That is the absolute BEST and clearest explanation of what i have (lumbar spondy, L4) that I have EVER gotten. And, gives me hope (yes, i can get better)! Thank you so much! And now, as I wait for 6 weeks (after my mri) to even be able to see a PT, I will continue with NSAIDS until my appointment and find some easy strengthening to help until I can get actual professional help. I cannot thank you enough! My day, and journey with this challenge, just got much brighter thanks to you...💕
I have done decompression therapy with a chiropractor to avoid surgery and it has seriously changed my life. I almost couldn't walk and now I have ZERO pain.
@@Starbabynn thank you so much for that! i have been reticent to go to a chiropractor out of fear...i will keep that option open now! glad you are doing so much better!
This is my surgeon! I had TLIF surgery at the end of March and have done so well.Thank you, Dr. Armaghani for your great, work, compassionate care, and these videos! So helpful!
11:58 Thank you for your wonderful and thorough explanation of what this is and the treatments of it. I have done conservative treatment for the past four years and finally, I am getting the OLIF surgery in two weeks. I am a 72 year old retired RN and this totally explained what was going to happen to me. Thank you so much for your great explanation!
I had this and ended up with fusion surgery of the s-1 and L-5. My butt and legs hurt/numb and when I woke up from surgery it was GONE. That was 2 yrs ago and still good to go.
@ Daryl Smioth your L5-S1 is fusion, what kind of fusion did you get? After your fusion healed we’re you able to move and carry on with life with normal functions and activities?
It's surgery is successful??? I mean I heard so bed abt surgery I m from India n I also suffer from listhesis l5 S1.... And I m so worried Dr suggest to me surgery My question is can I live normal after surgery?????
@@loveyourself_5797 is your issue solved? Did you get operated or can you please tell me which medication did you use. I am also suffering with lumbar spondylitis. I have an issue in L5-S1.
Im 59 and I have a level 1 of this symptom., as indicated from an X-ray. I also have very slight scoliosis too… You did a better job of explaining treatment tree than my own PCP did. Thank you! Super clear, right to the point and you inspire confidence and hope. Thank you
Your video is very informative, and your use of pictures helps nonmedical individuals get a better understanding of the condition. I searched this after learning about this condition which afflicted Luigi Mangione. As a clinical psychologist, it's very important for medical professionals to refer patients who have medical conditions causing emotional pain along with physical pain in order for the mental health professional address the emotional impact and provide psychological coping skills.
I have both spondylolisthesis and scoliosis. I have spondylolisthesis from a broken spinal hook on the lumbar region (I forget what vertebrae exactly). The pain the I was in before physical therapy was so bad I couldn’t walk. Numbness in my leg, and extreme muscle weakness in my left leg as well, I couldn’t even put my weight on it without collapsing. I don’t want spinal surgery so Pt was perfect, strengthened core muscles to hold my vertebrae in place.
This was a very thorough and precise explanation of the condition , and treatment, thank you. I have been dealing with this for well over a month, and taking quite a bit of medication. I’m hoping to have the epidural done to relieve my discomfort/pain.
A great presentation for non-professionals done in such a manner that gave me a total understanding of my diagnosis and the possible avenues of treatment and outcomes. Thank you for doing this.
Don't waste your time. None of this crap works. None of it. They just drain your pocket and your time. You'd be better off just finding a heroine dealer. It works and it's cheaper. To top that off, your quality of life will be so much better. Just find a dealer and skip all the pain and headaches.
A very good video of full clarity.one week back my wife was diagnosed spondilolesthsis. For a fall wayback 8 years ago,all the while no problem at all,but all of a sudden one morning she could not stand and was falling down. An MRI and other tests were on, steroid injections for 5 days and now on medication. No Improvement at all,but Your video has given lot of hope and Confidence.
That is great to hear, Don. In general, recovery from a revision fusion takes about a year and can be slow and gradual. Great to hear that you no longer require pain meds. Keep up the good work!
Thank you, Rachel. My coder also thought this was helpful knowing what was done in surgery. There are another dozen or so episodes on my channel that go over all the surgeries in detail that may be helpful to your coders as well.
Yes they do help tremendously. I have seen the videos and actually I do view them when I am coding operative reports and auditing for our compliance department.
I have this between L5-S1. PE teacher injured me in ninth grade. Discovered four years later in boot camp physical. Broken pars from injury causes instability and APT. Been 44 years.
I was to a point where I couldn't stand nor sit. I didn't want needles in my back for a temporary cure and certainly didn't want surgery, heard to many that caused more harm than good. Been going to Chiropractor for almost a year, do sit ups, presently 70 with 3 lb weight on my chest and walk as much as I can. I have to be very conscious on my posture at all times as I still tend to slouch. I will get pain and stiff if I sit to much but otherwise about 80% pain free. My pain is not the debilitating pain that it was. I am so happy to have found the right Chiropractor. There are many chairs I cannot sit in at all because it'll throw my back out and I bring my car seat cushion to use at work where I have two desks, one regular and one I made into a stand up desk so I can switch back and forth. Anything to avoid surgery. For now I'm comfortable. Not 100% but doing what I can to see how close I can be.
I think that is key. Every patient has their own trigger for when they feel ready for surgery. I always tell my patients that surgery is a last resort if everything else stops working. Good luck!
Thank you so much for the very informative lecture. I have Spondylolisthesis 1st grade an a a bi scoliosis. I tried everything. Ibuprofen helps for the excersises. My target is having a very strong corb, try to have a sixpak, 3 pack would be o.k. as well. I feel better, if I bend my back it hurts, hope I can stop the pain and being able to walk better and do Zumba like befor the bad pain, whick got worse after a broken foot
Thank you for this video. You are very thorough and take the time to explain everything in the best possible detail. This has helped me a great deal. I have subscribed to this channel.
