This video has given me hope. You have been upfront about possible complications and done an excellent job for us neophytes. Explaining such a procedure in a very simple demonstration is an exceptional talent. After suffering from tingling, extreme shoulder pain, neck pain and my balance being thrown off, I'm not even supposed to drive anymore, you have given me a great deal of hope. Hope to, get my life back. Thank you so much.
Its like watching Blues Clues, but for Spinal Surgery!😂 I love it, and appreciate you and your effort to bring information that is easily understood. I hope for future MDs that you are at a teaching hospital, because you are amazing.
I have watched your videos with serious intent and great appreciation. Neuro surgery appt next Tuesday and I have taken notes, have my questions ready, and hopefully will be given options. Just not a fan of multi level ACDF. More for long term dsyphagia and limiting movement. Thanks Dr A!!! This RN is equipped to make the best decision for me next week! Truly grateful for your videos.
Each of these surgeries have their unique pluses and minuses but ultimately having all the information at your disposal will help you make the best decision. good luck!
@@ArmaghaniSpine hi doc is it neuro surgeon or orthopedic surgeon. im looking for one coz im in pain. i will try to go to a hospital tommorrow and look for one.
I have 5 days since intervened for a laminoplasty at the Mass. General in Boston. My doctor Stuart Hershman did a wonderful job. No meds since yesterday and very little pain. I stayed two days at the hospital although the 2nd day was more for comfort reasons since we are from out of town.
Thankyou for posting this informative discussion of the laminoplasty procedure. I am having the procedure done in 10 days on C3,C4, & C5. While my doctor explained things to me, your explanations were very helpful and answered questions I didn't think to ask.
Thank you for posting the video. It's regarding my mother who has been suffering from vertigo (without any neck pain) since May. After MRI and diagnosis, the doctor said it's cervical stenosis. She has been on medication since May and started physio in August. There is slight improvement, but the vertigo keeps swtiching back especially while lying down and getting up. Do you reckon the surgery is recommended in this case? I understand this takes time, but it's been almost 7 months....Appreciate your advise in this matter. Wish everyone here a speedy recovery!
Thank you for the video. Just some anatomical corrections [Via Cramer and Gray's Anatomy]: the word "lateral mass" is only used for Atlas (C1). What you are calling the lateral masses, are actually called the articular pillars (superior and inferior articular processes). At 10:15 the view is actually an inferior-to-superior view, not an superior-to inferior view.
Thank you for these excellent videos Dr.ARMAGHANI,I did cervical 3 levels 3 weaks ago, but over 2 weeks the radiculopathy symptoms are worsening in the same levels C6-c7 especialy when moving arms or sleep on lt side,is that usual?
Hello Dr. Armaghani, I've spent about two days trying to find out what the term "frank" compression means. It's a term mentioned in my MRI; "...severe foraminal narrowing and frank compression on the L5 nerves. Thank you!
A question: Is there a way that you could remove the bone and then make the space that was in the removed bone bigger and then putting it back where it was?
Helo sir..iam very infuenced by your videos...they are very good..iam a doctor ...my husband went acdf for c5 c6...20 days post surgery..his paresthesias havent subsided...we want to talk to you..about this...
Artificial disks can be done for the conditions that could be treated for cervical laminoplasty, but you are limited by the amount of disks you can replace. As of 2021 the FDA has only approved cervical disk replacements for 2 disks and no more. That may change in the future but you are limited by that. As for laminoplasty, you can easily do 3, 4, or even 5 levels. Laminoplasty tends to be my go to for patients who have more than 3 levels of disease causing compression.
I am going to get posterior fusion c2-c6 I am going to loose 20 percent of neck movement after the operation and was told I need this I was told that anterior cervical discertony would only be short term do you believe there is anything else my case is severe
Thanks for the detailed video and information. I had this surgery performed 4 days ago based on my spinal surgeons recommendation and thus far I'm very pleased with the results. I'm dealing with some neck pain but it is manageable with pain pills. My question pertains to the bracket that you install. Does the bone grow back together at this location to form a solid neck bridge? My surgeon said he packed this space it with cadaver bone but I thought others might have this question and didn't see it covered within the video.
Excellent question, Dave. On the side opposite where the kickstand plate is, there is bone growth that heals the "hinge" of the door if you want to think of your lamina as a door. That usually takes only about 6 weeks to fully heal. Some surgeons place cadaver bone in the bracket to also get bone to bone healing but I don't do that and have found that the hinge heals just as a quick.
@@ArmaghaniSpine Doesn't the hinge get repaired with new bone tissue and become non moveable? Good to know healing is just as quick w/o added bone tissue as that stuff is expensive!
Thank you so much for this video. I am scheduled for a C5-7 ACDF along with a C3/C4 laminoplasty in August. The surgeon explained that, since he'd be doing the laminoplasty and has to cut through the back anyway, he would also add rods/screws to reinforce the ACDF, which should guarantee fusion, and since those 2 levels will result in very minimal loss of mobility this is the best approach for me. One question - I had originally gotten a recommendation from another surgeon for a C3/4 disc replacement, skip a level, then C5/6 disc replacement, and C6/7 fusion. But the second opinion surgeon insisted that no medical insurance provider would approve that in the US (he said he's tried for years but it isn't FDA approved and even once it is approved it will take time for the insurance companies to begin covering it). Is that your experience?
