This information you provide on spinal surgery is helping a lot of people so much. I am about to undergo fusion surgery of L1-L2-L3, and being able to watch these videos allows me to understand what the process involves. Thank you!
Brilliant! Appreciate your education regarding spinal issues. Past 10 years with moderate to severe spinal issues. Preparing for another fusion - L5/S1. L4/5 were fused eight years ago, and bilateral SIJ’s fused three years ago. Something most people do not understand - the areas above and below the fusions - which are compensating for the changes, will eventually wear down, causing similar symptoms. Seems like in this century there should be something new … something more than current treatments. I am a ‘forced-to-retire’ trauma Nurse. It’s devastating to leave the career I love. As an RN and as a patient, your education is superb! Keep making these videos!
Thank you for your kind words, very much appreciated 🙏 You are correct: Adjacent segment degeneration (ASD) is a real phenomenon, and every patient should discuss this possibility with their surgeon before signing-up for surgery. I do my very best to educate my patients about this important topic. Wishing you all the best for your L5/S1 fusion 👍
I am a 65 year old nurse on disability . I know w a fusion is in my future per two surgeons and my long history of DDD,spinal stenosis ,and spondylolisthesis, my r leg pain and foot numbness which was intermittent is now almost constant, I sure wish you were in Virginia. I thank you so much for your honest and informative videos.
I had L4 and L5 fused together I had a disc slide into my sciatic nerve put it back in place put a screw in it to hold it in place I am still in a lot of pain I know something's not right I cannot hardly walk Harley set I meant so much pain it's worth now since I had my surgery I know something's not right my surgeon said well you know you have something foreign inside your body you're going to have pain but I'm in more pain now than I was before my surgery and before my surgery was bad it's real bad now I'm lost
Your an amazing surgeon you have just given this person his life back. I have been waiting for 3 years for micro desectomy on lumbar back l4 l5 seven months ago took severe pain on right side looks like the disc has herniated on that side. Got an mri update just a couple of weeks ago waiting results. The waiting time on nhs in northern ireland u.k is terrible. The wrong movement can put severe pain in my back and cause numbness. Just wondering after a fusion what limitations does this put on you going forward. Wished you were close to me I would be contacting you as my surgeon.
Back surgery really sucks. My lumbar laminectomy (without fusion) in 2021 caused spondylolisthesis, sciatica, radiculopathy, peripheral neuropathy….😢 Pathetic! I know that the successful rate of back surgery with fusion is low although most surgeons suggest it. You can hardly find any surgeons who are able to tell you how to manage the pain without having surgery. Sigh…
Same thing at 55yoa. I was told immediate spinal fusion. I read and rehabed myself. Now 61yoa no problems. I know each situation is different but not enough info on rehahab alternitives.
That's a very good question @RoadMechanic ! It turns out that the majority of the bony purchase by the screw is in the pedicle (the narrow part of the bone) and not so much in the vertebral body (where the tip of the screw ends up). This is something that I actually may make a video about... stay tuned.
Thanks so much for this video 🙏I’ve been suffering with chronic back pain in my lower lumbar for over 7 yrs . I’m based in the uk 🇬🇧.Could you give me some idea of what a procedure like this would cost privately in the USA 🇺🇸.Thanks
I’m currently on workman’s comp due to a lower back injury and I was door dashing after a few weeks of being injured. My legs started to get weak and it was hard tocefen walkz
Spinal fusion when you have neuropathy in the legs?? Before I can stay stabil with all the pain I can walk with the pain. Now with the fusion and stenose operation I can do nothing I NEED ALWAYS HELPING WITH EVERY THING. WITH A WALKER IN HOUSE AND GOUNG OUT ONLY 50 METER AND THAN THE PAIN COMES AND THECWEAKNES. THINK BEFORE YOU DECIDED. MY RIGJT FOOT IS PARALYSED TOO
I have only one question. I have milde grade 1 spondylolisthesis and in my pre-op i have mild symptoms but tolerable. After my spinal fusion it got increased, the doctor again did revision surgery, again it increased a lot. I am unable to sleep, stand, work and have become completely disabled due to excruciating pain. What was wrong for me??
I cannot diagnose your problem, but it seems to me you may want to get a second opinion from another surgeon. Sometimes you need a new pair of eyes to look at an old problem. Wishing you all the best.