I’m almost positive I have this condition. When I have lower back pain my torso is twisted to one side, it hurts to stand or walk, and lasts weeks. When it gets really bad, my whole back spasms upward to my neck and is the worst pain I’ve ever felt. Yet I’ve been going to doctors for years and am continuously told, “it’s back pain, you’ll have it for the rest of your life.” Very frustrating…
I have it to start strengthening your core your abdomen but you cannot do sit-ups you got to start doing planks moving more away from an anterior pelvic tilt you want to bring your pelvis forward so you have to do stuff like lying on your back doing leg raises to strengthen your core and doing like planks and you need to start strengthening your lower back you need to get as much lower back strength and as much core strength as you can and I know you're thinking that it's impossible but there's a way to do it you got to start slow and work your way up I have it really bad my torso twist as well and it shoots up to my neck you got to start small and keep going start strengthening your glutes and your hamstrings and your quads and your ankles that way you have more muscle support so that your body can rely on your muscles to keep yourself straight because that bone in there is just it's just decimated it's missing it's not active
@@brandondennison1443 this was very helpful for me..I’ve been doing everything I’m supposed to (moderate exercise, active job, new mattresses, new shoes, hot epsom salt baths, TENS unit, foam roller, massage chair, massage appointments, healthy diet, etc…) shy of committing to a $3,000 chiropractic treatment plan…I keep wondering why my workouts seem more difficult to complete. I always loved core exercises, but sit-ups are becoming more difficult and not giving the usual results. I will definitely be trying your advice by starting with planks and move forward from there. Thank you!
@@laurathran8198 start planking and watch a video on RUclips on how to activate your core it's the one muscle in our body that our brain loses connection with we literally can't flex our ABS cuz over time you don't use them as much and you lose the muscle mind connection before you start doing sit-ups you got to learn how to engage your core so watch a video on that
I have this between sacrum and the next vertebrae and core strengthening plus stretching psoas and legs have helped. Standing is the worse. I’ve had back issues since I was a child and now at middle age is only worse. Wondering if I’ll need surgery at some point
Dr. I love your video's and I trust your knowledge. I was recently diagnosed with Disc Degenerative Disease. Can you please do a video to explain what this really is and how it affects the body. Please and thank you.
Thanks for the detailed videos of this and the alif. I have this at L 4L5 and 10 yrs ago it only caused intense sciatica for 3 yrs and then stabilized on its own. This year it became unstable and its just causing intense nerve pinch on both legs but no back pain. I have done everything you said including the epidural a few weeks ago. Its only helping a little. I already saw a surgeon and I am having an alif in a month. Only other thing was a facet joint synovial cyst in the same area but I have no problem with it. I really have no choice as I cant walk much from the leg pain, weakness, spasms and tingling etc. I live 24 hrs a day in fitted blue jeans with a belt for support and use tape on my back, sometimes duct tape, on either side of my spine, anchoring at the bottom then pulling that area up and then taping down. It seems to give the nerves more room when I am at level 10 but not so good for the skin. After watching your video I am more informed, Thanks.
Excellent presentation. I have Spondylolesthesis, HNP of L4-L5 by MRI. The Orthopedic surgeon said that, in plain language, the disk was squashed in every direction. This was due to a weight lifting accident when I was doing barbell squats and went down too deeply. That was in 2014 and I wind up aggravating it every once in a while.
@@vladislavsafronov245 I was doing sets of 6 with 225 and would stack up with each set until I got to a max rep of 270. That was 8 years ago and I was 67. Cheers, Bob
@@ferosekhan2389 I have a little sciatica pain now and then. Funny thing is I had my hip replacement last Friday, now both hips are titanium and I haven't had any sciatica. BTW, my Irish- American cousin's husband's name is Khan. Cheers, Bob
In 2010 I was diagnosed with severe spinal stenosis and spondylolisthesis. I had fallen 8 ft on to concrete, and was bent over. I could not straighten up without severe pain. I am in the UK, and the waiting times to see a specialist can be very long. It was 10 months before I was seen by an orthopedic surgeon, and another year before having decompression surgery...L4 and 5. However during all the waiting time my spinal cord was pinched and I ended up with a dead sciatic nerve in my left leg, and I have never walked well or much since. I did not have pain until last April, when it came on suddenly and worse in my good Right leg. I have since seen a pain specialist, and had an MRI. I nowhave stenosis at L3/4, L4/5, and very severe at L5/S1, and degenerated arthritis, and I am 87, but in very good health otherwise. I only retired from my piano teaching job in a school a year ago. I have been offered physiotherapy from a very good practitioner, with a first appointment in 10 days time. Motivation to do the exercises will be difficult as I have much pain now. You mention lumbar fusion. This was not suggested to me, but I wondered if that would help, and what does it entail? (I am unable to sit at the piano for more than 10 minutes since April 2021)..
Check out the TLIF video in my collection on the youtube page and that can help explain more. Not everyone is a candidate for fusion though and it may not be the right answer for each unique patient. Good luck!
I have this exact problem from wear and tear over the years of work and also my weight which I am taking steps now to lose some weight and am now set up for phys/Therapy.
great work! if you are able to get stronger in your core and lower back muscles, coupled with a little bit of weight loss, you may be able to avoid any sort of intervention.
Is there a way of bringing the slipped vertebra in line with the rest without fusion? Artificial disc to retain motion? I have spondylolisthesis and currently going through a rehabilitation program which is not helping.
unfortunately as of 2023 there is not. only fusion. there are some artificial disk replacements that are coming on line with maybe some improvement of alignment
Grade 1-2. It depends on how big your bones are. If it is greater than 25% slipped forward that is the limit of grade 1. 10mm correlates to a high grade 1/low grade 2 spondylolisthesis but treatment does not change between them.
