Lumbar Degenerative Disc Disease : Part 3: Surgical Treatments, The "Tiger Woods" Surgery.
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- čas přidán 28. 05. 2019
- This episode on surgical treatments for Lumbar Degenerative Disc Disease looks at the same surgery that Tiger recently had on his back, the anterior lumbar interbody fusion surgery.
#thespineguy #anteriorlumbarinterbodyfusion #alif #spinesurgery #bmp #stryker #lumbarcage #thetigerwoodssurgery #tigerwoodsbacksurgery
Dr. Brian W. Su, MD
Spine Surgeon
Chief Development and Strategy Officer | California Orthopedics and Spine
Medical Director of Spine Surgery | Marin General Hospital
Director | Marin Healthcare District Board
Chairman | Marin Specialty Surgery Center
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Contact two locations:
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415-927-5300
2 Bon Air Road, Suite 120
Larkspur, CA 94939
7100 Redwood Blvd, Suite 200
Novato, CA 94945
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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Information obtained from this video should not be taken in lieu of your own medical provider's advice and treatment plan. Please consult directly with a physician or other healthcare professional regarding any diagnosis or treatment plan options. Content provided on this CZcams channel is for informational purposes only and should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose , treat, cure or prevent disease.
Tiger is a billionaire & celebrity top athlete. They all get the very best care on the planet & don’t need insurance approval.
Thanks for this. I’m 35, and this has had me pretty depressed lately. Seeing these options and having these clear explanations clears up a lot of ambiguity and gives me hope for effective treatment.
Just found out I got it bro. We got this. It's a manageable condition. Easily at best if caught early and taken seriously. You already there man 6 months ago dude hmu with a reply how ya feel? Lol we got this man. Your life ain't about to change permanently that much for the rest of your life. O ly difference with us is that ours is triggered whereas most people have the damage as is but it just hasn't started.
I have just found out I have got DDD and it getting worse every day and it affecting my sleep and my work and I am waiting to see physiotherapist for it
I'm an EMT in the same boat. Scared to death bro.
Dr. Su, your explanation of this surgery is fascinating. I'm a 70 yo, male, who suffers with a number of spinal maladies with spondyliothesis at L5 to S1, Spondylosis throughout the spine , facet joint arthritis and dextroscoliosis of 25 degrees resulting from a fractured right femur at age 15. The leg is 1 inch short,and was left unaddressed for about 45 years. I have been to 6 Neuro and spinal surgeons sin e 2019 ,, all of who said o surgery for you. Too much arthritis. Moral to my story, I waited far to long to something about axdressing the pain and stiffness.
We can send a rocket ship to Mars, land a Rover on the planet, control it from millions of miles away, yet, we can't overcome and or eliminate health issues of arthritis and spinal well being.
If you only knew how much I appreciate your videos, I’ve learned a great deal. After being told repeatedly for years and as recent as last month, there’s nothing we can do for you. A fusion and disc replacement, nothing will work for you, you will have to go back to PM. Feels like I’m beating my head against the wall, the frustration is real. Severe DDD L4-5, L5-S1, with two prior lower back surgeries. Thank you & blessings to you! ❤
Thanks doc. You guys are miracle workers. I had a XLIF double fusion. L3 to l5 in 2018. Couldn’t have been better. I run , swim, lift weights etc. You guys are game changers.
The way this process is explained makes a patient very comfortable to do this surgery. after putting it off for five years I think am better prepared physiologically. Thanks Dr.
These are the best videos I’ve ever seen to explain spine disease
Been researching surgery’s for my back. By far the most informative video I’ve seen. Thanks.
Quite interesting. You are a good teacher of quite complex material. I really appreciate your efforts to demystify surgical options.
Thank you Dr Su . Your presentation is very thorough & easy to understand.
As a former OR tech and many many orthopedic surgeries I have been apart of this is very very informative for those not familiar with surgery. Thanks ironically all those years of standing and sports I now need the same surgeries. I have had neck fusion and still need more
Very good. As we now know Tiger had trouble finishing his last tournament, had trouble walking the course and was in pain and he has retired so the moral of the story is surgeons do not track their patients long enough to evaluate longer term surgical success.
Tiger Woods also has a surgically repaired leg from the MV accident.
I’m having multiple severe back problems and have been getting baited to the racket of back surgeon s and this is exactly wat I need to corolate my point to these con surgeons where I’m at rite now…thank u so much ur a true spine master mechanic and relay info perfectly
Thank you Docter, I like the way you explains, I am learning a lot… have a nice day.