Wondering what kind of mobility the patient is left with after this procedure. Would the patient be able to continue an active lifestyle with physical activities such as golf and gym visits? Many thanks
Your question is an excellent one, maybe I should make a video about it someday. Oddly enough, the mobility of most patients is not as significantly affected after this surgery as you would guess (based on the Xray). For example, before the surgery patients with this type of a problem will have severe pain with most types of movements, so mobility was limited by pain. After the surgery (once the spine is decompressed and stabilized) within a few months the mobility of most patients will actually improve compared to before surgery because the nerves are free and no longer causing severe pain. Finally, it is important to remember that most mobility of the trunk comes from a combination of hip/hamstring/quad/knee coordination.
Hi sir I got diagnosed with grade 1 spondylolisthesis and l5 spondylosis after 6 months of injury i came to know about it detaild and its due to collision with steps sir while sitting and stopped sports activities where i feel pain while bending.Wearing braces and if bone fused due to braces as they said its hairline crack can i return to sports and if fused is decompression through endoscope is enough or do i need a tlif sir.I can raise my leg till 90 degree and rarly having keg numbness. while activities pain is high but bearable at rest good sir and 22 years old.
Great video Doc. But couldn't you have done some leminectomy to enlarge the canal and the space between facets without doing the fusion? Nevermind, you explained it further because of the spondy. But what if the person didn't have spondylolisthesis.. is fusion still necessary?
This is an excellent question: Yes, a lot of times we *have*to* fuse the spine even if the patient does not have a spondylolisthesis. This happens if the facet-joints are very degenerated (and more than 50% of the facets have to be resected) or if the nerve is pinched in the foramen (the "exit ramp") which requires a resection of the facet-joint completely. This is a very important point and I will make a video about it (it's on my to-do list). Thank you for watching, stay tuned . Cheers, -MK
I had TLIF L2-s1 to pelvis fusion with laminectomy and cages 2 weeks ago, I am 59 female. So far everything is good, now can walk normally and keep my lumbar straight (I was hinged over pre-op). Nerve pain minimal now , my left foot back to normal (had some foot drop), no leg weakness anymore. I decided on fusion quickly, Dr said the longer wait, the more permanent nerve damage.
You are suggesting that a patient should have a fusion with laminectomy ( if the patient has spondylolisthesis). Like you all the doctor's say you should avoid fusion at any cost at early age, you should adjust as much as possible, however again they say you shouldn’t wait too much as it will affect the upper level & make it hard to surgeon correct the spine to it’s pre-spondy level. this patient i think was older than 60 as his disc was not healthy, so it was mandatory. But for a young patient, age 30, what is your suggestion to get a solution if the patient has only one level (L5) pars defect and grade 1 spondy along with that only levels disc degeneration. *** the patient feels a littel pain while a lot long time working. His nerve compression is not severly happened. As you said that nothing can correct it without surgery. I agree. But does surgery guarentee that the patient will not face again problem. From my study i saw that the fusion cause ASD, making more arthiritic to the upper level, besides the scar tissue forms from the surgery. And though he can get relief for some time but he will face problem again after some years. *** so isn't it wise to delay the surgery as much as possible for adolescents because delaying it will ensure that he maybe just have to get the surgery once in a life time.
i just had stem cell( from my bone ) short to my sine at L5 S1 and lumbar section last 4 months. so far it get better but still not 100%. the Doctor still call me every month to follow up my case. The surgeon wanted fusion at l5s1 but I m so scare and went to stem cell to try out. my case is l5s1 bone to bone, paint real bad at low back and numb right leg. could't stand for long, felt burn at l5s1 and had to line down. now the paint is less and i able to stand for 8 hours work shift. but the right leg still problem, cold feet and stinging sensation. still hope that i don't have to see the surgery doctor but never know. i have to wait and see in the next several months, now I still do with the chiropractor and physical therapy.
This information you provide on spinal surgery is helping a lot of people so much. I am about to undergo fusion surgery of L1-L2-L3, and being able to watch these videos allows me to understand what the process involves. Thank you!
Brilliant! Appreciate your education regarding spinal issues. Past 10 years with moderate to severe spinal issues. Preparing for another fusion - L5/S1. L4/5 were fused eight years ago, and bilateral SIJ’s fused three years ago. Something most people do not understand - the areas above and below the fusions - which are compensating for the changes, will eventually wear down, causing similar symptoms. Seems like in this century there should be something new … something more than current treatments. I am a ‘forced-to-retire’ trauma Nurse. It’s devastating to leave the career I love. As an RN and as a patient, your education is superb! Keep making these videos!