I’m 24 and found out I have this recently after having pain for over a year and being basically bed ridden for months. I’ve tried PT and cortisone injections and they haven’t worked however I’m nervous about the surgery option. Any advice is wonderful, thank you!
I've been dealing with pain from spondy for over a year. The doctor didn't want to do a microdiscectomy or laminectomy because I have a pars defect at L5 causing it to slip over S1. The surgeon wants to do ALIF/TLIF... I'm scared shitless
Also a part of non-operative care. Remember though that RFAs typically only help with back pain but not so much leg symptoms. If back pain is a big part of a patient's pain picture, RFAs can definitely be a part of the non-operative process.
great question. it has to do with the disks degenerating between the vertebrae. sometimes when that happens, people develop some laxity in their joints that connect the vertebrae together. That laxity mixed with the disk degeneration leads to the slip or spondylolisthesis
In 2016 I had a Gil Laminectomy and my neurosurgeon in Nashville said I needed fusion, but bc it was only a grade 1, my insurance company wouldn’t pay for the fusion. He argued with them over and over and they denied. I remember him telling me that he hated to do the laminectomy without the fusion, bc he knew I would need another surgery later. Here we are, in 2024, and I am having a great deal of pain in my lower back, radiating to my butt, and down the leg. Ugh.
This is the problem i have, my DR told me to do surgery, since other conservatives tx don't work since 2yrs, this is my question , is it true that after fusion surgery you have the same problem again in the next 4 to 8 yes?
Good question. After a successful fusion in 1 area, there is a chance of roughly 20% that you will need surgery at an area above or below your fusion within 10 years of surgery. So it is not everyone but it is not an insignificant amount of people who do need surgery later on.
I think it like 3 to 5 year's I'm suffering with it now since I had my first back fusion in 2016. Been suffering for over 3 year's now adjacent segment disease is what they call it and it's very common
You did mention that is some cases a spondy may not require a fusion if there is little movement. Is there a measurement amount that you use to determine if a spondy is required?
Excellent question. A couple factors come into play with that. Typically people with severely degenerated disks will not move all that much if we do just a laminectomy instead of a fusion. I, personally, don't want to see more than 2mm of motion on x-rays.
Good day Doctr.. thanks for your video I did an MRI scan that showed mild cervical straightening but I have symptoms on both my cervical shoulder blade and now my lumbar spine. The doctor said I have both cervical and lumbar spondylitis. Althou it’s just tingling on feet and hands and sometimes when I seat too much my hip muscle hurts. The neck X-ray shows more than the MRI. What do I believe Dr?
I have spondylolisthesis in L4, L5 and S1 and it’s painful. That combined with an arthritic knee makes me want to scream some days. My doctor hasn’t offered anything to help the pain. Aging sucks.
those are very clear pain generators. hopefully going through conservative measures can help you with what youre experiencing. if not a consultation with a surgeon wouldn't be a bad idea just to get your options.
@@ArmaghaniSpine Thank you doctor. I do need to be more aggressive in seeking treatment. Now that my Medicare plan allows me to self-refer, I will take your advice to see a surgeon. Thank you doctor for explaining this condition to us. We do need the information to make good choices.
Really nice and well explained. I have had real pain that almost is disabling me. I have had physio since 1994 and it helps. My spine has been going in but doctors say its natural aging
Hi bro I think u should recover from this .I also grade 1 anterolisthesis over l5 s1 with bilateral pars defect. Help me how to heal pls...I hope u gone reply..thank
I have mild lumbar scoliosis convex to the left. My bone density is reduced. Spondylotic changes are seen throughout and narrowing of L1/2,L2/3 and L3/4 is preserved. The SI joints are normal. Is this serious Doctor? Tq
If some one has pain in only spot at L4 vertebrae in middle of spine.... I'm not able to diagnose.... Can uh tell me differential diagnosis of this conditions
sir! ive l5 over s1 subtle anterolisthesis with bilateral pars defect and whenever i try to stand or walk i have instability issues and most of the time while walking i feel like somwething is pushing towards right side direction.... im unable to do normal routines for the last 1.3 years!!! im 21 what should i do? is it worth it to undergo a surgery.... because, im an athlete and wanna return back to competitve sports and games.... please, let me knw what should i do right now
i generally advise patients that if the pain limits activities they enjoy doing and they have tried everything else, surgery can be an acceptable option
Here in Canada, they won't operate unless you're in a wheelchair and/or diapers. It's sickening our health system. It's inhumane to leave an animal in pain but apparently a person it's ok. Just ridiculous
It’s ridiculous that in any money grabbing non government insutitution anywhere else they will inject you stuff to sleep and almost kidnap you until you agree to surgery whether you need it or not
hi dr .my 35 year daughter has l5s1 spondylolisthesis with mild bulging disc indenting thecal sac she has back pain ,gait disturbance and frequent big toe extension. so what do you think the exact cause for her symptoms and should she consider fusion .thanks
Her issue is coming from likely compression of her L5 nerve root. Depending on the imaging and her personal characteristics, she may be able to get away with a decompression but most will benefit more with fusion on average.
retrolisthesis is more of a radiological finding that some people have and doesn't always cause pain as much as an anterolisthesis like you see in the lumbar spine. it could be a normal variant
excellent question. those present at many different stages of ones life. some start having problems in their 20s and some don't have issues into their 60s or 70s. what we do know is that 10% of people walking around today have one and don't even know. the older you are the less likely it is to progress and fusion is really only indicated if it is causing leg pain that isn't alleviated by conservative measures.