You are the best I’ve seen. I will be following you.. I have a complicated problem. I fell out of a second story window at 18 years old.. I’m 67, now and having problems walking, doing physical therapy, taking OTC meds for pain.. using muscle rub.. all this started in mid July, PT helps, some days are good and some days it seems like nothing working.. will be talking to my Dr. about epidural.. thank you for sharing your knowledge and skills, it is so appreciated I’m so grateful.. many blessings..
Excellent presentation. Big help!
Very informative ND comforting I'm considering surgery now after 20yrs thnx Dr
These videos are so good...
Amazing explanation. I have L5S1 very bad disc with isthmic spondylolisthesis grade 1 (with broken pars etc.). He covered all the questions I had. Thank you Doc!!
Look at the isthmic spondy playlist
Enlightening, wonderful medical science.
I need this. I’m going to see my back doctor again
Thanks Doc great info!
Thanks for this. After scans 2 years ago I was diagnosed with this. Severe sciatica, and pretty much bed bound for a few weeks, then pain went completely. It's just when I am active that it triggers it. I'm vey active so this happens regularly.
I'm sitting here in pain as I type (with rigid upright posture), and considering surgery. Based on your preceding video I will discuss non surgical methods first, but I'll probably just go for surgery. My lifestyle involves a lot of climbing, running, and downhill biking.. well, used to.. BUT I'll get back to that eventually.
Subscribed. :)
I have been dealing with this for the past two months and it started off as just minor back pain feeling like I had slept wrong and recently it got worse and moved into my butt feeling like it was going to cramp, I’ve also had sharp pains running down my leg to the back of my ankle and my legs feel like they’re going numb. I got my MRI report back today and they told my I have DDD. Watching your videos on treatment options and what it can look like has made me feel a lot better about my treatment to come. I had read things saying that it’s something you just have to learn to live with and I’m only 23 and I feared living the rest of my life in this pain. It’s hard for me to get out of bed in the mornings and complete simple tasks. My only fear of the surgery is not knowing what the chances of being paralyzed are.
If you have leg pain you most likely have lumbar spinal stenosis. You should watch the videos on that playlist. As a disclaimer please consult your surgeon.
Don't panic I'm sure they can help you ...
@@DrBrianSuTheSpineGuy I have leg pain as well down my thigh and butt, but have no spinal canal stenosis as per two MRI's. Any thoughts?
Sciatica
If you only have a grade one spondylolisthesis, is a fusion really required when you do a Laminectomy for spinal stenosis. Will the Coflex device avoid having to do a fusion?
So informative and everything explained in a way I can understand it. I had an L4-L5 laminectomy two months ago and now the pain is back. MRI shows disc slipped again and I’m needing a lumbar fusion. Thanks to your video, I will have good questions for the surgeon. Thank you, Dr Su.
That's crazy, sorry to hear that. I'm going to speak with a neurosurgeon soon to discuss surgery.
I have been on oral non-medical osteoporosis pills prescribed by my surgeon. I can't get my dexabone scan until June. I will call for a video appointment when I get the results. Thank you
You rock!
Thank you for your kindness..I have a lumbar disc hernia and it’s not easy to get fixed and I live in Tokyo, Tokyo..if I could get on the flight out I love to see you and thank my again doctor…my is L2/3 L3/4 L4/5 L5/S1
I appreciate your very informative videos. I’m struggling with DDD ++++. I’m told I need a fusion but surgeon begged me to wait as long as I can bc I’ll need another fusion in 10/12 years. I’m hoping to find the best option as it’s my spine i can’t afford to f it up worse . Thanks again!
Would that bone surely grow as planned in between 2 bones?
Thank you for posting this video to help me better understand the process and procedure of a Fusion. I had a Microdiscectomy done on my L5/S1 seven years ago and that same disc recently herniated again. Two surgeons recommended I do a Fusion, but I was scared and very concerned about being operated on through the front. You said Tiger Woods had discectomy done in his back, is that the same as a Microdiscectomy? Also, I was doing Jiu Jitsu prior to this disc re-herniating. Will I be able to do Jiu Jitsu again if I were to do the Fusion surgery?
Yes, once you are fused you should have no limitation to your activities. You should be able to do all the things you were doing previously. As disclaimer please consult your spine surgeon
Great explanation. What’s your opinion on artificial lumbar discs and their potential to stave off adjacent segment disease?
I think in theory it sounds good but all of the data would prove otherwise that is not industry-funded. In general I'm a bigger fan of cervical disc replacements than lumbar because I fear what needs to happen to revise a lumbar disc and there's a lot more biomechanical force on the lumbar disc. However, I would not fall someone for wanting to get one or a surgeon for doing one. It is good technology.
