Failed back surgery: Why does it happen?
Vložit
- čas přidán 31. 05. 2024
- 1:06 Patients who should never have had surgery
5:25 Right diagnosis, but wrong surgery
10:00 Complications after surgery
14:23 Unknown causes
16:22 A surgeon's perspective
Linked videos:
Don't have spine surgery if... : • Don't have spine surge...
Smoking and spine surgery: • How smoking ruins spin...
Failed spinal fusion: How I fixed it: • Failed spinal fusion: ...
Risks of spine surgery: • RISKS of spine surgery
For more information, please visit:
www.MustafaKhanMD.com
DISCLAIMER:
The contents of this CZcams video/ channel (including but not limited to: Images, text, graphics, links, other materials) are for educational/ informational purposes ONLY. This content is NOT professional medical advice, and is NOT meant to be a substitute for professional medical advice. Watching this video does not establish a patient-doctor relationship. The content of this CZcams video should not be used to make judgments/ decisions regarding diagnosis or treatment. As with any medical condition, SEEK THE PROFESSIONAL OPINION OF A PHYSICIAN FOR A THOROUGH EVALUATION. All Images, text, graphics, audio, video etc. are SUBJECT TO COPYRIGHT.
If you find this video helpful, you may also want to check out this video:
"Don't have spine surgery if..."
czcams.com/video/ovSTtD08Olw/video.html
Respect to your channel Dr. , For at least 15 years Dr's in the US said NOTHING could be done for my DDD. Forced out of work many times, pain management, injections, spinal cord stimulators etc etc.. I have seen every top spine surgeon in South Florida (at least 20) NONE offered help of any sort. I finally went to Germany 2 Level Lp-ESP at L4/5 L5/S1 and the relief was instant! Millions of dollars wasted, and nearly 20 years of my life destroyed for a 40k procedure, it was that simple! AND guess why I needed a 2 level surgery, BECAUSE the Americans are behind in there thinking, ASD had already moved up to the next level. My surgeon in Germany has placed over 5k ADR without an access surgeon, they are dumbfounded at the Americans!! SAD!!!
You are correct: Spine surgeons in the U.S. generally follow very similar clinical/ surgical guidelines (for a variety of reasons related to insurance/ payments/ medicolegal-considerations/ FDA-regulations/ accepted standard-of-care criteria etc). Therefore some treatments which are commonly available in Europe are not as easily available in the U.S. So your observation is accurate.
However, there is a flip-side to this situation: A lot of surgical complications which happen routinely in the rest of the world are relatively infrequent in the U.S.
Here is an excellent talk about the issue that you mentioned, hope you find it helpful:
czcams.com/video/ea5XxCiakbA/video.htmlsi=Q_KDTZhBD0R4L9Mb
Thank you for your feedback, good luck to you 👍
Hello Brian maybe you could name the exact location where you went for the surgery in Germany? I'm living here, so I could easily decide where to go..
Assalamualikum dear doctor. Very brilliant discussion and nice presentation. The world need more doctors like you. Stay well and long live ❤
Thank you, very kind of you.
Im almost positive my first surgery failed simply because they wanted the chance to do a second surgery. I had herniated discs L4,L5 and L5,S1. They only removed part of one disc claiming the other one wasnt bad enough to worry about yet. Well, i was in worse pain after that surgery. I did a lot of research and found another surgeon. 2.5 years later, both discs are replaced with spacers, parts of vertebrae removed and fused L4-S1 now. Im 2.5 months out of that surgery. Research, research, research...
Thank you for reaching out. I hope you are doing well after surgery.
I made a video about this issue:
czcams.com/video/ovSTtD08Olw/video.html
@@SpineSurgeonSpeaks I'll check it out if I haven't already. I found your channel a few days ago. Most of the videos I've come across on spine surgery are 5-7, even 10+ years old. That seems strange to me considering how much and how quick technology changes.