What is difference between and laminoplasty and lamino Sorry for spelling. I’m in Dallas and just had a appt with my neurosurgeon regarding which procedure to choose. He spoke of laminoscopy or laminoscopy with fusion. He didn’t mention laminoplasty. Plz help me to understand what’s going on.
Hi Doc, thank you so much for making all these videos. I will consider you a miracle. Depression and stress always kicks in when you have this condition, me as one of them. But with all these information, that you precisely layed out, it relieves much of those stresses and resets me back in focus on evaluating the right procedure for my case. Again, Thank you. My question to you Doc is: Is CERVICAL LAMINOPLASTY a good option for me. I’m 63 y. o. and have 2 Mobi-C put on me (c4-c5 and c6-c7) and a cage on c5-c6 last June, 2019. And now with new symptoms and several mri’s, x-ray and ct scan, my latest Neorosugeon told me that I have opll. And I always had it before I had my prior surgery. Now it’s getting thicker and pushes the spinal cord more at c4-c5 where the mobi-c is. I don’t want to lose more of my range of motion. Doc, I will appreciate it if you can enlighten me procedure to go - Cervical laminoplasty or - posterior cervical laminectomy and fusion. From c3 - t1. Thank You so much.
In general, any posterior based surgery can help with spinal cord compression with OPLL. There is some evidence in the literature that without a fusion, the OPLL can worsen. Fusion can help stop the progression. Either option can get the job done but it's important to speak with your surgeon and see what the pros and cons are of each procedure in your specific case. Good luck, Gerry!
@@gerryarendain487 if you haven’t already gotten it don’t let these neurosurgeons sell you their bag of goods. You are going to lose almost ALL you motion with that laminectomy/fusion. You will be in excruciating pain for at least 6 mos likely more. If you don’t go into it in perfect posterior muscular shape (which I basically did and still have issues almost 9 mos later) you will not be happy. They will tell you to wait wait wait. I would suggest, if it’s not a neurological emergency work on your posterior chain muscles as much as you can and try to get relief that way. The domino effect never stops. You’ll have a host of long term problems. Not to mention all the surgical risk. Infection, hematoma, muscle atrophy from possible palsies etc etc. hope one way or another you find/found some true relief and not a trade of one nightmare for a likely worse one.
@@mhopes4901 I have OPLL. Pressing and start to damage my spinal cord around c4-c5. Symptoms are progressing really fast. Just a month after I saw my neurosurgeon with severe numbness and tingling on my hands and weakening triceps, I started to feel weakness on my right leg and burning pain on the left leg. He told me that’s going to happen because of what he saw on my MRI. The only way to stop the progression and may end up not walking is to have Laminectomy. I had 2 options: have a Laminectomy and deal of weak leg or not do it and deal the possibility of being on a wheelchair. I talked to 3 neurosurgeons and they all have the same solution on my case. For anybody that already have symptoms, be enquisitive when talking to your doctor. Let them define what they saw on your MRI. And also do some research. CZcams is one of the best source. When you have myelopathy, sooner or later you will need surgery.
Had it done back in 96 open door c3-c7 right side. No hardware used just hinged side is keeping the door open. in 2014 I had an ACDF for severe formaninal stenosis C5-C7. I've always have had limited use of my right arm. Pectoral Minor Scalene and scm muscles all get upset if I use my right arm. Not sure if there is another procedure for me at 68. It's been 8 years since my last mri
When you keep motion by having the laminoplasty, you always will be at risk for age appropriate degeneration causing foraminal stenosis as you experienced 8 years ago. It may be a good idea to see someone about a new MRI to evaluate if there is another area. The laminoplasty did its job however. It saved you from a fusion for almost 20 years. That's an excellent result.
Great question, Angel. The herniations remain but because space is created behind the spinal cord, it is able to drift backwards off the herniations making it so there is no pressure anymore. There is a small chance the vertebrae may fuse in the years after surgery but that has little bearing on the overall outcome of your surgery as the most important thing is getting the pressure off of the spinal cord.
There are several non-operative options including but not limited to physical therapy, over the counter and prescription pain medication, and epidural injections. These are just some of the non-operative techniques surgeons generally use prior to surgery.
My father in law had a trauma on his neck; he just had this surgery but now he just woke up but he can't move.. does that mean he will be paralyzed for life? Or is there a hope he will be able to recover?
Thanks for the video ; however, I still have a lot of pain in my neck ... I have issues turning my neck, to the point where I stopped driving ...any suggestions?
I spoke with you in the other video you posted about Acdf. I had this procedure and acdf done. However my surgeon did not recognize that I had a reverse of the normal cervical lordosis. Which I believe is the culprit of my pain 4 months later. Having a laminoplasty does that prevent a chiropractor from helping restore the neck curve? They didn’t use metal for my procedure. They used Allograft.
I typically advise patients against any deep tissue massage or chiropractic adjustments following a laminoplasty because of the hinge that is made could theoretically break.
Every patient is different but after a duration of about 6 months, I generally allow my ALIF patients to return to any and all activity. Some patients are able to but some are not due to permanent injury to the nerves or the muscles of the back. It is all dependent on the patients characteristics such as age, weight, strength prior to surgery, and the amount of permanent damage done due to the compression.
