If you liked this video, you can also check out The Four Myths of Spine Surgery: ruclips.net/video/kTglV1700Yg/видео.html RISKS of spine surgery: ruclips.net/video/bMZkT6p0EX0/видео.html
I will. I just seen your response. Tomorrow I find out if it’s fusing! A long wait. Surgeon concerned it may not. I’ve had 3 cervical spine surgeries but this one was really rough. On me & surgeon
Thank you Doctor, your educational video has confirmed why I didn’t go ahead with a spine surgeon scheduling for surgery without ever seeing me in person, only saw my MRI
Sorry so many are in the same boat, but glad to hear I wasn’t the only one. The defensiveness to questions or researched knowledge, even from other doctors, is alarming.
Agree. Your life is ruined with pain and dismobility. Still its hard to even get an appointment. Even if I pay for it the surgeon dont seem to care, not answering questions and holding back information. For example I had a meeting with a surgeon together with my father as support. The surgeon starts to tell us there is nothing he can do. No explanation, no nothing. Then my father points at the x-ray of my spine and says, but what is that? The surgeon responds: ohh that is inflammation. And my father points at another area, and what is that? Ohh, that's your previous fusion 3 yeras ago that has not healed. So if my father had not asked we wouldn't have been informed that my previous fusion was a non-union.
Two weeks ago I had oblique interbody minimally invasive surgery to treat severe spinal stenosis at L4 and L5. My surgeon walked me through my x rays and MRI and explained that a worse fate than the continuing severe pain down my right leg could be a loss of nerve function because of the compression of the spinal cord.. He made a convincing case to me for the procedure and this video helps assures me that I made the right decision
I was hoping to hear about your post surgical outcome. Has your pain been reduced or more liveable. Has your pain in the surgical site decreased and did you have any nerve damage at the surgical site. I'm curious because my surgeon suggested 5 level laminoplasty and an L4L5 fusion. I'm worried about my outcome and how I'll be able to manage my own care for two months after surgery.
Yes I had a lumbar laminectomy the bone grows back sort of like when you pull a tooth from my understanding and the arthritis sets in again no cure for spinal stenosis
I wish I had seen this video 9 years ago. When I had decompression surgery to my L5-S1, I was never told I would probably have to have spinal surgery in about 10 years. I am 9 years post op and about to have fusion in that area due to the significant slipping and now I am not in a position to take off the time and get the care I need. You are a God send and I am glad I found your channel.
Some great questions to ask. Thank you. My Dr. talks to me for 15 minutes and gave me a packet and then said to call his office when I’m ready. You are really in charge of your own health.
Thank you for your comment. Yes, the discussion to have surgery should be thorough, including an analysis of risks/ benefits and pros/cons. Most of the time (unless it is an emergency), the patient should go home after the initial discussion, research this matter, write down their questions/ concerns and then schedule a follow-up ("Talk-Surgery") appointment with the surgeon. You are correct: You are really in charge of your own health.
@@SpineSurgeonSpeaks I need a new doctor. The one I am using is useless. He couldn't care less about my situation and will prescribe one visit after another. I can barely walk and in a lot of pain.
I'm so glad I ran across this video because Im going for a second opinion before having surgery on my c-spine. I have retrolithesis at C4-C5, with bone spurs in and out of the vertebrae, severe foraminal narrowing at C4-5 , bilateral C5-7 foraminal stenosis, and moderate cord compression. Most of the discs are gone in my c-spine. Last August I consulted with a neurosurgeon and told him that I did not want any type of fusion. He told me that there would be no fusion, he would only go in and put a disc in the space between the two vertebrae, and remove all the bone spurs. When I received the letter from my insurance company about the pre-authorization, it stated clearly that his plan of action was to fuse two levels in my c-spine and he was going to use a material for the disc space that my insurance would not cover. Since it was a partial denial by my insurance company I didn't have the surgery and I sure am glad that I read what the insurance company said because the doctor had flat out lied to me! If I had agreed to the surgery without checking on things first I would have come out with a horrible surgery that I did not want! I started physical therapy 2 weeks ago and I'm already feeling a lot better. My PT seems to have hope that I can realign the vertebrae through physical therapy and using one of those expanding collar things, kind of like traction. I found one online for $5. In 2001 I had bilateral sacroiliac fixation with large screws and washers. It literally gave my life back because I wasn't able to walk for about 2 years prior to the surgery. The orthopedic doctor who performed that surgery had told me that if I chose to have the surgery done it would put more pressure on the lumbar discs and would cause them to wear sooner than they normally would. And they did, but I expected it! I don't have any discs left in my lumbar spine, the vertebrae are pretty much fused together. I had no choice though because before the SI surgery the pain was so intense that I would pass out, and I couldn't walk. Because of all of the disc and bone loss I have went from 5 ft 8 in tall to 5 ft 4 in tall over the last 10 years. But I have continued to stay as active as I possibly can. For the most part I stay busy at least 12 hours a day. Most doctors can't believe that I am still able to walk, they are thoroughly shocked. Staying as physically active as possible will strengthen the muscles parallel to your spine and keep you upright and mobile. It's good to always ask lots of questions about any upcoming surgery to know exactly what the doctor will be doing. But not only that, you should also read the pre-authorization letter from your insurance company, that will explain everything the doctor is going to be doing. Sometimes you will find out things that the doctor didn't tell you! Just like what happened to me!
Thank you for your very thoughtful comment, appreciate it. Yes, it is important to consider other options before committing to surgery, to see if any alternatives may be available. It is not unusual for patients with severe pain/ disability due to sciatica/ back or neck pain to get better with nonsurgical means. Physical therapy, medications and pain-management procedures can improve the symptoms dramatically. It is great to see that you are doing well, good luck to you in the future!
@@SpineSurgeonSpeaksYes but all those that you've mentioned above comment are "temporary"Band-Aids only covering up the real issue. In order to get to the root of the cause surgery is your option & only true option but if you want to keep putting Band-Aids on go ahead they are eventually going to come off & it is surprising to me that you'd say something like this because you know this is true.
I had two C-Spine disks replaced because of “Severe cord compression”. It was less than half thickness, and my shoulder and arms felt like they were on fire. It was only after over a year of nerve blocks that they agreed to do the surgery. Immediately after the surgery I had no pain at all.
When done for the right reasons, spine surgery can be life-altering. Thank you for sharing your experience. Wishing you the best of luck and the best of health int he future.
Thank you for your honesty. Next Monday I have a permanent spine stimulator placed in my lower spine. The trial worked well for me. Now to find an excellent neurosurgeon that can help undo the back surgery my veteran son went through.
@@SpineSurgeonSpeaks I'm from Iceland. I had a crack in my spine in 2018 and have developed postural kyphosis on top of it since then and want to get surgery. The doctors in Iceland don't do much to help me and I'm looking for help abroad. Where would you recommend I go?
Thank you for reaching out. I am only familiar with the US healthcare system, so my experience is limited to it. Medical care in the US is much more expensive in the rest of the world, so for people traveling to the US for surgery this is an important consideration. However: If you search for it on Google, you will find some cash-based surgical practices who may be able to give you an up-front fixed cost estimate for surgery. Good luck to you! 👍
Thank you so much for the explanation. I’m facing right now the possibility of a spine surgery . With this information, I learned a lot about it, specially the questions I’m going to ask my surgeon.
Dr. I am undergoing surgery because I lost sensibility, strength and movement of the toes of my left foot. :( My Dr showed and explained to me the MR and pointed to the area where the hernia was crushing the nerves. My pain started in my lower back, ran across all my left leg, until my toes. I have been under medication for almost 2 months and the last change was the loss of sensibility and movement, what made my surgeon recommend the surgery. Thank you for your video. It helped me to be ever surer of the surgery!
Thank you for reaching out, glad to hear that the video was helpful to you. Wishing you good luck with the surgery and the best of health in the future.
Thank you for your valuable information. I'm being scheduled for fusion on L5 and problems with L3 and 4. I feel a lot better about it from your educational video.
Wow! A spine surgeon doctor with a heart and concern for the interests of the patient! I twice visited a neurologist who was 45 minutes late for each appointment; and would barely let me get a word in edgewise to the conversation about surgery! All he could mumble was "you need surgery". I had a barrage of questions to ask him, but he was in too much of a hurry to care! What is the objective of the surgery? On what part of my spine anatomy would such a surgical procedure be performed? Show me why the MRI leads you to this conclusion or strategy? And why there? What would the surgical procedure actually accomplish? And would it resolve my issues completely? Or would I need to come back later possibly for another surgery? What are the risks? Are there any guarantees that this will fix all of my pain and neuropathy? If so, are they in writing? And then if it fails to accomplish the objectives; will you refund the money back to me and my insurer? Will it take multiples trips to the operating table to effect total relief of the involved pinched nerve roots or spinal canal? What is the healing process feel like? How long typically does it take?.......my God, as a critical thinker; these questions roam my mind and those of others!! Is the doctor more interested in collecting money for the office visit than he is in caring for the patient? Then "eff" him and move on to another! Thank-you doctor!
If I were your surgeon I would have ran out of the room, you really need to compact all of that into a much shorter version & yes they are extremely busy & don't have time for a short book. Only celebrities like Tiger Woods receive that kind of timely treatment.
Living in Canada, it is really quite interesting to watch this video. Our situation is exactly the OPPOSITE of what you describe. There is a tendency to strongly triage and focus only on the most severely disabled patients first, where there is a clear sign of dysfunction such as lack of muscle tone, lack of reflexes, not being able to function. Pain alone is rarely a basis for surgery, as is the case of numbness, burning etc. -- even when it is corroborated by imaging. Spine surgeons do not want to operate on cases where there is not a clear path to success or a very strong case for doing something in order to prevent an irreversible worsening. I'd say the average waiting time for a pt complaining of pain (but no weakness) is probably 3-4 years. I had a listhesis during the pandemic, walked with a cane for 2 years and still was considered low priority as I had no cauda equina (but saddle area numbness was imminent). Most good spine surgeons will not brag about results, but go over the possible complications, as a matter of due diligence and to cover themselves in case something goes wrong. They are not looking for patients, but looking to focus on the patients that will benefit most. In reality, most patients will see an improvement even if there is a complication, because they were so bad pre-op. New technologies are rarely promoted, as the doctors do not want to risk using something they are not familiar with. We do have lumbar ADR and MIS but open is still done too. Computer guided screw placement is generally not used, as is multiplanar intraoperative imaging. Surgeon skill really matters. I've had 5 spine surgeries and I think the advice given in this video is very solid.
Thank you for your very thoughtful & insightful comment, and your kind words. Physicians and patients are often significantly constrained by the healthcare system within which they exist. This can lead to a lot of unusual discrepancies, such as when you compare the U.S. vs. Canadian healthcare systems. I had previously made a video comparing the healthcare systems of the U.S. vs. Canada vs. Brazil, which may be of interest to you: ruclips.net/video/1KRRttIkpGE/видео.html The problem is that it makes *rational* sense to triage patients (as you described) in the system so that the most severely-disabled patients are helped first. However, this "computerized" approach fails to take into account the terrible pain (and resultant suffering/ disability) that some patients have to live with for years and years. The example you cited (your own experience during the pandemic years) is sufficient to illustrate this point. If you had been in the U.S. during that time, you would've had the surgery done very quickly and you would have been spared years of pain and suffering. I see this every single day. Thank you for sharing your experience. I should probably make a video about it at some point... stay tuned. Best of luck to you 👍
@@SpineSurgeonSpeaks yes. Precisely that, lack of resources. In most ortho surgery it is the post-op care and the intraoperative support (surgical nurses, anesthesiologist).
