Thank you for this information. At 63 I have severe, debilitating stenosis. The "shopping cart" thing was classic! I have to grab a cart immediately and hunch over it. I am trying different surgeries to relieve pain.
I had severe pain in my lower lumbar. sciatica, groin down leg to knee all on my right side. Orthopedic surgeon said it was L4 and L5. I started physical therapy for 8 weeks 2 times a week and go to pain management doctor for spinal injections about every 4 months. I take Tramadal on days when pain kicks up but it definitely is about 90% better without surgery. I had all symptoms people are exhibiting. Laying in bed at night was torture I am so lucky to have found relief.
I had spinal stenosis at my L4-L5. Sciatic nerve pain down both backsides to my knee and ankle. The surgeon I saw took one look at my x-ray and put the fear of God into me. He said by right I shouldn't be even standing let alone walk. He advised me to get surgery without delay, blablabla. Guess what, I took the surgery, and now I cannot pee or shit naturally. I had to use a catheter to drain my bladder and my finger in my rectum to void the shit. That was 2011. There is numbness down both cheeks and my genitals, down to my ankle, and my toes on both legs. My advice to all backpain sufferers, get all the research you can get, check out all options. Best of luck.
Excellent, comprehensive and easy to understand if you have a basic understanding of spinal anatomy. The Chiro Geek is a born teacher, as well as a patient, and everything he says makes sense to me as an Emergency physician and interventional pain specialist (retired).
Had a Laminectomy about 10 years ago. Successful. Dr. Hartl NY Presbyterian. Loved the direction against flexive physical therapy, lol. Exactly what several docs rx'd. And of course made it worse. Very interesting lecture. Should add the diagnosis was Caude Equina, severe stenosis.
I would like to ask a question. Am a 52 year old man I have been diagnosed with back problems. Because of family situations I had to work I started working in construction and tree removal at 12yrs old stopped going to school in mid 4th grade I have had pain since I was a child I would like to find out if there is help for me I spent many years addicted to oxycontin but I quit in 2012 but the pain with my back neck and shoulders is horrible! I have been told I have stenosis and narrowing but other than that have not had much done about this as my insurance and money are not great.
Very insightful sniff cough and images clear throat showing potential existing phlegm indicating some natural irregular drainage consistent with allergic reaction to seasonal pollens mixed with bodily collisions that can have damaging effects on bone health and overall ability to focus and concentrate on published educational presentation without audience experiencing every snort & dribble. Please, listen to complete sound track five consecutive nights before sleeping & consider re-making this potentially A+ video without sound OR keep video and have student intern help make entirely new sound track, over track this one. Hope you are feeling better.
@@wandapiacenza1544 I’m so 🙂 😅😅😅😅😅😅😅😅😅u 😅😅 y😅😅u😅😅u😅😊😅😅😅😅it😅😅😅😅😅i😅u😅😊😊yeah 😅😅😅😅 😅🙂 I’m not gonna t you😊 😅😊😊😊😊😊😊😊😊😊😊😊😊😊yes you do and yes 🙌🏽 we do 😅😅ty😅😅😅😅y
As I weigh-up the prospect of back surgery, with symptoms of right low back, groin and pain to knee level, with the inability to stand upright or walk even a few steps before excruciating pain fires up, I thank you SO much for this information. This has empowered me to speak with my neurosurgeon with a level of clarity and understanding of the situation and options. All the very best for you.
About 20 years ago I awoke with horrific back pain. I could barely leave my bed. My right foot wouldn't lay flat. I was walking on my toes. I went to my regular doctor and was referred to a spine surgeon. I went through all the conservative treatments. My wife was a Physical Therapist(PT) and she puzzled about some of the exercises and treatments I was getting. Regardless, nothing worked and a Laminectomy was scheduled. I was sent to a pain clinic for a steroid shot. I had the strange sensation of cold water being poured down my leg.. A week before the surgery the pain became more intense. The pain came in spasms which at their peaks left me unable to do anything except lie on the floor as they passed through me. I went to the ER and I was given a course of four drugs twice by IV. I fell asleep for an hour. My wife said I was going through the spasms in my sleep which was why I was run through the second time. At last it all stopped but my foot was worse. It was completely uncooperative. The steroid shot had pushed disc fragments down into the nerve bundle. The surgeon spent nearly an extra hour removing them. The pain diminished a great deal after the surgery. I walked with a limp and my leg and foot hurt. Regardless I went back to work. I owned a company installing voice and data cabling systems. My right leg was week so I used the let on to lift me up the ladder with the right one following. I was slow but I got it done. I passed more of the climbing work onto the employees and I did the equipment ends. Two years later the same thing occurred on my left leg and foot. I had another laminectomy and there was improvement. Three years later the pain had increased greatly and I had a third laminectomy. The results were minimal and I resolved not to have another ever. I'm now retired. I work in my yard raking and sweeping. I have 10 birds feeders I take care of daily. I also put out corn for the 20 or so deer that come every day. When the pain becomes too severe I stop and rest. I take a 30 mg Morphine ER tablet three times a day. I guess it helps. I've never stopped it to see the difference. A few years ago I developed Type 2 Diabetes. That has caused much swelling in my legs and feet. I also have three kinds of arthritis. Every joint hurts but I keep going. I've accepted the fact that this is my lot in life and I refuse to give in or up.
I had non-invasive surgery by endoscope for spinal stenosis and am so very happy with the results. I could hardly walk, had severe leg pain, couldn’t sleep on my sides, before the surgery. The doctor lasered off some calcified bone that was pressing on my spine to give some relief and packed the area with stem cells. I walked out of there the same day and am so much better now. Almost back to normal.
What was his name? I desperately need help .. I have a massive bone spur that grew over my disc implant in 2 months . My body is so swollen.. my body is full of pulse ations.. feel like my heart is going to give out..
@@Raiseyourvoiceadvocates my guess is u already had small bony projections present your surgeon missed it and you should have had them taking care of first then you should have had the disc arthroplasty reconstruction depending on what condition you have do you have multi-level injuries is it cervical was it lumbar was it thoracic do you have CSM DDD so your surgeon probably fucked up and never should have did the artificial disc replacement without taking care of the bony projections first if they are at same level ur disc replacement is then u should not get any bony projections at that same level you should be fine bone spurs start because the disc shrinks all the fluid leaks out and then it's like no padding there so that's when you start to get the bony projections happens when your left untreated for a long time or if you have multi-level injuries then he should never done the disc either you should have probably had a fusion because if other levels are injured and he puts that disc in matter of time before the other levels starts degenerate or whatever and shit moves it's just no good. I feel you I'm going through the same thing I have CSM cervical spondylitic myelopathy I'm neurologically symptomatic spinal cord compression with my myelmoaiacia my neurological exam upper extremities include bilaterally positive Hoffman sign with an abductor twitch at the coming on with deep tendon reflex challenge at the elbow flexors and brachioradialis the formal manual test is positive only on the right at the legs we find very brisk deep tendon reflexes at the knees largely absent ankle jerks and no conus C3-4 motion segment is kyphotic and my bulge is big enough to traverse the subarachnoid fluid bath impacting the spinal cord my MRI clearly states I have and uncovertebral joint degenerative hypertrophy and I have problems from C2-C3 C3-C4 C4-C5 C5-C6 C6-C7 I have at every level impingement on the thecal sac lot of narrowing at the intervertebral foramen have small disc bulges and large Central disc protrusion I have a broad-based disc bulge my cervical spine is worse from c3 c4 c5 c6 signs of cord deformity at c3 c4 and c5 c6 my first MRI was January 16th 2019 the orthopedic neurosurgeon I saw Dr Drew a bedner wanted to do decompression discectomy and artificial disc replacement which made no sense because I have unconvertible joint degenerative hypertrophy and I have multi-level injuries you can't put an artificial disc in like that because you're just going to cause problems down the road it's called Brian's disc replacement or some shit I don't fucking know and I got to call 3 years later let's book your surgery come and sign the papers so I mentioned to him cuz I still love research so I can't have the artificial disc replacement because of the bilateral unconvertible joint degenerative hypertrophy he said yep you need a fusion I still haven't had my surgery because of covid I forgot to get a covid swab I was hooked up to IV the surgical down you're in with it pump hot air into you didn't surgeon came in and told me already good luck finding a new one to my second MRI my updated one for my cervical was December 22nd 2001 showing a progression getting worse moderate Central canal stenosis with indentation and deformity of the ventral cord parenchyma
I had an MRI scan they found I spinal canal stenosis , and they also found a blockage which they don't know what this is yet . I have had difficulty walking for the few years but worsened 2yrs ago there is a weakness in the right leg , and I know I'm suffering from claudication as I have numbness and heaviness in upper and lower limbs the blood pools on my ankles and feet also my hands , I live in Britain and they dont know whats causing this I have been awaiting another scan for over 1 yr I'm worried they are missing something
Great video, I’m 72yrs old with a spinal fusion done on my L2 and L4 two yrs ago. Unbearable pain for the first year and a half. Taking 8 tramadol a day until I realize I had to slow down and take it easy. I’m off tramadol and only taking celebrex once a day now . I have been diagnosed with spinal stenosis and living with some pain even though I can go for a walk up a hill for an hour. If I had my time back, I don’t know if I would have taken surgery. I couldn’t stand for ten minutes with out my thighs burning like hell but now it isn’t to bad.
How did you come with that much tramadol? Was there side effects? Here in Cameroon, tramadol is banned so one can't get any relief drug. No drug like celebrex here. Four years on, I can't get any relief for my spinal cord problem. So so hard....
Thank you, my hip needs replacing and my lower back l4 l5 needs removing. I am looking for anything that can give me the relief I hurt all day and night it wakes me from my sleep with a sharp and burning in my groan.
Very informative Lecture, a must watch for anyone really interested in MRI findings of various spinal conditions and requirement of spinal surgery and its outcome. It is also of great interest to radiologists who want to report on MRI of spine.
You have a dream job for sacral tarlov cyst gonna put your career on the map. Doctors dont know the proper MRI technique to detect them. Not for high intensity image of entrapped cerebral spinal fluid. Every fibromyalgia has the cyst. Might be true for a hold host of neurologically conditions. Forget everything that you been taught.
Thank you soooo much for this amazing presentation. As an experienced physiotherapist I learned more from that course than many other presentations that I have attended. You Sir are phenomenal. That was an awesome advance lecture indeed
I am 47yr old and was previously working as a food delivery rider using motorcycles. To a start, I have numbness on & off on my groin area and down along my both leg if I sit too long on the bike, or when I stand still for a minute or so, numbness appear. Later part, I experience extreme right calf pain, tiredness, pull on my right thigh as well. I also could not press myself up using my right feet. Despite taking an MRI and got a steroid jab at my L3, 4 & 5 lumber after consulting a musculoskeletal doctor at a local hospital. Till date, I still have yet to make significant improvement. Please advise.