Hi I have spondylolisthesis. I had a fusion on l5 l4 5 months ago. I have 2 loose screws one is at a 40 degree angle on yhe xray . Is this normal. Will they take the screws out or replace the. Revision surgery in 2 weeks
@@haleshendrickson7297 I can tell you, NO, not normal… This is exactly why I will not have any type of fusions which is what they want to do to me. Too much room for error - too much risk for failed back surgery syndrome. And, when your bones get brittle and worse where the screws are placed. They can’t stay in place. - like putting a spoon in thick pudding or thick mashed potatoes, the spoon will eventually move. I am sure Dr. A is amazing. But, our bodies will do what our bodies will do. Age - and eventually fall apart. That said: I hope you find relief and I would NOT go back to that same surgeon if you can avoid it. I mean seriously. And, they’ll replace those with BIGGER screws. - I wish you the best with whatever you end up doing. :(
yes you can especially in the neck. Not everyone is a candidate particularly in the lumbar spine and in the setting of alignment issues (such as a spondylolisthesis) it is even less of a durable solution.
I'm an orthopedic surgeon with specific training in just spine surgery. Both orthopedic surgeon and neurosurgeons do the same procedures and I know fantastic neurosurgeons as well as fantastic orthopedic spine surgeons. My suspicion in the future is there will be just "spine surgeons" with similar trainings instead of this split that is seen. Long story short is, get a couple different opinions and go with whoever you feel most comfortable with!
Hey sir.. I'm a 21 years student from India suffering from Lumber Spondylitis in which partial socialization of L5 vertebrae is seen leading to mild canal narrowing at L5-S1 level. I'm suffering from back pain and if excess standing, sitting or walking is done, the pain also transmitted to the part of hamstring (sometimes). Which exercises should I follow and which activity should I ignore? Should forward and backward bending are also restricted? Waiting for your reply..
We usually have our patients see a physical therapist who does a full evaluation on them to find out what they are good at and not so good at and then give them tailored exercises for those areas that could use a little improvement.
Dear Dr. Armaghani, I am reaching out to discuss my ongoing health condition. For the past three years, I have been diagnosed with Lumbar Spondylolisthesis. This condition has not only caused me persistent back pain but also discomfort in my knees. In my attempts to find relief, I have undergone physical therapy sessions multiple times. Additionally, I once received a cortisone injection, which provided significant relief for about two months. However, the pain has since returned. I am now at a crossroads and seek your guidance. Would it be advisable for me to consider another two cortisone injections? Or is it time to consider more definitive measures such as surgery? Your expertise and advice will be invaluable in helping me navigate my next steps. Thank you for your time and consideration.
Hi plz help me... My mother is in Grade III.. We took MRI and consulted doctor they told it is spondylolisthesis... Will it cure after surgery... Will she able to walk after surgery plzzz suggest me...
Thanks yours explanation is very good. Let me understand my condition and the treatment will be conservative fisiotherapy no nsais or steroids I can not handle the side effects but thanks to you very much0
That is the absolute BEST and clearest explanation of what i have (lumbar spondy, L4) that I have EVER gotten. And, gives me hope (yes, i can get better)! Thank you so much! And now, as I wait for 6 weeks (after my mri) to even be able to see a PT, I will continue with NSAIDS until my appointment and find some easy strengthening to help until I can get actual professional help. I cannot thank you enough! My day, and journey with this challenge, just got much brighter thanks to you...💕
I have done decompression therapy with a chiropractor to avoid surgery and it has seriously changed my life. I almost couldn't walk and now I have ZERO pain.
@@Starbabynn thank you so much for that! i have been reticent to go to a chiropractor out of fear...i will keep that option open now! glad you are doing so much better!
This is my surgeon! I had TLIF surgery at the end of March and have done so well.Thank you, Dr. Armaghani for your great, work, compassionate care, and these videos! So helpful!
11:58 Thank you for your wonderful and thorough explanation of what this is and the treatments of it. I have done conservative treatment for the past four years and finally, I am getting the OLIF surgery in two weeks. I am a 72 year old retired RN and this totally explained what was going to happen to me. Thank you so much for your great explanation!
best of luck!
Karen, why an OLIF vs a TLIF or ALIF? How did the surgery go?
How was your surgery??? You fine now??
You're a great teacher that makes this information very easy to understand.
Thank you!
I had this and ended up with fusion surgery of the s-1 and L-5. My butt and legs hurt/numb and when I woke up from surgery it was GONE. That was 2 yrs ago and still good to go.
Wonderful to hear!
@ Daryl Smioth your L5-S1 is fusion, what kind of fusion did you get? After your fusion healed we’re you able to move and carry on with life with normal functions and activities?
It's surgery is successful???
I mean I heard so bed abt surgery
I m from India n I also suffer from listhesis l5 S1.... And I m so worried
Dr suggest to me surgery
My question is can I live normal after surgery?????
@@loveyourself_5797 me too. Now what's your condition
@@loveyourself_5797 is your issue solved? Did you get operated or can you please tell me which medication did you use. I am also suffering with lumbar spondylitis. I have an issue in L5-S1.
Im 59 and I have a level 1 of this symptom., as indicated from an X-ray. I also have very slight scoliosis too… You did a better job of explaining treatment tree than my own PCP did. Thank you! Super clear, right to the point and you inspire confidence and hope. Thank you
I got diagnosed a few days ago and this has been golden information.
Glad it was helpful!
Your video is very informative, and your use of pictures helps nonmedical individuals get a better understanding of the condition. I searched this after learning about this condition which afflicted Luigi Mangione. As a clinical psychologist, it's very important for medical professionals to refer patients who have medical conditions causing emotional pain along with physical pain in order for the mental health professional address the emotional impact and provide psychological coping skills.
Best explanation I’ve gotten after years of searching
I have both spondylolisthesis and scoliosis. I have spondylolisthesis from a broken spinal hook on the lumbar region (I forget what vertebrae exactly). The pain the I was in before physical therapy was so bad I couldn’t walk. Numbness in my leg, and extreme muscle weakness in my left leg as well, I couldn’t even put my weight on it without collapsing. I don’t want spinal surgery so Pt was perfect, strengthened core muscles to hold my vertebrae in place.
