The most interesting takeaway from this video is that the degenerative (through arthritis etc.) consequences of the bone rubbing on bone actually causes the pain. No one has ever explained that to me. Thank you!!
I had the Intracept (brand) procedure (basilvetebral nerve ablation) done for this condition and it was extremely successful. I knew if the procedure was successful I would still have back pain from other issues, but my back pain would be significantly reduced. This was the case. I would say 60%-70% pain reduction which was life changing in my case. INsurance didn’t want to pay and made me jump through a lot of hoops, but ultimately after almost a year, they paid. I’m glad I didn’t give up.
I had ablasion done 3x in Boston area in 2011. It had minimal affect if any. I eventually had a lamenectomy in late 2012. I got 8 good years normal activety and learned to manage pain and care (streching, exercise, and diet) since then. While not ideal I live relatively well with occasional flare ups. Since there are always risks and no guarantee with surgery, I concider a fusion a last step. Ablasion is definitley worth a try, the procedure is minimal, I just wanted to address expectations.
Through a zoom consult it was interesting to know that it is actually the bone rubbing on the adjacent bone that causes the pain. No one ever told me that before. Be well!
@@calshepherd3659 In those 8 years I sold off my construction business and home, split my time golfing in SC, teaching skiing in Park City, UT for my 22-28 year, and living in Chiang mai Thailand. Before the surgery I had a lot more active life. Doc said if I slowed down the laminectomy would last 10 years. It's been 12 and with more management I will continue this way. 4 years ago I fully retired from teaching skiing, now full time Thailand playing golf. I'm 68 no complaints, just trying to stay healthy and enjoy life. Everyone's back problems are unique. What kind of shape you are in, tolerance to pain, the specific way your back is wearing out all play a part. If you have back problems I wish you success in dealing with it. Best wishes.
Always the best and most informative videos... look no further! I can't thank you enough for your zoom consult. It helped me sooo much. No words.. I am so grateful. Pain is debilitating! 👍🤗
Thanks for sharing. I've had a L4-L5 laminectomy with a disco gram. Less than 1 year later double herniated L4-L5 received bone graphed fusion. I had 8 wonderful years no pain to speak of. Now it's an everyday thing. Very limited on my standing still abilities. I have had MRI's ,CT scans, etc... basically arthritis and wearing out of joints above and below fusion. I manage without meds but I seem to have 2 to 3 episodes a year where I'm down for approximately 3 weeks due to pain and nerve issues I believe. Neurosurgeon said I will to have another fusion sometime in my lifetime. I'm trying to do my best and prove him wrong, not sure if I will but another fusion is the absolute LAST thing I want. With all that said thank you doctor for sharing your knowledge. I wish I was closer to the west coast to get your opinion on my issues. Thanks again
✅ You hit it right on the nerve… I am seeing a pain physician today to get a second opinion for this potential procedure. Thank you for the pre-test advice I was not told. I am in Chicago. Hope your day is fantastic. Jerry
The dulling of the nerves is dangerous because pain serves as a warning signal that something is wrong. If you numb or cauterize the nerves, you won't feel any pain and may not realize there's a problem until it's too late. These are just my thoughts on the matter; I'm not a professional.
Great video Doc, I have severe disc collapse with mild modic type 1 at l5s1. Moderate stenosis. Ive watched a lot of your videos. What about vacuum disc phenomenon?(i have this as well) Is that usually a good indicator for a fusion?
All that means is air within the disk space. You really need to look at how much modic change there is. You are probably a candidate for basivertebral ablation
@DrBrianSuTheSpineGuy Thank you for the response ... not much back pain. Mainly burning pain in the butt and numb and tingly heels. Sometimes pain in the back of my thighs
18 years ago, I had the discogram, I told them it WAS causing the desired pain but in the wrong place. ( which seemed to me to say they were focusing on the wrong disc. L5/S1…they insisted it was the one and fused it. That did NOT help and in fact made it worse. Today, many years later, I live with daily pain, and have to reply on meds. I’ve had all kinds of injections, PT, bla bla bla….but still have the pain 24/7… Very disappointed and will never trust these kinds of specialists again.
There is a difference between a provocative discogram which causes pain and an anesthetic discogram which takes away pain. Provocative discograms have not been shown to be as predictive of outcome of surgery.
Please look at the video on cervical facet joint syndrome or ablation for facet joints are discussed. There's currently no way to do a basivertebral ablation for the cervical spine
So if the cause of pain is a stable chronic anterior wedge compression fracture do they inject the vertebrae directly instead of this procedure or what do they do? And since this is a nerve ablation does it have risk of multifidus weakness like face blocks might?
There is some subjective interpretation of anesthetic discogram. False positive and negatives occur and is not free of complications including discitis. I performed these for years.
That is absolutely correct. It's not a perfect science although the literature does suggest that outcomes of surgery correlates well with functional anesthetic discogram.
Go to Germany 🇩🇪 Best spine Dr's in the world. Artificial disc 2 level Lp-Esp, went back for 1 level Cp-Esp, best decision of my life. The Americans are at least 10 years behind in spine because of insurance and the fda!!
The most interesting takeaway from this video is that the degenerative (through arthritis etc.) consequences of the bone rubbing on bone actually causes the pain. No one has ever explained that to me. Thank you!!
I had the Intracept (brand) procedure (basilvetebral nerve ablation) done for this condition and it was extremely successful. I knew if the procedure was successful I would still have back pain from other issues, but my back pain would be significantly reduced. This was the case. I would say 60%-70% pain reduction which was life changing in my case. INsurance didn’t want to pay and made me jump through a lot of hoops, but ultimately after almost a year, they paid. I’m glad I didn’t give up.