Okay I am watching your video and you just explained exactly what I am dealing with in my spine at the 8:47 mark. I have been diagnosed with spondylolisthesis. I have facet cysts that swell and make my spinal nerves very angry. I have back pain daily and the facet cysts get so swollen and irritated that they are not responding well to anti inflammatory meds. I had to lay off of them due to my kidney function declining. I had decompression surgery on June1, 2015 in the L5, S1 area. Now due to the shifting and facet cyst swelling, I have sciatic nerve pain that starts in my lower back, goes around the groin and down my left leg. I was never told that I would be facing another surgery because I thought I was one and done. Now I see that having another surgery may not fix my back pain at all. I am so tired and tired of hurting because the instability has affected my quality of life, my daily activities and my marriage. I am afraid of going through fusion surgery but living with the pain is worse. I work as a business officer so there is no good time of the year to be out of work for 3 months. I hate I found myself in this position, but glad I found your channel. I will continue to do my research before agreeing to another surgery, but there are no guarantees. Thank you so much for your advice.
I slipped a disc around L4 when I was 26 yrs old. My GP told me it was not unusual of someone working in the building trade ( bricklayer ) and that it was wear and tear. ( at 26 yrs?). Anyway I am now 73 and still suffering. My last surgery in 2016 / 17 I had a L4/ L5/S1 fusion at Nottingham Queens Medical. The day after when my wife and son came to see me I was apparently in good spirits. They said the surgery went successfully. However, from day two onwards from what I have been told things changed dramatically and instead of ending up in the hospital for 3/4 days, I was there four and a half weeks. My wife discovered that they had tore into my spinal canal and as I had to remain motionless for ten days they overdosed me with Ketamine and morphine. My wife said I was in a really bad temper and saying nasty things to her and others. I had my Father and Brother visit me from Wales ( they had died years previously ). They had constructed a scaffold outside the window and a pop concert had taken place the day before. These were the side effects of too many drugs to keep me motionless. Since then and increasing daily, i suffer with more pain in my back than ever. Now that I am expecting Pain Management at the hospital to concentrate on lessening the pain my hopes are vanishing. None of them will admit that things did not go to plan and their sympathy towards what pain can do for you not just physically but mentally but also the stress and pressure it puts in my case ( my dear wife ). From being allowed the privilege of retiring at leisure and be free to organise each day as it comes? she is now a carer and nurse and has no quality time for herself as would be expected when retired. She can’t plan ahead because each day there is a problem. We are due to attend my dear Uncle’s funeral on Monday next in Wales. We are going to travel down on Saturday ( health permitting ) so I can have Sunday to rest after the journey to be prepared for Monday. But I will not know until Monday if I am able to attend health wise. My advice is this, think very very hard about surgery to your spine. It cannot be reversed and not all consultants are as good as they think they are.
Oof, I had the same problem and surgery etc, but I realize now that it’s better to do a laminectomy if the discs are calcified, because if they go tearing up the disc it is quite likely it will reherniate uncontrollably, it’s not the surgeons fault, they have a tough decision to make but I stopped thinking that they would hurt me on purpose. My sciatica is unbearable and my back is absolutely destroyed from the operation but a few months post op is not grounds to say it’s better or worse, disc replacements aren’t going to fail right away, but let me know how you’re doing in 5 years. I’m putting off a fusion as long as possible but yea, life sucks.
Thanks for being honest with us ❤
Thank you for your kind words, glad that is was helpful 👍
Excellent video
Thank you for your kind words, appreciate it ❤️
Okay I am watching your video and you just explained exactly what I am dealing with in my spine at the 8:47 mark. I have been diagnosed with spondylolisthesis. I have facet cysts that swell and make my spinal nerves very angry. I have back pain daily and the facet cysts get so swollen and irritated that they are not responding well to anti inflammatory meds. I had to lay off of them due to my kidney function declining. I had decompression surgery on June1, 2015 in the L5, S1 area. Now due to the shifting and facet cyst swelling, I have sciatic nerve pain that starts in my lower back, goes around the groin and down my left leg. I was never told that I would be facing another surgery because I thought I was one and done. Now I see that having another surgery that may not fix my back pain at all. I am so tired and tired of hurting because the instability has affected my quality of life, my daily activities and my marriage. I am afraid of going through fusion surgery but living with the pain is worse. I work as a business officer so there is no good time of the year to be out of work for 3 months. I hate I found myself in this position, but glad I found your channel. I will continue to do my research before agreeing to another surgery, but there are no guarantees. I have had steroid shots, PT, chiropractic care, currently in PT now, dry needling, med management, you name it, I have done it or been referred for it. Thank you so much for your advice. This video is very helpful and I am reviewing your other videos for more information. I got a second opinion as the first surgeon just sent me to have shots and RFA treatment. After getting tired of being a human pen cushion, I got my second opinion and he found I had instability in my cervical spine that was corrected with fusion in August 23. He was able to get another MRI due to a positive Hoffman sign (you got a video for that) as I was more focused on my lower back pain I didn’t notice the signs of numbness and tingling in my hands. I just thought I was sleeping wrong. Now I have to focus on my lumbar surgery with no leave time and a lengthy rehab journey ahead. I am just tired of this journey. Thank you for your videos.