What does the hinging do to the alignment of the cervical spine post procedure? This seems like the procedure moves the spinous processes to whichever side is hinged. Wouldn’t that cause secondary issues throughout ones entire frame? I sadly found myself very temporarily in sarasota in an emergency by scratching bug bites getting lymphangitis being misdiagnosed down there until I left. Turned away from SMH er 2X as healthy as a horse just to go back in an ambulance septic and being diagnosed while in SMH 8 days later with a ridiculously delayed mri as having a cervical SEA. I was proposed a ridiculous surgery by Christopher Guerin who actually outright lied to me about my options while I was essentially dying in SMH. I declined. Left SMH after 2 weeks just to return a week later for emergency surgery by his partner John Cassidy (Guerin lost privileges at SMH) who did a fantastic acdf partial corpectomies/fusion and saved my life HOWEVER Just to come back the next am while I was still doped up and essentially lied to me saying if I didn’t sign this paper I’d be a quadriplegic. So bullying and fear mongering got me a very likely unnecessary laminectomy fusion c3-5 10 hrs after a life saving acdf partial corpectomy c3-4 with allograft and fusion. All in all now I have PTS which showed up basically 8 weeks post 2nd procedure which caused a compressive hematoma that was left in there. My feeling is the hematoma caused the PTS. Moral of the story. As you say, get educated but the burden is on your colleagues to not play god and do unnecessary procedures while leveraging fear in emergency patients. I am thankfully gone from Florida but wish I had encountered you that first time I presented with spontaneous neck pain that was misdiagnosed by K/W as a pinched nerve and corroborated by SMH er 2X etc etc. it goes on and on. You shed light on honesty as a medical provider in a state that is severely lacking transparency and honesty and is hinged on levering pain into profit. You’ve surely earned your reviews. Thank you for the videos.
Sorry to hear about your experience. To your question about the alignment, the hinging doesn't cause any secondary issues from side to side following the surgery but by going through the back of the neck, the muscles can become weaker and as a result of that we can see patient's start to have their head fall forward about 5-10 degrees more than what they are at baseline. Most, if not all, people don't notice this but we do see it on x-rays from time to time.
@@ArmaghaniSpine thanks. Does a circumferential (360) fusion, as in my case, typically prevent that kephotic change? I feel like my previously almost perfectly lordoic cspine is now wanting to “tilt” despite being backstopped with this ridiculous and essentially criminal laminectomy/fusion. I get I had an infection and a supposedly well educated and experienced neurosurgeon got scared when pus came out of my cervical spine most likely but it seems like what I was given is actually not doing what the alleged intent (other than charging my good insurance to lever my emergency into bank account deposits) was. To prevent a kephotic “disaster”. Perhaps it’s just me trying to break out of this straight jacket I never will be able to 😢😢💔💔. Who knows. Thanks
same treatments but we typically will order a CT Scan which is designed to evaluate bone to see if a disk is calcified or not and if it is in a position where removing it can be dangerous. I usually always evaluate for calcifications in the cervical spine.
Great question. Bone spurs form as a result of the disk degenerating and giving less and less cushion between the bones. In an effort to decrease the strain the bones are seeing due to the decreased amount of disk, they form bone spurs to increase their surface area.
Done my surgery one year already but why my condition still not good.... There's a time i suddenly freeze and cant move whole body and when i move my head i feel dizzy for about half an hour or more then i cant walk properly thats why i just lydown and till two to three days my walk is not so stable....After a few months after surgery i noticed my shoulder had a tik ,its moving uncontrolled sometimes if relax it didnt move but sometimes my shoulder move they said its a tik .....i cant understand why i have this after surgery though the doctor said after surgery everything can back to normal ,my life can back to normal .....😔😔😔😔
Thank you for putting out these video's, when my doctor explained everything to me,i heard everything but...later I was brain dead and your video refreshed my "brain fog "...thank you.
You're most welcome. That is why I made the videos. For patient's, such as yourself, to have an opportunity to hear the same description at home and you can watch it as many times as you like to be as comfortable as possible before making a decision.
Thats exactly how I felt. Upon running across @Armaghani Spine videos I had no understanding of the posterior laminectomy and spinal fusion surgery my doctor is telling me I need right away. I wasn't given options. Just told that this is what he's doing. Im so grateful i came across Dr. ARMAGHANI! I Have so many questions but his videos have helped so much!
Laminoplasty is the surgery you just viewed and commented on. I'm not sure of laminoscopy but he could have meant laminectomy and fusion which is another video I have. It may be best to check with him or her again to make sure you have a full understanding of all your options and dont be afraid to ask for them to clarify if you don't understand. Having an understanding of your condition and the options to fix it is what will help you make the best decision! Good luck!
Case by case basis. Usually has to do with how a patient's alignment is when they are standing. The more their neck is leaning forward, the worse it will get with a laminectomy. Laminoplasty does get some increase in neck lean after surgery but much less than with laminectomy alone. It's rare that a laminectomy alone is done in the cervical spine in 2022.
@@ArmaghaniSpine I’m not completely understanding the “laminectomy alone”. What is usually done with a laminectomy in 2022? C4 has myelomacia C6-7 serious compression of spinal cord.