Thank you for your kind words, very much appreciated 🙏
You are correct: Adjacent segment degeneration (ASD) is a real phenomenon, and every patient should discuss this possibility with their surgeon before signing-up for surgery. I do my very best to educate my patients about this important topic.
Wishing you all the best for your L5/S1 fusion 👍
I am a 65 year old nurse on disability . I know w a fusion is in my future per two surgeons and my long history of DDD,spinal stenosis ,and spondylolisthesis, my r leg pain and foot numbness which was intermittent is now almost constant, I sure wish you were in Virginia. I thank you so much for your honest and informative videos.
I live in WV and flew to Wisconsin to have Dr. Khan do my surgery. He's the best!!
I am in VA too and keep getting the run around. Numb.
I had L4 and L5 fused together I had a disc slide into my sciatic nerve put it back in place put a screw in it to hold it in place I am still in a lot of pain I know something's not right I cannot hardly walk Harley set I meant so much pain it's worth now since I had my surgery I know something's not right my surgeon said well you know you have something foreign inside your body you're going to have pain but I'm in more pain now than I was before my surgery and before my surgery was bad it's real bad now I'm lost
Awesome as always, thank you!!
Thank you and a Happy New Year to you 👍
@@SpineSurgeonSpeaks ❤️
Your an amazing surgeon you have just given this person his life back. I have been waiting for 3 years for micro desectomy on lumbar back l4 l5 seven months ago took severe pain on right side looks like the disc has herniated on that side. Got an mri update just a couple of weeks ago waiting results. The waiting time on nhs in northern ireland u.k is terrible. The wrong movement can put severe pain in my back and cause numbness. Just wondering after a fusion what limitations does this put on you going forward. Wished you were close to me I would be contacting you as my surgeon.
Back surgery really sucks. My lumbar laminectomy (without fusion) in 2021 caused spondylolisthesis, sciatica, radiculopathy, peripheral neuropathy….😢 Pathetic!
I know that the successful rate of back surgery with fusion is low although most surgeons suggest it. You can hardly find any surgeons who are able to tell you how to manage the pain without having surgery. Sigh…
Same thing at 55yoa. I was told immediate spinal fusion. I read and rehabed myself. Now 61yoa no problems. I know each situation is different but not enough info on rehahab alternitives.
My Specialist did L4;5 S1 interbody fussion with spacers I could walk before now I can walk I got an excellent specialist. Just like you advised.
Awesome! Great to hear that. Wishing you the best of health in the future 👍
Nice
you should of used longer screws on L3 and possibley L4. How did that happen?
That's a very good question @RoadMechanic !
It turns out that the majority of the bony purchase by the screw is in the pedicle (the narrow part of the bone) and not so much in the vertebral body (where the tip of the screw ends up). This is something that I actually may make a video about... stay tuned.
@@SpineSurgeonSpeaks Ok, that makes sense. Thanks for answering my question.
Thanks so much for this video 🙏I’ve been suffering with chronic back pain in my lower lumbar for over 7 yrs . I’m based in the uk 🇬🇧.Could you give me some idea of what a procedure like this would cost privately in the USA 🇺🇸.Thanks
I’m currently on workman’s comp due to a lower back injury and I was door dashing after a few weeks of being injured. My legs started to get weak and it was hard tocefen walkz
Spinal fusion when you have neuropathy in the legs??
Before I can stay stabil with all the pain I can walk with the pain.
Now with the fusion and stenose operation I can do nothing
I NEED ALWAYS HELPING WITH EVERY THING.
WITH A WALKER IN HOUSE AND GOUNG OUT ONLY 50 METER AND THAN THE PAIN COMES AND THECWEAKNES.
THINK BEFORE YOU DECIDED.
MY RIGJT FOOT IS PARALYSED TOO
Sorry to hear about your severe difficulties, wish you all the best in the future 👍
I have only one question. I have milde grade 1 spondylolisthesis and in my pre-op i have mild symptoms but tolerable. After my spinal fusion it got increased, the doctor again did revision surgery, again it increased a lot. I am unable to sleep, stand, work and have become completely disabled due to excruciating pain. What was wrong for me??