I’m fused from c2 to c7 and am still in horrible chronic pain my surgeon is wanting to reopen the back of my neck and strengthen c2 to c7 and fuse c7 to t1 the last mri showed disc problem at t2 to t5 so I’ve never been more worried and confused about this next surgery I pray 🙏 continually
I had C2 to T1 and although those joints are Good the adjacent C1 and T2 are now a problem. No one tells you about adjacent displacement. U probably have the same.
Glad I found this video before my first consultation. Guess if the doc does not have time to answer questions or explain things, it will not be the right one for me, regardless if I was to consider surgery or not. Thanks for the advice!
I remember my self with all of what you said. My dad had that cauda equina syndrome due to that tumor affecting L3-L5, spine surgeon advice to take out that tumor and add disc for support, I didn't understand everything even though I did record and write everything it was to much for me to understand, we did a lot of extensive repeated test and after a month my papa past away, it was metastatic spine cancer, it was really fast that tumor spreads everywhere and I wanted to have the surgery but my papa cannot move his feet his lower limbs he cannot pee and poop he can't sleep, It was a nightmare seeing someone experience this type of cancer, I was hopeful it was just spine cancer because I have a lot of trust with our spine surgeon, he did his best to explain so me and my papa understand it and did explore other options. Thank you for this.
Thank you for sharing your experience. I cannot even begin to imagine the heartbreak that you and your family went through. Prayers to you and your family ❤️🙏
My recent MRI revealed "severe" bilateral foraminal stenosis and severe central canal stenosis in several locations. Those results and the horrific pain I am experiencing lead me to believe surgery is in my future. Oh boy!
I have severe spinal stenosis L4-L5. And doing lamenectomy. Doing it Tuesday. I do have good days and horrible days though. I just want to get back on the tennis court
@@HomelightRealtyAZ or not...look at" discseel" in washington state. and frankly...if you are not a professional tennis player than those days are over. I had to give up stuff i loved doing... these guys inject your disc with fibren and seals it right up and you are out in 30 minutes. and no i have not done it though i did stem cells in costa rica which was great until i did the thing i love doing... i have researched a lot and this is my choice when i get funded...
Thank you. I have symptomatic lumbar ddd with no stenosis. Severely painful and life changing. Surgeons will not move foreword with a disc replacement even when I am begging them.
Thank you for reaching out. Low-back pain with multilevel-DDD is a difficult problem, I agree. Surgical results (with fusion) are unpredictable. I understand your frustration completely, but I have seen too many patients who underwent a (well-performed) spine surgery without relief. Just make sure you have your SI-joint checked out to make sure that it is not a pain-generator. Good luck!
What a great video, talking about the issues a patient should really be talking about before embarking on a surgery. A lot of times I think we have surgeries where time and patience would have worked as well. And as the surgeon pointed out, surgeries seldom put you back to the way you were. And considering surgeries push you backwards before you can improve, in some circumstances perhaps it's better to accept some loss associated with aging and avoiding the pain of surgical procedures.
My first surgeon failed on 5 of these points. When I went back for followups he just poked his head in the door (like literally wouldn't even step inside the room, all I saw was his head) and asked if I was ready for surgery yet. When I would say no, he'd disappear until my next followup. I switched surgeons and never even had the surgery.
Thank you for this question. After a laminectomy, the spinal-cord and nerves are covered by a thick layer of muscle and fascia; practically speaking this provides them with excellent protection from trauma.
Hurt my neck on a military freefall jump back in 1988. Hurt for months after that. 35 years of flare ups and pain went chronic three years ago. Having more ridiculopathy especially in left arm and sporadic severe pains in left C3-C4 area. I do commercial HVAC for a living so constantly looking up which aggravates my neck. The last visit with my neurosurgeon he said to go as long as I can stand it because if he goes in, he is going to fuse from C3-C7. Been doing pain management last two years but it doesn’t help with the pain I have now. As far as I can tell no muscle weakness in my arms yet. Zero family history of degenerative disc disease. Anterolisthesis C3-C4 Retrolisthesis C4-C5 Narrow waisted fusion C5-C6 Severe formaminal narrowing C3-C7 Severe spinal stenosis C4-C5 Disc bulge C6-C7 Posterior disc osteophyte complex C4-C5 Facet arthropathy C3-C7 Thanks for the informative videos!
Thank you for watching, and for your kind words. Neck pain and radiculopathy can really affect your life in many ways. I can only imagine how difficult it must have been for you to live with this condition for so many years. I am sure you have researched ACDF surgery. Here is a link to my video about the procedure which you may find interesting: ruclips.net/video/rboB5n4aIVo/видео.html Wishing you all the best in the future 👍
Very clear and concise explanation! Thanks I wish I would have come across this sooner. But luckily I did do a lot of research and found a dr that didn’t get annoyed with all my questions. All good points that luckily I did ask. Because otherwise I did feel extremely rushed and uncomfortable with overall outcomes! Ask away if it bothers them that you take your health seriously. Find another doctor!! I go soon
Thank you for the compliment, appreciate it. Good communication between doctors and patients is absolutely essential. If you feel that your doctor is not listening to you, you need to get a second opinion. Your comment is spot on.
@@SpineSurgeonSpeaks thanks for the reply the doctor did . But I have so many reservations about having this done . I have literally seen thousands of people online and not one really good outcome or great results. Barring something like a bad accident or a tumor or such ! So Leary about all of it , and having it done!
I ended up with allergic reactions to the titanium and now have to get it redone and found titanium free options except for the screws. We will see on 11/7 how it goes.
Titanium allergy is extremely rare, but possible. Most patients who are told that they have a "titanium allergy" are in fact allergic to the trace elements (metals like cobalt, nickel) that are sometime alloyed into the titanium.
@@SpineSurgeonSpeakscrazy part is cobalt and nickel I had no issue with. Also nothing with titanium dioxide just the rod in patch test. In the hospital right now as I just had revision surgery and sadly he was unable to get the cage out without breaking the bone. He covered it with something to make a barrier around it. Rods come out once fused and hopefully that helps reduce the reaction to it.
Great video doctor. Hope you’ll do that video about the differences between one position fusions vs 360 fusions (ALIF 360 front and posterior/two stage operation for example) advantages and disadvantages and why doctors opt for the first or the latter procedure. Thanks :)
dear doctor, my wife's back surgeon (laminectomy with coflex) would never spend the time to answer such questions. now that she's had the surgery (2 weeks ago) and is practically crippled, way worse off than when she went in for it, now he won't even answer our phone calls. and by the way, he has no medical malpractice insurance.
I am sorry to hear about your very difficult experience. I can't even imagine what you and your wife must be going through. Maybe getting a second opinion from another surgeon (at a University hospital) could be a reasonable option. Wish you all the best and good luck 🙏
@SpineSurgeonSpeaks nwei doc can i ask, because im 4weeks post op laminotomy and discectomy L5-S1,i still have numb pain in legs and both feet..and maybe you have exercises in your channel ,bec my pt will start nextyr and i want to stretch my body..thank u for your help
Had L5 S1 fusion two years ago due to desiccated disc, severe foraminal stenosis and bilateral pars defect grade 2 spondylolthesis. I was told all this was result of spine not fusing properly during prenatal development. The nerve pain is much better, but now I am having chronic pain in SI joints. I have heard that fusions put stress on adjacent vertebrae😑
Thank you for sharing. Fusion is the accepted treatment for this condition. I made a video about pars-fracture/spondylolisthesis, hope you find it helpful: ruclips.net/video/sXS62ydvovY/видео.html Good luck 👍
Thanks for watching I am one of the patients who had spine surgery due to herinated disc. Now I am one year two months old. I am ok. My surgeon told me every thing concerning the surgery and I was convinced. Thanks be to God for giving these people wisdom
Good morning , I’m awaiting to have 2 different spinal surgeries. I’m having left sided Si joint fusion and L5 and L4 fusion . With regards to the Si fusion he has said it’s a 70/30% chance of great improvement , which I’m happy with this as I’m in chronic pain can’t stand , sit or walk for long ! As for my L5 L4 I suffer with chronic pain from my right hip down to my foot !
Thank you for reaching out. Yes, the SI-joint can be a pain-generator, but the diagnosis is often difficult to make. Interventional diagnostic procedures (by a pain-management specialist) can give you a rough idea about what percentage of the pain may be coming from the lumbar spine vs. the SI-joint. Wishing you all the best in your upcoming surgeries! 👍
Thank you for reaching out. As surgeons, we have a duty to be ethical. I like to think that most surgeons take their professional responsibilities seriously, with a primary goal of helping their patients to the best of their abilities. -MK
I had 2 herniated discs. The first surgeon said one wasn't bad enough to operate on yet. He went in and ground down one disc. I was in worse pain after. 2.5 years later I had a second surgery. Both discs removed, canal opened up, spacers, rods and screws installed. Fused from L4-S1. I'm almost positive the first surgeon did that simply so he could do another surgery on me.
My surgeon performed a Endoscopic disectomy on my lower back to correct a disc bulde in the year 2021. Three years down the line, the pain is even worse and he recomends endoscopic decompression with foraminotomy after reviewing a MRI i took recently. I am cnfused.
Is there a possibility that PT can help with the pressing of the diac against my spinal cord? No pain just numbness in legs to the point where mynbornal sensations are not presernt but slowly coming back. I always had mild scoliosis and never had any doctor tell me I need surgery. But the orthopaedic mentioned "we can fix your scoliosis if surgery is needed". He didnt mention the disc in my T9 - T11. I havent started PT yet but I will soon. Ibam 47 year female. What do you suggest? Blessings~
I am 29 years old and just married one month ago. I was diagnosed with a T1-T2 benign schwannoma 6 years ago. I have pain in the tumor region, tingling and pain down my right arm and shaky right hand. I have been taking Gabapentin 3x per day. However, I will not be able to take RX when pregnant. I am not pregnant now. But we would like have children in the not-to-distant future. Due to the location of the tumor extraction of the tumor would be extremely complicated with a very long recovery period. Also, no guarantee of total removal or elimination of pain. I am very apprehensive of surgery. My surgeon has told me repeatedly, over the years, that the location is what the issue is. Not the tumor itself. Has anyone found a way to control the pain without drugs?
Lost my dad last night right before the time change. 8-10hr procedure, spinal fusion. Took over 12hr. And that was oct.24 a week of good news to bad news to good to bad to rollercoaster of unanswered questions. After the surgery he was just a vegetable. Then downhill more problem after problem but they couldn't figure it out. what was used to keep him stable after this rushed intense procedure wound up killing him. I'm angry. My poor mom and brothers
I am terribly sorry to hear about your devastating loss. Your pain must be unimaginable. Wishing you and your family all the best in this very difficult time. My prayers are with you.
