurgeon had case conference to discuss my case and I'm waiting for response C4/5 and C6/7 makes sense why I'm uncomfortable lie either side for long period.. your explanation are always so clear thank you!
Hello Christine
Your videos are great. I've learned more from you than from my doctor. Thank-you so much!
A+ video in every respect. I saved it as a go to reference. My recent MRI indicates "moderate cervical myelopathy". I just did the MJOA eval and have a score of 16, mild myelopathy symptoms. Yesterday a neurosurgeon suggested surgery sooner rather than later. I'm 78 and dubious. Has anyone tried non surgical treatments that seemed to help? Thanks in advance.
Yes you can try physical therapy and collar wear
Thank you so much for this very informative video. I’m currently waiting to see a neurosurgeon because I’ve been symptomatic and have cord compression on my MRI. I sort of went down a rabbit hole of worry not being able to ask anybody any questions while I wait. This answered so many questions for me. Thank you so so much.
You need to travel doc .i live on a small island we lack expertise in orthopedic!!!!!! Many ppl are suffering we also lack surgeons imo . If only you could come your explanation is well spoken , trustful and highly analysed . Well explained step wise .
Dr Brian, you really made my day, my week and my year. My score is 14 and only have little numbness and pain in my neck. In 8 weeks my pain has went from a 9 to 5 and your advise is gold. You sir are a very good person and I wish you all the succes in the world!
Very useful for me . I have cervical stenosis. I learned a lot . Thank you Dr. Your lecture was on time to listen.
Awesome video, excellent presentation; you just helped me out if I need a surgery and when will I need it. Thank you very much Dr Brian Su.
So very appreciative of this video. Our family is going thru really rough time. Booked an appointment with you but it’s not until December. I really need your help asap to make the decision.
Thanks for your video it’s been very helpful I was scheduled for neck surgery and after watching your videos I decided to get a second opinion and was told I don’t need surgery yet that’s been almost two years ago 😮😊. I now see my new Neurosurgeon once a year unless I feel something wrong.
This has been so in depth, I really appreciate it. I feel like Im in purgatory at the moment and Ive been sedentary in bed almost 2 mos.
After uterine surgery at the end of August- 2 weeks later I felt like what was a muscle knot in my shoulder that would not go away and I could not put my head back or look up. It got worse and eventually was excruciating pain day and night into my left shoulder, my elbow and my wrist and arm and fingers. MRI showed severe ossification between c6-7 with a reversed-c and impingement. Im on 900mg of gabapentin 3x's a day, muscle relaxants and oxycodone Im trying to not take but I cant even see the neurosurgeon for another 2 1/2 mos. So Im just rotting away waiting. Its a horrible place to be in.
Hi Dr Su how are you? I re-watched this video today. Since I last posted, my left sided neck pain has got worse and since in the last 7 days (as of 10/4/2023), I feel that there is a lot of extreme tightness, pain inside the left of the neck base where it meets the SCM muscle roughly.
This has kept me awake all night despite strong pain medication when lying down. I am also feeling referred pain to my left index finger mainly and sometimes the thumb, middle, ring, little fingers as I move my head. As of 1 and half months ago I developed some numbness, tightness, pain in my groin and feet.
Standing improves the situation, sitting and lying down make it worse. I have done nothing to make it worse. I was manipulated by an osteopath towards the end of February 2023 and this is when things started getting worse.
I don't think that I have myelopathy because I used your mJOA chart to score myself. The sum came up to 17. I can still walk despite some right nerve impingement in the lumbar spine, I can control my bladder with very slight difficulty due to an existing mild prostate enlargement (I am 66), no numbness in the arms yet, but some pain on and off..
Can you please explain the meaning of the following statements in simple terms?
Mild to moderate C4/5 and mild C5/6 central canal stenosis.
Right C4/5, left C5/6 and right C6/7 neural compressive foraminal stenosis.
Some disc degenerative activity at C4/5, C5/6 and C6/7
Thoracic upper and mid facet joint degenerative change as well as costovertebral degenerative
Also, since I live in AUS, how do I arrange a zoom appointment with you? Do I do this online or do I have to call?
Thank you.
Best regards
Alfred
You can call California orthopedics and spine and request a zoom appointment with me. They know how to deal with my international patients. I have seen a few people from Australia and have had some come over for surgery as well.
I had chiari decompression at age 42. Six months later C3-to-T1 was fused. The surgeon wanted to also fuse C1-C2 because there was so much rotation in the bones. I have bad neuropathy throughout my entire body and have had difficulty walking since 2013. Not sure what would help. 🥺
Thank you so much! Now I understand what my doctors did not say to me. Thank you again. Love and Blessings from the Philippines🇵🇭♥️
I'm learning about my problems this video
Is very informative I'm learning alot from u I have severe back problems I've had it for quite awhile
Congratulations Ashley on your Gold Metal!!! (If you see this) Thank goodness you didn't get sent down the surgery rabbit hole!! 🙌👊👍👍🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇🥇
Thank you for sharing these videos they are very helpful. Currently I am researching everything I possibly can about the spinal cord. A recent MRI shows herniated discs (c5/c6) , stenosis, and a severely damaged spinal cord. Surgeons are recommending disc replacement or fusion to project the spinal cord. Unsure if I should go the route of surgery or try to rehabilitate my neck on my own. Open to thoughts or insights.