To all people in the spine field (first another thank you to Dr, Gillard), as I am waiting to hopefully see or hear from Dr. Gillard, I am putting together many photos and videos onto a web page with my symptoms. I am willing to pay a reward at this point to help me figure out what is causing my burning / stabbing pain in my mid to upper back / center almost between spine and edge of left side body. I have been in agony for 17 years now and all I hear from doctors is...My pain makes no sense. Please leave a comment if you want to be notified when I finish this web page project and you would like to take a look at all my images, maybe something will jump out or maybe I need different types of scans which I am willing to do. Thank you.
Best info I've heard so far. I had that rare problematic central disc herniation on L4_5 and left lateral L5_S1. It blew one month post microdiscectomy and then I had retrolisthesis L4'5 . TLIF on both levels left me with scar tissue on nerve roots and intractable pain. Now there's central and foraminal stenosis, DDD, facet arthritis in all spine levels. Not a happy ending.
I suffer from spinal stenosis degenerative disk disease.. Just got thru with spinal cord stimulation trial.. I seemed to help with lumbar/ sciatic nerve pain..
I’m 80 year old woman who has had stenosis for many years. The past 4 or 5 have been the worse. I saw 5 or 6 doctors, over the last 3 years, all said I needed fusion. Laminectomy would not help me. I have beginnings of osteoporosis, and at the last minute my planned surgery was cancelled due to a bone density. I was told I need a hyperbolic doctor for shots. I went to a doctor who said at my age, it wouldn’t work. Back to square one and pain. I tried injections, after a year or two, didn’t work anywhere. I went to another back surgeon, he suggested a laminectomy; I had pain in. Uttocks, thigh, calf and outside foot. Numbness, I stability, shooting electric shocks an low back pain. He said in 85% of patients will be helped with the remainder a mixed bag. I had no other choice, so I took the chance one month ago. I find that my thigh, and calf has regained feeling; no more numbness. Y foot is the same. It gives. E hope. The doctor said that if I’ve had this pain a long time, it will take me longer to heal. I heard you say that if you’ve had sciatica more than one year, nothing will work.what are my chances for healing? I’m such an active person, but I can’t walk 1/2 block that I have to stop. I’m at my wits end. Please help with guidance.😊
Hello Diane, I sure I'm sorry to hear about your struggle central stenosis and the associated claudication. In order to help you, I would have to know more about your orthopedic and neurologic status, as well as see your latest MRI /CT with my own eyes. I do offer a consultation service during which you and I would meet via Zoom to go over your imaging; after which, I can put forth some evidence-based treatment recommendations for your unique situation and answer all your questions. You can learn more about this consultation service (I call it a coaching session) at these links: ^ Learn all about Dr. Gillard's coaching service via website: www.chirogeek.com/Coaching%20Service/coachingService-2.html ^ Learn all about Dr. Gillard's coaching service via this RUclips video: ruclips.net/video/A0GJ_r-uvpQ/видео.html Best, Dr. Gillard
These lectures are perhaps the most informative I have come across. I have a bit of a mess in my back and Ill upload the MRI to your site in the coming days and schedule a coaching session with you.
11:27 it seems unreasonable to call anything below 12mm stenosis. In the lower spine, there are fewer signals that have to be sent up or down, so should need less space. Even though the lower spinal canal has a wider diameter than upper, this may be by design to allow for more damage. 22:03 standing/walking tests for claudication 29:19 maybe ‘conservative care’ leads to the need for widening the canal/decompression? 37:17 aren’t we mixing up things in these studies? You said in the beginning the major problem with stenosis was claudication, which isn’t really pain related but about weakness etc. Also you said the pain would be coming from the facet joints. The studies would mostly be treating pain, not so much claudation as the former is much more common. In any case I’ve never seen a big study that wasn’t centered on pain. So why is pain now suddenly a stenosis problem? Clearly, doing decompression and spacer have one thing in common, which is taking the facet joint out of the equation, so no surprise the result is the same. Let me check you said their didn’t do foramitomy? Well they only said they included traditional decompressive surgery. I would guess that the clever surgeon would extend that to the superior spinous processes if he knows there is pain in that region. I just looked at a random study which did a comparison, and they included ‘all traditional’ decompression such as ‘laminotomy with undercutting’, which is a euphemism for removing part of the facet joint. Percutaneous Interspinous Spacer versus Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients? 2017 42:02 intrathecal venous plexus I take it, not epidural plexus. Now it makes a lot of sense why concussion type events would impair blood flow for a while, with this loose web of veins. 43:38 if the blood vessels swell in front of blocked sections, I’m not sure that would cause an issue, rather hypoxemia of the nerves seems more relevant. But weak blood vessels could not only swell but rupture, so I’m guessing micro hemorrhage is a bigger problem. Which would not be stenosis related, but be caused by weak blood vessels, which would of course rupture exactly in locations where there are additional problems like a bit of stenosis pressure. But blood vessel issues could be addressed independently of stenosis, and maybe that fixes most stenosis related issues, if micro hemorrhage is prevented. 57:18 hemorrhage can also cause radicular pain. Repeat hemorrhage seems a lot more likely to me than repeat spilling of nucleus pulposa, because there is only so much of the latter before it dries out. 1:02:46 piriformis being over diagnosed when it’s rare 1:05:38 exception to the rule: unhospitalized patients recover. 1:09:06 sciatica (radicular pain in sciatic nerves) eventually non-surgery patients healed to catch up with the patients who had surgery (3 years). Speed up healing: walking, swimming, do not stretch. 1:13:49 you have cited that 85% being herniating disc number numerous times, and I can’t find that paper even searching the journal directly. F porchet does not show up as the lead author in any article in journal of neurosurgery. 1:14:06 some missing anatomy I found: there are ligaments attaching the longitudinal anterior ligament to the dural sac. The anterior dural (Hofmann) ligaments, 2004 1:19:31 so disc material has eaten away at the vertebra, on the left cut? I thought only tumors do that. 1:22:39 discectomy is contraindicated for a bulging disc. 1:25:33 micro discectomy only for herniation radicular pain. For low back pain only 40% chance of success. Fusion: the gold standard for everything spine surgery related, like disc herniation back pain from disc and dura pain nerves. 1:34:31 great study: 15 patients who were all referred for emergency surgery for huge herniation but couldn’t afford it. All healed on their own. 1:37:38 example of PT/chiro being worse than walking. 1:39:32 you should only do a discectomy for extreme leg pain or progressive motor loss/cauda eq syndrome 1:40:50 example of fully reabsorbed disc herniation.
Excellent lecture! Perfect review on some things I already knew, but presented in a way that firmed up the reasons why behind certain theories or outcomes . And then Dr. provided a wealth of information about things I had always had questions about or had never known before. Done in a clear, logical manner that is so easy to understand. One of the best videos on RUclips and so valuable to medical staff, students, and patients alike. Everyone can get a nugget of gold out of it. Thank you so much for sharing your time and expertise! Fully enjoyed!
I was in an accident in 2005. Herniated discs L3/L4 , then following week ruined the discs above and below from the Physio forcing me to walk on my knees across the gym floor . I was crying with so much pain. Then I developed spinal stenosis which then turned into Caudia Equina Syndrome. Not fun at all. I mentioned from day one something was wrong with my bladder and ignored. I was then ambulanced from passing out. I had went into diuresis. They finally tested me and my bladder and bowel severe neurogenic. I'm Allergic to all anti-inflammatory meds and steroids'. The past three months I have some changes with acute pain within the lower sacrum so I cannot sit at all. i wished there was a fix .
Even though I’m not in the medical field, what brings me here of course if my progressive back problems, I find this so interesting. I have curiosity for any kind of learning. Listening to educational and intelligent discussion is also calming. Thanks for you’re posts!
Hello, I would have to know way more information! But the obvious is to make sure you have a good firm mattress. Mattresses that are too soft don't mix well with folks who have back issues. I would suggest you visit your primary health care provider to get your complaints worked up more thoroughly.
I would like to know if that artery I side the tail sprout could cause some intermittent signs of vascular with mainly Neurogenic stenosis in a failed fusion of L5&L4 misaligning L3 and herniated the L3 disc?
My father suffered for years from vascular intermittent claudication of the aortoiliac vessels, both legs. Needed to stop walking and stand still to allow some blood to flow, then he could resume walking. He had bypass surgery and could immediately walk forever. Happy man!
Dear Dr. Gillard, I received your email but I am uncertain whether you want me to use this for the purpose of sending you the information requested regarding my conditions? Please be advised that I do not reside in the U.S, that referenced medical records are writen in Italian; XRays, Cat Scanc, and MRIS are in CD/DVD formate, please reply with instructions. Thank you, respectfully F.Z
I'm L5-S1 spinal stenosis,have already had fusion at L4-L5 , I recently mentioned to my ambulatory specialist,that I was having bladder issues and he kind of sluffed it off,i;m on the wait list for some rods and screws,another fusion,and praying for a miracle
The new development of bladder issues is considered a medical emergency. A new MRI should be obtained to make sure nothing is severely compressing the thecal sac/cauda equina. Fusion alone is not the treatment for spinal stenosis. Decompression is and then its controversial whether or not fusion should accompany that decompression. All depends on whether or not you're stable at L5/S1.
My L3 disc is herniated at the front caused I believe by a Lazer fusion w/instruments that was done .? It was not there before the surgery ,1st Lazer surgery but I've already had 6 fusion surgeries on my lower lumbar since age 19 and I don't think my history with my congenital spine disease was fully taken into consideration.? So I fully understand that in this country our surgeons take shortcuts as well as radiologists on MRI's and CT's exams sometimes the saddest part is it's always to the determent of their patients health .It's been 2 years and I'm still at the state I was in when I woke up in recovery no exaggeration I'm still having the same extreme sciatica electric nerve pain ,hot sensations I woke up with ?The phrase "It will go away don't worry about it " should be illegal to say in the medical profession? My personal opinion only .Thank you for these videos and truth of information without them patients would be left to anyone who says that phrase ? P!ease tell and supply all patients with this information to educate themselves with their diagnoses and steps that their current Dr.s have ordered ?Patients that are learning through Dr.Gillard Well Done!! Blessed are the Hands that Help ,Coveted are The Voices that Teach.💜🙏 for all Patients Health .
I am very interested in your in your brain’s a smart talk. I will be following you permanently I recently was studying medicine and had not gotten quite this far in spinal fluid Verdie and very courios on some side effects. You definitely blow my mind. Big booms coming from all around.