My sister aged 33 was told by surgeon that she has cervical stenosis in c1 c2 by birth n it was compressing spinal cord as was having severe pain in neck n legs but was very normal eight months back except for some instances of back ache during last six years
In my case is the other way around. My surgeon doesn't want me to have procedure even tho he says mri look not too good. I was complaining about my left side of my back, and his comment was,"How's your right side", cuz looks worse then the left. I'm 65y, thin man, that still can get around, doing exercise and staying active, but some aches bother me a lot.
I am glad I came across your channel. I've seen neuro & orthapedic surgeons who both reccomend a MD procedure. I'm concerned about back instability and future problems. My sciatica comes & goes but I feel like the pain is always present. I know surgery should be the very last option and i'm wondering if I should do more PT and weight loss to avoid surgery. Got injured April 2023 and still not better. The orthapedic surgeon told me he would be a better fit for the procedure as it's his specialty vs a neuro who does it as more of a "side-gig" I would love to hear your thoughts on this.
I have been in chronic pain for 10 years, to cut a very long story short, I have been diagnosed with bulging disc at L5 S1 Spondyolythesis stonosis and arthritis in my spine I am in agony every day had 12 MRI scans getting wgere tablets dont work very depressed now no life 23 injections over 10 years that dont work , I now don't have any control over my bladder can you please help me with what you think is a complex case and I also have had fibromyalgia for 40 years, please advise me what I can a do, it's killing me slowly. your video was excellent
Northwestern Memorial hospital says that they only do fusion surgery. Why is that? Is it because it is a teaching hospital or because fusion pays more?
Since I am not familiar with your case, I am unable to comment on its particulars. My practice is in Milwaukee (414-276-6000); if you would like, I can arrange for a second-opinion visit.
What about Dr. recommended spinal fusion after spinal disc decompression, and spinal cord stimulator failed. My disc right before the tail bone looks like a Letter Z and herniated disc is about 9-10 with barely any disc left. Looks like a pancake in there.
Thank you for reaching out. Since each case is unique, a physical examination & image-review would be required to answer your question. I recommend getting a second opinion from another surgeon in your area. Good luck.
Weakness and muscle waste is why I had my neck surgery 30 years ago. Micro surgery through the back of the neck c4 and 5. Yes I thought I could live with the tingling but 9 months later I could not even pull my shirt off. Surgery was a piece of cake and 45 minutes. Herniated disk and bone spur. Fast forward to today and pin and needles down my arm upon lifting my neck up. Disk compression c5 and c6. .no weakness yet. One surgeon so far says he would have to do fusion but try a epidural first since I have no weakness. Going to have two more surgeons look at me. At 68 fusion scares me. He said something about the bulging disk is to hardend to go through the back and he would not know how bad the bone is compressiontill he got in there.. 7:52
Thank you for your thoughtful comment. Cervical radiculopathy is a difficult problem, agreed. I have a few videos which you may find helpful: Cervical radiculopathy: ruclips.net/video/Hml_6kM4fY8/видео.html ACDF surgery: ruclips.net/video/5HPlzxWN2dk/видео.html Why spine surgery fails: ruclips.net/video/ZN_RLDOEBmA/видео.html It is always a reasonable idea to get a second opinion. Looks like you are on the right track. Good luck to you 👍
My Neuro Surgeon has said I need to have a complex surgery. due to adult onset sciolosis, degenerated discs, spinal stenosis, arthritis...... 2 day surgery, 1 day cut side, 2nd day cut back. would use screws and rods thruout spine. Have had back pain for many years. Is now also affecting walking more now, cannot walk long distances without stopping (ie 3 or 4 city blocks). I have avoided having this surgery for almost 4 years but pain and physical limitations have increased. I will be 82 in September this year. Your Opinion?
I had a bilateral laminectomy. It helped for maybe a month. 8 months later I had L3-S1 fusion. I’m 10 months post op now and I hurt every single day still, my legs are numb, they burn, I can’t shave my legs, my balance is still way off… the only thing good that came out of the surgeries is I can stand up straighter than before. I’ve gained weight because I can no longer work out, I get depressed because I feel like I can’t take care of my family properly. I’m only 41, and I feel like I’m 81. 😔
very sorry even I waiting for the doctors decision if I should have surgery or being injected . the problem is disc bulges and erosion, grained a mean. disc3 and 4
Thank you. Very helpful. I went to 4 different neurosurgeons and one orthopedic surgeon. Everyone has a different view on what lumbar surgery I need. It’s so frustrating
Thank you for the feedback, I am glad you found the video helpful. It is not unusual for patients to get very different opinions from medical professionals, which can be quite frustrating. Wishing you the best of luck.
Waiting for clearance to get an ALIF & posterior spinal fusion on L5-S1 due to spondylolisthesis. Thanks for this video, I'm going back in so that I can ask these questions. I've not met with the surgeon, yet. I am confused when I hear minimally invasive. Makes me apprehensive. 🤔
I just got a second opinion on a lamanectomy.. first dr. Said I need the l2 the l5 fixed, so I went to another Dr. And he said I just need the l4 and l5 fixed. I have went through physical therapy and had the shots in the back. I really dont want the surgery but they telling its nothing else they can do.
Thank you for your comment. I have a video about surgical outcomes and why they (sometimes) turn out to be different from what patients expect before surgery: ruclips.net/video/ZN_RLDOEBmA/видео.html
Thanks for this video presentation. I am going today to a spine surgeon for second opinion. The first one had suggested PLIF for L5 S1 anteriolisthesis. Will ask these questions if he too suggests a surgical intervention.😊
Thank you for reaching out, appreciate the compliment. If you are dealing with L5/S1 spondylolisthesis, the following video may be helpful to you: ruclips.net/video/sXS62ydvovY/видео.html Good luck 👍
Hi Dr. I have L4 L5 S1 lumbar decompression surgery last month. Pre op I had sciatica on left leg. Now I have numbness on both legs especially below the knees. Is it normal? Tqvm for your sharing
I Will have surgery. Im beyond Bad. To say the least. Ut im going to Research before then. If i can be 50% Better,what alone would ve Amazing.... I have a list if things i need to fix in my back,(spine) And more Thank just For Caring.. many don't. I pray i get into tge Right Hands... Always in God's too. Thank you again for being helpful.
I ride broncs for a living does anybody that has done this think it's a good idea if I want to keep going or should I wait. I'm 26 and have a good amount of atrophy in my riding shoulder and bicep. Has anybody tried decompression? I want to avoid surgery but I'm losing strength and muscle by the day. Doc wants to do a disc replacement at c5 and c6
Dear Dr., I am a 42 year old female who had an L5 Laminectomy and L5 S1 microdiscectomy just 1 day ago. I wanted to know if my spine will become week because of the removed lamina and will I be able to get back to my normal activities after a few months?
Thank you for your question. Since I did not perform your surgery, and therefore I am not aware of exactly what type of surgery your had, I am unable to comment on your specific condition. I suggest that you ask your surgeon this question. Wishing you the best of health in the recovery process 👍
I had lumbar fusion 2 years back.In the xray taken 3 months after surgery one of the scews got loose and the l4 had again slipped forward.I am 75 and the surgeon blamed it on soft bone . Pls give youy advice .I have no pain now but severe instability and loss of balace while walking.
Thank you for reaching out. Since I am not familiar with your particular case, I cannot give you specific advice about your condition. Having said that, it would be reasonable to get a second opinion from another surgeon (such as at an academic university-based practice) for this matter. Depending on the circumstances, surgery may (or may not) be offered. Obviously instability/loss-of-balance while walking poses significant risks, and I understand why you are rightfully concerned. Wishing you good luck 👍
My mother has severe chronic spinal stenosis she is 68 and i really tried everything for her not to get the surgery but everday she is more and more bed bound and is disoriented . Im on the second surgeon because i wanted to get 2 opinions ... she walks like she has no balance im just scared
Thank you for reaching out. The anxiety that you feel is quite normal and understandable. It is never easy to watch a loved one go through such difficulties. Wishing your mom the best of luck and the best of health in the future 🙏
Sir I am sure if the patient has recess stenosis in 4 different levels hardly walking with a shifted towards back T12 Lumbar 1 with vacuum phenomena I think surgery should take place past 6 months nerves will be affected
Hey doctor will a spondylolisthesis warranty a surgery if xray shows unstable but there is minimal symptoms and no weakness. It's grade 1 . I am 24.had severe symptoms but all have disappeared like numbness. What will you do as a doctor? Will annual xray worth it?
That's a good question, I should make a video about it. I cannot comment on your case in particular (since I am not familiar with the details) but in general most surgeons will not perform surgery for a patient who is asymptomatic. Perhaps annual follow-up with a surgeon will be a reasonable idea. Wishing you all the best.
I had spinal surgery for disc bulging. While conducting surgery doctor found that my disc is hardened by calcification so disc is not removed another bulging of flesh was also there which is removed. It was on 13th November this month..now there is pain on my left foot. Share your experience please.
Cages are used commonly in spine surgery. Their use depends on the particular situation/ surgical-problem that is being treated and the surgeon's preference. If you are not sure about the recommendation of the surgeon, the best thing to do would be to get a second opinion.
Yes, agreed. But I also understand that patients with spine problems are often in very difficult circumstances and live with terrible pain. I do my best to point them in the right direction, but obviously I cannot diagnose their condition. You are correct.
I have done mri and ct angiogram and bone scan. I have spinal cord compression in a severe manner. But I don’t have too much pain or discomfort in this case. My surgeon said surgery is necessary due to its severity. Do I need a surgery at this point??. Could you please advise me.
Thank you for your question. I cannot comment on your particular case because I don't have the necessary information. Having said that, it is possible to have minimal pain if the spinal cord is compressed. If the spinal cord is compressed severely (and for a long time) it can potentially have significant/ severe consequences. In such cases surgery can be the right answer. If you are not satisfied with your surgeon's recommendation, it would make sense to get a second opinion from another surgeon. Good luck 👍
@@SpineSurgeonSpeaks Thank you so much for your reply. Mine MRI showes c2-c4 severe ossification and c4-c5 moderate central canal narrowing. But I have no severe pain or numbness. That’s why, I am so worried. Is it will going worse within days or something. Thanks
Hi doc, I know you reached out before and thank you. How about if someone is pain free after having herniated disk and sciatica, is being pain free a good sign and if it needs urgency of a surgery?..
I found out 2 years ago that I had a slipped disc c6-7 I have spurs cervical spondolosis myelopathy I have stenosis at c3-4 I been having a hard time with arms where I can’t even lift a gallon of milk I have 4 out of 5 weekness numbness and tingles sharp pain from neck down to the arm I can’t hardly turn my head or look up my legs go numb and hurt last night I was cutting my toe nails I got a sharp pain from my big toe up my leg and now I can’t walk or put pressure I don’t know what happen I’m I’m so much pain I’m only 24 I have a 3 year old he mention acdf with fusion he mention physical therapy but never went and done it and then he straight ask do I want surgery I said I do but I’m scared he said well it’s your choice rather you want it or rather you think you can live the way you are so I don’t know what to do 😭 I’m gonna go for a second opinion for sure he told me all the risk and that’s a lot of risk I’m scared I’m gonna go paralyzed or it gets so bad that surgery won’t fix it later on what would you recommend
Thank you for reaching out. Since I am not familiar with your specific case, unfortunately I am unable to make any recommendations. However, getting a second-opinion makes very good sense. Here is a recent video that I made, which might be helpful to you: ruclips.net/video/m-t3L7nDAgM/видео.html Good luck! 👍
I also suffer with extreme dizziness like the rook and ground fells like it moving and I have to hold onto the walls and sometimes fell like ima pass out can cervical spondolosis cause that he told me he don’t believe it’s from my neck that it’s my ears and that I need to see a ear nose and throat specialist
Do sny of you guys have any recommendations , currently at home resting slipped disc 33years of age started working at 14 as a mechanic. Injured my l4l5 s1 since 2008 slipping a discs atleast 2 to 3times a year bed rest for a few weeks, but in the last 18months they pain hasnt gone , and few days ago bang its gone again . i go gym and swim i see a physio already , when do you call it time on an operation bkoz im out of work again. Im based london uk .