I had ablasion done 3x in Boston area in 2011. It had minimal affect if any. I eventually had a lamenectomy in late 2012. I got 8 good years normal activety and learned to manage pain and care (streching, exercise, and diet) since then. While not ideal I live relatively well with occasional flare ups. Since there are always risks and no guarantee with surgery, I concider a fusion a last step. Ablasion is definitley worth a try, the procedure is minimal, I just wanted to address expectations.
Through a zoom consult it was interesting to know that it is actually the bone rubbing on the adjacent bone that causes the pain. No one ever told me that before. Be well!
What happened after 8 yrs? Your age also plays a part?
@@calshepherd3659 In those 8 years I sold off my construction business and home, split my time golfing in SC, teaching skiing in Park City, UT for my 22-28 year, and living in Chiang mai Thailand. Before the surgery I had a lot more active life. Doc said if I slowed down the laminectomy would last 10 years. It's been 12 and with more management I will continue this way. 4 years ago I fully retired from teaching skiing, now full time Thailand playing golf. I'm 68 no complaints, just trying to stay healthy and enjoy life. Everyone's back problems are unique. What kind of shape you are in, tolerance to pain, the specific way your back is wearing out all play a part. If you have back problems I wish you success in dealing with it. Best wishes.
Always the best and most informative videos... look no further! I can't thank you enough for your zoom consult. It helped me sooo much. No words.. I am so grateful. Pain is debilitating! 👍🤗
Doctor Brian is the bomb 💣 😊
I totally agree! Why did I not find him sooner...? His zoom consult was more helpful than any other surgeons I saw in person.
Thanks for sharing. I've had a L4-L5 laminectomy with a disco gram. Less than 1 year later double herniated L4-L5 received bone graphed fusion. I had 8 wonderful years no pain to speak of. Now it's an everyday thing. Very limited on my standing still abilities. I have had MRI's ,CT scans, etc... basically arthritis and wearing out of joints above and below fusion. I manage without meds but I seem to have 2 to 3 episodes a year where I'm down for approximately 3 weeks due to pain and nerve issues I believe. Neurosurgeon said I will to have another fusion sometime in my lifetime. I'm trying to do my best and prove him wrong, not sure if I will but another fusion is the absolute LAST thing I want. With all that said thank you doctor for sharing your knowledge. I wish I was closer to the west coast to get your opinion on my issues. Thanks again
✅ You hit it right on the nerve… I am seeing a pain physician today to get a second opinion for this potential procedure. Thank you for the pre-test advice I was not told. I am in Chicago. Hope your day is fantastic. Jerry
Thank you very much for this great educational video.
They did a preliminary test on me to see if I would respond to ablation and it failed. Still looking for less-invasive interventions than fusion.
The dulling of the nerves is dangerous because pain serves as a warning signal that something is wrong. If you numb or cauterize the nerves, you won't feel any pain and may not realize there's a problem until it's too late. These are just my thoughts on the matter; I'm not a professional.
Great video Doc, I have severe disc collapse with mild modic type 1 at l5s1. Moderate stenosis. Ive watched a lot of your videos. What about vacuum disc phenomenon?(i have this as well) Is that usually a good indicator for a fusion?
Stay away if you can from fusion
All that means is air within the disk space. You really need to look at how much modic change there is. You are probably a candidate for basivertebral ablation
@DrBrianSuTheSpineGuy
Thank you for the response ... not much back pain. Mainly burning pain in the butt and numb and tingly heels. Sometimes pain in the back of my thighs
Can this procedure be done post-fusion?
I just had a lumbar spine MRI. Is there any way to send it to you?
You can call 415-925-8200 for a second opinion
Figures the insurance company would deny the procedure.
Had fall during chemo 22 L4 fell inward can Ablation help now?
18 years ago, I had the discogram, I told them it WAS causing the desired pain but in the wrong place. ( which seemed to me to say they were focusing on the wrong disc. L5/S1…they insisted it was the one and fused it. That did NOT help and in fact made it worse. Today, many years later, I live with daily pain, and have to reply on meds. I’ve had all kinds of injections, PT, bla bla bla….but still have the pain 24/7…
Very disappointed and will never trust these kinds of specialists again.
There is a difference between a provocative discogram which causes pain and an anesthetic discogram which takes away pain. Provocative discograms have not been shown to be as predictive of outcome of surgery.
"hang upside-down with a weight!!?"
How is this different from Intercept?
I recently had the intercept procedure. it help but only about 50%
It is the identical procedure
Is nerve ablation used for cervical problems?
Please look at the video on cervical facet joint syndrome or ablation for facet joints are discussed. There's currently no way to do a basivertebral ablation for the cervical spine
Why would i want to degenerate my spine? Sheesh!
So if the cause of pain is a stable chronic anterior wedge compression fracture do they inject the vertebrae directly instead of this procedure or what do they do? And since this is a nerve ablation does it have risk of multifidus weakness like face blocks might?
This is not meant to treat fractures
There is some subjective interpretation of anesthetic discogram. False positive and negatives occur and is not free of complications including discitis. I performed these for years.
That is absolutely correct. It's not a perfect science although the literature does suggest that outcomes of surgery correlates well with functional anesthetic discogram.
I am contemplating going to Asia for help, i feel America is not keeping up with the science for back diseases
Go to Germany 🇩🇪 Best spine Dr's in the world. Artificial disc 2 level Lp-Esp, went back for 1 level Cp-Esp, best decision of my life. The Americans are at least 10 years behind in spine because of insurance and the fda!!