Hi will the vertebrae comes back to position with pt?
Kƙ O UN
😅 5:20 5:20 😅 5:20
Bagaimana keadaan mu sekarang tanpa operasi
Excellent presentation 👏 I can now show my family what my back issue is from the video. Thank you!
Glad it was helpful!
whats your issue???
This was a very thorough and precise explanation of the condition , and treatment, thank you. I have been dealing with this for well over a month, and taking quite a bit of medication. I’m hoping to have the epidural done to relieve my discomfort/pain.
A great presentation for non-professionals done in such a manner that gave me a total understanding of my diagnosis and the possible avenues of treatment and outcomes. Thank you for doing this.
You're most welcome!
Don't waste your time. None of this crap works. None of it. They just drain your pocket and your time. You'd be better off just finding a heroine dealer. It works and it's cheaper. To top that off, your quality of life will be so much better. Just find a dealer and skip all the pain and headaches.
@@ArmaghaniSpine great presentation Dr easily understood
Thank you for this video. It's the most informative I've found.
A very good video of full clarity.one week back my wife was diagnosed spondilolesthsis. For a fall wayback 8 years ago,all the while no problem at all,but all of a sudden one morning she could not stand and was falling down.
An MRI and other tests were on, steroid injections for 5 days and now on medication. No Improvement at all,but
Your video has given lot of hope and
Confidence.
best of luck!
Got no explanation from my doctor at all. This is so helpful.
Yes! After a car accident, my lumbar spine looked like stair steps. Nice to have the real name for it!
Did you fracture anything?
The style of explanation is excellent.
Thank you!
Omg, you are great. The best explanation/description of spondylolisthesis. Articulated perfectly. Thank you
I had L4 L5 fusion for my spondy 2 years later S1 had to be fused ...that was Dec. 2020 doing much better but still healing on no pain meds
That is great to hear, Don. In general, recovery from a revision fusion takes about a year and can be slow and gradual. Great to hear that you no longer require pain meds. Keep up the good work!
I love this channel. I am a Coding Compliance Auditor and this has helped me. Please may I request for you to explain a Spinal Surgery
Thank you, Rachel. My coder also thought this was helpful knowing what was done in surgery. There are another dozen or so episodes on my channel that go over all the surgeries in detail that may be helpful to your coders as well.
Yes they do help tremendously. I have seen the videos and actually I do view them when I am coding operative reports and auditing for our compliance department.
I have this between L5-S1. PE teacher injured me in ninth grade. Discovered four years later in boot camp physical. Broken pars from injury causes instability and APT. Been 44 years.
What kind of injury?
I was to a point where I couldn't stand nor sit. I didn't want needles in my back for a temporary cure and certainly didn't want surgery, heard to many that caused more harm than good. Been going to Chiropractor for almost a year, do sit ups, presently 70 with 3 lb weight on my chest and walk as much as I can. I have to be very conscious on my posture at all times as I still tend to slouch. I will get pain and stiff if I sit to much but otherwise about 80% pain free. My pain is not the debilitating pain that it was. I am so happy to have found the right Chiropractor. There are many chairs I cannot sit in at all because it'll throw my back out and I bring my car seat cushion to use at work where I have two desks, one regular and one I made into a stand up desk so I can switch back and forth. Anything to avoid surgery. For now I'm comfortable. Not 100% but doing what I can to see how close I can be.
I think that is key. Every patient has their own trigger for when they feel ready for surgery. I always tell my patients that surgery is a last resort if everything else stops working. Good luck!
Thank you so much for the very informative lecture. I have Spondylolisthesis 1st grade an a a bi scoliosis. I tried everything. Ibuprofen helps for the excersises. My target is having a very strong corb, try to have a sixpak, 3 pack would be o.k. as well. I feel better, if I bend my back it hurts, hope I can stop the pain and being able to walk better and do Zumba like befor the bad pain, whick got worse after a broken foot
good luck. happy to hear you are doing your part in keeping your back and core strong!
Thank you for this video. You are very thorough and take the time to explain everything in the best possible detail. This has helped me a great deal. I have subscribed to this channel.
Glad it was helpful!
He gave better information then the neurosurgeon I went to.
Glad you enjoyed it!
I’m almost positive I have this condition. When I have lower back pain my torso is twisted to one side, it hurts to stand or walk, and lasts weeks. When it gets really bad, my whole back spasms upward to my neck and is the worst pain I’ve ever felt.
Yet I’ve been going to doctors for years and am continuously told, “it’s back pain, you’ll have it for the rest of your life.” Very frustrating…
I encourage an evaluation by someone near you. Couldn't hurt and maybe could give you some answers. Good luck!
@@ArmaghaniSpine I went to a doctor, they refused to do any tests and told me to see a physiotherapist.
I have it to start strengthening your core your abdomen but you cannot do sit-ups you got to start doing planks moving more away from an anterior pelvic tilt you want to bring your pelvis forward so you have to do stuff like lying on your back doing leg raises to strengthen your core and doing like planks and you need to start strengthening your lower back you need to get as much lower back strength and as much core strength as you can and I know you're thinking that it's impossible but there's a way to do it you got to start slow and work your way up I have it really bad my torso twist as well and it shoots up to my neck you got to start small and keep going start strengthening your glutes and your hamstrings and your quads and your ankles that way you have more muscle support so that your body can rely on your muscles to keep yourself straight because that bone in there is just it's just decimated it's missing it's not active
@@brandondennison1443 this was very helpful for me..I’ve been doing everything I’m supposed to (moderate exercise, active job, new mattresses, new shoes, hot epsom salt baths, TENS unit, foam roller, massage chair, massage appointments, healthy diet, etc…) shy of committing to a $3,000 chiropractic treatment plan…I keep wondering why my workouts seem more difficult to complete. I always loved core exercises, but sit-ups are becoming more difficult and not giving the usual results. I will definitely be trying your advice by starting with planks and move forward from there. Thank you!