Your condition sounds very like mine. I was 44 when I first started getting sore a back and pain between the legs. Occasionally I would drop something weighing 20 pounds or so due to the sudden agony in my lower back, it put me on the ground, unable to stand. Then at 48 I picked up a cabinet weighing probably 80 pounds with one hand and I blew my discs big time. I was screaming in agony for like two whole minutes. Unfortunately I was alone and could not move even a finger without causing agony. I lay there for hours before I painfully and slowly crawled to my couch, it took an hour to go five yards. I couldn't reach my phone on the shelf. I never went to hospital and gradually got better despite constant sciatica. Like you every few months, despite taking great care, I would move the wrong way and it would go again, me on the floor in agony unable to stand up. I couldn't take the pain anymore so my doctor gave me strong opiate based painkillers which helped a fair bit. The blowouts kept happening for years. I could barely lift a kettle of water without back pain. Couldn't walk, couldn't sit for long, only lying down gave relief. For example, a wasp came into my kitchen and flew right towards me, naturally I bent forward to duck away from it. Bang! I was on the floor in agony, never move without caution was the lesson learned. Took about six weeks to get better. I couldn't work and had to give up everything including jogging, cycling and country walks. I never did have surgery, the risk of infection and long term outcome were unconvincing. Apparently after five years those with or without surgery will often deteriorate to the same level. MRI showed I had damaged L4-L5 and L5-S1 discs pressing on my nerve. I ended up in hospital a few times with uncontrollable agony in my back and spasms or unbearable sciatica requiring IV pain meds. It's been 12 years now and I am still disabled by it. Still taking pain killers, tried them all including brain medication with huge side effects. Yuk. Physio never helped. Life has never been the same. I can't even drive anymore. I lie down most of the day, every day. There seems to be a genetic element to mine. My mechanic Dad had similar problems in his forties while working, it ended his career, my brother too. I wish you the best with your health and future prognosis. I don't envy you trying to decide on surgery, we can only make our own choice and accept the risk of our choices.
Diskectomy is the step where a disc is removed *before* a cadaver-bone-graft (or "cage") is placed in the disc-space. If you watch this video, this concept will be quite clear to you: ruclips.net/video/5HPlzxWN2dk/видео.html Once a bone-graft is placed (and the plate is used to secure it), the goal is for the body to gradually convert the cadaver-bone-graft into its own bone. This process is called "fusion". If a fusion doesn't take, it means that the body was unable to convert the bone-graft into its own bone. This condition is called "pseudoarthrosis" or "nonunion". Hope this explanation helps.
i had kyphosis surgery 2019, last year 2023 i removed my rods and screws…. because the screws stuck out my back and i was allergic to the cobalt rods. My hunchback came back with a 67 degree curve and i’m getting another surgery with screws and rods again in a week…. the surgeon will use lower profile screws and titanium rods, do u think it’ll be a better outcome????
Thank you for reaching out. Unfortunately I am not able to comment on your particular case since I am not familiar with the details. However, sometimes revision surgery is indeed necessary (if the previous surgery was not successful). I hope you have had a detailed discussion with your surgeon about the rationale of the surgery and potential options if the surgery leads to unexpected outcomes in the future. Wishing you all the best, good luck 👍
Hello one of my spine surgeons say they need to do a front to back level 3 from L3 to S1 less than 4% recovery on this major surgery. What do you think?
Thank you for the information. I’m curious about your opinion of a staged procedure for severe central and foraminal stenosis in a 78 year old patient.
Thank you for reaching out. Each patient case is unique. Without examining a patient (and reviewing the imaging studies) it is unfortunately not possible for me to offer opinions about a particular surgical approach/ procedure. If you are not sure about the surgical option offered to you, I think getting a second opinion from another surgeon is probably your best bet. Good luck.👍
I had a traffic accident years ago and now have severe cervical degeneration and foraminal and central stenosis. I had a 5 year wait to see a neurosurgeon and saw him today, he said I have signs of myolopathy and need surgery and there is a spot at the moment in 3 days time. I also am concerned about degeneration above and below the fusion as these joints are also degenerated and discs desiccated, with anteriolethsesis in the vertebrae above the fusion. I can put up with the pain and aching, I dont have nerve pain all the time, just constant headache and neck ache and fatigue but surgeon said I need the surgery because of myolopathy signs, positive hoffmans and hyperreflexia and some signalling at compressed cord, disc is Max 6mm, and if I wait until symptoms are worse the damage can't be undone. Not only that, in our public system the wait list can be long. So I dont feel I have any choice and no time to think about it or see them again to ask more questions. I dont understand why a disc replacement can't be done, or endoscopic surgery or kyphoplasty instead so I still have function of all the joints?
Thank you for your thoughtful comment. Yes, myelopathy is a difficult problem which can be tricky to diagnose initially. Most patients end up needing surgery, and do very well. Usually fusion is the preferred option (since it will stabilize the spine) as compared to disc-replacement. Wishing you all the best, good luck! 👍
@@SpineSurgeonSpeaks thank you your reply has eased a lot of uncertainty and stress. Yes I see, as I have so much degeneration there would be a lot of instability and can see now fusion is best... Just amazing work you do and helping so many lives. Thank you.
Sorry to hear about the very trying situation which you find yourself in. Your question is difficult to answer for me because only a surgeon who has examined your father (and also reviewed the history and imaging-studies) can make such a determination. I hope that your father has been evaluated by at least one spine surgeon. If you are not satisfied with the first surgeon's recommendation, then perhaps getting a second opinion from another surgeon would be quite appropriate. Good luck to you, wishing you all the best 🙏
Hi Dr I was Diagnosed with chronic severe lumbar stenosis on my L5-S1 level 1 in 2018, recently Did a New MRI found out i have CAUDA EQUINA SYNDROME BUT IS NOT SEVERE WHICH PROBABLY NEED I SURGERY? DO I NEED SURGERY IF I HAVE NO SYMPTOMS? IM 34YRS
Hello: Without a physical examination and a review of the imaging studies, unfortunately I cannot tell you how to proceed. But at the very least I would recommend a formal evaluation by a spinal-surgeon to answer this question. This is probably the best way forward. Wishing you good luck.
Is there anything newer than a fusion. I don’t want another fusion.I have severe stenosis, ruptured discs, a torn disc, facet disc disease, terrible arthritis and a doctor told me I have a visible kink in my back. I have not gone back to the surgeon because I don’t want another fusion, the above and below disc on my l4 and 5 are bad now. I spasm for hours in the morning. I need help. I do try to move, walk some, do yard work, etc but have flare ups especially when I sit too much.
Thank you for reaching out. I am sorry to hear about your difficult situation. Sometimes when a surgeon is not able to help you, it can be very helpful to get a second opinion from another surgeon. The goal of a fusion procedure is to stabilize the spine after it has been decompressed with a laminectomy: That is the reason why a laminectomy is often performed with a fusion. Hope this helps.
@@SpineSurgeonSpeaks I did not get a laminectomy. My surgeon was great. He did what he thought and I might be too active and did too much. I did do all my walking and what I was supposed to do. My doctor gave me muscle relaxers…make me feel drugged.
If you liked this video, you can also check out
The Four Myths of Spine Surgery: ruclips.net/video/kTglV1700Yg/видео.html
RISKS of spine surgery:
ruclips.net/video/bMZkT6p0EX0/видео.html
I will. I just seen your response. Tomorrow I find out if it’s fusing! A long wait.
Surgeon concerned it may not.
I’ve had 3 cervical spine surgeries but this one was really rough. On me & surgeon
Thx I enjoyed! What state is your practice in?
Thank you Doctor, your educational video has confirmed why I didn’t go ahead with a spine surgeon scheduling for surgery without ever seeing me in person, only saw my MRI
You are a great patient advocate. Patients are lucky that you give them such comprehensive advice.
very few surgeons will spend more than 5 minutes with you. If you ask them questions they get defensive.
This is unfortunately true for a lot of surgeons. I should make a video about it. Thank you for reaching out and commenting.
You got the wrong surgeon.
Not my experience at all. You need a new surgeon if possible.
Sorry so many are in the same boat, but glad to hear I wasn’t the only one. The defensiveness to questions or researched knowledge, even from other doctors, is alarming.
Agree. Your life is ruined with pain and dismobility. Still its hard to even get an appointment. Even if I pay for it the surgeon dont seem to care, not answering questions and holding back information. For example I had a meeting with a surgeon together with my father as support. The surgeon starts to tell us there is nothing he can do. No explanation, no nothing. Then my father points at the x-ray of my spine and says, but what is that? The surgeon responds: ohh that is inflammation. And my father points at another area, and what is that? Ohh, that's your previous fusion 3 yeras ago that has not healed. So if my father had not asked we wouldn't have been informed that my previous fusion was a non-union.
Two weeks ago I had oblique interbody minimally invasive surgery to treat severe spinal stenosis at L4 and L5. My surgeon walked me through my x rays and MRI and explained that a worse fate than the continuing severe pain down my right leg could be a loss of nerve function because of the compression of the spinal cord.. He made a convincing case to me for the procedure and this video helps assures me that I made the right decision
I was hoping to hear about your post surgical outcome. Has your pain been reduced or more liveable. Has your pain in the surgical site decreased and did you have any nerve damage at the surgical site. I'm curious because my surgeon suggested 5 level laminoplasty and an L4L5 fusion. I'm worried about my outcome and how I'll be able to manage my own care for two months after surgery.
😊i had spine surgery April 18, may 18, it was to start im doing . better but im doing betterl
😊by the grace😮 of god!!
Great to hear that you are doing well! Good luck! 👍
Yes I had a lumbar laminectomy the bone grows back sort of like when you pull a tooth from my understanding and the arthritis sets in again no cure for spinal stenosis
I wish I had seen this video 9 years ago. When I had decompression surgery to my L5-S1, I was never told I would probably have to have spinal surgery in about 10 years. I am 9 years post op and about to have fusion in that area due to the significant slipping and now I am not in a position to take off the time and get the care I need. You are a God send and I am glad I found your channel.
Thank you for your kind words, I am honored.
Wish you the best 🙏
Thanks Dr😊
Very informative.very detailed, and very professional presentation. Thank you
Glad you enjoyed it!
Some great questions to ask. Thank you. My Dr. talks to me for 15 minutes and gave me a packet and then said to call his office when I’m ready. You are really in charge of your own health.
Thank you for your comment.