Hi Dr. Armaghani, my father has visited three neurosurgeons with 2 recommending a cervical laminectomy with fusion and 1 recommending a laminoplasty. Why would there be differing of opinions?
it's always determined on a case by case basis after weighing the potential risks and benefits with the patient. make sure to get a clear understanding of what are the risks esp at your father's age for having the surgery and what is his expected outcome.
Hello Doctor, can cervical myelopathy cause a drop foot? I had all the tests done for other areas of my body that are supposed to cause drop foot and all were negative. I am getting an MRI of my neck next. Is it possible to get 0/5 foot drop from neck problem? Thank you.
I have heard of that before. If a patient comes in with something like 0/5 strength in a foot, I would then image their cervical as well as their thoracic spine to check for any spine compression. If those are then clean, I would have them see a neurologist to see if there could be something else going on in their body that could be causing weakness like that. Sometimes nerves outside the spine like the peroneal nerve can be compression around the knee and that can cause a foot drop. First thing is first though and that is rule out the spinal cord as the cause.
Are laminoplasties ever done on the lumbar spine? I have a three-level (L2-L5) Laminectomy scheduled for February 1st of 2023 and am worried about instability. My doctor says there should be no instability or any need for fusion. Is he correct? I know it's late in the game, but I just found out about Laminoplasty a few days ago. Please let me know!
thats a great question. They have tried them in the past but the lamina is too thick to perform as opposed to the cervical spine where it is much more thin. Your doctor seems very by the book as i am also of the thought that bones don't need to be fused unless there is instability. you will do just fine with a laminectomy.
@@ArmaghaniSpine Thanks for your response. You are one of the few doctors who take the time to do so and it's appreciated. I'm 6 days post-op now and coming along. Although after this, I have to deal with a bone-on-bone left hip! As my grandmother said, it's hell getting old. (I'm just turning 60 next month). Thanks again! Oh, and in your laminectomy description, you seemed to keep a portion of the Lamina intact and just cut off the top of one and the bottom section of the other. My doctor said that he removed the ENTIRE Lamina on all three levels. He also did a Foraminotomy on one level.
@@ArmaghaniSpine I've already had an acdf in this location back in 2016. It helped, but I was rear ended at a stoplight in fall of 2021 and have since been in debilitating pain again. I really don't want another surgery, but I'm running out of options. I've been to over 30 sessions of pt, had two CESIs, and now scheduled for the 3 part ablation series. If that doesn't work my neurosurgeon wants me to get a myleogram.... something I'm more terrified of than the actual surgery.
it's opened only a small amount to allow the spinal cord to drift back so it isn't compressed. The bone heals that way and stays in that position after only 6 weeks. the other alternative is a fusion which causes patients to lose range of motion. some want to keep their motion and others dont mind. there are options for both kinds of patients.
Sir, i am suffering from cervical meyolopathy and operated at C5-6-7 PIVD/ACDF. After surgery tingling and numbness vanishes in my neck, shoulder and hand. However due to Myelopathy my walking /gait still not improving. After 5 years of surgery still feel numbness and stiffness in both legs hence waiting affected and lumber pain. As per post surgery MRI there is no further changes means old and new MRI are exactly similar except at C5-6-7 which is fused after surgery. Hence please advise whether this can be improved means are there any chances to strengthen the legs, remove stiffness by overcoming this cervical meyolopathy. Please advise suitably. Thanks!
Quit talking down to people. “Door” “kickstand”. I wouldn’t trust you at all with my cervical surgeries. Yes, plural. I just had my third cervical surgery. I am very fortunate all surgeries, so far, have been anterior openings.
This video has given me hope. You have been upfront about possible complications and done an excellent job for us neophytes. Explaining such a procedure in a very simple demonstration is an exceptional talent. After suffering from tingling, extreme shoulder pain, neck pain and my balance being thrown off, I'm not even supposed to drive anymore, you have given me a great deal of hope. Hope to, get my life back. Thank you so much.
best of luck!
Dr. Armaghani is very knowledgeable and a lovely Dr. Thank you for this video.
I love your videos so simply explained without missing any detail. Thank you!
Much appreciated!
This is the best video regarding the surgery that I have seen. Thank you.
Thank you so much!
Best explanation and illustrations I have seen regarding this procedure.
Thank you so much!
From your excellent presentation I now know this procedure is what I need.
glad it could help!
Its like watching Blues Clues, but for Spinal Surgery!😂 I love it, and appreciate you and your effort to bring information that is easily understood. I hope for future MDs that you are at a teaching hospital, because you are amazing.
Thank you for this hilarious channel and really very educational videos...Greetings from Istanbul 🇹🇷
Thanks for watching!
Your videos are excellent!
Glad you like them!
Thank you for these excellent videos. You explain things so thoroughly. Why do some surgeons want to do a laminectomy instead of this lamineplasty?
I have watched your videos with serious intent and great appreciation. Neuro surgery appt next Tuesday and I have taken notes, have my questions ready, and hopefully will be given options. Just not a fan of multi level ACDF. More for long term dsyphagia and limiting movement. Thanks Dr A!!! This RN is equipped to make the best decision for me next week! Truly grateful for your videos.
Each of these surgeries have their unique pluses and minuses but ultimately having all the information at your disposal will help you make the best decision. good luck!
@@ArmaghaniSpine hi doc is it neuro surgeon or orthopedic surgeon. im looking for one coz im in pain. i will try to go to a hospital tommorrow and look for one.