@@laurathran8198 start planking and watch a video on RUclips on how to activate your core it's the one muscle in our body that our brain loses connection with we literally can't flex our ABS cuz over time you don't use them as much and you lose the muscle mind connection before you start doing sit-ups you got to learn how to engage your core so watch a video on that
Good video thanks 🙏.
I have this between sacrum and the next vertebrae and core strengthening plus stretching psoas and legs have helped. Standing is the worse. I’ve had back issues since I was a child and now at middle age is only worse. Wondering if I’ll need surgery at some point
Very informative. I have the condition and is very debilitating.
Dr. I love your video's and I trust your knowledge. I was recently diagnosed with Disc Degenerative Disease. Can you please do a video to explain what this really is and how it affects the body. Please and thank you.
Excellent presentation. I have no other choice than to subscribe to your videos sir. Thanks a lot.
Great video. I start PT for this in a few days
Thanks for the detailed videos of this and the alif. I have this at L 4L5 and 10 yrs ago it only caused intense sciatica for 3 yrs and then stabilized on its own. This year it became unstable and its just causing intense nerve pinch on both legs but no back pain. I have done everything you said including the epidural a few weeks ago. Its only helping a little. I already saw a surgeon and I am having an alif in a month. Only other thing was a facet joint synovial cyst in the same area but I have no problem with it. I really have no choice as I cant walk much from the leg pain, weakness, spasms and tingling etc. I live 24 hrs a day in fitted blue jeans with a belt for support and use tape on my back, sometimes duct tape, on either side of my spine, anchoring at the bottom then pulling that area up and then taping down. It seems to give the nerves more room when I am at level 10 but not so good for the skin. After watching your video I am more informed, Thanks.
you're most welcome!
@@ArmaghaniSpine I am 6 weeks post alif surgery and doing very well.
mine is in the same L4 L5 had it since 2012.
I feel you!
I totally enjoy your presentation. Thanks a lot💚
So nice of you
Excellent presentation. I have Spondylolesthesis, HNP of L4-L5 by MRI. The Orthopedic surgeon said that, in plain language, the disk was squashed in every direction. This was due to a weight lifting accident when I was doing barbell squats and went down too deeply. That was in 2014 and I wind up aggravating it every once in a while.
How heavy was the barbell?
@@vladislavsafronov245 I was doing sets of 6 with 225 and would stack up with each set until I got to a max rep of 270. That was 8 years ago and I was 67. Cheers, Bob
@@rvnmedic1968 Now how are you??
@@ferosekhan2389 I have a little sciatica pain now and then. Funny thing is I had my hip replacement last Friday, now both hips are titanium and I haven't had any sciatica. BTW, my Irish- American cousin's husband's name is Khan. Cheers, Bob
@@rvnmedic1968 what for?
In 2010 I was diagnosed with severe spinal stenosis and spondylolisthesis. I had fallen 8 ft on to concrete, and was bent over. I could not straighten up without severe pain. I am in the UK, and the waiting times to see a specialist can be very long. It was 10 months before I was seen by an orthopedic surgeon, and another year before having decompression surgery...L4 and 5. However during all the waiting time my spinal cord was pinched and I ended up with a dead sciatic nerve in my left leg, and I have never walked well or much since. I did not have pain until last April, when it came on suddenly and worse in my good Right leg. I have since seen a pain specialist, and had an MRI. I nowhave stenosis at L3/4, L4/5, and very severe at L5/S1, and degenerated arthritis, and I am 87, but in very good health otherwise. I only retired from my piano teaching job in a school a year ago. I have been offered physiotherapy from a very good practitioner, with a first appointment in 10 days time. Motivation to do the exercises will be difficult as I have much pain now. You mention lumbar fusion. This was not suggested to me, but I wondered if that would help, and what does it entail? (I am unable to sit at the piano for more than 10 minutes since April 2021)..
Check out the TLIF video in my collection on the youtube page and that can help explain more. Not everyone is a candidate for fusion though and it may not be the right answer for each unique patient. Good luck!
such is the reason that many of us in America are so opposed to the European model of health care!
Best ever explanation.....even a 10 yrs old kids can understand...thank u doc
Thank you so much!
You're a born teacher.
Thank you so much!
Thank you ❤️it's really nice explanation
Glad it was helpful!
Best spondy video i've ever seen.
Help for lower back stiffness afraid to walk thank you very much
PT is the safest and most effective option to help with back pain/stiffness but also takes the longest to show results.
Yes I have 55% slippage and lumbar spondolythesis with radicular symptoms like hip pain, leg pain and numbness and tingling down my leg
Also I have spinal and forminal stenosis and a pars defect
I have this exact problem from wear and tear over the years of work and also my weight which I am taking steps now to lose some weight and am now set up for phys/Therapy.
great work! if you are able to get stronger in your core and lower back muscles, coupled with a little bit of weight loss, you may be able to avoid any sort of intervention.
Thank you for nice presentation.
Can't it be in control without surgery for long time.
Is there a way of bringing the slipped vertebra in line with the rest without fusion? Artificial disc to retain motion? I have spondylolisthesis and currently going through a rehabilitation program which is not helping.
unfortunately as of 2023 there is not. only fusion. there are some artificial disk replacements that are coming on line with maybe some improvement of alignment
I have a question. I have a 10 mm vertebra slippage of L4 L5. What grade would that be? The flexion/extension xrays says it's a mild grade 1.
Grade 1-2. It depends on how big your bones are. If it is greater than 25% slipped forward that is the limit of grade 1. 10mm correlates to a high grade 1/low grade 2 spondylolisthesis but treatment does not change between them.