Thank you for your very thoughtful comment, I understand completely.
Sometimes hindsight is 20/20, agreed. As a patient it can be very difficult to make decisions about whether or not fusion is a good idea for you because there is an element of uncertainty associated with this choice. I wish you the best of health and good luck 👍
Omg, I wish I had you for a Dr. I’ve been through ringer with failed back surgery. I had spondylolisthesis and severe spinal stenosis. My life has been a debilitating hell. Looking at a pump stimulator🙏
Thank you for reaching out, appreciate your kind words.
Recovery from spine surgery is not easy, agreed.
Wishing you the best, hope you feel better soon 🙏
I have severe stenosis also. Would you mind getting back to me about surgical treatment; I need someone to talk to. This is HORRIBLE!
Spine should be operated only on three indications
1. Cauda equina syndrome
2. Unstable symptomatic spine
3. Trauma spine causing spinal cord compression.
Doctor you hit the nail right on the head he took out a lot of bone in my laminectomy went through another surgeon he said you need a two-level fusion I have one disc on top of the other now no more diss left full of arthritis but on the foramen it's pinching the nerve because of the instability I should have listened to the first surgeon said laminectomy and two level fusion went to this other guy he said you'll be fine with just the laminectomy evidently he was wrong going back for a second surgery last year June 15th I had my first I should have listened to the first surgeon I would have been all done now but this is life I have to bother my daughter as when I got hurt I was an electrician My wife divorced me so I have to bother my daughter she has her own life as a speech pathologist but she's going to help me out hopefully I won't need him no more than 3 weeks That's what I did last time thank you for these videos very informative you know your stuff I'm in the New York City area supposably the best spine surgeons I don't know problem is go to second opinion they tell you something different each one
Sometimes when you have a lot of surgeons in a big city, unfortunately you get many conflicting opinions (for a variety of reasons). This problem is very difficult for patients to solve, and it makes their decision-making unusually arduous. I hear you.
@@SpineSurgeonSpeaks my degree in mechanical engineering but I went for electrician it paid better help me when the first doctor wanted to put coflex I said that will hold nothing it's only on two points with the steel bar left and right the weight will be more dispersed he agreed with me maybe he wanted to make money for the colflex company 🤔
Non smoker/drinker/druggy. Had a re-fusion L4-L5 after finding out 30-years later that the first doc didn't do a good job. New Doc did a "360" S1 thru L5 then up to thru L2. Also both SI joints got screwed together. Post op 2-months, I'm doing good feeling really great no pain in legs/back. After simply pushing on my truck just a little to get it rolling into the garage for repair (crank sensor)...BAM...now I'm bent over with spasms at my belt line right side. A week has gone by and it won't stop hurting spasm sudden shock of pain for no reason or movement. Saw my Doc he doesn't want to guess. Just had CT scan today....hope nothing broke or came loose. I was doing so well with high hopes....