Yes, the discussion to have surgery should be thorough, including an analysis of risks/ benefits and pros/cons. Most of the time (unless it is an emergency), the patient should go home after the initial discussion, research this matter, write down their questions/ concerns and then schedule a follow-up ("Talk-Surgery") appointment with the surgeon.
You are correct: You are really in charge of your own health.
yep. same here.
@@SpineSurgeonSpeaks I need a new doctor. The one I am using is useless. He couldn't care less about my situation and will prescribe one visit after another. I can barely walk and in a lot of pain.
I'm so glad I ran across this video because Im going for a second opinion before having surgery on my c-spine.
I have retrolithesis at C4-C5, with bone spurs in and out of the vertebrae, severe foraminal narrowing at C4-5 , bilateral C5-7 foraminal stenosis, and moderate cord compression. Most of the discs are gone in my c-spine. Last August I consulted with a neurosurgeon and told him that I did not want any type of fusion. He told me that there would be no fusion, he would only go in and put a disc in the space between the two vertebrae, and remove all the bone spurs. When I received the letter from my insurance company about the pre-authorization, it stated clearly that his plan of action was to fuse two levels in my c-spine and he was going to use a material for the disc space that my insurance would not cover. Since it was a partial denial by my insurance company I didn't have the surgery and I sure am glad that I read what the insurance company said because the doctor had flat out lied to me! If I had agreed to the surgery without checking on things first I would have come out with a horrible surgery that I did not want!
I started physical therapy 2 weeks ago and I'm already feeling a lot better. My PT seems to have hope that I can realign the vertebrae through physical therapy and using one of those expanding collar things, kind of like traction. I found one online for $5.
In 2001 I had bilateral sacroiliac fixation with large screws and washers. It literally gave my life back because I wasn't able to walk for about 2 years prior to the surgery. The orthopedic doctor who performed that surgery had told me that if I chose to have the surgery done it would put more pressure on the lumbar discs and would cause them to wear sooner than they normally would. And they did, but I expected it! I don't have any discs left in my lumbar spine, the vertebrae are pretty much fused together. I had no choice though because before the SI surgery the pain was so intense that I would pass out, and I couldn't walk.
Because of all of the disc and bone loss I have went from 5 ft 8 in tall to 5 ft 4 in tall over the last 10 years. But I have continued to stay as active as I possibly can. For the most part I stay busy at least 12 hours a day. Most doctors can't believe that I am still able to walk, they are thoroughly shocked. Staying as physically active as possible will strengthen the muscles parallel to your spine and keep you upright and mobile.
It's good to always ask lots of questions about any upcoming surgery to know exactly what the doctor will be doing. But not only that, you should also read the pre-authorization letter from your insurance company, that will explain everything the doctor is going to be doing. Sometimes you will find out things that the doctor didn't tell you! Just like what happened to me!
Thank you for your very thoughtful comment, appreciate it.
Yes, it is important to consider other options before committing to surgery, to see if any alternatives may be available. It is not unusual for patients with severe pain/ disability due to sciatica/ back or neck pain to get better with nonsurgical means. Physical therapy, medications and pain-management procedures can improve the symptoms dramatically. It is great to see that you are doing well, good luck to you in the future!
@@SpineSurgeonSpeaksYes but all those that you've mentioned above comment are "temporary"Band-Aids only covering up the real issue. In order to get to the root of the cause surgery is your option & only true option but if you want to keep putting Band-Aids on go ahead they are eventually going to come off & it is surprising to me that you'd say something like this because you know this is true.
I had two C-Spine disks replaced because of “Severe cord compression”. It was less than half thickness, and my shoulder and arms felt like they were on fire. It was only after over a year of nerve blocks that they agreed to do the surgery. Immediately after the surgery I had no pain at all.
When done for the right reasons, spine surgery can be life-altering. Thank you for sharing your experience. Wishing you the best of luck and the best of health int he future.
Thank you for your honesty. Next Monday I have a permanent spine stimulator placed in my lower spine. The trial worked well for me. Now to find an excellent neurosurgeon that can help undo the back surgery my veteran son went through.
Wishing you an excellent recovery, good luck!
Many doctors, not just surgeons, scoff at inquisitive/informed patients. This reveals the character their character and motivation.
Sadly, this is sometimes true. You need to look for a doctor who is a good communicator and who cares about you.
@@SpineSurgeonSpeaks I'm from Iceland. I had a crack in my spine in 2018 and have developed postural kyphosis on top of it since then and want to get surgery. The doctors in Iceland don't do much to help me and I'm looking for help abroad. Where would you recommend I go?
Thank you for reaching out.
I am only familiar with the US healthcare system, so my experience is limited to it. Medical care in the US is much more expensive in the rest of the world, so for people traveling to the US for surgery this is an important consideration. However: If you search for it on Google, you will find some cash-based surgical practices who may be able to give you an up-front fixed cost estimate for surgery.
Good luck to you! 👍
@@SpineSurgeonSpeaksany clue where to find those? I'm on dr #9, 3rd hospital system, 3 different specialists. All I get is rushed and nit listened to
That’s what I’m going through, I asked for a referral to talk with another surgeon, and they won’t give it to me
Thank you so much for the explanation. I’m facing right now the possibility of a spine surgery . With this information, I learned a lot about it, specially the questions I’m going to ask my surgeon.
Thank you for your kind words, glad that I could help in some way.
Good luck to you!
@@SpineSurgeonSpeaks thank you so much.
I'm in the same situation as you. Insurance has agreed to pay for it and so the questions now need to be asked and answered.
Dr. I am undergoing surgery because I lost sensibility, strength and movement of the toes of my left foot. :(
My Dr showed and explained to me the MR and pointed to the area where the hernia was crushing the nerves. My pain started in my lower back, ran across all my left leg, until my toes. I have been under medication for almost 2 months and the last change was the loss of sensibility and movement, what made my surgeon recommend the surgery. Thank you for your video. It helped me to be ever surer of the surgery!
Thank you for reaching out, glad to hear that the video was helpful to you.
Wishing you good luck with the surgery and the best of health in the future.
Thank you for your valuable information. I'm being scheduled for fusion on L5 and problems with L3 and 4. I feel a lot better about it from your educational video.
Thank you for your kind words, appreciate it. Wishing you the best, good luck 👍
Wow! A spine surgeon doctor with a heart and concern for the interests of the patient! I twice visited a neurologist who was 45 minutes late for each appointment; and would barely let me get a word in edgewise to the conversation about surgery! All he could mumble was "you need surgery". I had a barrage of questions to ask him, but he was in too much of a hurry to care! What is the objective of the surgery? On what part of my spine anatomy would such a surgical procedure be performed? Show me why the MRI leads you to this conclusion or strategy? And why there? What would the surgical procedure actually accomplish? And would it resolve my issues completely? Or would I need to come back later possibly for another surgery? What are the risks? Are there any guarantees that this will fix all of my pain and neuropathy? If so, are they in writing? And then if it fails to accomplish the objectives; will you refund the money back to me and my insurer? Will it take multiples trips to the operating table to effect total relief of the involved pinched nerve roots or spinal canal? What is the healing process feel like? How long typically does it take?.......my God, as a critical thinker; these questions roam my mind and those of others!! Is the doctor more interested in collecting money for the office visit than he is in caring for the patient? Then "eff" him and move on to another! Thank-you doctor!
Thank you for excellent analysis, I agree with you. Appreciate your kind words 👍
If I were your surgeon I would have ran out of the room, you really need to compact all of that into a much shorter version & yes they are extremely busy & don't have time for a short book. Only celebrities like Tiger Woods receive that kind of timely treatment.
Living in Canada, it is really quite interesting to watch this video. Our situation is exactly the OPPOSITE of what you describe. There is a tendency to strongly triage and focus only on the most severely disabled patients first, where there is a clear sign of dysfunction such as lack of muscle tone, lack of reflexes, not being able to function. Pain alone is rarely a basis for surgery, as is the case of numbness, burning etc. -- even when it is corroborated by imaging. Spine surgeons do not want to operate on cases where there is not a clear path to success or a very strong case for doing something in order to prevent an irreversible worsening. I'd say the average waiting time for a pt complaining of pain (but no weakness) is probably 3-4 years. I had a listhesis during the pandemic, walked with a cane for 2 years and still was considered low priority as I had no cauda equina (but saddle area numbness was imminent). Most good spine surgeons will not brag about results, but go over the possible complications, as a matter of due diligence and to cover themselves in case something goes wrong. They are not looking for patients, but looking to focus on the patients that will benefit most. In reality, most patients will see an improvement even if there is a complication, because they were so bad pre-op. New technologies are rarely promoted, as the doctors do not want to risk using something they are not familiar with. We do have lumbar ADR and MIS but open is still done too. Computer guided screw placement is generally not used, as is multiplanar intraoperative imaging. Surgeon skill really matters. I've had 5 spine surgeries and I think the advice given in this video is very solid.
Thank you for your very thoughtful & insightful comment, and your kind words.
Physicians and patients are often significantly constrained by the healthcare system within which they exist. This can lead to a lot of unusual discrepancies, such as when you compare the U.S. vs. Canadian healthcare systems.
I had previously made a video comparing the healthcare systems of the U.S. vs. Canada vs. Brazil, which may be of interest to you:
ruclips.net/video/1KRRttIkpGE/видео.html
The problem is that it makes *rational* sense to triage patients (as you described) in the system so that the most severely-disabled patients are helped first. However, this "computerized" approach fails to take into account the terrible pain (and resultant suffering/ disability) that some patients have to live with for years and years. The example you cited (your own experience during the pandemic years) is sufficient to illustrate this point. If you had been in the U.S. during that time, you would've had the surgery done very quickly and you would have been spared years of pain and suffering. I see this every single day.
Thank you for sharing your experience. I should probably make a video about it at some point... stay tuned.
Best of luck to you 👍
@@SpineSurgeonSpeaks yes. Precisely that, lack of resources. In most ortho surgery it is the post-op care and the intraoperative support (surgical nurses, anesthesiologist).
I’m fused from c2 to c7 and am still in horrible chronic pain my surgeon is wanting to reopen the back of my neck and strengthen c2 to c7 and fuse c7 to t1 the last mri showed disc problem at t2 to t5 so I’ve never been more worried and confused about this next surgery I pray 🙏 continually
Good luck
I had C2 to T1 and although those joints are Good the adjacent C1 and T2 are now a problem. No one tells you about adjacent displacement. U probably have the same.
I recommend you look into stem cell therapy
Glad I found this video before my first consultation. Guess if the doc does not have time to answer questions or explain things, it will not be the right one for me, regardless if I was to consider surgery or not. Thanks for the advice!
You are welcome. Thank you for watching, glad to be of help 👍
I remember my self with all of what you said. My dad had that cauda equina syndrome due to that tumor affecting L3-L5, spine surgeon advice to take out that tumor and add disc for support, I didn't understand everything even though I did record and write everything it was to much for me to understand, we did a lot of extensive repeated test and after a month my papa past away, it was metastatic spine cancer, it was really fast that tumor spreads everywhere and I wanted to have the surgery but my papa cannot move his feet his lower limbs he cannot pee and poop he can't sleep, It was a nightmare seeing someone experience this type of cancer, I was hopeful it was just spine cancer because I have a lot of trust with our spine surgeon, he did his best to explain so me and my papa understand it and did explore other options. Thank you for this.