Could you comment on psudomeningocel and the possible effects of a screw into the disk space. L2- 3 Had ant. and post long spinal fussion with pinning 2009 had pain since. Now it is really bad. Had to retire early from nursing. Nerve pain mostly R leg. Numbness to L foot and lower leg Sever back pain and muscle spasms. Difficulty sitting and standing. Walking a little better. Laying flat is my only relief. My spine surgeon said he could not do anymore. Had second opinion he wont touch me. I do have an appointment with a neursurgon who specializes in complex spinal conditions for a 3rd opinion. I have a dx.of scoliosis. Love your videos!!! Thanks for sharing your expertise.
Dr Gillard, just stumbled upon this Vid. I'm no doctor, but I am a sufferor of a number of spinal issues including stenosis and facet joint arthritis throughout the spine including scoliosis and chronic pain and stiffness. I have been to at least 5 different spinal and neurosurgeons during the past 3 years, seeking relief. I have done tons of my own research , not in medical journals but on line dissertations like this one and from other doctors & chiropractors who offer advice and information. I have consulted with excellent doctors at Mt. Sinai, Columbia Presbyterian, Stamford CT Spine center and White Plains Hospital Spine center. All of the surgeons said - no surgery for you. Dr. McCormick at Columbis Presbyterian in fact said "no one will touch your lumbar spine....... I'd have to reconstruct your lumbar spine.......Pain Management. I also have cervical issues of herniated discs, stenosis, and "military neck". What the hell can I do? I have a shorter right leg by 1 inch a result of a fractured femur at 15 years of age , in a body cast for 4 months and the right did not grow , but the left leg did !! I'm 69 years old now. Lots of thigh and hip weakness, calf cramping and feet problems . Bouts of bladder incontinence. What a freakin mess
Such as life in this world. So many sad stories. Go to God. Eat well, no sugar, alcohol etc. We have to build immune system. Sorry for all you go thru. I understand. I pray and read my bible. Use moist heat pads, stretches that can do help. God Help Us for we have worked hard in this life!
@@juliayelle2942 afraid god isn't into spine information or is asleep, NO god isn't the answer, science is the solution, nothing personal Julia, just a fact
@1:09 Flexion/distraction on an articulated table by my Chiropractor massively improved my symptoms immediately! I hobbled into the office, and could walk upright out of the office, every single treatment provided a few % immediate and sustained improvement. I showed him my MRI image of massive L4/L5 central disc extrusion and he suggested the treatment its for local decompression effects. I opted for no surgery and yes it hurt incredibly for 6-9 months. Now 13 years later and still without surgery I'm noticing some early cauda equina impairment symptoms, surgery probably coming soon.
@@sarcasticmeeeeee5499 Neurosurgeon said it’s not CES but nerves aren’t happy. PT taught me some good mobilization and stretching to make and maintain some space. Seems I have Hypermobile Ehlers-Danlos Syndrome and that bendiness causes all sorts of issues.
@@DougKremer did you do MRI to find out?? I have dic herniation and Central canal stenosis since 7 months and I did my MRI twice in the span of 4 months 1st my ortho asked me to do and 2nd I did by own to check if have CES both the time it came normal and again since 2 days I have some problem with bladder and bowel so again I'm freaking out I don't what to do.
can severe bilateral spinal stenosis of the c5-6 be caused by MS lesions.. I asked my Neurologist if my spine instability and being hunched over is due to MS. Ther nurse said no but Neurologist said yes. I went to get my MRI of the cervical and thoracic spine. I was shocked to read I had severe bilateral spinal stenosis of the c5-6, moderate bilateral c4-5. I have moderate to severe disc degernation c4-5, C5-6. I am angry that my Neurologist did not refer me to a neurosurgeon to get decompression surgery. Thanks for the educational video.
No, MS lesions will not cause central stenosis. Central stenosis, however, can cause MS -like symptoms (myelopathy). Sounds like you do need to see a neurosurgeon as soon as possible. Good luck!
50:33 Optimal time for surgery for CES (CESI, CESR) is until 4-6 hours. Later surgery is also helpfull, but RR(relative risk) is bigger - prognose is worse. Look at works from NV. Todd 2005, 2008, 2014, 2015, 2017, 2019, or Igor Sulla on animals or from other authors, but no at Ahn 2000, which one is mistake and source of lots of disabled persons. Last year was published Hogan 2019 on 20000 patients, who says also death rate is lower with earlier surgery. Attention, Hogan at all was maded from insurance or medical stats and they have info only about date of surgery and they can not do from these numbers stats for 6 or 12 hours, but from DeLong 2008 You can be sure. 😉
Doctor told me that.i have spinal stenosis.and a cyst on the lumbar spine. Symptoms stiffness between m the back and sto and difficulty walking and pain from back cramps and heavines rotating in legs and calf muscles more pain increases when waking when I walk in the sun for a long time like an hour or so pain goes a way until sit and stand. .
Informative lecture and makes some great points. But I could not disagree more that time and mother nature are the best treatments for sciatica. In my 40 years of professional practice, time and nature alone will not correct sciatica and discogenic radiculopathy. Just the opposite, it can lead to lifelong pain and disability. If the disc is not decompressed the pain and motor weakness will persist. I believe this may be where the expression "once you have a back problem you always will have a back problem " comes from. However, there are successful nonsurgical spinal decompression treatment protocols that can end this lifelong pain and disability. These protocols include nonsurgical surgical decompression along with anti-inflammatory adjunctive treatments as needed. Lance C Durrett MD DC
This is what I am suffering after a fall I never suffer from that kind the pian before I need to be operate in my back in my right shoulder ln I have shoulder tears in my bove arms let me know what should I do I am in pian twenty four hours a day
Ugh story of my life. Blown disc's, spinal stenosis chronic injury, new symptoms: thighs and hips going numb now with severe inflammation. I'd give anything for surgery.
Can you help me possibly or direct me to help. I have been suffering for close to three decades. I have chronic compression fx of thoracic vert. MRI 06/07/2018: T4,5,6,7,8 and 9. Vertebral loss of losses as follow: T4 10% mid, T5 30% mid 50% anterior, T6 no significant loss, T7 50% mid and anterior, T8 greater than 50% both mid and anterior and T9 25% mid and anterior. Accentuated Kyphosis of the Thoracic Spine. T5-6 Minimal posterior central disc bulge, T9-10 Minimal disc bulge, T11-12 minimal disc bulge. I just had an ACDF on 10/03/2018 of C4,5,6 on Oct. 3rd, 2018 for herniated C4/5 abutting the cord with myelitis at C5 and disc bulges at C5/6 and C6/7. Foraminal and Canal Stenosis and uncovertebral joint hypertrophy contributing to the bilateral foraminal stenosis. The ACDF seems to have helped the neuropathy in the arms but is still present. Now on to the Lumbar. MRI 10/02/2018: L1/2 Minimal broad based disc bulge, L2/3 Broad Based Disc Bulge extending into the bilateral neuroforamina. Moderate to Severe facet degenerative changes, Mild central canal stenosis and mild bilateral neuroforaminal stenosis. L3/4 Broad based disc bulge and moderate to severe facet degenerative changes. Moderate central canal stenosis and moderate central canal stenosis and mild bilateral neuroforaminal stenosis. L4/5 Broad-based disc bulge. Moderate to severe facet degenerative changes. There is mild bilateral neuroforaminal stenosis. L5-S1 Minimal disc bulge. Moderate facet degenerative changes. History of a 40-60 foot fall on 03/31/2005 in which the right fibula was fractured and dislocated. Had an open fixed reduction and internal fixation with a distular plate and ten screws. History of Grand Mal Seizures adult onset of idiopathic origin started in 1996. Pediatric history of Viral Spinal Meningitis and Encephalitis with Petit Mal Seizure at age 9. Septic thrombphlebitis and septic thrombosis from infected iv catheter while having a broken rib evaluated in 2008 and MRSA, DVT, Septic Pulmonary Emboli, and acute renal failure. Bursitis of the hips bilateral. Sciatica and other neurogenic conditions. I need a doctor who cares and will help me. Social Security denied me at the ALJ level back in March of 2018 despite all of these. Also, I suffer from Stressor Effective Disorder (PTSD), Depression, Anxiety, Panic Attacks, ADHD, inability to urinate effectively, suicidal ideation and thoughts with previous failed attempts, idiopathic cardiomyopathy, hypertensive disorder, previous history of acute pancreatitis, non-cardiac specific chest wall pain, previous ventricular tachycardia and more. Yet I cannot get proper help and Social Security will not approve me for disability. I am beyond myself after typing all of that out and realizing the list of disorders and impairments that I suffer from. I need help soon because I am not planning to stay alive much longer in this world without help because I just cannot take it much longer. I have suffered since childhood and I have seen people have more compassion for sick dogs and animals than they do for humans like myself. Brandon Kachmar, ytech1758@gmail.com
I’m looking at another back surgery, the surgeon who is the one in my area is in the Denver area and has refused to operate due to a subluxation of L2 L3 L4 and stenosis on most of the lumbar spine. Also I had a fusion of the T7 T8 in 98 after auto accident. My symptoms are numbness in my left leg mostly in my foot and great toe up my leg and into lower left back region it’s the sciatic nerve. I also have a spine cord stimulator installed and a pain pump from an accident that nearly removed my left arm. Had a ct Myelogram and it revealed that it was stable by comparison to the last ct taken in 2020. Could you give me at least one opinion hopefully not what I’ve heard already why nobody will fix the subluxations? Thanks Steve
I'm sorry to hear about your struggle with chronic pain. I would have to look at your latest MRI and CT images with my own eyes and know something about your current neurological and orthopedic condition. I do offer a Zoom consultation service to select members of the public (you would qualify). If you're interested, you can learn all about the service at either of these links: ^ Learn all about Dr. Gillard's coaching service via website: www.chirogeek.com/Coaching%20Service/coachingService-2.html ^ Learn all about Dr. Gillard's coaching service via this RUclips video: ruclips.net/video/A0GJ_r-uvpQ/видео.html
Thank you Doctor for your brilliant and precise explanations. I love you, you don't talk very fast. Perfect. But the only thing is your board, it can't be read. The letters can't even be seen. VERYVERY tiny. But the pictures are very good XXXX
Does unilateral chronic L4,5 pain with a history of central disc prolapse imply lateral stenosis? Pain does not radiate to buttock or legs. Comes with pelvic twist when sitting for a long time, leaning towards one side, goes away when exercising, moving, walking.
Have you any info on lateral recess narrowing with S1 irritation? I’ve NIC but pain remains in buttocks on left side, pain begins from standing /walking and I’ve to sit or bend over which is painful but a relief. I’m a nurse and can’t work & I’m only 39 :( also have paracentral disc protrusion
Lateral recess is also known as the paracentral zone. This is the most typical place a disc herniation occurs (paracentral disc herniation's) which end up compressing the traversing nerve root. Ligamentum flavum thickening and superior articular process bone spurs can also invade the lateral recess and also compress the traversing S1 nerve root. Sometimes facet joint cysts can also enter the zone. So for you, the $64,000 question is what is causing the lateral recess stenosis (a.k.a., narrowing). The cause would dictate the evidence-based treatment. Good luck!