That video is perfect for you it depends on your myelopathy index
Great video
Could you please make a video about vertebral artery compression and ischemic stacks from caused by spine
I can put that on the list but it is extremely unusual
Thanks so much for your comprehensive and clear explanation.
Thank you for teaching about the spine. It’s something I took for granted so many years. You are a generous and kind person. Would be interested to hear what research is being done on disc replacement. Thanks again!!
Hello Wanda
Thank you Dr. Su for this very thorough video. I have spinal compression that is just as bad as the example MRI’s that you depict in the video but I would score an 18 on the mJOA score. I have no numbness, no degradation of motor skills, etc. None of the symptoms in the mJOA test. I do, however, have a lot of neck pain and stiffness. My doctor is telling me I risk permanent paralysis in the event of an accident and that surgery is inevitable. He does agree that with the “treat the symptoms not the MRI” philosophy.
My neck pain had been kept in check with Aleve but over the last couple of months it is getting noticeably worse. Physical therapy didn’t really help at all. What do you recommend for 67 year old patients like me that really don’t want to jump into surgery but need to get the neck pain solved to get back to leading an active life.
In general we follow the guidelines in my video. There are always exceptions please consult your surgeon
2
Thanks for the very helpful presentation. BTW, I'm over 65 and deteriorated over several weeks after a misjudged (5 ft, not 2) backward jump from a wall with akward heel landing. I thought I might be ok as my jaw, knees and joints seemed to improve, despite a clear spinal concussion (1-2 sec. paralysis) and hearing what sounded like several disc crushes, but after a week of trying to return to regular activities, I started with severe neck spasms and electrical shocks to moderate myeolopathy. An Xray and the PA at the walk in clinic dx'd bad DJD, radiculopathy, sent me to PT exercises and dry needling and I deteriorated over 4+ more weeks. The surgeon I saw said continue PT but ordered an MRI which his office bungled for weeks and when I got to the ER they found multiple hreniated discs with one halfway wrapped around my cord in a stenotic canal. After posterior C3-T2 fixation with laminectomy, I got everything back immediately after surgery, but then had some return of para/hyperestesia on one side and both hands (at least numbed my arthritis) after my 2 post surgical neck spasms. That is clearing nicely since surgery 5 weeks ago. I am a pretty healthy, athletic 68yo non smoker, light drinker who has always healed quickly and apparently auto fused a factured c3-c4 after a diving accident (spinal concussion in the water with 45 sec paralysis) for which I never got treatment (except for advil) at age 21; I did have neck spasms for around 5 years. Anyway, my surgeon suggested possibly some return over the first year for my surgery, but underestimated me. You mentioned in your video that quick onset is associated with better outcome, so I think that was my case, along with being resilient. Again, thanks for the great vid!
Thanks for the detailed and easy to understand videos.
I have been experiencing muscle wasting of the hands arms and chest over the last five years. But my strength is still good and I have no pain.
I've had many many headaches that always start with pain in the neck usually when I wake up in the morning. But I have found that physical therapy and exercise have really helped with the headaches. But have had no effect on the muscle wasting.
I have been to several spinal surgeons and I've been told I do not need surgery and there is no clear explanation for the muscle wasting. I have had both ulnar nerves released and one carpal release.
You may want to see a neurologist
Thank you, for making this video. Dr. Brian Su, you are helping us understand what we are dealing with after a year of trying to find answer. ER 9/11 pain shoot to back head from the spine. CTscan with & without contrast. Later I saw my Neurology he order MRA MRI Head & spine Have Multi- Aneurysm He listens on 9/21/2022 after seeing the results Diagnosis:
Cervical Stenosis Of Spinal Canal
At C5-6, there is a broad-based disc osteophyte complex with more focal right paracentral components. Severe central spinal stenosis with anterior cord compression. Facet and uncovertebral hypertrophy. Moderate bilateral neural foraminal stenoses. At C6-7, there is a central disc osteophyte complex with mild superior and inferior migration. Moderate to severe central spinal stenosis with mild anterior cord compression. Facet and uncovertebral hypertrophy. Moderate bilateral neural foraminal stenoses. Other multilevel degenerative changes with congenitally short pedicles. There are varying degrees of central spinal and neural foraminal stenoses. Please see above for the remainder of the individual-level details.
My neck started to lock up morning sometime can't lift myself out of bed my husband has to help me. Dr has been saying is Rheumatoid arthritis. but it came back Neg for Rheum & positive for Oth. Arthritis in the spine. Then I fall and things go worst. Seeing a Spine Dr. Monday 9/26/2022 thank you, I'm less worried.