I cannot diagnose your problem, but it seems to me you may want to get a second opinion from another surgeon. Sometimes you need a new pair of eyes to look at an old problem. Wishing you all the best.
Wondering what kind of mobility the patient is left with after this procedure. Would the patient be able to continue an active lifestyle with physical activities such as golf and gym visits? Many thanks
Your question is an excellent one, maybe I should make a video about it someday.
Oddly enough, the mobility of most patients is not as significantly affected after this surgery as you would guess (based on the Xray).
For example, before the surgery patients with this type of a problem will have severe pain with most types of movements, so mobility was limited by pain.
After the surgery (once the spine is decompressed and stabilized) within a few months the mobility of most patients will actually improve compared to before surgery because the nerves are free and no longer causing severe pain.
Finally, it is important to remember that most mobility of the trunk comes from a combination of hip/hamstring/quad/knee coordination.
I think you should have just sewed them back up and did nothing. Most of the time no surgery is better...
Hi sir I got diagnosed with grade 1 spondylolisthesis and l5 spondylosis after 6 months of injury i came to know about it detaild and its due to collision with steps sir while sitting and stopped sports activities where i feel pain while bending.Wearing braces and if bone fused due to braces as they said its hairline crack can i return to sports and if fused is decompression through endoscope is enough or do i need a tlif sir.I can raise my leg till 90 degree and rarly having keg numbness. while activities pain is high but bearable at rest good sir and 22 years old.
Great video Doc. But couldn't you have done some leminectomy to enlarge the canal and the space between facets without doing the fusion? Nevermind, you explained it further because of the spondy. But what if the person didn't have spondylolisthesis.. is fusion still necessary?
This is an excellent question:
Yes, a lot of times we *have*to* fuse the spine even if the patient does not have a spondylolisthesis. This happens if the facet-joints are very degenerated (and more than 50% of the facets have to be resected) or if the nerve is pinched in the foramen (the "exit ramp") which requires a resection of the facet-joint completely.
This is a very important point and I will make a video about it (it's on my to-do list).
Thank you for watching, stay tuned .
Cheers,
-MK
I had TLIF L2-s1 to pelvis fusion with laminectomy and cages 2 weeks ago, I am 59 female. So far everything is good, now can walk normally and keep my lumbar straight (I was hinged over pre-op). Nerve pain minimal now , my left foot back to normal (had some foot drop), no leg weakness anymore. I decided on fusion quickly, Dr said the longer wait, the more permanent nerve damage.
Great to hear that you are recovering nicely, wishing you the best in the future. Thank you for reaching out.
You are suggesting that a patient should have a fusion with laminectomy ( if the patient has spondylolisthesis). Like you all the doctor's say you should avoid fusion at any cost at early age, you should adjust as much as possible, however again they say you shouldn’t wait too much as it will affect the upper level & make it hard to surgeon correct the spine to it’s pre-spondy level.
this patient i think was older than 60 as his disc was not healthy, so it was mandatory. But for a young patient, age 30, what is your suggestion to get a solution if the patient has only one level (L5) pars defect and grade 1 spondy along with that only levels disc degeneration.
*** the patient feels a littel pain while a lot long time working. His nerve compression is not severly happened. As you said that nothing can correct it without surgery. I agree. But does surgery guarentee that the patient will not face again problem. From my study i saw that the fusion cause ASD, making more arthiritic to the upper level, besides the scar tissue forms from the surgery. And though he can get relief for some time but he will face problem again after some years.
*** so isn't it wise to delay the surgery as much as possible for adolescents because delaying it will ensure that he maybe just have to get the surgery once in a life time.
What's your opinion about stem cell therapy for disc herniation?
If it sounds too good to be true, it is likely too good to be true.
i just had stem cell( from my bone ) short to my sine at L5 S1 and lumbar section last 4 months. so far it get better but still not 100%. the Doctor still call me every month to follow up my case. The surgeon wanted fusion at l5s1 but I m so scare and went to stem cell to try out. my case is l5s1 bone to bone, paint real bad at low back and numb right leg. could't stand for long, felt burn at l5s1 and had to line down. now the paint is less and i able to stand for 8 hours work shift. but the right leg still problem, cold feet and stinging sensation. still hope that i don't have to see the surgery doctor but never know. i have to wait and see in the next several months, now I still do with the chiropractor and physical therapy.