I'm paraplegic and lying in BLK-MAX SUPER SPECIALITY HOSPITAL PUSA ROAD india due to neurosurgery of thoracic and lumber spine tumor ( myxopapillary ependymoma). Pray for me brethren
Իմ որդին գոտկատեղից չի զգում վիրահատվել է 3 տարի առաջT4 T5 ողերը կոտրվել են փոխարենը դրված է իմպլանտ այժմ չի քայլում բայց ձեռքերը շատ լավ շարժվում են ։Խնդրում եմ պատասխանեք կոգնեք իմ որդուն որ քայլի
I am almost 78y4s old, I have spinal stènosis in lower back. I have been on tagging for more years than I like to admit, however I broke the 2 pedicals on the l .2 8n 2016 since then everything seems to go wrong. I push myself to at least keep the house clean but I pay a heavy price for it. I would like a treatment for this to make life easier.
I need to have a LTIF! I am 50 years old. Would you be Able to look at my MRI? I had a fusion in Sept. 2015 and had to go back in January 2016 because I couldn’t walk. Had a mri and I have severe stenosis. L2-3 and moderate buldge at L1-2. Fused L-3-4 to L5S1.
Hello, I do have a consultation service that I offered to select clients. Sounds like you would qualify. If you're interested, send me an email [chirogeek@chirogeek.com] or you could read all about the service at this link: www.chirogeek.com/Coaching%20Service/coachingService-2.html
This is so interesting, I've got sciatica and waiting for epidural injection for L5 nerve block, and if that doesn't work then surgery, I believe the problem all simply came about by too many years sitting at computer, thank you for great explanatory video
I didn,t see my problem too well, but my problem is that if I stand for 10 or 15 minutes, my back bothers me and I am glad to sit down. Walking does not bother me but I do you a Carex thing it is on wheels and I can support myself with it. That way I can walk without pain. Lately, I have had trouble walking without bending over and I tend to not be able to walk standing straight. I'm 90 years old.
You probably have an anterolisthesis (a.k.a. spondylolisthesis). I seriously doubt you have a dislocated vertebra :-) if you did, you would most certainly be in the emergency room. :-)
I am interested and would be greatly appreciative if you could view my MRI and X-RAY. Yes, it is Anteriolistethis at L2-3. Your message is cut off so I couldn’t view it in its entirety. I am scheduled for surgery on January 26, 2022. I keep putting off the surgery since Oct. 2020.
Very informative, but instead of saying "NO Mckenzie exercises" (17:31) you could say no extension exercises Mckenzie exercises is not only extension exercises, its an approach to treat a patient, there is flexion principle that might improve the symptoms of stenosis.
Doc... I have 2 Disc Herniation. L4-L5 and L5-S1. Im being in Pain for 8 Months. 30 Therapies and nothing. I got Worse because they made do those rotation exercises and things. I have to stay on bed for 5 days and then start walking again... One doctor said I don't need surgery. Im looking for a Second Opinion because I can't get better. I want to know if you can see my last MRI, I don't think they Really know what's going on. Most they just looking for money. and this is Getting me Crazy. any help would be.....
It's not surprising that rotational exercise/stretching flared you up. That's a big "no no" when it comes to rehabilitation, for the intervertebral disc, especially when torn, does not like to be rotated. In fact, in my experience, it can make things worse. That not only includes rotational stretching an exercise, it also includes grade 5 chiropractic/Physical therapist manipulation when done in the side posture style. You don't know how many clients I've had we have been hurt by side posture! I try to teach my students that they should never use grade 5 manipulation in the side posture style or at all for that matter on a patient with a suspected disc herniation. There are plenty of other low force chiropractic techniques, including flexion distraction treatment, that can be used more safely. I would be happy to go over your MRI images with you and then put forth some evidence-based treatment plans through what I call a coaching service. You can read all about it here: www.chirogeek.com/Coaching%20Service/coaching-service.html Please feel free to contact me via email if you have further questions: chirogeek@chirogeek.com
make sure to get a bonescan ,ct, mri (weight bearing and laying down) and Xray... My injury is almost 6 years ago, 4 fractures, 8 bulging discs, 2 hips, secondary neck pain, shoulder pain, left elbow and both wrist pain due to crutch use, after requesting an Xray they finally found a vertebrae slippage and my par fractures still haven't healed, 4 nerve roots are affected, urination symptoms since last year.
So many PT etc recommend the Cobra pose( back extensions) for sciatica - very dangerous. I am sure I got my herniation from extending back - in the gym - overhead pressing - Cobra pose made it worse - and also squatting with a weight on my shoulders. Deadlifting is ok if I do not extend backwards. Today got an epidural, after Nsaids and Prednisolone failed.(just hide the pain)
I can't stand still for more that a minute, depending on the day, 30 seconds. I just plop down to my knees due to severe low back pain. Spinal stenosis, sciatica and quite a few other things. Is there anything that will help me stand longer? I have pretty much everything. My disks are herniated or just the other one with the black stuff over grown. My family Dr is not sure if back surgery is worth it, since I have so much going on. Thanks! Can you recommend a safe exercise?
I have had two lumbar L3/L4 spinal fusions that have failed. The X-rays taken by the orthopedic surgeon shows nothing is wrong. The front thigh has pain. Not in the back nor on either side of the thigh, just the front. I can sit and lay without any pain whatsoever. BUT when standing for more than a minute or whenever I try to walk around 20 or 25 feet even, I freak. My back feels like it’s breaking! I become anxious as sometimes my legs buckle, other times I just hunch over because of the pain but always my breathing, heart rate and even sweats become apparent. How can somebody be in that shape and that much pain and the X-ray shows nothing. At that point my surgeon tells me it’s too soon to tell. It will be a year for the second surgery on April 20th. Everything is the same…pardon my French…but shitty.
I'm sorry the fusion has failed. Without a thin-sliced CT scan, however, the orthopedic surgeon cannot know for sure whether or not you have pseudoarthrosis - i.e., the fusion didn't take or the two bones didn't fuse/grow together like they're supposed to. An x-ray is only about 50% accurate for diagnosing pseudoarthrosis. So, press for a thin-sliced CT if you really want to know what went wrong with that fusion.
Sir, You said only 2% of ppl with back pain, leg pain due to herniated disc (extruded) need spinal surgery. Is it same said for sequestration? I have16mm size of fragment between the recess of L4L5 paracentrally on left side from L5S1 herniation upward movement causing leg pain and numbness in the calf. This is second time at same level. First was smaller than 5mm extrusion 5 years ago. But now MRI shows it is Sequestration after heavy lifting load and unnecessary yoga exercises including cobra(Mackenzie).Should i continue my conservatory treatment? Will it gonna heal its own way. I read story of 73 year old man was quite impressive.
Figuring out when to have surgery is an art form. You have to be the perfect candidate. The MRI findings must match the neurological findings and patient complaints. Without seeing your MRI with my own eyes and then learn something about your current neurological and orthopedic status and the history of injury, I couldn't possibly advise you. I do have a consulting service during which I answer questions like "do I need surgery." You can read all about the service at this link: www.chirogeek.com/Coaching%20Service/coachingService-2.html
1:04:27 Fantastic. I didn't even read about that! 1:04:50 Where is list of sources with ids [14],[22], also for a slide before this one? :) 1:06:13 Big true!!! But also source [95]?
I have some of these issues, haven’t being able to work for a year now and the doctors I have seen aren’t helping much, besides injecting and drugs, but never ask if I am able to pay my bills. I told one I might have to apply for disability and he looked at me like I was crazy or faking my pain. Has not been easy.
Thank you for this information. At 63 I have severe, debilitating stenosis. The "shopping cart" thing was classic! I have to grab a cart immediately and hunch over it. I am trying different surgeries to relieve pain.
I had severe pain in my lower lumbar. sciatica, groin down leg to knee all on my right side. Orthopedic surgeon said it was L4 and L5. I started physical therapy for 8 weeks 2 times a week and go to pain management doctor for spinal injections about every 4 months. I take Tramadal on days when pain kicks up but it definitely is about 90% better without surgery. I had all symptoms people are exhibiting. Laying in bed at night was torture
I am so lucky to have found relief.
I had spinal stenosis at my L4-L5. Sciatic nerve pain down both backsides to my knee and ankle. The surgeon I saw took one look at my x-ray and put the fear of God into me. He said by right I shouldn't be even standing let alone walk. He advised me to get surgery without delay, blablabla. Guess what, I took the surgery, and now I cannot pee or shit naturally. I had to use a catheter to drain my bladder and my finger in my rectum to void the shit. That was 2011. There is numbness down both cheeks and my genitals, down to my ankle, and my toes on both legs. My advice to all backpain sufferers, get all the research you can get, check out all options. Best of luck.
@@eltoro6064 see
Excellent, comprehensive and easy to understand if you have a basic understanding of spinal anatomy. The Chiro Geek is a born teacher, as well as a patient, and everything he says makes sense to me as an Emergency physician and interventional pain specialist (retired).
Had a Laminectomy about 10 years ago. Successful. Dr. Hartl NY Presbyterian. Loved the direction against flexive physical therapy, lol. Exactly what several docs rx'd. And of course made it worse. Very interesting lecture. Should add the diagnosis was Caude Equina, severe stenosis.
I would like to ask a question.
Am a 52 year old man I have been diagnosed with back problems.
Because of family situations I had to work I started working in construction and tree removal at 12yrs old stopped going to school in mid 4th grade I have had pain since I was a child I would like to find out if there is help for me I spent many years addicted to oxycontin but I quit in 2012 but the pain with my back neck and shoulders is horrible! I have been told I have stenosis and narrowing but other than that have not had much done about this as my insurance and money are not great.
Needless to say, I'll watch this video a few more times. Excellent, thank you
You can also check out "the spine guy"... breaks it down very easy to understand. Highly recommend
Mi fa sentire in italiano , questo problema della stenosi, o un nipote che soffre, grazie
Oh mio nipote che soffre della nonna
Very insightful sniff cough and images clear throat showing potential existing phlegm indicating some natural irregular drainage consistent with allergic reaction to seasonal pollens mixed with bodily collisions that can have damaging effects on bone health and overall ability to focus and concentrate on published educational presentation without audience experiencing every snort & dribble. Please, listen to complete sound track five consecutive nights before sleeping & consider re-making this potentially A+ video without sound OR keep video and have student intern help make entirely new sound track, over track this one.
Hope you are feeling better.