It has cleared my doubts and given a picture of what I can expect
aan
Great to hear!
I have 5 days since intervened for a laminoplasty at the Mass. General in Boston. My doctor Stuart Hershman did a wonderful job. No meds since yesterday and very little pain. I stayed two days at the hospital although the 2nd day was more for comfort reasons since we are from out of town.
Appreciate you and your help 🆘💫
youre most welcome
Thankyou for posting this informative discussion of the laminoplasty procedure. I am having the procedure done in 10 days on C3,C4, & C5. While my doctor explained things to me, your explanations were very helpful and answered questions I didn't think to ask.
Best of luck!
Thank you for posting the video. It's regarding my mother who has been suffering from vertigo (without any neck pain) since May. After MRI and diagnosis, the doctor said it's cervical stenosis. She has been on medication since May and started physio in August. There is slight improvement, but the vertigo keeps swtiching back especially while lying down and getting up. Do you reckon the surgery is recommended in this case? I understand this takes time, but it's been almost 7 months....Appreciate your advise in this matter.
Wish everyone here a speedy recovery!
Very nice info sir.
So nice of you
Thank you for the video. Just some anatomical corrections [Via Cramer and Gray's Anatomy]: the word "lateral mass" is only used for Atlas (C1). What you are calling the lateral masses, are actually called the articular pillars (superior and inferior articular processes). At 10:15 the view is actually an inferior-to-superior view, not an superior-to inferior view.
hi doctor I would like to know the treatment procedure to treat intramedullary edema how does it work?
Thanks very much
You are welcome
Thank you for these excellent videos Dr.ARMAGHANI,I did cervical 3 levels 3 weaks ago, but over 2 weeks the radiculopathy symptoms are worsening in the same levels C6-c7 especialy when moving arms or sleep on lt side,is that usual?
Hello Dr. Armaghani, I've spent about two days trying to find out what the term "frank" compression means. It's a term mentioned in my MRI; "...severe foraminal narrowing and frank compression on the L5 nerves. Thank you!
A question: Is there a way that you could remove the bone and then make the space that was in the removed bone bigger and then putting it back where it was?
Helo sir..iam very infuenced by your videos...they are very good..iam a doctor ...my husband went acdf for c5 c6...20 days post surgery..his paresthesias havent subsided...we want to talk to you..about this...
Great information what about artifical disc?
Artificial disks can be done for the conditions that could be treated for cervical laminoplasty, but you are limited by the amount of disks you can replace. As of 2021 the FDA has only approved cervical disk replacements for 2 disks and no more. That may change in the future but you are limited by that. As for laminoplasty, you can easily do 3, 4, or even 5 levels. Laminoplasty tends to be my go to for patients who have more than 3 levels of disease causing compression.
Nice Fish!! Looks like you and some friends caught a big Tuna. If you are a fisherman and need any vertical jigs, just let me know. Steve
Sounds good
I am going to get posterior fusion c2-c6 I am going to loose 20 percent of neck movement after the operation and was told I need this I was told that anterior cervical discertony would only be short term do you believe there is anything else my case is severe
Thanks for the detailed video and information. I had this surgery performed 4 days ago based on my spinal surgeons recommendation and thus far I'm very pleased with the results. I'm dealing with some neck pain but it is manageable with pain pills. My question pertains to the bracket that you install. Does the bone grow back together at this location to form a solid neck bridge? My surgeon said he packed this space it with cadaver bone but I thought others might have this question and didn't see it covered within the video.
Excellent question, Dave. On the side opposite where the kickstand plate is, there is bone growth that heals the "hinge" of the door if you want to think of your lamina as a door. That usually takes only about 6 weeks to fully heal. Some surgeons place cadaver bone in the bracket to also get bone to bone healing but I don't do that and have found that the hinge heals just as a quick.
@@ArmaghaniSpine Doesn't the hinge get repaired with new bone tissue and become non moveable?
Good to know healing is just as quick w/o added bone tissue as that stuff is expensive!
Thank you so much for this video. I am scheduled for a C5-7 ACDF along with a C3/C4 laminoplasty in August. The surgeon explained that, since he'd be doing the laminoplasty and has to cut through the back anyway, he would also add rods/screws to reinforce the ACDF, which should guarantee fusion, and since those 2 levels will result in very minimal loss of mobility this is the best approach for me. One question - I had originally gotten a recommendation from another surgeon for a C3/4 disc replacement, skip a level, then C5/6 disc replacement, and C6/7 fusion. But the second opinion surgeon insisted that no medical insurance provider would approve that in the US (he said he's tried for years but it isn't FDA approved and even once it is approved it will take time for the insurance companies to begin covering it). Is that your experience?
I would try to get it approved. Worst thing that happens is they tell you no. I really like the recovery and outcomes following disk replacements.
What is difference between and laminoplasty and lamino
Sorry for spelling. I’m in Dallas and just had a appt with my neurosurgeon regarding which procedure to choose. He spoke of laminoscopy or laminoscopy with fusion. He didn’t mention laminoplasty. Plz help me to understand what’s going on.
Hi Doc, thank you so much for making all these videos. I will consider you a miracle. Depression and stress always kicks in when you have this condition, me as one of them. But with all these information, that you precisely layed out, it relieves much of those stresses and resets me back in focus on evaluating the right procedure for my case. Again, Thank you.