Apakah anda sudah operasi
Thank you for the information
My pleasure
So very helpful - Thank you Dr. Armaghani !
I’m 24 and found out I have this recently after having pain for over a year and being basically bed ridden for months. I’ve tried PT and cortisone injections and they haven’t worked however I’m nervous about the surgery option. Any advice is wonderful, thank you!
I've been dealing with pain from spondy for over a year. The doctor didn't want to do a microdiscectomy or laminectomy because I have a pars defect at L5 causing it to slip over S1. The surgeon wants to do ALIF/TLIF... I'm scared shitless
How are you
Thank you for a very informative video. I wanted to ask before surgery, what about A radiofrequency ablation?
Also a part of non-operative care. Remember though that RFAs typically only help with back pain but not so much leg symptoms. If back pain is a big part of a patient's pain picture, RFAs can definitely be a part of the non-operative process.
Excellent...I m suffering from this....but don't want surgery...what Can I do...??? Please suggest
Dear Dr. Armagmani thank you very much for sharing your knowledge. Why the vertebral bones lose alignment producing spondylolisthesis?
great question. it has to do with the disks degenerating between the vertebrae. sometimes when that happens, people develop some laxity in their joints that connect the vertebrae together. That laxity mixed with the disk degeneration leads to the slip or spondylolisthesis
helpful. thanks for the presentation.
Glad it was helpful!
In 2016 I had a Gil Laminectomy and my neurosurgeon in Nashville said I needed fusion, but bc it was only a grade 1, my insurance company wouldn’t pay for the fusion. He argued with them over and over and they denied. I remember him telling me that he hated to do the laminectomy without the fusion, bc he knew I would need another surgery later. Here we are, in 2024, and I am having a great deal of pain in my lower back, radiating to my butt, and down the leg. Ugh.
Thank u so very much for explaining this so I can see n know more.
Glad it was helpful!
This is the problem i have, my DR told me to do surgery, since other conservatives tx don't work since 2yrs, this is my question , is it true that after fusion surgery you have the same problem again in the next 4 to 8 yes?
Good question. After a successful fusion in 1 area, there is a chance of roughly 20% that you will need surgery at an area above or below your fusion within 10 years of surgery. So it is not everyone but it is not an insignificant amount of people who do need surgery later on.
I think it like 3 to 5 year's I'm suffering with it now since I had my first back fusion in 2016. Been suffering for over 3 year's now adjacent segment disease is what they call it and it's very common
This is very helpful and well explained thank you!
Thanks so much!
You did mention that is some cases a spondy may not require a fusion if there is little movement. Is there a measurement amount that you use to determine if a spondy is required?
Excellent question. A couple factors come into play with that. Typically people with severely degenerated disks will not move all that much if we do just a laminectomy instead of a fusion. I, personally, don't want to see more than 2mm of motion on x-rays.
My doctor told me need to perform open surgery. Can't endoscopy technique be done for this condition. What's ur suggestion?
Thank you for this video 🙏
Great video and very informative information
thanks much!
Good day Doctr.. thanks for your video I did an MRI scan that showed mild cervical straightening but I have symptoms on both my cervical shoulder blade and now my lumbar spine. The doctor said I have both cervical and lumbar spondylitis. Althou it’s just tingling on feet and hands and sometimes when I seat too much my hip muscle hurts. The neck X-ray shows more than the MRI. What do I believe Dr?
8mm slippage in L4 and L5. Scared to death. Horrible pain! What course of treatment?
Can we do weightlifting with this condition?
great explaination!
I have spondylolisthesis in L4, L5 and S1 and it’s painful. That combined with an arthritic knee makes me want to scream some days. My doctor hasn’t offered anything to help the pain. Aging sucks.
those are very clear pain generators. hopefully going through conservative measures can help you with what youre experiencing. if not a consultation with a surgeon wouldn't be a bad idea just to get your options.
@@ArmaghaniSpine Thank you doctor. I do need to be more aggressive in seeking treatment. Now that my Medicare plan allows me to self-refer, I will take your advice to see a surgeon. Thank you doctor for explaining this condition to us. We do need the information to make good choices.
Thank you so much, very appreciative 🙏
You're most welcome!
Most educational well explained tks dr
Really nice and well explained. I have had real pain that almost is disabling me. I have had physio since 1994 and it helps. My spine has been going in but doctors say its natural aging
Thank you for your kind words!
Sir I have left side pars defect over s1l5 and disc bulge and grade 1 anterolisthesis
Hi bro I think u should recover from this .I also grade 1 anterolisthesis over l5 s1 with bilateral pars defect. Help me how to heal pls...I hope u gone reply..thank
Pls sir enlightened me more about the anatomy and physiology of lumbar spondylolysis
I have mild lumbar scoliosis convex to the left. My bone density is reduced. Spondylotic changes are seen throughout and narrowing of L1/2,L2/3 and L3/4 is preserved. The SI joints are normal. Is this serious Doctor? Tq
If some one has pain in only spot at L4 vertebrae in middle of spine.... I'm not able to diagnose.... Can uh tell me differential diagnosis of this conditions
Thank you that helped me a lot 🌹
You’re welcome 😊
sir! ive l5 over s1 subtle anterolisthesis with bilateral pars defect and whenever i try to stand or walk i have instability issues and most of the time while walking i feel like somwething is pushing towards right side direction.... im unable to do normal routines for the last 1.3 years!!! im 21 what should i do? is it worth it to undergo a surgery.... because, im an athlete and wanna return back to competitve sports and games.... please, let me knw what should i do right now
i generally advise patients that if the pain limits activities they enjoy doing and they have tried everything else, surgery can be an acceptable option
@Armaghanispine What are the after effects of the surgery doctor will I be able to live a normal life with no restrictions to my body
Very good video.