@@wandapiacenza1544 I’m so 🙂 😅😅😅😅😅😅😅😅😅u 😅😅 y😅😅u😅😅u😅😊😅😅😅😅it😅😅😅😅😅i😅u😅😊😊yeah 😅😅😅😅 😅🙂 I’m not gonna t you😊 😅😊😊😊😊😊😊😊😊😊😊😊😊😊yes you do and yes 🙌🏽 we do 😅😅ty😅😅😅😅y
As I weigh-up the prospect of back surgery, with symptoms of right low back, groin and pain to knee level, with the inability to stand upright or walk even a few steps before excruciating pain fires up, I thank you SO much for this information. This has empowered me to speak with my neurosurgeon with a level of clarity and understanding of the situation and options. All the very best for you.
How are you now ?
@Alexander black how are you now?
About 20 years ago I awoke with horrific back pain. I could barely leave my bed. My right foot wouldn't lay flat. I was walking on my toes. I went to my regular doctor and was referred to a spine surgeon. I went through all the conservative treatments. My wife was a Physical Therapist(PT) and she puzzled about some of the exercises and treatments I was getting. Regardless, nothing worked and a Laminectomy was scheduled. I was sent to a pain clinic for a steroid shot. I had the strange sensation of cold water being poured down my leg.. A week before the surgery the pain became more intense. The pain came in spasms which at their peaks left me unable to do anything except lie on the floor as they passed through me. I went to the ER and I was given a course of four drugs twice by IV. I fell asleep for an hour. My wife said I was going through the spasms in my sleep which was why I was run through the second time. At last it all stopped but my foot was worse. It was completely uncooperative.
The steroid shot had pushed disc fragments down into the nerve bundle. The surgeon spent nearly an extra hour removing them. The pain diminished a great deal after the surgery. I walked with a limp and my leg and foot hurt. Regardless I went back to work. I owned a company installing voice and data cabling systems. My right leg was week so I used the let on to lift me up the ladder with the right one following. I was slow but I got it done. I passed more of the climbing work onto the employees and I did the equipment ends.
Two years later the same thing occurred on my left leg and foot. I had another laminectomy and there was improvement. Three years later the pain had increased greatly and I had a third laminectomy. The results were minimal and I resolved not to have another ever.
I'm now retired. I work in my yard raking and sweeping. I have 10 birds feeders I take care of daily. I also put out corn for the 20 or so deer that come every day. When the pain becomes too severe I stop and rest. I take a 30 mg Morphine ER tablet three times a day. I guess it helps. I've never stopped it to see the difference. A few years ago I developed Type 2 Diabetes. That has caused much swelling in my legs and feet. I also have three kinds of arthritis. Every joint hurts but I keep going.
I've accepted the fact that this is my lot in life and I refuse to give in or up.
God bless you and your family. I pray for your healing.
Ever tried cannabis? Hugs
Absolutely amazing! The clear concepts given really make it easy for us to grasp complicated topics
I had non-invasive surgery by endoscope for spinal stenosis and am so very happy with the results. I could hardly walk, had severe leg pain, couldn’t sleep on my sides, before the surgery. The doctor lasered off some calcified bone that was pressing on my spine to give some relief and packed the area with stem cells. I walked out of there the same day and am so much better now. Almost back to normal.
What was his name? I desperately need help .. I have a massive bone spur that grew over my disc implant in 2 months . My body is so swollen.. my body is full of pulse ations.. feel like my heart is going to give out..
How are you feeling now Ms klapstein
mam please reply endoscopy surgery good ya not
how much improvement your pain
@@Raiseyourvoiceadvocates my guess is u already had small bony projections present your surgeon missed it and you should have had them taking care of first then you should have had the disc arthroplasty reconstruction depending on what condition you have do you have multi-level injuries is it cervical was it lumbar was it thoracic do you have CSM DDD so your surgeon probably fucked up and never should have did the artificial disc replacement without taking care of the bony projections first if they are at same level ur disc replacement is then u should not get any bony projections at that same level you should be fine bone spurs start because the disc shrinks all the fluid leaks out and then it's like no padding there so that's when you start to get the bony projections happens when your left untreated for a long time or if you have multi-level injuries then he should never done the disc either you should have probably had a fusion because if other levels are injured and he puts that disc in matter of time before the other levels starts degenerate or whatever and shit moves it's just no good. I feel you I'm going through the same thing I have CSM cervical spondylitic myelopathy I'm neurologically symptomatic spinal cord compression with my myelmoaiacia my neurological exam upper extremities include bilaterally positive Hoffman sign with an abductor twitch at the coming on with deep tendon reflex challenge at the elbow flexors and brachioradialis the formal manual test is positive only on the right at the legs we find very brisk deep tendon reflexes at the knees largely absent ankle jerks and no conus C3-4 motion segment is kyphotic and my bulge is big enough to traverse the subarachnoid fluid bath impacting the spinal cord my MRI clearly states I have and uncovertebral joint degenerative hypertrophy and I have problems from C2-C3 C3-C4 C4-C5 C5-C6 C6-C7 I have at every level impingement on the thecal sac lot of narrowing at the intervertebral foramen have small disc bulges and large Central disc protrusion I have a broad-based disc bulge my cervical spine is worse from c3 c4 c5 c6 signs of cord deformity at c3 c4 and c5 c6 my first MRI was January 16th 2019 the orthopedic neurosurgeon I saw Dr Drew a bedner wanted to do decompression discectomy and artificial disc replacement which made no sense because I have unconvertible joint degenerative hypertrophy and I have multi-level injuries you can't put an artificial disc in like that because you're just going to cause problems down the road it's called Brian's disc replacement or some shit I don't fucking know and I got to call 3 years later let's book your surgery come and sign the papers so I mentioned to him cuz I still love research so I can't have the artificial disc replacement because of the bilateral unconvertible joint degenerative hypertrophy he said yep you need a fusion I still haven't had my surgery because of covid I forgot to get a covid swab I was hooked up to IV the surgical down you're in with it pump hot air into you didn't surgeon came in and told me already good luck finding a new one to my second MRI my updated one for my cervical was December 22nd 2001 showing a progression getting worse moderate Central canal stenosis with indentation and deformity of the ventral cord parenchyma
You are very lucky you were able to receive stem cells, mostly prohibited by FDA in favor of drugs....
Thank you so much. This eased my fears and may save me money on surgery. Now I know to be patient and keep moving.
Bravo! Excellent content, either for the educated patient or interested professional .
😟i have everything but the tumors
This video is helpful as I have an extensive diagnosis that I didn’t fully understand before watching. Thank you!
I had an MRI scan they found I spinal canal stenosis , and they also found a blockage which they don't know what this is yet . I have had difficulty walking for the few years but worsened 2yrs ago there is a weakness in the right leg , and I know I'm suffering from claudication as I have numbness and heaviness in upper and lower limbs the blood pools on my ankles and feet also my hands , I live in Britain and they dont know whats causing this I have been awaiting another scan for over 1 yr I'm worried they are missing something
Great video, I’m 72yrs old with a spinal fusion done on my L2 and L4 two yrs ago. Unbearable pain for the first year and a half. Taking 8 tramadol a day until I realize I had to slow down and take it easy. I’m off tramadol and only taking celebrex once a day now . I have been diagnosed with spinal stenosis and living with some pain even though I can go for a walk up a hill for an hour. If I had my time back, I don’t know if I would have taken surgery. I couldn’t stand for ten minutes with out my thighs burning like hell but now it isn’t to bad.
How did you come with that much tramadol? Was there side effects? Here in Cameroon, tramadol is banned so one can't get any relief drug. No drug like celebrex here. Four years on, I can't get any relief for my spinal cord problem. So so hard....
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@@ndiforgroupcompany4861 Praying for you! Try capsaicin.❤️
@@SongOfSongsOneTwelve thanks so much. Yes, I will do.
Back surgery is a scam
Thank you, my hip needs replacing and my lower back l4 l5 needs removing. I am looking for anything that can give me the relief I hurt all day and night it wakes me from my sleep with a sharp and burning in my groan.
Very informative Lecture, a must watch for anyone really interested in MRI findings of various spinal conditions and requirement of spinal surgery and its outcome. It is also of great interest to radiologists who want to report on MRI of spine.
Awesome of you to keep on going with the illness you have! Hope you feel better!
Amazing teaching!!! Thanks 😊
I have arachnoditis do you know anything about that
Thank you beautiful lady
I'm data scienist researching about MRI reading. Lecture are so good
You have a dream job for sacral tarlov cyst gonna put your career on the map. Doctors dont know the proper MRI technique to detect them. Not for high intensity image of entrapped cerebral spinal fluid. Every fibromyalgia has the cyst. Might be true for a hold host of neurologically conditions. Forget everything that you been taught.
The best presentation about sciatica and herniated discs I have ever seen. Thank you very much
Thank you soooo much for this amazing presentation. As an experienced physiotherapist I learned more from that course than many other presentations that I have attended. You Sir are phenomenal. That was an awesome advance lecture indeed
I am 47yr old and was previously working as a food delivery rider using motorcycles. To a start, I have numbness on & off on my groin area and down along my both leg if I sit too long on the bike, or when I stand still for a minute or so, numbness appear. Later part, I experience extreme right calf pain, tiredness, pull on my right thigh as well. I also could not press myself up using my right feet. Despite taking an MRI and got a steroid jab at my L3, 4 & 5 lumber after consulting a musculoskeletal doctor at a local hospital. Till date, I still have yet to make significant improvement. Please advise.
To all people in the spine field (first another thank you to Dr, Gillard), as I am waiting to hopefully see or hear from Dr. Gillard, I am putting together many photos and videos onto a web page with my symptoms. I am willing to pay a reward at this point to help me figure out what is causing my burning / stabbing pain in my mid to upper back / center almost between spine and edge of left side body. I have been in agony for 17 years now and all I hear from doctors is...My pain makes no sense. Please leave a comment if you want to be notified when I finish this web page project and you would like to take a look at all my images, maybe something will jump out or maybe I need different types of scans which I am willing to do. Thank you.
@@bert1450 what is that?
Very Good and Educational! Thanks for posting Dr.Gillard
Best info I've heard so far. I had that rare problematic central disc herniation on L4_5 and left lateral L5_S1. It blew one month post microdiscectomy and then I had retrolisthesis L4'5 . TLIF on both levels left me with scar tissue on nerve roots and intractable pain. Now there's central and foraminal stenosis, DDD, facet arthritis in all spine levels. Not a happy ending.
I feel for u I'm in that pain right now in threpy too help 😖😖😖
What cause electric shocks in lower back and down into the buttocks.
My MRI didn't show the numbers
I suffer from spinal stenosis degenerative disk disease.. Just got thru with spinal cord stimulation trial.. I seemed to help with lumbar/ sciatic nerve pain..