Need you in SC. You sound like a unbelievable pleasant dr. Thank you for your video.
Hello. I really need your expertise here, I have a serious lumbar ddd, last 25 yrs. I’m 55 now. The pain is well, crippling where I end up on my bedroom floor for a quite long while until I’m able to pull myself up on bed. And take whatever I have to elleviate the pain. Without getting into lot of details. Who do I go see if this is as severe as I’m saying? What type of dr. And how will he tell if I need surgery, especially if it’s what you just showed. I know you do this. But I live in a diff state. I’m on disability. Prob have to pay co pay plus 20% of the total cost of surgery if that’s what’s needed. Dr. I’ve been in serious pain since age 30. I’m hlb-27 positive. At 30. Still am. I don’t know what to do. I’ll mention because this may be really hindering my way to a solution. I have adhd and have much difficulty processing to do what I should. To the point I have to ask a hundred ppl how do I go about this. In other words I have problem w problem solving and I go around and around. It’s been 25 years in circle’s because of the adhd I’m on disability for. It’s significant. Hope you understand what I said. I’m just getting up for the day. Saw my wife off to her job and I’m on my bed sideways because when I sit anywhere. Within 5 min pain is unreal I’m my lower spine. It seems to go into my hip pelvic area then I feel like my ankles and legs feel weak. That’s when all the fatigue sets in. My energy is zapped. That’s when I fall over to my side and usually on the floor from that. That’s everyday. Every morning. In fact last night I said to my wife as we got into bed. “ honey I don’t want to go to bed because I know what’s happening in morning “ that’s where I’m at. Litterally stand for 5 min after waking it starts. I then sit for 5. Then I’m done. For many many hours. Pls. Help w any good advice.
Hi. Earlier I sent you a long text. Because of adhd at times when it’s too much I write it all out. Then after a while I want to explain shorter to the point. I really hope you read so far, ok… I need advice. For over 20 years almost every single morning and thru day I experience severe pain thru out spine especially lower where they said ddd, osteoarthritis, facet arthritis, lot of osteophyts, (sp). Reum said I don’t know what happened to you. I was using walker and crutches to get around. I will not explain. Trust me. My daughter was holding me to walk. No accidents. Just hard physically work with a body that should had done. Adhd- over do everything. Result not good. So I said all that to say why after touching my floor from bed walk several feet everything starts in , within 5-10 min of standing the pain is rising all thru lumbar. Now I’m sitting on bed. Pain increases as I sit. Now I feel crippled, slide to the floor where I stay as long as needed. Now tears are falling. I’m either yelling or crying. The pain feels like a large stake is in my lumbar spine. Oh they said dessication of L4 L5. Maybe other ones. I then start taking any thing for pain. I’ve never been on narcotics or pain pills. Only tramadol and prednisone for 3 years for inflammation. I wait and wait until I can get up. Mind you I can barely walk. And it’s like this for few hours more. Then meds kick in sometimes. Sometimes medication isn’t enough. Only thing ever helped consistently was Prednisone which was a life saver. No more pain and lot of energy = Able to work and of course over do my work. Then I’m back to where I was. Increased prednisone. I blew up 60 lbs. you would not reconize me now. I look like pic of health. I look 15-20 younger than my age. I list all that weight. Here’s the kicker. I look great on outside. On the inside it a frigen mess disaster whatever. How is this dr? Genetics? Hlb-27? I e had so many mri and extra and a cat scan. All confirmed arthritis. My question is why is morning hell for hours until I pump up w Gabapentin, tylonol , Celebrex and this green powder that’s nasty. It’s hard to swallow. They use it for pain. It’s ONLY then I get relief and able to walk. But as soon as I start bending or walk long distances back where I was. I’ll be surprised if I actually read all this. I hope. Because I need some answers. I see your video. I’m like that’s it! Maybe that will help me so much. Can’t seem to find the right dr. Imagine me telling him all this. Start to get the picture Dr? Forgive me if this was too much. It’s a sample of mornings are. Things improve as day progresses. But pain inside spine always there. Flexing back oh no!! Relief bending forward? Yes feels like relief while I stay that way while my back snaps cracks pops etc. God bless you ✝️😊❤️
This information is very helpful. Thank you! I had a "tummy tuck" about 19 years ago. Does that make me NOT eligible for ALIF surgery?
That is not usually something that prevents an alif. Sometimes major abdominal surgery or colon surgery is a contraindication and typically radiation for prostate cancer is as well. A tummy tuck usually is not a contraindication.