Good luck to you, wishing you all the best 🙏
Hi Dr. Khan, these videos you are making are phenomenally helpful. Hope your channel grows exponentially. Question: I had a large disc herniation and ended up going with endoscopic laminectomy for L4-L5 as the surgeon was very confident with endoscopic route. Post surgery it took away my sciatic leg pain but I still had severe pain nonstop in disc area, Post surgery I followed everything surgeon recommended even did an epidural injection but it didn’t relieve my pain in disc area. Post 1 year I decided to get a second opinion from a different surgeon who did another MRI and stated I still had large herniation but disc was calcified. He advised me to do a revision discectomy and I went for it. I’m post 3 weeks out of traditional discectomy surgery and Surgeon was very happy with results but I feel my pain is amplified even more instead of going down, the incision area is healed nicely, no leg pain, walking wise I feel bit crooked as if my body is automatically pushing me to opposite side of the surgery location. It gets worse standing or walking, sitting or laying doesn’t cause pain, Could this be the instability you’re referring to in this video? Or am I being paranoid and need to wait it out longer? I would be heartbroken if this was another failed back surgery. Please let me know your thoughts. Thank you so much!
Thank you for watching, and for your kind words.
The situation you described is certainly complex, of course.
At three weeks out from surgery, it is still too early in the healing process; full recovery from spine surgery can take between 6-12months.
Obviously I cannot make a diagnosis or treatment recommendations in your case (since that would require a physical examination and careful review of imaging studies). Having said that, for most patients the results from spine surgery for the treatment of back pain only (in the absence of radiculopathy/ nerve-pain) are quite unpredictable. Getting flexion/ extension X-rays can be helpful in determining whether or not instability is present, and perhaps this could be at the root of the back pain. Persistent back pain after diskectomy surgery is, unfortunately, a difficult problem, but some patients can benefit from Pain-Management procedures (like facet-injections/ radiofrequency ablations). Hope this helps. Wishing you all the best 🙏
I have spondylolistheses grade 2 in LWS 3/4 , spinal stenosis, arthritis, osteochondrosis. I have sciatic pain and osteoporosis. I'm 70 years old and my spinal surgeon wants to do a TLIF and an decompression. But I' m afraid that the screws may destroy my bones or that I must have further surgery after years. I don' t smoke (never did) and I always did sport in my younger life. Unfortunately I can' t do normal sports any longer, only some exercises for my back to release the pain. I' m not sure, if I should do the surgery. Sorry for my english, I come from Germany.
Thank you for reaching out.
I cannot make a recommendation in your case, obviously, because I have not examined you or reviewed the imaging data. If you are not sure about your spine-surgeon's recommendation, you can always get a second-opinion from another surgeon to clarify this matter.
The decision to have/not-have surgery is not easy, I hear you.
You need to research this matter a bit more, so that when you discuss the pros/cons of surgery with the surgeon you can have a meaningful/ fruitful conversation.
The following videos may be helpful to you:
czcams.com/video/DfQnd9IeW6E/video.html
czcams.com/video/ovSTtD08Olw/video.html
Thank you for watching, wishing you good luck 👍
@@SpineSurgeonSpeaks Thank you so much for your answer. Yes I will get a second opinion from another surgeon. And I must be convinced, that surgery is the best way. I really appreciate your Videos.
Am 3 weeks out from L3-L4 LLIF fusion and spinal stenosis decompression. The sciatica is completely gone. The fusion part will take awhile to heal. I am 72 and am anxious to get back to yoga swimming and hiking. Patience is key.
Do I understand correctly that minimally invasive endoscopic laminectomy is not the same as normal cut laminectomy with regard to the outcome? In normal cut you can do more and on both sides of vertebra?
Great question.
Yes, a conventional/ normal laminectomy gives you much greater exposure, as a surgeon and you can remove much more of the bone. This allows the surgeon to perform a more thorough surgical decompression.
I have had surgery on my neck and lower back, many years have passed now and now I have started having numbness, weakness, and losing strength in my left arm & leg. I’m aware of some disc problems in my cervical, thoracic and lumber spine. Is there something that you can do to help me out?
Thank you for your question.
Obviously, I cannot diagnose or treat your condition, since I am not familiar with it. Having said that, the best course of action would be to get an in-person evaluation by a spine-surgeon.
Maybe the following two videos could be helpful to you:
czcams.com/video/X9JMMaeBUJc/video.html
czcams.com/video/Hml_6kM4fY8/video.html
Wishing you the best of luck 👍
I have trace levoscoliosis and cervical erosion endplates? and extremely dry lumbar discs…..do I need surgery?
Thank you for reaching out.
Unfortunately it is not possible for me to diagnose your condition or make a treatment recommendation without performing a physical examination and reviewing the imaging studies.