My question to you Doc is:
Is CERVICAL LAMINOPLASTY a good option for me.
I’m 63 y. o. and have 2 Mobi-C put on me (c4-c5 and c6-c7) and a cage on c5-c6 last June, 2019. And now with new symptoms and several mri’s, x-ray and ct scan, my latest Neorosugeon told me that I have opll. And I always had it before I had my prior surgery. Now it’s getting thicker and pushes the spinal cord more at c4-c5 where the mobi-c is.
I don’t want to lose more of my range of motion.
Doc, I will appreciate it if you can enlighten me procedure to go
- Cervical laminoplasty or
- posterior cervical laminectomy and fusion. From c3 - t1.
Thank You so much.
In general, any posterior based surgery can help with spinal cord compression with OPLL. There is some evidence in the literature that without a fusion, the OPLL can worsen. Fusion can help stop the progression. Either option can get the job done but it's important to speak with your surgeon and see what the pros and cons are of each procedure in your specific case. Good luck, Gerry!
Thank you Doc.
@@gerryarendain487 if you haven’t already gotten it don’t let these neurosurgeons sell you their bag of goods. You are going to lose almost ALL you motion with that laminectomy/fusion. You will be in excruciating pain for at least 6 mos likely more. If you don’t go into it in perfect posterior muscular shape (which I basically did and still have issues almost 9 mos later) you will not be happy. They will tell you to wait wait wait. I would suggest, if it’s not a neurological emergency work on your posterior chain muscles as much as you can and try to get relief that way. The domino effect never stops. You’ll have a host of long term problems. Not to mention all the surgical risk. Infection, hematoma, muscle atrophy from possible palsies etc etc. hope one way or another you find/found some true relief and not a trade of one nightmare for a likely worse one.
@@mhopes4901
I have OPLL. Pressing and start to damage my spinal cord around c4-c5. Symptoms are progressing really fast. Just a month after I saw my neurosurgeon with severe numbness and tingling on my hands and weakening triceps, I started to feel weakness on my right leg and burning pain on the left leg. He told me that’s going to happen because of what he saw on my MRI. The only way to stop the progression and may end up not walking is to have Laminectomy. I had 2 options: have a Laminectomy and deal of weak leg or not do it and deal the possibility of being on a wheelchair.
I talked to 3 neurosurgeons and they all have the same solution on my case.
For anybody that already have symptoms, be enquisitive when talking to your doctor. Let them define what they saw on your MRI. And also do some research. CZcams is one of the best source.
When you have myelopathy, sooner or later you will need surgery.
@@gerryarendain487 so sorry you have to deal with all this. Did you get fusion as well? What city/state are you in? Hope you’re on the mend ❤️🩹
I would like info on how to sleep with this operations
DR. I JUST ASKED AFTER THE C3 TO C6 LAMINO PLASTY HAS BEEN OPERATED. HOW MANY MONTHS OR YEARS WILL THE ANESTHESIA LOSE PERMANENTLY?
Had it done back in 96 open door c3-c7 right side. No hardware used just hinged side is keeping the door open. in 2014 I had an ACDF for severe formaninal stenosis C5-C7.
I've always have had limited use of my right arm. Pectoral Minor Scalene and scm muscles all get upset if I use my right arm. Not sure if there is another procedure for me at 68.
It's been 8 years since my last mri
When you keep motion by having the laminoplasty, you always will be at risk for age appropriate degeneration causing foraminal stenosis as you experienced 8 years ago. It may be a good idea to see someone about a new MRI to evaluate if there is another area. The laminoplasty did its job however. It saved you from a fusion for almost 20 years. That's an excellent result.
what happens the the hernations and he disk hieght post? is there a chance that the vertebrae may fuse?
Great question, Angel. The herniations remain but because space is created behind the spinal cord, it is able to drift backwards off the herniations making it so there is no pressure anymore. There is a small chance the vertebrae may fuse in the years after surgery but that has little bearing on the overall outcome of your surgery as the most important thing is getting the pressure off of the spinal cord.
What can be done to the neck while waiting for the surgery date that may be months away from diagnosis?
There are several non-operative options including but not limited to physical therapy, over the counter and prescription pain medication, and epidural injections. These are just some of the non-operative techniques surgeons generally use prior to surgery.
My father in law had a trauma on his neck; he just had this surgery but now he just woke up but he can't move.. does that mean he will be paralyzed for life? Or is there a hope he will be able to recover?
Thanks for the video ; however, I still have a lot of pain in my neck ... I have issues turning my neck, to the point where I stopped driving ...any suggestions?
therapy therapy therapy. usually stiffness is a muscle related issue and not related directly to a bony block or structural problem.
👌11:38~15:21 打開幾扇門
16:59 說明可能的神經損傷 17:54 脊椎管硬膜破損 20:37 術後6週 不要伸手而出做動作或搆/拿/抬/搬
I spoke with you in the other video you posted about Acdf. I had this procedure and acdf done. However my surgeon did not recognize that I had a reverse of the normal cervical lordosis. Which I believe is the culprit of my pain 4 months later. Having a laminoplasty does that prevent a chiropractor from helping restore the neck curve? They didn’t use metal for my procedure. They used Allograft.