Thank you Dr. Su for your channel. It is very helpful. I have been struggling with S1-L4 disc herniation and left side sciatica since 2006. I have always been afraid of spinal surgery. My mother has several reactions to surgical screws and pins (the metal elements) and I think I too may have the same issues if I opt for the "Tiger Woods" surgery. Are there any options for the screw metals (elements) for those who are sensitive? Are there any newer methods for this surgery?
There are. Please call California orthopedics and spine for a virtual appointment
Superb
Would love to hear your thoughts on the OLLIF (Oblique Lateral Lumbar Interbody Fusion) method for spine fusion. Thank you!
I do like that technique although from my perspective and anterior lumbar interbody fusion is better for fusion rate and restoration of lordosis and carries with it the same risk profile.
Is there just the three? I've never had someone explain this stuff to me in a way that was as understandable as you. My pain tends to wrap around and go into the tail bone and down one leg. Sometimes both, but rarely at the same time. But like I said on your other video I have both degenerative disc L4 and L5 and spondylosis as well. Sometimes it feels like bone on bone, or I'm getting up and it wants to snap back into place if that makes sense to you. Great videos. If you have more input or videos I'd love to hear it!
My hubby is 33 and had his first MRI almost 3yrs ago in which was Dx with DDD. His Rheumatoid Arthritis doesn't help either with all his pain. He was order a new MRI because it has come to the point that he won't get out of the house bc 15-20mins in the passanger seat he wants to go back to bed🥺
I understand how he feels.
Mee too. It's horrible that your activities are severely limited.
Can you do a video explaining a PLIF? And also what a PLIF AND ALIF together consist of? Also what does it mean when you have back pain from laying down and standing up? I get the worse of it anytime I lay down for more than 20 minutes, get up, and the pain eventually lessens the longer I stand.
That surgery is typically associated with a degenerative spondylolisthesis. I will be publishing that video next
Can you pls have a video on spinal cyst L 4-5
This is extremely helpful. I will be moving to the Bay Area in a few months and plan to schedule an appt with you then, as this makes me feel very hopeful. In the meantime, I have a question: My MRI shows that my L5-S1 disk is much more degenerated that L4/L5, and I have the attendant lower back pain, but what I have long referred to as my sciatica is pain that travels down the outer side of my left thigh from hip to knee and not down the back of my left leg. Is it possible that the S-1 nerve is creating what I am now thinking is "non-typical" sciatic pain that doesn't travel from my lower back down the back of my leg but rather from my lower back to the nerves in the left leg. I have virtually no sciatic pain down the back of my leg.
It's hard to say without a physical examination
Hi, as the doctor said on his previous video, L5/S1 are often more affected that the ones above. However, they are often incidental findings, meaning it is not the source of the pain. Bear in mind what you described could also be caused by greater trochanteric pain syndrome (GTPS), which can be treated by physiotherapy. As said by Dr Brian, it is difficult to know without examination. However, you could try the GTPS exercises pain free to see if they are effective, bear in mind they take time to show results.
@@mol6036 Yes, entire spine imaged. Big reveal on that was L5/S1. Some degeneration on discs above L5 but nothing compared to L5/S1. Yes, I can lift my leg when seated.
Dr Su I’ve tried it all. Pregablin is causing cognitive issues and now have another herniated disk with legs pain and stiffness in both legs. I can’t take my walks I love so much and now finding myself feeling more depressed and hopeless I just want fusion.
Hello Doctor. Can you please make a video on the M6-L replacement discs. They are not FDA approved in the States but they look like the closest thing to the natural discs. They have been replacing discs with M6-L in Germany and I believe they have performed like 50k replacements. Can you please share with us anything you know about this new technology artificial discs ? Thank you
The m6 disc is more physiologic in the cervical spine. It just got approved for use in the United States. I will certainly do a video on it sometime soon.
So, here is my question, if you have a 1+ spondy, do you actually place the vertibrae back into place before you place the screws in the cage?
Once the disc comes out it usually naturally re aligns. If it does not we usually don't force it because it can cause nerve traction.
Dr. Great and informative. Does PLIF L5-S1 fusion heal faster than a PLIF L4-5- S1 fusion ?
a two level fusion has a higher chance of non-union but in general both levels heal at the same rate as a one level.