I’m 80 year old woman who has had stenosis for many years. The past 4 or 5 have been the worse. I saw 5 or 6 doctors, over the last 3 years, all said I needed fusion. Laminectomy would not help me. I have beginnings of osteoporosis, and at the last minute my planned surgery was cancelled due to a bone density. I was told I need a hyperbolic doctor for shots. I went to a doctor who said at my age, it wouldn’t work. Back to square one and pain.
I tried injections, after a year or two, didn’t work anywhere.
I went to another back surgeon, he suggested a laminectomy; I had pain in. Uttocks, thigh, calf and outside foot. Numbness, I stability, shooting electric shocks an low back pain.
He said in 85% of patients will be helped with the remainder a mixed bag. I had no other choice, so I took the chance one month ago.
I find that my thigh, and calf has regained feeling; no more numbness. Y foot is the same. It gives. E hope. The doctor said that if I’ve had this pain a long time, it will take me longer to heal. I heard you say that if you’ve had sciatica more than one year, nothing will work.what are my chances for healing?
I’m such an active person, but I can’t walk 1/2 block that I have to stop. I’m at my wits end. Please help with guidance.😊
Hello Diane, I sure I'm sorry to hear about your struggle central stenosis and the associated claudication. In order to help you, I would have to know more about your orthopedic and neurologic status, as well as see your latest MRI /CT with my own eyes. I do offer a consultation service during which you and I would meet via Zoom to go over your imaging; after which, I can put forth some evidence-based treatment recommendations for your unique situation and answer all your questions. You can learn more about this consultation service (I call it a coaching session) at these links:
^ Learn all about Dr. Gillard's coaching service via website:
www.chirogeek.com/Coaching%20Service/coachingService-2.html
^ Learn all about Dr. Gillard's coaching service via this RUclips video: ruclips.net/video/A0GJ_r-uvpQ/видео.html
Best,
Dr. Gillard
These lectures are perhaps the most informative I have come across. I have a bit of a mess in my back and Ill upload the MRI to your site in the coming days and schedule a coaching session with you.
Awesome I have some of these and its amazing that you have more info then some of the docs I have seen.
11:27 it seems unreasonable to call anything below 12mm stenosis. In the lower spine, there are fewer signals that have to be sent up or down, so should need less space. Even though the lower spinal canal has a wider diameter than upper, this may be by design to allow for more damage.
22:03 standing/walking tests for claudication
29:19 maybe ‘conservative care’ leads to the need for widening the canal/decompression?
37:17 aren’t we mixing up things in these studies? You said in the beginning the major problem with stenosis was claudication, which isn’t really pain related but about weakness etc. Also you said the pain would be coming from the facet joints. The studies would mostly be treating pain, not so much claudation as the former is much more common. In any case I’ve never seen a big study that wasn’t centered on pain. So why is pain now suddenly a stenosis problem?
Clearly, doing decompression and spacer have one thing in common, which is taking the facet joint out of the equation, so no surprise the result is the same. Let me check you said their didn’t do foramitomy? Well they only said they included traditional decompressive surgery. I would guess that the clever surgeon would extend that to the superior spinous processes if he knows there is pain in that region.
I just looked at a random study which did a comparison, and they included ‘all traditional’ decompression such as ‘laminotomy with undercutting’, which is a euphemism for removing part of the facet joint.
Percutaneous Interspinous Spacer versus Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients? 2017
42:02 intrathecal venous plexus I take it, not epidural plexus. Now it makes a lot of sense why concussion type events would impair blood flow for a while, with this loose web of veins.
43:38 if the blood vessels swell in front of blocked sections, I’m not sure that would cause an issue, rather hypoxemia of the nerves seems more relevant. But weak blood vessels could not only swell but rupture, so I’m guessing micro hemorrhage is a bigger problem. Which would not be stenosis related, but be caused by weak blood vessels, which would of course rupture exactly in locations where there are additional problems like a bit of stenosis pressure.
But blood vessel issues could be addressed independently of stenosis, and maybe that fixes most stenosis related issues, if micro hemorrhage is prevented.
57:18 hemorrhage can also cause radicular pain. Repeat hemorrhage seems a lot more likely to me than repeat spilling of nucleus pulposa, because there is only so much of the latter before it dries out.
1:02:46 piriformis being over diagnosed when it’s rare
1:05:38 exception to the rule: unhospitalized patients recover.
1:09:06 sciatica (radicular pain in sciatic nerves) eventually non-surgery patients healed to catch up with the patients who had surgery (3 years).
Speed up healing: walking, swimming, do not stretch.
1:13:49 you have cited that 85% being herniating disc number numerous times, and I can’t find that paper even searching the journal directly. F porchet does not show up as the lead author in any article in journal of neurosurgery.
1:14:06 some missing anatomy I found: there are ligaments attaching the longitudinal anterior ligament to the dural sac.
The anterior dural (Hofmann) ligaments, 2004
1:19:31 so disc material has eaten away at the vertebra, on the left cut? I thought only tumors do that.
1:22:39 discectomy is contraindicated for a bulging disc.
1:25:33 micro discectomy only for herniation radicular pain. For low back pain only 40% chance of success.
Fusion: the gold standard for everything spine surgery related, like disc herniation back pain from disc and dura pain nerves.
1:34:31 great study: 15 patients who were all referred for emergency surgery for huge herniation but couldn’t afford it. All healed on their own.
1:37:38 example of PT/chiro being worse than walking.
1:39:32 you should only do a discectomy for extreme leg pain or progressive motor loss/cauda eq syndrome
1:40:50 example of fully reabsorbed disc herniation.
Great to read. Can bilateral foraminal exiting at l5 s1 cause cauda equina?
Excellent lecture! Perfect review on some things I already knew, but presented in a way that firmed up the reasons why behind certain theories or outcomes . And then Dr. provided a wealth of information about things I had always had questions about or had never known before. Done in a clear, logical manner that is so easy to understand. One of the best videos on RUclips and so valuable to medical staff, students, and patients alike. Everyone can get a nugget of gold out of it. Thank you so much for sharing your time and expertise! Fully enjoyed!
Pnnonohhh
I was in an accident in 2005. Herniated discs L3/L4 , then following week ruined the discs above and below from the Physio forcing me to walk on my knees across the gym floor . I was crying with so much pain. Then I developed spinal stenosis which then turned into Caudia Equina Syndrome. Not fun at all. I mentioned from day one something was wrong with my bladder and ignored. I was then ambulanced from passing out. I had went into diuresis. They finally tested me and my bladder and bowel severe neurogenic. I'm Allergic to all anti-inflammatory meds and steroids'. The past three months I have some changes with acute pain within the lower sacrum so I cannot sit at all. i wished there was a fix .
Even though I’m not in the medical field, what brings me here of course if my progressive back problems, I find this so interesting. I have curiosity for any kind of learning. Listening to educational and intelligent discussion is also calming. Thanks for you’re posts!
Another video easy to understand is by "the spine guy" dr. Brian su
Traduction français svp merci
@@vivianejeckelmann5721 p 00
what is diagnosis if majorly hurts between 3 and 5 am when trying to sleep?
Hello, I would have to know way more information! But the obvious is to make sure you have a good firm mattress. Mattresses that are too soft don't mix well with folks who have back issues. I would suggest you visit your primary health care provider to get your complaints worked up more thoroughly.
I would like to know if that artery I side the tail sprout could cause some intermittent signs of vascular with mainly Neurogenic stenosis in a failed fusion of L5&L4 misaligning L3 and herniated the L3 disc?
There wasn't a single commercial for this whole lecture
Dr Gillard...... nah
Saint Gillard choosing education over money
My father suffered for years from vascular intermittent claudication of the aortoiliac vessels, both legs. Needed to stop walking and stand still to allow some blood to flow, then he could resume walking. He had bypass surgery and could immediately walk forever. Happy man!
God Bless you both!!!
Wuuuuuuejhda
Hi sir, whats the difference between radiating pain up to above knee level vs radiating down to lower knee level up to the sole?
The most beneficial lecture about disc prolapse great thanks for you DR Douglas
Great lecture, thank you! What a trooper- powering through, despite your cold!
Dear Dr. Gillard, I received your email but I am uncertain whether you want me to use this for the purpose of sending you the information requested regarding my conditions? Please be advised that I do not reside in the U.S, that referenced medical records are writen in Italian; XRays, Cat Scanc, and MRIS are in CD/DVD formate, please reply with instructions. Thank you, respectfully F.Z
U$d f+soslskosddf chca
I'm L5-S1 spinal stenosis,have already had fusion at L4-L5 , I recently mentioned to my ambulatory specialist,that I was having bladder issues and he kind of sluffed it off,i;m on the wait list for some rods and screws,another fusion,and praying for a miracle
The new development of bladder issues is considered a medical emergency. A new MRI should be obtained to make sure nothing is severely compressing the thecal sac/cauda equina. Fusion alone is not the treatment for spinal stenosis. Decompression is and then its controversial whether or not fusion should accompany that decompression. All depends on whether or not you're stable at L5/S1.
How are you now??
@@mehmetsanl6267 sonu ameliyat olur Mehmet bey bu hastalığı yaşayan bilir çok şiddetli agrilari var
@@fatmatekbas6482 mesane problemleri yaşatan fıtığa mı sahipsiniz?
@@mehmetsanl6267 evet 2 aya yakındır Dar kanal daralması ve bel fıtığı ameliyatı oldum Pilatin takıldı
i have L4-L5 disc problem
I have a lumbar disc rupture compression nerve inflammation caused by itching, itching for more than a year, ask for treatment
Excellent lecture, doctor!
My L3 disc is herniated at the front caused I believe by a Lazer fusion w/instruments that was done .? It was not there before the surgery ,1st Lazer surgery but I've already had 6 fusion surgeries on my lower lumbar since age 19 and I don't think my history with my congenital spine disease was fully taken into consideration.? So I fully understand that in this country our surgeons take shortcuts as well as radiologists on MRI's and CT's exams sometimes the saddest part is it's always to the determent of their patients health .It's been 2 years and I'm still at the state I was in when I woke up in recovery no exaggeration I'm still having the same extreme sciatica electric nerve pain ,hot sensations I woke up with ?The phrase "It will go away don't worry about it " should be illegal to say in the medical profession? My personal opinion only .Thank you for these videos and truth of information without them patients would be left to anyone who says that phrase ? P!ease tell and supply all patients with this information to educate themselves with their diagnoses and steps that their current Dr.s have ordered ?Patients that are learning through Dr.Gillard Well Done!! Blessed are the Hands that Help ,Coveted are The Voices that Teach.💜🙏 for all Patients Health .
I am very interested in your in your brain’s a smart talk. I will be following you permanently I recently was studying medicine and had not gotten quite this far in spinal fluid Verdie and very courios on some side effects. You definitely blow my mind. Big booms coming from all around.