I typically advise patients against any deep tissue massage or chiropractic adjustments following a laminoplasty because of the hinge that is made could theoretically break.
@@ArmaghaniSpine Wow so what am I suppose to do about the reverse curve? It’s compressing my vagus nerve causing multiple neurological symptoms
Hes under lot of stress and depression..cannu help us out
What are the chances of returning to a very hard heavy lifting construction job after a L5\S1 Alif with pedicle screws ??
Every patient is different but after a duration of about 6 months, I generally allow my ALIF patients to return to any and all activity. Some patients are able to but some are not due to permanent injury to the nerves or the muscles of the back. It is all dependent on the patients characteristics such as age, weight, strength prior to surgery, and the amount of permanent damage done due to the compression.
what is the maximum number of cervical joints that can be done?
Good question, Kelli. You can do this procedure at any of the cervical vertebrae below C2 and sometimes even T1
What does the hinging do to the alignment of the cervical spine post procedure? This seems like the procedure moves the spinous processes to whichever side is hinged. Wouldn’t that cause secondary issues throughout ones entire frame? I sadly found myself very temporarily in sarasota in an emergency by scratching bug bites getting lymphangitis being misdiagnosed down there until I left. Turned away from SMH er 2X as healthy as a horse just to go back in an ambulance septic and being diagnosed while in SMH 8 days later with a ridiculously delayed mri as having a cervical SEA. I was proposed a ridiculous surgery by Christopher Guerin who actually outright lied to me about my options while I was essentially dying in SMH. I declined. Left SMH after 2 weeks just to return a week later for emergency surgery by his partner John Cassidy (Guerin lost privileges at SMH) who did a fantastic acdf partial corpectomies/fusion and saved my life HOWEVER Just to come back the next am while I was still doped up and essentially lied to me saying if I didn’t sign this paper I’d be a quadriplegic. So bullying and fear mongering got me a very likely unnecessary laminectomy fusion c3-5 10 hrs after a life saving acdf partial corpectomy c3-4 with allograft and fusion. All in all now I have PTS which showed up basically 8 weeks post 2nd procedure which caused a compressive hematoma that was left in there. My feeling is the hematoma caused the PTS. Moral of the story. As you say, get educated but the burden is on your colleagues to not play god and do unnecessary procedures while leveraging fear in emergency patients. I am thankfully gone from Florida but wish I had encountered you that first time I presented with spontaneous neck pain that was misdiagnosed by K/W as a pinched nerve and corroborated by SMH er 2X etc etc. it goes on and on. You shed light on honesty as a medical provider in a state that is severely lacking transparency and honesty and is hinged on levering pain into profit. You’ve surely earned your reviews. Thank you for the videos.
Sorry to hear about your experience. To your question about the alignment, the hinging doesn't cause any secondary issues from side to side following the surgery but by going through the back of the neck, the muscles can become weaker and as a result of that we can see patient's start to have their head fall forward about 5-10 degrees more than what they are at baseline. Most, if not all, people don't notice this but we do see it on x-rays from time to time.
@@ArmaghaniSpine thanks. Does a circumferential (360) fusion, as in my case, typically prevent that kephotic change? I feel like my previously almost perfectly lordoic cspine is now wanting to “tilt” despite being backstopped with this ridiculous and essentially criminal laminectomy/fusion. I get I had an infection and a supposedly well educated and experienced neurosurgeon got scared when pus came out of my cervical spine most likely but it seems like what I was given is actually not doing what the alleged intent (other than charging my good insurance to lever my emergency into bank account deposits) was. To prevent a kephotic “disaster”. Perhaps it’s just me trying to break out of this straight jacket I never will be able to 😢😢💔💔. Who knows. Thanks
What can be done for calcified disc?
same treatments but we typically will order a CT Scan which is designed to evaluate bone to see if a disk is calcified or not and if it is in a position where removing it can be dangerous. I usually always evaluate for calcifications in the cervical spine.
Do bone spurs form in an effort of the body to protect the disc?
Great question. Bone spurs form as a result of the disk degenerating and giving less and less cushion between the bones. In an effort to decrease the strain the bones are seeing due to the decreased amount of disk, they form bone spurs to increase their surface area.
Done my surgery one year already but why my condition still not good....
There's a time i suddenly freeze and cant move whole body and when i move my head i feel dizzy for about half an hour or more then i cant walk properly thats why i just lydown and till two to three days my walk is not so stable....After a few months after surgery i noticed my shoulder had a tik ,its moving uncontrolled sometimes if relax it didnt move but sometimes my shoulder move they said its a tik .....i cant understand why i have this after surgery though the doctor said after surgery everything can back to normal ,my life can back to normal .....😔😔😔😔
Thank you for putting out these video's, when my doctor explained everything to me,i heard everything but...later I was brain dead and your video refreshed my "brain fog "...thank you.
You're most welcome. That is why I made the videos. For patient's, such as yourself, to have an opportunity to hear the same description at home and you can watch it as many times as you like to be as comfortable as possible before making a decision.
Thats exactly how I felt. Upon running across @Armaghani Spine videos I had no understanding of the posterior laminectomy and spinal fusion surgery my doctor is telling me I need right away. I wasn't given options. Just told that this is what he's doing. Im so grateful i came across Dr. ARMAGHANI! I Have so many questions but his videos have helped so much!