Thanks so much for providing this information.
I have pinched cervical nerves and my imaging shows spinal cord impingement but not the symptoms. I do have radiculopathy and will be having epidural shots. Crossing my fingers it improves my condition.
I’m disappointed my doctor didn’t either take time to explain all the details or provide me with information like this.
You should watch the cervical radiculopathy videos.
@@DrBrianSuTheSpineGuy Thank you for letting me know it is there. I was going to look through your videos to see what you have on my issues. Outstanding of you!!
Thank you for making things simple. I had cervical cord compression due to opll and had pcdf surgery but it still didn't help with pain in my thoracic spine like the dr hoped it would.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on RUclips channel now for help for Any kind of health issues.
Thank you, sir. Very informative, helpful and inspiring. God Bless.
Thank you for the valuable information. I discovered I have cervical and thoracic spinal stenosis from speed walking which rapidly turned into unbearable pain. Of course my PCP wanted to send me for surgery. I insisted on PT which took me from pain to returned full activity. I had setback again at age 61. PT helped again.
But as of recently I'm having pain in my right neck down my arm with numbness to my hand and a minimal amount even up the side of my face to my brow. I'm 100% sure it's not a stroke.
I'm beyond annoyed at how the symptoms are keeping me from living my life and surely getting worse.
What surgeries do you perform?
Very good information. Thank you Doctor.
Perfectly explained but I have both. From December 2023 to March 7th 23 had progressed by 6years. Coord is barley attached neck C6 C7 T1
Always, you are a great Doctor for what you do. You have been helping me understand my back issues and know understanding my neck which I had a car wreck 21 years ago and had 2 clean breaks on C5 and 6. Have no issues now, but understanding helps and people that understand can make better desicions. Thank you again. Just love you for what you do Sir!
I agree, he always explains things in a way that I can understand. Super helpful and also interesting to learn about.
WOW! I HOPE YOU’RE GETTING BETTER! I’M CONSIDERING SURGERY! LIKE YOU, I WAS IN A CAR ACCIDENT 22 YEARS AGO. HOWEVER, NO FRACTURES OR DIRECT INJURY TO MY C5,C6 TO MY KNOWLEDGE!
I am at a 16 on the mJOA (thank you God), was hit by a car on my ebike, found myself on the concrete, not sure if I was dying or living. Luckily, after my ER visit, all tested normal for my CT of my thoracic, blood work, sent home. Working with a Personal attorney, bike was replaced, but my chiropracter found on MRI, multiple disc herniations, stenosis, all kinds of commotion on my C-S spine, L-S Spine (Wondering why they didn't check my T-Spine, Inquiring minds asking.). Your video was on point, spot on, what I needed. Learning a lot, from your videos, I am a past Physician Assistant but didn't spend much time with Neurology (did about 2 years), so your knowledge and teaching method is amazingly comforting. Do you do long distance consultations on Zoom? :) I want to of course do non invasive, but I don't want to risk my full function. My goals was to restart skiing, and maybe running in a 5 k by next year. I am fine if not possible, because I understand biking is coolio if we stay on smooth pavement.
Please call California orthopedics and spine for a zoom appointment with me
thank you so much! now everything is much more clear to me! so better no chiropractic , I was actually not sure about it
So! Brilliant talk!! I have cervical cord compression and am scheduled for ACDF in about 6 weeks. I have all the myelopathy symptoms. Yet my findings on MRI report only describe moderate to severe stenosis. I am 57 and have had spasticity issues in my left leg, and am not able to walk without a walker. It’s been 3 years living this way…oh, I also have MS. My question is could my symptoms be associated with the cervical stenosis? I’m thinking my diagnosis is getting lost due to pre-existing MS diagnosis. Am I crazy??
I would have to look at the imaging. You can call 415-925-8200 for an appointment with me
what are your thoughts on prp and prolotherapy for stenosis, herniated and bulging disc?
That's a good question and I think that's going to be my next video because I get a lot of questions about it. When you really look at the evidence PRP injections in the spine do not work except when there is a dark disc with a posterior high intensity zone. It does not work for degenerative change and cartilage loss and it does not work for nerve root compression even though many doctors do it.
Thanks so much for that wonderful explanation of my condition. I’m very nervously awaiting for neurosurgeon appointment.😩🙏🏿
The thing I struggle with is:
I have a herniated disc at C6/C7. I was in unrelenting pain for about 2 months, my pain was at a 10, cut me open now and fix it type pain. But after waiting those 2 months my pain is probably a 4, I still have some numbness in my forefinger and get tingling/burning in my arm if I lay in the right position.
But is that enough to say I should be cut open and my spine changed forever?
That’s what I struggle with. Do I feel fragile? Yes. Do I live in fear of flaring it up again? Yes. Still, is that a good reason to operate? I can’t decide.
Thank you / You answer all of my questions without even asking...