Whether surgery is/isn't appropriate for you can be determined only after the above steps have been undertaken.
I recommend a consultation with a spine-surgeon, and perhaps even a second-opinion evaluation if you are not sure.
I have made a video which may be of interest to you:
czcams.com/video/ovSTtD08Olw/video.html
Wishing you good luck, thank you for watching! 👍
@@SpineSurgeonSpeaks
Thank you, Yes I have an appointment on June 11, with a Neurosurgeon Dr. Xun Li at Jamaica hospital.
I’m Nervous
….thank you for the video
Have a Good day 🙂
I had to laminectomy L5 S1
2012, 2013.
After surgery six weeks later the pain was back scar tissue grew.
I couldn’t feel my foot.
6 months later surgeons operated & cleaned scar tissue. Six weeks later scar tissue back.
Today new MRI scar tissue grew 3x’s bigger.
Is there any new procedures to help me? I’m in horrible pain now. Foot is on fire, cannot wear sock, pain is unbearable? Injections help 20%
Thank you for sharing. Since I am not familiar with your case, I cannot recommend specific treatments. But have you discussed the possibility of trying a Spinal-Cord-Stimulator with a pain-management doctor? That could be one option.
I feel like I need to inject morphine straight into my calves it is so freaking painful
I’m not a smoker
Hello, it is now 3 weeks post ACDF C5-7. I would like more information on why I shouldn't do things for first 6 weeks and why certain activities can cause a failed fusion or other problems. Firstly, I am not sure what device they used in discectomy and fusion, I can't see a plate on xray, just the spacer and then something small in front of the spacer covering the gap and 2 screws one diagonal up into top vertebrae and one screw diagonally down into bottom vertebrae, nothing like all the things I have seen on You Tube where there is a visible plate and screws go in horizontally. So two of these small contraptions one at C5-6 and one at C6-7. So overnight in hospital, no collar, home next day. Didn't need pain killers. Only pain was laying down to sleep, deep inside neck bones and into head like the bone was pulling on the screw is the only way I can explain it. Had headache all night with neck pain and migraines every morning for several days, it took a couple of weeks to be able to lay flat and still have some pain laying down, not much, but ok when upright, and is improving. I can do stuff that it says I shouldn't, like sweeping, carrying grocery bags, driving... I try not to as not supposed to but can without pain. I have noticed though, if I do have to do something and it seem well tolerated, its the next day that I feel the consequences and not at the time. So can I do damage or prevent fusion if I do stuff? Why can't I lift more than 5kg (in Australia and that is their limit) my cat is heavier than 5kg, what if I briefly lift him onto my lap? Can you do a video explaining the mechanism of these activities and how and why they cannot be done in first 6 weeks when it feels as though one can? If it takes 6-12 months for fusion what kind of physical activities can be detrimental to that process.
I dont take any fish oil supplements, or Vit E and others like Ginko etc as they are reported to hinder fusion. I take vit C, Vit D with K2, Q10, Glucosamine with condroitin and a concentrated bone broth with high collagen content and focus on high protein diet. I have Crohns so absorption and appetite is a bit of a problem... But curious how it works as to why I shouldn't be physically active and what I really should not do, is it the soft tissue, stitches and ligatures rather than the fusion that is the worry? Many thanks for all your videos and help. Much appreciated.
Thank you for reaching out, and I think your concerns/ questions are quite valid.
To begin with, since I am not familiar with your particular case, I cannot make specific recommendations for you. I think the best course of action would be for you to contact your surgeon and ask him/her these questions.
For my patients, I generally recommend collar for 2-3weeks, and at around 3weeks most patients are quite functional. It is common/ normal for patients to be fatigued/ achy for weeks after surgery.
I think the best way to gauge/ improve your functional progress after surgery is to work with a physical therapist. That way you have a professional monitoring your milestones who can guide you as needed.
ACDF is one of my favorite surgeries.
I have made a few videos about this surgery (and the related condition of cervical radiculopathy):
czcams.com/video/5HPlzxWN2dk/video.html
czcams.com/video/Hml_6kM4fY8/video.html
Wishing you all the best, and thank you for watching.
I think you will do very well.
Good luck! 👍