Oops differences between laminoplasty and laminoscopy?
Laminoplasty is the surgery you just viewed and commented on. I'm not sure of laminoscopy but he could have meant laminectomy and fusion which is another video I have. It may be best to check with him or her again to make sure you have a full understanding of all your options and dont be afraid to ask for them to clarify if you don't understand. Having an understanding of your condition and the options to fix it is what will help you make the best decision! Good luck!
What are the requirements for a laminoplasty vs a laminectomy? My surgeon suggested a laminectomy without offering a laminoplasty.
Case by case basis. Usually has to do with how a patient's alignment is when they are standing. The more their neck is leaning forward, the worse it will get with a laminectomy. Laminoplasty does get some increase in neck lean after surgery but much less than with laminectomy alone. It's rare that a laminectomy alone is done in the cervical spine in 2022.
@@ArmaghaniSpine I’m not completely understanding the “laminectomy alone”. What is usually done with a laminectomy in 2022? C4 has myelomacia C6-7 serious compression of spinal cord.
@@myrnawicks9227 I think fusion is the other part.
Hi Dr. Armaghani, my father has visited three neurosurgeons with 2 recommending a cervical laminectomy with fusion and 1 recommending a laminoplasty. Why would there be differing of opinions?
Is your Dad diabetic or smoker?
Hi doc, my dad is 85 year old and 5 months, can he get this operation? His doc suggests this operation and I'm worry for him.
it's always determined on a case by case basis after weighing the potential risks and benefits with the patient. make sure to get a clear understanding of what are the risks esp at your father's age for having the surgery and what is his expected outcome.
Hello Doctor, can cervical myelopathy cause a drop foot? I had all the tests done for other areas of my body that are supposed to cause drop foot and all were negative. I am getting an MRI of my neck next. Is it possible to get 0/5 foot drop from neck problem? Thank you.
I have heard of that before. If a patient comes in with something like 0/5 strength in a foot, I would then image their cervical as well as their thoracic spine to check for any spine compression. If those are then clean, I would have them see a neurologist to see if there could be something else going on in their body that could be causing weakness like that. Sometimes nerves outside the spine like the peroneal nerve can be compression around the knee and that can cause a foot drop. First thing is first though and that is rule out the spinal cord as the cause.
@@ArmaghaniSpine Will insurance actually pay for images of more than one back section at a time?
Are laminoplasties ever done on the lumbar spine? I have a three-level (L2-L5) Laminectomy scheduled for February 1st of 2023 and am worried about instability. My doctor says there should be no instability or any need for fusion. Is he correct? I know it's late in the game, but I just found out about Laminoplasty a few days ago. Please let me know!
thats a great question. They have tried them in the past but the lamina is too thick to perform as opposed to the cervical spine where it is much more thin. Your doctor seems very by the book as i am also of the thought that bones don't need to be fused unless there is instability. you will do just fine with a laminectomy.
@@ArmaghaniSpine Thanks for your response. You are one of the few doctors who take the time to do so and it's appreciated. I'm 6 days post-op now and coming along. Although after this, I have to deal with a bone-on-bone left hip! As my grandmother said, it's hell getting old. (I'm just turning 60 next month). Thanks again! Oh, and in your laminectomy description, you seemed to keep a portion of the Lamina intact and just cut off the top of one and the bottom section of the other. My doctor said that he removed the ENTIRE Lamina on all three levels. He also did a Foraminotomy on one level.
Am I a candidate for this surgery if I also have foraminal stenosis at c5/c6?
yes in most cases if you have pain going down the arm. most patients with single level disease opt for surgery through the front of the neck though.
@@ArmaghaniSpine I've already had an acdf in this location back in 2016. It helped, but I was rear ended at a stoplight in fall of 2021 and have since been in debilitating pain again. I really don't want another surgery, but I'm running out of options. I've been to over 30 sessions of pt, had two CESIs, and now scheduled for the 3 part ablation series. If that doesn't work my neurosurgeon wants me to get a myleogram.... something I'm more terrified of than the actual surgery.
PS
If I had known better I would have suggested this technique when I had a spinal fusion back in 2012.
So you leave the lamina propped open? Doesn’t sound like a good idea.
it's opened only a small amount to allow the spinal cord to drift back so it isn't compressed. The bone heals that way and stays in that position after only 6 weeks. the other alternative is a fusion which causes patients to lose range of motion. some want to keep their motion and others dont mind. there are options for both kinds of patients.
Sir, i am suffering from cervical meyolopathy and operated at C5-6-7 PIVD/ACDF. After surgery tingling and numbness vanishes in my neck, shoulder and hand. However due to Myelopathy my walking /gait still not improving. After 5 years of surgery still feel numbness and stiffness in both legs hence waiting affected and lumber pain. As per post surgery MRI there is no further changes means old and new MRI are exactly similar except at C5-6-7 which is fused after surgery. Hence please advise whether this can be improved means are there any chances to strengthen the legs, remove stiffness by overcoming this cervical meyolopathy. Please advise suitably. Thanks!
How are you now?
Try stem cells it might help
Quit talking down to people. “Door” “kickstand”. I wouldn’t trust you at all with my cervical surgeries. Yes, plural. I just had my third cervical surgery. I am very fortunate all surgeries, so far, have been anterior openings.