Thank you for sharing your experience. I cannot even begin to imagine the heartbreak that you and your family went through. Prayers to you and your family ❤️🙏
Beautiful explanation...very helpful
Thank you sir. Very happy to hear that it was helpful.
My recent MRI revealed "severe" bilateral foraminal stenosis and severe central canal stenosis in several locations. Those results and the horrific pain I am experiencing lead me to believe surgery is in my future. Oh boy!
Sorry to hear about your difficulties. Wish you the best of luck and the best of health in the future 🙏
try the cantor spine center in florida. they use untrasound.
I have severe spinal stenosis L4-L5. And doing lamenectomy. Doing it Tuesday. I do have good days and horrible days though. I just want to get back on the tennis court
@@HomelightRealtyAZ or not...look at" discseel" in washington state. and frankly...if you are not a professional tennis player than those days are over. I had to give up stuff i loved doing... these guys inject your disc with fibren and seals it right up and you are out in 30 minutes. and no i have not done it though i did stem cells in costa rica which was great until i did the thing i love doing... i have researched a lot and this is my choice when i get funded...
Im on the wait list for the neurosurgeon to have spinal surgeon and lamionectomy. He spent 44 minites witb me and told me everything
Sounds like you have a good surgeon.
Wishing you good luck with the surgery and the best of health👍
Better get better soon you doctors are hit and miss with this.
Thank you. I have symptomatic lumbar ddd with no stenosis. Severely painful and life changing. Surgeons will not move foreword with a disc replacement even when I am begging them.
Thank you for reaching out.
Low-back pain with multilevel-DDD is a difficult problem, I agree. Surgical results (with fusion) are unpredictable. I understand your frustration completely, but I have seen too many patients who underwent a (well-performed) spine surgery without relief.
Just make sure you have your SI-joint checked out to make sure that it is not a pain-generator.
Good luck!
@@SpineSurgeonSpeaksthank you for the response.
So sorry l didnt have thatinformation before l had my lumber decompression surgery to listen to so many questions l didnt ask, thank ypu so much
Thank you for the compliment, appreciate it 🙏
Absolutely excellent video and content. Very very important very relevant questions and things to know. Thank you so much for your candidness.
Thank you for your kind words, I am honored by them 🙏
Glad to be of help!
What a great video, talking about the issues a patient should really be talking about before embarking on a surgery. A lot of times I think we have surgeries where time and patience would have worked as well. And as the surgeon pointed out, surgeries seldom put you back to the way you were. And considering surgeries push you backwards before you can improve, in some circumstances perhaps it's better to accept some loss associated with aging and avoiding the pain of surgical procedures.
Thank you for your kind words, appreciate it.
Glad to hear that you found the video helpful ❤️🙏
This was terrific! Thanks very much for posting. Very well spoken, clear, and to the point. 👍👍
Thank you for your kind words, happy to hear that you found it helpful 🙏
My first surgeon failed on 5 of these points. When I went back for followups he just poked his head in the door (like literally wouldn't even step inside the room, all I saw was his head) and asked if I was ready for surgery yet. When I would say no, he'd disappear until my next followup. I switched surgeons and never even had the surgery.
why the conversation with a spine surge didn't look like on the video and instead it was just short: you need spine surgery
Dr. Khan, After a Laminectomy, to what extent is the spinal chord vulnerable to injury from the back? Thank you.
Thank you for this question. After a laminectomy, the spinal-cord and nerves are covered by a thick layer of muscle and fascia; practically speaking this provides them with excellent protection from trauma.
Hurt my neck on a military freefall jump back in 1988. Hurt for months after that. 35 years of flare ups and pain went chronic three years ago. Having more ridiculopathy especially in left arm and sporadic severe pains in left C3-C4 area. I do commercial HVAC for a living so constantly looking up which aggravates my neck. The last visit with my neurosurgeon he said to go as long as I can stand it because if he goes in, he is going to fuse from C3-C7. Been doing pain management last two years but it doesn’t help with the pain I have now. As far as I can tell no muscle weakness in my arms yet.
Zero family history of degenerative disc disease.
Anterolisthesis C3-C4
Retrolisthesis C4-C5
Narrow waisted fusion C5-C6
Severe formaminal narrowing C3-C7
Severe spinal stenosis C4-C5
Disc bulge C6-C7
Posterior disc osteophyte complex C4-C5
Facet arthropathy C3-C7
Thanks for the informative videos!
Thank you for watching, and for your kind words.
Neck pain and radiculopathy can really affect your life in many ways. I can only imagine how difficult it must have been for you to live with this condition for so many years.
I am sure you have researched ACDF surgery. Here is a link to my video about the procedure which you may find interesting:
ruclips.net/video/rboB5n4aIVo/видео.html
Wishing you all the best in the future 👍
Very clear and concise explanation! Thanks I wish I would have come across this sooner.
But luckily I did do a lot of research and found a dr that didn’t get annoyed with all my questions.
All good points that luckily I did ask. Because otherwise I did feel extremely rushed and uncomfortable with overall outcomes!
Ask away if it bothers them that you take your health seriously. Find another doctor!!
I go soon
Thank you for the compliment, appreciate it. Good communication between doctors and patients is absolutely essential. If you feel that your doctor is not listening to you, you need to get a second opinion. Your comment is spot on.
@@SpineSurgeonSpeaks thanks for the reply the doctor did . But I have so many reservations about having this done . I have literally seen thousands of people online and not one really good outcome or great results. Barring something like a bad accident or a tumor or such !
So Leary about all of it , and having it done!
Yes
I ended up with allergic reactions to the titanium and now have to get it redone and found titanium free options except for the screws. We will see on 11/7 how it goes.
Titanium allergy is extremely rare, but possible. Most patients who are told that they have a "titanium allergy" are in fact allergic to the trace elements (metals like cobalt, nickel) that are sometime alloyed into the titanium.
@@SpineSurgeonSpeakscrazy part is cobalt and nickel I had no issue with. Also nothing with titanium dioxide just the rod in patch test.
In the hospital right now as I just had revision surgery and sadly he was unable to get the cage out without breaking the bone. He covered it with something to make a barrier around it.
Rods come out once fused and hopefully that helps reduce the reaction to it.
Plz guide me what to do..
My sis of 50 year has bulge disc at lumbar section. It hurts sciatic nerve badly... Muscle stretches...
What if you have atrophy and muscle weakness? Does that warrant surgery??
Great video doctor. Hope you’ll do that video about the differences between one position fusions vs 360 fusions (ALIF 360 front and posterior/two stage operation for example) advantages and disadvantages and why doctors opt for the first or the latter procedure. Thanks :)
dear doctor, my wife's back surgeon (laminectomy with coflex) would never spend the time to answer such questions. now that she's had the surgery (2 weeks ago) and is practically crippled, way worse off than when she went in for it, now he won't even answer our phone calls. and by the way, he has no medical malpractice insurance.
I am sorry to hear about your very difficult experience. I can't even imagine what you and your wife must be going through.
Maybe getting a second opinion from another surgeon (at a University hospital) could be a reasonable option.
Wish you all the best and good luck 🙏
What are the other options except fusion
Nice explanation doc..
Glad you found it helpful!
@SpineSurgeonSpeaks nwei doc can i ask, because im 4weeks post op laminotomy and discectomy L5-S1,i still have numb pain in legs and both feet..and maybe you have exercises in your channel ,bec my pt will start nextyr and i want to stretch my body..thank u for your help
Had L5 S1 fusion two years ago due to desiccated disc, severe foraminal stenosis and bilateral pars defect grade 2 spondylolthesis. I was told all this was result of spine not fusing properly during prenatal development. The nerve pain is much better, but now I am having chronic pain in SI joints. I have heard that fusions put stress on adjacent vertebrae😑
Thank you for sharing.
Fusion is the accepted treatment for this condition.
I made a video about pars-fracture/spondylolisthesis, hope you find it helpful:
ruclips.net/video/sXS62ydvovY/видео.html
Good luck 👍
Same issue here. Try burning the si nerves . Helped me little
Thanks for watching I am one of the patients who had spine surgery due to herinated disc. Now I am one year two months old. I am ok. My surgeon told me every thing concerning the surgery and I was convinced. Thanks be to God for giving these people wisdom
Thank you for watching, very happy to hear that you had a great surgical result 👍
Good morning ,
I’m awaiting to have 2 different spinal surgeries.
I’m having left sided Si joint fusion and L5 and L4 fusion .
With regards to the Si fusion he has said it’s a 70/30% chance of great improvement , which I’m happy with this as I’m in chronic pain can’t stand , sit or walk for long ! As for my L5 L4 I suffer with chronic pain from my right hip down to my foot !
I also have chronic Arthritis affecting all my joints and Spinal stenosis and fibromyalgia
Thank you for reaching out.
Yes, the SI-joint can be a pain-generator, but the diagnosis is often difficult to make. Interventional diagnostic procedures (by a pain-management specialist) can give you a rough idea about what percentage of the pain may be coming from the lumbar spine vs. the SI-joint.
Wishing you all the best in your upcoming surgeries! 👍
I hate to think that any doctor can be that unethical to do surgery when it’s not needed . But it is true.
Thank you for reaching out.
As surgeons, we have a duty to be ethical. I like to think that most surgeons take their professional responsibilities seriously, with a primary goal of helping their patients to the best of their abilities.
-MK
Most have a god complex.
Money, money!
I had 2 herniated discs. The first surgeon said one wasn't bad enough to operate on yet. He went in and ground down one disc. I was in worse pain after. 2.5 years later I had a second surgery. Both discs removed, canal opened up, spacers, rods and screws installed. Fused from L4-S1. I'm almost positive the first surgeon did that simply so he could do another surgery on me.
@@aaadamt964 Bro i too have same problem of 2herniated discs. One at l4, another complicated at C3. Iam scared to go for surgery. What's best??
Thank you very much, this is a very usefull advice, very useful ❤❤❤
Glad to hear that you found it helpful! ❤️
My surgeon performed a Endoscopic disectomy on my lower back to correct a disc bulde in the year 2021. Three years down the line, the pain is even worse and he recomends endoscopic decompression with foraminotomy after reviewing a MRI i took recently. I am cnfused.
I suggest a second-opinion if the first surgeon's recommendation did not inspire confidence.
Is there a possibility that PT can help with the pressing of the diac against my spinal cord? No pain just numbness in legs to the point where mynbornal sensations are not presernt but slowly coming back. I always had mild scoliosis and never had any doctor tell me I need surgery. But the orthopaedic mentioned "we can fix your scoliosis if surgery is needed". He didnt mention the disc in my T9 - T11. I havent started PT yet but I will soon. Ibam 47 year female. What do you suggest? Blessings~
I am 29 years old and just married one month ago. I was diagnosed with a T1-T2 benign schwannoma 6 years ago. I have pain in the tumor region, tingling and pain down my right arm and shaky right hand. I have been taking Gabapentin 3x per day. However, I will not be able to take RX when pregnant. I am not pregnant now. But we would like have children in the not-to-distant future. Due to the location of the tumor extraction of the tumor would be extremely complicated with a very long recovery period. Also, no guarantee of total removal or elimination of pain. I am very apprehensive of surgery. My surgeon has told me repeatedly, over the years, that the location is what the issue is. Not the tumor itself. Has anyone found a way to control the pain without drugs?