Here in Canada, they won't operate unless you're in a wheelchair and/or diapers. It's sickening our health system. It's inhumane to leave an animal in pain but apparently a person it's ok. Just ridiculous
@srs3572have you fused your vertebra???
It’s ridiculous that in any money grabbing non government insutitution anywhere else they will inject you stuff to sleep and almost kidnap you until you agree to surgery whether you need it or not
Same here in Srilanka..they care about only money.
😂😂😂😂😂😂😂😂
Surgery doesn't always fix pain nor last. I've had 2 cervical spine fusions and now need a 3rd. Man cannot recreate God's work.
hi dr .my 35 year daughter has l5s1 spondylolisthesis with mild bulging disc indenting thecal sac she has back pain ,gait disturbance and frequent big toe extension. so what do you think the exact cause for her symptoms and should she consider fusion .thanks
Her issue is coming from likely compression of her L5 nerve root. Depending on the imaging and her personal characteristics, she may be able to get away with a decompression but most will benefit more with fusion on average.
@@ArmaghaniSpine even if she doesn't have leg pain? thanks dr.
Where are you located?
Can u please do a video on cervical retrolisthesis?.
retrolisthesis is more of a radiological finding that some people have and doesn't always cause pain as much as an anterolisthesis like you see in the lumbar spine. it could be a normal variant
Very insightful
thank you!
I have this , is it going worse if I keep driving .
Thank you for you information 🙏
So nice of you
Hi. What about unstable isthmic spondylolisthesis? Is there any chance , it won't progress? Or fusion , just a matter of time.?
excellent question. those present at many different stages of ones life. some start having problems in their 20s and some don't have issues into their 60s or 70s. what we do know is that 10% of people walking around today have one and don't even know. the older you are the less likely it is to progress and fusion is really only indicated if it is causing leg pain that isn't alleviated by conservative measures.
@@ArmaghaniSpine Thank YOU!
Hi I have spondylolisthesis. I had a fusion on l5 l4 5 months ago. I have 2 loose screws one is at a 40 degree angle on yhe xray . Is this normal. Will they take the screws out or replace the. Revision surgery in 2 weeks
In general, loose screws do get revised to bigger ones placed in proper position but every situation is different. Good luck on your revision surgery!
@@ArmaghaniSpine thank you so much for responding. Is it normal to have 2 loose screws so quickly
@@haleshendrickson7297 I can tell you, NO, not normal… This is exactly why I will not have any type of fusions which is what they want to do to me. Too much room for error - too much risk for failed back surgery syndrome. And, when your bones get brittle and worse where the screws are placed. They can’t stay in place. - like putting a spoon in thick pudding or thick mashed potatoes, the spoon will eventually move. I am sure Dr. A is amazing. But, our bodies will do what our bodies will do. Age - and eventually fall apart. That said: I hope you find relief and I would NOT go back to that same surgeon if you can avoid it. I mean seriously. And, they’ll replace those with BIGGER screws. - I wish you the best with whatever you end up doing. :(
Can you have an Artificial Disc Replacement rather than a fusion?
yes you can especially in the neck. Not everyone is a candidate particularly in the lumbar spine and in the setting of alignment issues (such as a spondylolisthesis) it is even less of a durable solution.
Do you feel an ortho can perform this surgery (a fusion) with great success, or would you recommend a neurosurgeon!?
I'm an orthopedic surgeon with specific training in just spine surgery. Both orthopedic surgeon and neurosurgeons do the same procedures and I know fantastic neurosurgeons as well as fantastic orthopedic spine surgeons. My suspicion in the future is there will be just "spine surgeons" with similar trainings instead of this split that is seen. Long story short is, get a couple different opinions and go with whoever you feel most comfortable with!
@@ArmaghaniSpine thank you for your knowledge!
Thanks doc. I'm in Kenya, how can I get you.
Hey sir..
I'm a 21 years student from India suffering from Lumber Spondylitis in which partial socialization of L5 vertebrae is seen leading to mild canal narrowing at L5-S1 level. I'm suffering from back pain and if excess standing, sitting or walking is done, the pain also transmitted to the part of hamstring (sometimes).
Which exercises should I follow and which activity should I ignore?
Should forward and backward bending are also restricted?
Waiting for your reply..
I have the same issue also man.
Am told my lumbar vertabrae L4 is what is giving me pain :(
Great.. very well explained
Glad it was helpful!
What are some stretches someone suffering from spondylolisthesis
We usually have our patients see a physical therapist who does a full evaluation on them to find out what they are good at and not so good at and then give them tailored exercises for those areas that could use a little improvement.
Thank you doctor
thank you!
Thank you doc , you are pretty cool!
Dear Dr. Armaghani,
I am reaching out to discuss my ongoing health condition. For the past three years, I have been diagnosed with Lumbar Spondylolisthesis. This condition has not only caused me persistent back pain but also discomfort in my knees.
In my attempts to find relief, I have undergone physical therapy sessions multiple times. Additionally, I once received a cortisone injection, which provided significant relief for about two months. However, the pain has since returned.
I am now at a crossroads and seek your guidance. Would it be advisable for me to consider another two cortisone injections? Or is it time to consider more definitive measures such as surgery?
Your expertise and advice will be invaluable in helping me navigate my next steps.
Thank you for your time and consideration.
I am from India . How can I consult you ?
Hi plz help me... My mother is in Grade III.. We took MRI and consulted doctor they told it is spondylolisthesis... Will it cure after surgery... Will she able to walk after surgery plzzz suggest me...
Thanks yours explanation is very good. Let me understand my condition and the treatment will be conservative fisiotherapy no nsais or steroids I can not handle the side effects but thanks to you very much0
Any one of those things can help. Time is the biggest healer. The PT, medication etc simply helps improve pain while your body does the healing.