Could you comment on psudomeningocel and the possible effects of a screw into the disk space. L2- 3 Had ant. and post long spinal fussion with pinning 2009 had pain since. Now it is really bad. Had to retire early from nursing. Nerve pain mostly R leg. Numbness to L foot and lower leg Sever back pain and muscle spasms. Difficulty sitting and standing. Walking a little better. Laying flat is my only relief. My spine surgeon said he could not do anymore. Had second opinion he wont touch me. I do have an appointment with a neursurgon who specializes in complex spinal conditions for a 3rd opinion. I have a dx.of scoliosis. Love your videos!!! Thanks for sharing your expertise.
Dr Gillard, just stumbled upon this Vid. I'm no doctor, but I am a sufferor of a number of spinal issues including stenosis and facet joint arthritis throughout the spine including scoliosis and chronic pain and stiffness. I have been to at least 5 different spinal and neurosurgeons during the past 3 years, seeking relief. I have done tons of my own research , not in medical journals but on line dissertations like this one and from other doctors & chiropractors who offer advice and information. I have consulted with excellent doctors at Mt. Sinai, Columbia Presbyterian, Stamford CT Spine center and White Plains Hospital Spine center. All of the surgeons said - no surgery for you. Dr. McCormick at Columbis Presbyterian in fact said "no one will touch your lumbar spine....... I'd have to reconstruct your lumbar spine.......Pain Management. I also have cervical issues of herniated discs, stenosis, and "military neck". What the hell can I do? I have a shorter right leg by 1 inch a result of a fractured femur at 15 years of age , in a body cast for 4 months and the right did not grow , but the left leg did !! I'm 69 years old now. Lots of thigh and hip weakness, calf cramping and feet problems . Bouts of bladder incontinence. What a freakin mess
Same here, spinal stenosis, facet joint syndrome, lumbar and cervical nerve damage, tell me no real help, have hard full brace an heavy medication.
Such as life in this world. So many sad stories. Go to God. Eat well, no sugar, alcohol etc.
We have to build immune system.
Sorry for all you go thru. I understand.
I pray and read my bible. Use moist heat pads, stretches that can do help. God Help Us for we have worked hard in this life!
@@juliayelle2942 afraid god isn't into spine information or is asleep, NO god isn't the answer, science is the solution, nothing personal Julia, just a fact
Перевести на русский язык текст
@1:09 Flexion/distraction on an articulated table by my Chiropractor massively improved my symptoms immediately! I hobbled into the office, and could walk upright out of the office, every single treatment provided a few % immediate and sustained improvement. I showed him my MRI image of massive L4/L5 central disc extrusion and he suggested the treatment its for local decompression effects. I opted for no surgery and yes it hurt incredibly for 6-9 months. Now 13 years later and still without surgery I'm noticing some early cauda equina impairment symptoms, surgery probably coming soon.
Hey did you do surgery?? what were your symptoms of CES??
@@sarcasticmeeeeee5499 Neurosurgeon said it’s not CES but nerves aren’t happy. PT taught me some good mobilization and stretching to make and maintain some space. Seems I have Hypermobile Ehlers-Danlos Syndrome and that bendiness causes all sorts of issues.
@@DougKremer did you do MRI to find out?? I have dic herniation and Central canal stenosis since 7 months and I did my MRI twice in the span of 4 months 1st my ortho asked me to do and 2nd I did by own to check if have CES both the time it came normal and again since 2 days I have some problem with bladder and bowel so again I'm freaking out I don't what to do.
@@sarcasticmeeeeee5499 Yes, several MRIs. I think for CES they have a pretty high standard for about full blockage, but any stenosis can cause issues.
@@sarcasticmeeeeee5499 how are you now??
can severe bilateral spinal stenosis of the c5-6 be caused by MS lesions.. I asked my Neurologist if my spine instability and being hunched over is due to MS. Ther nurse said no but Neurologist said yes. I went to get my MRI of the cervical and thoracic spine. I was shocked to read I had severe bilateral spinal stenosis of the c5-6, moderate bilateral c4-5. I have moderate to severe disc degernation c4-5, C5-6. I am angry that my Neurologist did not refer me to a neurosurgeon to get decompression surgery. Thanks for the educational video.
No, MS lesions will not cause central stenosis. Central stenosis, however, can cause MS -like symptoms (myelopathy). Sounds like you do need to see a neurosurgeon as soon as possible. Good luck!
50:33 Optimal time for surgery for CES (CESI, CESR) is until 4-6 hours. Later surgery is also helpfull, but RR(relative risk) is bigger - prognose is worse. Look at works from NV. Todd 2005, 2008, 2014, 2015, 2017, 2019, or Igor Sulla on animals or from other authors, but no at Ahn 2000, which one is mistake and source of lots of disabled persons. Last year was published Hogan 2019 on 20000 patients, who says also death rate is lower with earlier surgery. Attention, Hogan at all was maded from insurance or medical stats and they have info only about date of surgery and they can not do from these numbers stats for 6 or 12 hours, but from DeLong 2008 You can be sure. 😉
Doctor told me that.i have spinal stenosis.and a cyst on the lumbar spine. Symptoms stiffness between m the back and sto and difficulty walking and pain from back cramps and heavines rotating in legs and calf muscles more pain increases when waking when I walk in the sun for a long time like an hour or so pain goes a way until sit and stand.
.
Informative lecture and makes some great points. But I could not disagree more that time and mother nature are the best treatments for sciatica. In my 40 years of professional practice, time and nature alone will not correct sciatica and discogenic radiculopathy. Just the opposite, it can lead to lifelong pain and disability. If the disc is not decompressed the pain and motor weakness will persist. I believe this may be where the expression "once you have a back problem you always will have a back problem " comes from. However, there are successful nonsurgical spinal decompression treatment protocols that can end this lifelong pain and disability. These protocols include nonsurgical surgical decompression along with anti-inflammatory adjunctive treatments as needed. Lance C Durrett MD DC
Please how do I upload pics to you xx
This is what I am suffering after a fall I never suffer from that kind the pian before I need to be operate in my back in my right shoulder ln I have shoulder tears in my bove arms let me know what should I do I am in pian twenty four hours a day
Great information just had surgery on my L4 L5
Great spinal lectures.
What's the best treatment then for contained, broad based disk protrusion?
Flavum thickness,disc bulge,c.s.f leak which I had to read in my notes !!
Ugh story of my life. Blown disc's, spinal stenosis chronic injury, new symptoms: thighs and hips going numb now with severe inflammation. I'd give anything for surgery.
Can you help me possibly or direct me to help. I have been suffering for close to three decades. I have chronic compression fx of thoracic vert. MRI 06/07/2018: T4,5,6,7,8 and 9. Vertebral loss of losses as follow: T4 10% mid, T5 30% mid 50% anterior, T6 no significant loss, T7 50% mid and anterior, T8 greater than 50% both mid and anterior and T9 25% mid and anterior. Accentuated Kyphosis of the Thoracic Spine. T5-6 Minimal posterior central disc bulge, T9-10 Minimal disc bulge, T11-12 minimal disc bulge. I just had an ACDF on 10/03/2018 of C4,5,6 on Oct. 3rd, 2018 for herniated C4/5 abutting the cord with myelitis at C5 and disc bulges at C5/6 and C6/7. Foraminal and Canal Stenosis and uncovertebral joint hypertrophy contributing to the bilateral foraminal stenosis. The ACDF seems to have helped the neuropathy in the arms but is still present. Now on to the Lumbar. MRI 10/02/2018: L1/2 Minimal broad based disc bulge, L2/3 Broad Based Disc Bulge extending into the bilateral neuroforamina. Moderate to Severe facet degenerative changes, Mild central canal stenosis and mild bilateral neuroforaminal stenosis. L3/4 Broad based disc bulge and moderate to severe facet degenerative changes. Moderate central canal stenosis and moderate central canal stenosis and mild bilateral neuroforaminal stenosis. L4/5 Broad-based disc bulge. Moderate to severe facet degenerative changes. There is mild bilateral neuroforaminal stenosis. L5-S1 Minimal disc bulge. Moderate facet degenerative changes. History of a 40-60 foot fall on 03/31/2005 in which the right fibula was fractured and dislocated. Had an open fixed reduction and internal fixation with a distular plate and ten screws. History of Grand Mal Seizures adult onset of idiopathic origin started in 1996. Pediatric history of Viral Spinal Meningitis and Encephalitis with Petit Mal Seizure at age 9. Septic thrombphlebitis and septic thrombosis from infected iv catheter while having a broken rib evaluated in 2008 and MRSA, DVT, Septic Pulmonary Emboli, and acute renal failure. Bursitis of the hips bilateral. Sciatica and other neurogenic conditions. I need a doctor who cares and will help me. Social Security denied me at the ALJ level back in March of 2018 despite all of these. Also, I suffer from Stressor Effective Disorder (PTSD), Depression, Anxiety, Panic Attacks, ADHD, inability to urinate effectively, suicidal ideation and thoughts with previous failed attempts, idiopathic cardiomyopathy, hypertensive disorder, previous history of acute pancreatitis, non-cardiac specific chest wall pain, previous ventricular tachycardia and more. Yet I cannot get proper help and Social Security will not approve me for disability. I am beyond myself after typing all of that out and realizing the list of disorders and impairments that I suffer from. I need help soon because I am not planning to stay alive much longer in this world without help because I just cannot take it much longer. I have suffered since childhood and I have seen people have more compassion for sick dogs and animals than they do for humans like myself. Brandon Kachmar, ytech1758@gmail.com
I’m looking at another back surgery, the surgeon who is the one in my area is in the Denver area and has refused to operate due to a subluxation of L2 L3 L4 and stenosis on most of the lumbar spine. Also I had a fusion of the T7 T8 in 98 after auto accident. My symptoms are numbness in my left leg mostly in my foot and great toe up my leg and into lower left back region it’s the sciatic nerve. I also have a spine cord stimulator installed and a pain pump from an accident that nearly removed my left arm. Had a ct Myelogram and it revealed that it was stable by comparison to the last ct taken in 2020. Could you give me at least one opinion hopefully not what I’ve heard already why nobody will fix the subluxations? Thanks Steve
I'm sorry to hear about your struggle with chronic pain. I would have to look at your latest MRI and CT images with my own eyes and know something about your current neurological and orthopedic condition. I do offer a Zoom consultation service to select members of the public (you would qualify). If you're interested, you can learn all about the service at either of these links:
^ Learn all about Dr. Gillard's coaching service via website:
www.chirogeek.com/Coaching%20Service/coachingService-2.html
^ Learn all about Dr. Gillard's coaching service via this RUclips video: ruclips.net/video/A0GJ_r-uvpQ/видео.html
Thank you Doctor for your brilliant and precise explanations. I love you, you don't talk very fast. Perfect. But the only thing is your board, it can't be read. The letters can't even be seen. VERYVERY tiny. But the pictures are very good
XXXX
Does unilateral chronic L4,5 pain with a history of central disc prolapse imply lateral stenosis? Pain does not radiate to buttock or legs. Comes with pelvic twist when sitting for a long time, leaning towards one side, goes away when exercising, moving, walking.