Lost my dad last night right before the time change. 8-10hr procedure, spinal fusion. Took over 12hr. And that was oct.24 a week of good news to bad news to good to bad to rollercoaster of unanswered questions. After the surgery he was just a vegetable. Then downhill more problem after problem but they couldn't figure it out. what was used to keep him stable after this rushed intense procedure wound up killing him. I'm angry. My poor mom and brothers
I am terribly sorry to hear about your devastating loss. Your pain must be unimaginable.
Wishing you and your family all the best in this very difficult time. My prayers are with you.
My sister aged 33 was told by surgeon that she has cervical stenosis in c1 c2 by birth n it was compressing spinal cord as was having severe pain in neck n legs but was very normal eight months back except for some instances of back ache during last six years
In my case is the other way around. My surgeon doesn't want me to have procedure even tho he says mri look not too good. I was complaining about my left side of my back, and his comment was,"How's your right side", cuz looks worse then the left. I'm 65y, thin man, that still can get around, doing exercise and staying active, but some aches bother me a lot.
I am glad I came across your channel. I've seen neuro & orthapedic surgeons who both reccomend a MD procedure. I'm concerned about back instability and future problems. My sciatica comes & goes but I feel like the pain is always present. I know surgery should be the very last option and i'm wondering if I should do more PT and weight loss to avoid surgery. Got injured April 2023 and still not better. The orthapedic surgeon told me he would be a better fit for the procedure as it's his specialty vs a neuro who does it as more of a "side-gig" I would love to hear your thoughts on this.
I have been in chronic pain for 10 years, to cut a very long story short, I have been diagnosed with bulging disc at L5 S1 Spondyolythesis stonosis and arthritis in my spine I am in agony every day had 12 MRI scans getting wgere tablets dont work very depressed now no life 23 injections over 10 years that dont work , I now don't have any control over my bladder can you please help me with what you think is a complex case and I also have had fibromyalgia for 40 years, please advise me what I can a do, it's killing me slowly. your video was excellent
Northwestern Memorial hospital says that they only do fusion surgery. Why is that? Is it because it is a teaching hospital or because fusion pays more?
Since I am not familiar with your case, I am unable to comment on its particulars. My practice is in Milwaukee (414-276-6000); if you would like, I can arrange for a second-opinion visit.
What about Dr. recommended spinal fusion after spinal disc decompression, and spinal cord stimulator failed. My disc right before the tail bone looks like a Letter Z and herniated disc is about 9-10 with barely any disc left. Looks like a pancake in there.
Thank you for reaching out. Since each case is unique, a physical examination & image-review would be required to answer your question. I recommend getting a second opinion from another surgeon in your area. Good luck.
Weakness and muscle waste is why I had my neck surgery 30 years ago. Micro surgery through the back of the neck c4 and 5. Yes I thought I could live with the tingling but 9 months later I could not even pull my shirt off. Surgery was a piece of cake and 45 minutes. Herniated disk and bone spur. Fast forward to today and pin and needles down my arm upon lifting my neck up. Disk compression c5 and c6. .no weakness yet. One surgeon so far says he would have to do fusion but try a epidural first since I have no weakness. Going to have two more surgeons look at me. At
68 fusion scares me. He said something about the bulging disk is to hardend to go through the back and he would not know how bad the bone is compressiontill he got in there.. 7:52
Thank you for your thoughtful comment.
Cervical radiculopathy is a difficult problem, agreed.
I have a few videos which you may find helpful:
Cervical radiculopathy:
ruclips.net/video/Hml_6kM4fY8/видео.html
ACDF surgery:
ruclips.net/video/5HPlzxWN2dk/видео.html
Why spine surgery fails:
ruclips.net/video/ZN_RLDOEBmA/видео.html
It is always a reasonable idea to get a second opinion. Looks like you are on the right track.
Good luck to you 👍
My Neuro Surgeon has said I need to have a complex surgery. due to adult onset sciolosis, degenerated discs, spinal stenosis, arthritis...... 2 day surgery, 1 day cut side, 2nd day cut back. would use screws and rods thruout spine.
Have had back pain for many years. Is now also affecting walking more now, cannot walk long distances without stopping (ie 3 or 4 city blocks).
I have avoided having this surgery for almost 4 years but pain and physical limitations have increased.
I will be 82 in September this year. Your Opinion?
I had a bilateral laminectomy. It helped for maybe a month. 8 months later I had L3-S1 fusion. I’m 10 months post op now and I hurt every single day still, my legs are numb, they burn, I can’t shave my legs, my balance is still way off… the only thing good that came out of the surgeries is I can stand up straighter than before. I’ve gained weight because I can no longer work out, I get depressed because I feel like I can’t take care of my family properly. I’m only 41, and I feel like I’m 81. 😔
I am sorry to hear about the difficult situation you find yourself in.
Good luck. Wishing you all the best.
very sorry
even I
waiting for the doctors decision if I should have surgery or being injected .
the problem is disc bulges and erosion, grained a mean. disc3 and 4
I am sorry you feel so much older. I am the same going in for a cervical laminectomy c2-t2. I am so desperate because my life is hell.
My spine surgeon gave me the facts and I made up my mind
Thank you. Very helpful. I went to 4 different neurosurgeons and one orthopedic surgeon. Everyone has a different view on what lumbar surgery I need. It’s so frustrating
Thank you for the feedback, I am glad you found the video helpful. It is not unusual for patients to get very different opinions from medical professionals, which can be quite frustrating. Wishing you the best of luck.
Thank you for helpful exlanantion!
Thank you for the compliment, appreciate it 👍
Waiting for clearance to get an ALIF & posterior spinal fusion on L5-S1 due to spondylolisthesis. Thanks for this video, I'm going back in so that I can ask these questions. I've not met with the surgeon, yet. I am confused when I hear minimally invasive. Makes me apprehensive. 🤔
Best of luck!
I'm not the same position as you in on the list for surgery but been told I could end up worse off
I just got a second opinion on a lamanectomy.. first dr. Said I need the l2 the l5 fixed, so I went to another Dr. And he said I just need the l4 and l5 fixed. I have went through physical therapy and had the shots in the back. I really dont want the surgery but they telling its nothing else they can do.
Wow. You are nice. Surely you will have lot of enemies in your field .
Keep up the good work Sir!
Ha! Yes, telling the truth can cause some... discomfort. But my patients appreciate it. Thank you for your compliment, and thank you for watching 🙏
Great information. Thank you!
Thank you for watching, appreciate it 🙏
I had spinal stenosis had lumbar laminectomy help little 1 year ago today
Thank you for your comment.
I have a video about surgical outcomes and why they (sometimes) turn out to be different from what patients expect before surgery:
ruclips.net/video/ZN_RLDOEBmA/видео.html
Thanks for this video presentation. I am going today to a spine surgeon for second opinion. The first one had suggested PLIF for L5 S1 anteriolisthesis. Will ask these questions if he too suggests a surgical intervention.😊
Thank you for reaching out, appreciate the compliment.
If you are dealing with L5/S1 spondylolisthesis, the following video may be helpful to you:
ruclips.net/video/sXS62ydvovY/видео.html
Good luck 👍
Excellent, thank you 😊
I am praying I never need spine surgery.
Me too.
Hi Dr. I have L4 L5 S1 lumbar decompression surgery last month. Pre op I had sciatica on left leg. Now I have numbness on both legs especially below the knees. Is it normal? Tqvm for your sharing
thank u sir. that was my thought as well
so many surgeon will jump in instantly with surgery without even explaining the procedure in details.
Sadly, that is a true statement.
I Will have surgery. Im beyond Bad. To say the least. Ut im going to Research before then. If i can be 50% Better,what alone would ve Amazing....
I have a list if things i need to fix in my back,(spine) And more
Thank just For Caring.. many don't. I pray i get into tge Right Hands... Always in God's too.
Thank you again for being helpful.
Thank you for your kind words, I am honored by them.
Wishing you all the best, God bless you 🙏
I ride broncs for a living does anybody that has done this think it's a good idea if I want to keep going or should I wait. I'm 26 and have a good amount of atrophy in my riding shoulder and bicep. Has anybody tried decompression? I want to avoid surgery but I'm losing strength and muscle by the day. Doc wants to do a disc replacement at c5 and c6
Dear Dr., I am a 42 year old female who had an L5 Laminectomy and L5 S1 microdiscectomy just 1 day ago. I wanted to know if my spine will become week because of the removed lamina and will I be able to get back to my normal activities after a few months?
Thank you for your question.
Since I did not perform your surgery, and therefore I am not aware of exactly what type of surgery your had, I am unable to comment on your specific condition. I suggest that you ask your surgeon this question.
Wishing you the best of health in the recovery process 👍
I had lumbar fusion 2 years back.In the xray taken 3 months after surgery one of the scews got loose and the l4 had again slipped forward.I am 75 and the surgeon blamed it on soft bone . Pls give youy advice .I have no pain now but severe instability and loss of balace while walking.
Thank you for reaching out.
Since I am not familiar with your particular case, I cannot give you specific advice about your condition.
Having said that, it would be reasonable to get a second opinion from another surgeon (such as at an academic university-based practice) for this matter. Depending on the circumstances, surgery may (or may not) be offered. Obviously instability/loss-of-balance while walking poses significant risks, and I understand why you are rightfully concerned.
Wishing you good luck 👍
My mother has severe chronic spinal stenosis she is 68 and i really tried everything for her not to get the surgery but everday she is more and more bed bound and is disoriented . Im on the second surgeon because i wanted to get 2 opinions ... she walks like she has no balance im just scared
Thank you for reaching out.
The anxiety that you feel is quite normal and understandable. It is never easy to watch a loved one go through such difficulties. Wishing your mom the best of luck and the best of health in the future 🙏
Sir
I am sure if the patient has recess stenosis in 4 different levels hardly walking with a shifted towards back T12 Lumbar 1 with vacuum phenomena I think surgery should take place past 6 months nerves will be affected
❤Thank you for a great video..God bless you😊
Thank you for your kind words, appreciate it 🙏
Hey doctor will a spondylolisthesis warranty a surgery if xray shows unstable but there is minimal symptoms and no weakness. It's grade 1 . I am 24.had severe symptoms but all have disappeared like numbness. What will you do as a doctor? Will annual xray worth it?
That's a good question, I should make a video about it.
I cannot comment on your case in particular (since I am not familiar with the details) but in general most surgeons will not perform surgery for a patient who is asymptomatic. Perhaps annual follow-up with a surgeon will be a reasonable idea.
Wishing you all the best.
Doctor do you think if the herniated disk has a potential of shrinking in size and if does, does that will help relieve in compressing the nerves..
I had spinal surgery for disc bulging. While conducting surgery doctor found that my disc is hardened by calcification so disc is not removed another bulging of flesh was also there which is removed. It was on 13th November this month..now there is pain on my left foot. Share your experience please.
Yes, sometimes the outer-disc can calcify, which can pinch the nerve. This can cause radiating pain into the foot.