Hard to say. I would need to look at your MRI Images and then possibly order SNRBs and Flexion/extension radiographic study to figure out.
I have severe stenosis. ..several pinched nerves...thecal solid black...suffered for 21 yrs..dragging left foot....slapping...
Sir i have mild lumbar stenosis in l4 l5 is there any problem in feture
Have you any info on lateral recess narrowing with S1 irritation? I’ve NIC but pain remains in buttocks on left side, pain begins from standing /walking and I’ve to sit or bend over which is painful but a relief. I’m a nurse and can’t work & I’m only 39 :( also have paracentral disc protrusion
Lateral recess is also known as the paracentral zone. This is the most typical place a disc herniation occurs (paracentral disc herniation's) which end up compressing the traversing nerve root. Ligamentum flavum thickening and superior articular process bone spurs can also invade the lateral recess and also compress the traversing S1 nerve root. Sometimes facet joint cysts can also enter the zone. So for you, the $64,000 question is what is causing the lateral recess stenosis (a.k.a., narrowing). The cause would dictate the evidence-based treatment. Good luck!
@@douglasgillarddcprofessoro5285 thank you so much for replying! Much appreciated
I'm paraplegic and lying in BLK-MAX SUPER SPECIALITY HOSPITAL PUSA ROAD india due to neurosurgery of thoracic and lumber spine tumor ( myxopapillary ependymoma). Pray for me brethren
God bless you,just seen your message,hope you are doing better
Prayers 🙏🏻🙏🏻🙏🏻
God bless you
@@Shivakrishna61 I'm still in paraplegia till now, in God I trust
@@eliachalamila2259 you will definitely come out...
Good lecture, thank you Douglas.
Իմ որդին գոտկատեղից չի զգում վիրահատվել է 3 տարի առաջT4 T5 ողերը կոտրվել են փոխարենը դրված է իմպլանտ այժմ չի քայլում բայց ձեռքերը շատ լավ շարժվում են ։Խնդրում եմ պատասխանեք կոգնեք իմ որդուն որ քայլի
I am almost 78y4s old, I have spinal stènosis in lower back. I have been on tagging for more years than I like to admit, however I broke the 2 pedicals on the l .2 8n 2016 since then everything seems to go wrong. I push myself to at least keep the house clean but I pay a heavy price for it. I would like a treatment for this to make life easier.
Thanks for sharing🙏 this is VERY informative and helpful ✍️👍👍
Proceduralist are in the cyst and leak business correct? Dont know about nerve dilation and prolapse in regards to scoliosis though.
I need to have a LTIF! I am 50 years old. Would you be Able to look at my MRI? I had a fusion in Sept. 2015 and had to go back in January 2016 because I couldn’t walk. Had a mri and I have severe stenosis. L2-3 and moderate buldge at L1-2. Fused L-3-4 to L5S1.
Hello, I do have a consultation service that I offered to select clients. Sounds like you would qualify. If you're interested, send me an email [chirogeek@chirogeek.com] or you could read all about the service at this link: www.chirogeek.com/Coaching%20Service/coachingService-2.html
I have great photos of my disc ruptured and cauda equina syndrome. I am willing to share my MRI photos.
Can u share with me?
This is so interesting, I've got sciatica and waiting for epidural injection for L5 nerve block, and if that doesn't work then surgery, I believe the problem all simply came about by too many years sitting at computer, thank you for great explanatory video
I didn,t see my problem too well, but my problem is that if I stand for 10 or 15 minutes, my back bothers me and I am glad to sit down. Walking does not bother me but I do you a Carex thing it is on wheels and I can support myself with it. That way I can walk without pain. Lately, I have had trouble walking without bending over and I tend to not be able to walk standing straight. I'm 90 years old.
I had an open MRI that showed that I have spinal stenosis.
I also have a dislocation vertebrae L2-3
You probably have an anterolisthesis (a.k.a. spondylolisthesis). I seriously doubt you have a dislocated vertebra :-) if you did, you would most certainly be in the emergency room. :-)
I am interested and would be greatly appreciative if you could view my MRI and X-RAY. Yes, it is Anteriolistethis at L2-3. Your message is cut off so I couldn’t view it in its entirety. I am scheduled for surgery on January 26, 2022. I keep putting off the surgery since Oct. 2020.
Dr. Gillard, my sincere apologies.. I did misspell your email.
Thanks! What is SNRBS?
Thank you so much for the lectures and very superior
St marks told me I had cauda equine when I came back to jersey they lost my records I was told I had crones
Not easy finding information about the arduous the L1 l2 Tina .You got your hands full. Please update and luck be with you.
Very informative, but instead of saying "NO Mckenzie exercises" (17:31) you could say no extension exercises
Mckenzie exercises is not only extension exercises, its an approach to treat a patient, there is flexion principle that might improve the symptoms of stenosis.
agree - no extension - i am sure that caused my disk herniation - heavy weights in the gym- overhead extensions.
Fantastic lecture and great channel. Subbed.
Doc...
I have 2 Disc Herniation. L4-L5 and L5-S1.
Im being in Pain for 8 Months. 30 Therapies and nothing. I got Worse because they made do those rotation exercises and things. I have to stay on bed for 5 days and then start walking again...
One doctor said I don't need surgery. Im looking for a Second Opinion because I can't get better. I want to know if you can see my last MRI, I don't think they Really know what's going on. Most they just looking for money.
and this is Getting me Crazy. any help would be.....
It's not surprising that rotational exercise/stretching flared you up. That's a big "no no" when it comes to rehabilitation, for the intervertebral disc, especially when torn, does not like to be rotated. In fact, in my experience, it can make things worse. That not only includes rotational stretching an exercise, it also includes grade 5 chiropractic/Physical therapist manipulation when done in the side posture style. You don't know how many clients I've had we have been hurt by side posture! I try to teach my students that they should never use grade 5 manipulation in the side posture style or at all for that matter on a patient with a suspected disc herniation. There are plenty of other low force chiropractic techniques, including flexion distraction treatment, that can be used more safely.
I would be happy to go over your MRI images with you and then put forth some evidence-based treatment plans through what I call a coaching service. You can read all about it here: www.chirogeek.com/Coaching%20Service/coaching-service.html
Please feel free to contact me via email if you have further questions: chirogeek@chirogeek.com
Angel Robles
make sure to get a bonescan ,ct, mri (weight bearing and laying down) and Xray... My injury is almost 6 years ago, 4 fractures, 8 bulging discs, 2 hips, secondary neck pain, shoulder pain, left elbow and both wrist pain due to crutch use, after requesting an Xray they finally found a vertebrae slippage and my par fractures still haven't healed, 4 nerve roots are affected, urination symptoms since last year.
@@SmithsCrhronicles Hey did it cure??
So many PT etc recommend the Cobra pose( back extensions) for sciatica - very dangerous.
I am sure I got my herniation from extending back - in the gym - overhead pressing - Cobra pose made it worse - and also squatting with a weight on my shoulders. Deadlifting is ok if I do not extend backwards. Today got an epidural, after Nsaids and Prednisolone failed.(just hide the pain)
I can't stand still for more that a minute, depending on the day, 30 seconds. I just plop down to my knees due to severe low back pain. Spinal stenosis, sciatica and quite a few other things. Is there anything that will help me stand longer? I have pretty much everything. My disks are herniated or just the other one with the black stuff over grown. My family Dr is not sure if back surgery is worth it, since I have so much going on. Thanks! Can you recommend a safe exercise?
Does Spinal cord heal back?
I have had two lumbar L3/L4 spinal fusions that have failed. The X-rays taken by the orthopedic surgeon shows nothing is wrong. The front thigh has pain. Not in the back nor on either side of the thigh, just the front. I can sit and lay without any pain whatsoever. BUT when standing for more than a minute or whenever I try to walk around 20 or 25 feet even, I freak. My back feels like it’s breaking! I become anxious as sometimes my legs buckle, other times I just hunch over because of the pain but always my breathing, heart rate and even sweats become apparent. How can somebody be in that shape and that much pain and the X-ray shows nothing. At that point my surgeon tells me it’s too soon to tell. It will be a year for the second surgery on April 20th. Everything is the same…pardon my French…but shitty.
I'm sorry the fusion has failed. Without a thin-sliced CT scan, however, the orthopedic surgeon cannot know for sure whether or not you have pseudoarthrosis - i.e., the fusion didn't take or the two bones didn't fuse/grow together like they're supposed to. An x-ray is only about 50% accurate for diagnosing pseudoarthrosis. So, press for a thin-sliced CT if you really want to know what went wrong with that fusion.
Is inverted surgery performed on lumbar spinal stenosis?
Sir, You said only 2% of ppl with back pain, leg pain due to herniated disc (extruded) need spinal surgery. Is it same said for sequestration? I have16mm size of fragment between the recess of L4L5 paracentrally on left side from L5S1 herniation upward movement causing leg pain and numbness in the calf. This is second time at same level. First was smaller than 5mm extrusion 5 years ago. But now MRI shows it is Sequestration after heavy lifting load and unnecessary yoga exercises including cobra(Mackenzie).Should i continue my conservatory treatment? Will it gonna heal its own way. I read story of 73 year old man was quite impressive.
Figuring out when to have surgery is an art form. You have to be the perfect candidate. The MRI findings must match the neurological findings and patient complaints. Without seeing your MRI with my own eyes and then learn something about your current neurological and orthopedic status and the history of injury, I couldn't possibly advise you. I do have a consulting service during which I answer questions like "do I need surgery." You can read all about the service at this link: www.chirogeek.com/Coaching%20Service/coachingService-2.html
1:04:27 Fantastic. I didn't even read about that!
1:04:50 Where is list of sources with ids [14],[22], also for a slide before this one? :)
1:06:13 Big true!!! But also source [95]?
I have some of these issues, haven’t being able to work for a year now and the doctors I have seen aren’t helping much, besides injecting and drugs, but never ask if I am able to pay my bills. I told one I might have to apply for disability and he looked at me like I was crazy or faking my pain. Has not been easy.
V
That sucks dude. Have you found any relief since posting, how are things?
vascular intermittent claudication, do you often find the other findings of smooth shiny hairless legs as well with poor wound healing?
Thanks
I am from Serbia,how can I send to you my MRI scan,is that possible...I have problem with my spine...Thank you very much...👍👋👋
How to cure spinal stenosis
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Is that a MRI or CT scan?? To my understanding a CT Scan shows alot more of the problem!
Lara Greene New 3D CT tech is amazing. Check out Aqualine Prime.
Greatest lectures. Thank you.