Do you have any comments re: cages? My daughter’s surgeon wants to go thru the front and back and place a cage…Daughter is 38…
Cages are used commonly in spine surgery. Their use depends on the particular situation/ surgical-problem that is being treated and the surgeon's preference. If you are not sure about the recommendation of the surgeon, the best thing to do would be to get a second opinion.
Yep been told I need & must have surgery ,, that is my back , no I can not do it ..
So many people want this doctor to diagnose them on You Tube. Same thing over and over.
Yes, agreed.
But I also understand that patients with spine problems are often in very difficult circumstances and live with terrible pain. I do my best to point them in the right direction, but obviously I cannot diagnose their condition.
You are correct.
I have done mri and ct angiogram and bone scan. I have spinal cord compression in a severe manner. But I don’t have too much pain or discomfort in this case. My surgeon said surgery is necessary due to its severity. Do I need a surgery at this point??. Could you please advise me.
Thank you for your question.
I cannot comment on your particular case because I don't have the necessary information.
Having said that, it is possible to have minimal pain if the spinal cord is compressed. If the spinal cord is compressed severely (and for a long time) it can potentially have significant/ severe consequences. In such cases surgery can be the right answer.
If you are not satisfied with your surgeon's recommendation, it would make sense to get a second opinion from another surgeon.
Good luck 👍
@@SpineSurgeonSpeaks Thank you so much for your reply. Mine MRI showes c2-c4 severe ossification and c4-c5 moderate central canal narrowing. But I have no severe pain or numbness.
That’s why, I am so worried. Is it will going worse within days or something.
Thanks
What do you think about grade 1 spondy at l5-s1
Here is a video about this problem, hope you find it helpful:ruclips.net/video/sXS62ydvovY/видео.html
Hi doc, I know you reached out before and thank you. How about if someone is pain free after having herniated disk and sciatica, is being pain free a good sign and if it needs urgency of a surgery?..
I found out 2 years ago that I had a slipped disc c6-7 I have spurs cervical spondolosis myelopathy I have stenosis at c3-4 I been having a hard time with arms where I can’t even lift a gallon of milk I have 4 out of 5 weekness numbness and tingles sharp pain from neck down to the arm I can’t hardly turn my head or look up my legs go numb and hurt last night I was cutting my toe nails I got a sharp pain from my big toe up my leg and now I can’t walk or put pressure I don’t know what happen I’m I’m so much pain I’m only 24 I have a 3 year old he mention acdf with fusion he mention physical therapy but never went and done it and then he straight ask do I want surgery I said I do but I’m scared he said well it’s your choice rather you want it or rather you think you can live the way you are so I don’t know what to do 😭 I’m gonna go for a second opinion for sure he told me all the risk and that’s a lot of risk I’m scared I’m gonna go paralyzed or it gets so bad that surgery won’t fix it later on what would you recommend
Thank you for reaching out. Since I am not familiar with your specific case, unfortunately I am unable to make any recommendations. However, getting a second-opinion makes very good sense. Here is a recent video that I made, which might be helpful to you:
ruclips.net/video/m-t3L7nDAgM/видео.html
Good luck! 👍
@@SpineSurgeonSpeaks thank you I’ll check it out
I also suffer with extreme dizziness like the rook and ground fells like it moving and I have to hold onto the walls and sometimes fell like ima pass out can cervical spondolosis cause that he told me he don’t believe it’s from my neck that it’s my ears and that I need to see a ear nose and throat specialist
@@autumn3035how are you now ??? Surgery ???
Do sny of you guys have any recommendations , currently at home resting slipped disc 33years of age started working at 14 as a mechanic. Injured my l4l5 s1 since 2008 slipping a discs atleast 2 to 3times a year bed rest for a few weeks, but in the last 18months they pain hasnt gone , and few days ago bang its gone again . i go gym and swim i see a physio already , when do you call it time on an operation bkoz im out of work again. Im based london uk .
Your condition sounds very like mine. I was 44 when I first started getting sore a back and pain between the legs. Occasionally I would drop something weighing 20 pounds or so due to the sudden agony in my lower back, it put me on the ground, unable to stand.
Then at 48 I picked up a cabinet weighing probably 80 pounds with one hand and I blew my discs big time. I was screaming in agony for like two whole minutes.
Unfortunately I was alone and could not move even a finger without causing agony. I lay there for hours before I painfully and slowly crawled to my couch, it took an hour to go five yards. I couldn't reach my phone on the shelf.
I never went to hospital and gradually got better despite constant sciatica. Like you every few months, despite taking great care, I would move the wrong way and it would go again, me on the floor in agony unable to stand up.
I couldn't take the pain anymore so my doctor gave me strong opiate based painkillers which helped a fair bit. The blowouts kept happening for years. I could barely lift a kettle of water without back pain. Couldn't walk, couldn't sit for long, only lying down gave relief.
For example, a wasp came into my kitchen and flew right towards me, naturally I bent forward to duck away from it. Bang! I was on the floor in agony, never move without caution was the lesson learned. Took about six weeks to get better.
I couldn't work and had to give up everything including jogging, cycling and country walks. I never did have surgery, the risk of infection and long term outcome were unconvincing. Apparently after five years those with or without surgery will often deteriorate to the same level.
MRI showed I had damaged L4-L5 and L5-S1 discs pressing on my nerve. I ended up in hospital a few times with uncontrollable agony in my back and spasms or unbearable sciatica requiring IV pain meds.
It's been 12 years now and I am still disabled by it. Still taking pain killers, tried them all including brain medication with huge side effects. Yuk. Physio never helped. Life has never been the same. I can't even drive anymore. I lie down most of the day, every day.
There seems to be a genetic element to mine. My mechanic Dad had similar problems in his forties while working, it ended his career, my brother too.
I wish you the best with your health and future prognosis. I don't envy you trying to decide on surgery, we can only make our own choice and accept the risk of our choices.
If a fusion in cervical spine doesn’t take does that also mean the discectomy doesn’t either??
Diskectomy is the step where a disc is removed *before* a cadaver-bone-graft (or "cage") is placed in the disc-space. If you watch this video, this concept will be quite clear to you:
ruclips.net/video/5HPlzxWN2dk/видео.html
Once a bone-graft is placed (and the plate is used to secure it), the goal is for the body to gradually convert the cadaver-bone-graft into its own bone. This process is called "fusion".
If a fusion doesn't take, it means that the body was unable to convert the bone-graft into its own bone. This condition is called "pseudoarthrosis" or "nonunion".
Hope this explanation helps.
i had kyphosis surgery 2019, last year 2023 i removed my rods and screws…. because the screws stuck out my back and i was allergic to the cobalt rods. My hunchback came back with a 67 degree curve and i’m getting another surgery with screws and rods again in a week…. the surgeon will use lower profile screws and titanium rods, do u think it’ll be a better outcome????
Thank you for reaching out. Unfortunately I am not able to comment on your particular case since I am not familiar with the details. However, sometimes revision surgery is indeed necessary (if the previous surgery was not successful). I hope you have had a detailed discussion with your surgeon about the rationale of the surgery and potential options if the surgery leads to unexpected outcomes in the future. Wishing you all the best, good luck 👍
Hello one of my spine surgeons say they need to do a front to back level 3 from L3 to S1 less than 4% recovery on this major surgery. What do you think?
Thank you for the information. I’m curious about your opinion of a staged procedure for severe central and foraminal stenosis in a 78 year old patient.
Thank you for reaching out.
Each patient case is unique. Without examining a patient (and reviewing the imaging studies) it is unfortunately not possible for me to offer opinions about a particular surgical approach/ procedure. If you are not sure about the surgical option offered to you, I think getting a second opinion from another surgeon is probably your best bet. Good luck.👍
I had a traffic accident years ago and now have severe cervical degeneration and foraminal and central stenosis. I had a 5 year wait to see a neurosurgeon and saw him today, he said I have signs of myolopathy and need surgery and there is a spot at the moment in 3 days time. I also am concerned about degeneration above and below the fusion as these joints are also degenerated and discs desiccated, with anteriolethsesis in the vertebrae above the fusion. I can put up with the pain and aching, I dont have nerve pain all the time, just constant headache and neck ache and fatigue but surgeon said I need the surgery because of myolopathy signs, positive hoffmans and hyperreflexia and some signalling at compressed cord, disc is Max 6mm, and if I wait until symptoms are worse the damage can't be undone. Not only that, in our public system the wait list can be long. So I dont feel I have any choice and no time to think about it or see them again to ask more questions. I dont understand why a disc replacement can't be done, or endoscopic surgery or kyphoplasty instead so I still have function of all the joints?
Thank you for your thoughtful comment.
Yes, myelopathy is a difficult problem which can be tricky to diagnose initially. Most patients end up needing surgery, and do very well. Usually fusion is the preferred option (since it will stabilize the spine) as compared to disc-replacement.
Wishing you all the best, good luck! 👍
@@SpineSurgeonSpeaks thank you your reply has eased a lot of uncertainty and stress. Yes I see, as I have so much degeneration there would be a lot of instability and can see now fusion is best... Just amazing work you do and helping so many lives. Thank you.
@@Achala148 How are you now?? Surgery ??
Now looking at fusion L4 L5 S1
doc is it advisable to do spine surgery if u have spine cancer in L3 ang now my father is paraplegic i think it compress the nerve and has pain
Sorry to hear about the very trying situation which you find yourself in.
Your question is difficult to answer for me because only a surgeon who has examined your father (and also reviewed the history and imaging-studies) can make such a determination. I hope that your father has been evaluated by at least one spine surgeon. If you are not satisfied with the first surgeon's recommendation, then perhaps getting a second opinion from another surgeon would be quite appropriate. Good luck to you, wishing you all the best 🙏
this video is so insightful im keeping it on my saved tabs
Hi Dr
I was Diagnosed with chronic severe lumbar stenosis on my L5-S1 level 1
in 2018, recently Did a New MRI found out i have CAUDA EQUINA SYNDROME BUT IS NOT SEVERE WHICH PROBABLY NEED I SURGERY?
DO I NEED SURGERY IF I HAVE NO SYMPTOMS?
IM 34YRS
Hello: Without a physical examination and a review of the imaging studies, unfortunately I cannot tell you how to proceed. But at the very least I would recommend a formal evaluation by a spinal-surgeon to answer this question. This is probably the best way forward. Wishing you good luck.
Is there anything newer than a fusion. I don’t want another fusion.I have severe stenosis, ruptured discs, a torn disc, facet disc disease, terrible arthritis and a doctor told me I have a visible kink in my back. I have not gone back to the surgeon because I don’t want another fusion, the above and below disc on my l4 and 5 are bad now. I spasm for hours in the morning. I need help. I do try to move, walk some, do yard work, etc but have flare ups especially when I sit too much.
Thank you for reaching out. I am sorry to hear about your difficult situation. Sometimes when a surgeon is not able to help you, it can be very helpful to get a second opinion from another surgeon. The goal of a fusion procedure is to stabilize the spine after it has been decompressed with a laminectomy: That is the reason why a laminectomy is often performed with a fusion. Hope this helps.
@@SpineSurgeonSpeaks I did not get a laminectomy. My surgeon was great. He did what he thought and I might be too active and did too much. I did do all my walking and what I was supposed to do. My doctor gave me muscle relaxers…make me feel drugged.