I am already 2 surgeries down and having severe issues at 38 I had emergency surgery almost 2 years ago now for cauda equina I had a 2 level disectomy and laminectomy and 7 weeks later it had to be repeated due to the disc's herniation again. I now have the same issues going on plus more now. I have advanced DDD and Adhesive Arachnoiditis on top of some spinal stenosis and forminal stenosis..This is all at L3to S1 I can't sit for more than a couple of minutes without losing feeling in my legs and buttocks area and a couple other places.I have severe pain constantly and have parasthesia in both legs. I also have to cath to empty my bladder at times due to being unable to feel enough to do it normally. The issue im finding where I live here in Missouri is that the surgeon's here are willing to just let it continue to get worse. I'm unsure if it's due to having 2 surgeries already or if its because of the adhesive Arachnoiditis. A lot of drs here haven't even heard of the adhesive Arachnoiditis. My physical and mental quality of life is very poor at this time and I feel hopeless as to what to do. I have to ambulate with a walker at this time when I can manage to be up. Any recommendations on what to expect going forward. I have tried and failed non operative measures to improve my condition. I don't have a surgeon at this time and don't know where to turn. Anything you can Advise as to where to turn to or advice would be appreciated.
This is a difficult situation. Not much can be done about arachnoiditis. You may want to consider a spinal cord stimulator. As a disclaimer please consult your spine surgeon
@@DrBrianSuTheSpineGuy but what about the herniated disc's that are still causing issues and the other things that are going on that aren't related to the Arachnoiditis?
I see the cages used in the video and have a question. Does spinal fusion for disc degeneration help restore disc height loss? Also are all spinal fusion for ddd done in a similar way? I had a spinal fusion when I was 18 (im 31 now) becsuse i have scoliosis. My lumbar area was not fused so i guess over time i developed ddd. Plus i had a boxing injury a year and half ago which i felt sped up the ddd. I have been in a lot of pain since the boxing injury (didn't have much back pain prior) and was diagnosed with the ddd last month. I may have to have this surgery in the future and I just wanted to know if it's going to help with disc height because my torso has gotten shorter these last couple of months and I hate it 😢 Please answer I am so scared and depressed about this. 🥺
There are many different ways to do a spinal fusion but in general all of them for the disc disease restore height.
Thanks a lot man. I was tripping balls. Well I still am but not that much.
My Comments:
The Spine guy Dr Brian Su:....Age 87 normally perfect health. From your explanation it appears that I have some form of Lumbar Spinal Stenosis. Great series of information about the subject. I am performing PT at present for sciatica but still can't walk or stand for more than 10-20 minutes. At end of day my feet swell and I guess the numbness is called neuropathy. Sitting relieves pain. Of course I am looking for non surgical treatment.
Again from the series I have ruled out arthritic hip diagnosis.
Is this procedure good on someone who has Ehlers Danlos Syndrome Hypermobility and a past history of pulmonary embolisms?
It can be effective in that situation. Please consult your spine surgeon.
Hey I have DDD can you take a look at my MRI and tell me if it’s bad and what treatment would be great for me? I’m 26 years old and I’ve stopped playing sports 6 months already since one of my doctors told me not to do any sport anymore thank you
You can always call my office for an appointment at California orthopedics and spine.
Dr. Su, what do you think about places that do spinal decompression?
I don't have a problem with that
Q: IF I have L4, L5, S1 done at once, how will this affect my range of motion/stiffening?
It should not affect your range of motion but it will stiffen those levels so that you could have some issues at the adjacent levels.
Hello Doc, thank you for the info. Well explained. How much is the surgery if the insurance will not cover it?
You would have to call California orthopedics and spine
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I did not know RE was a risk for that. That's two surgeries I may be having that can do that (the other is TURPS which is very likely to cause RE). The Spaghetti Monster does not want me to have kids it appears (53 years old, two marriages, no kids).
A second spinal surgery is not decided yet. The surgeon said if the nerve root injection did not relieve pain he would want to operate. Apart from the local anaesthetic reducing pain a bit, it did not work, so now I am waiting for the decision.
Usual thing for me. L5/S1 fully dehydrated and collapsed. Severe, or grade 3 foraminal stenosis. DDD is graded as severe too. I think what got the surgeon's attention is how I am finding it ever more difficult to walk, no matter how much I do my PT routine.
It's in NZ and hospitals are still catching up after all the pandemic delays, plus they are doing some reform of the system. Urgent and life threatening stuff is done fast, but elective surgery here takes up to four months. No bills though, so there is an upside (can't get lost time back though).
What about people with diabetes nerves damage n disc desease L 4 L5 n my neck too chronic back pain is horrible that sometimes it hit my whole body
That looks terrifying.
Hi, l live in the UK & have had 2 discectomies & C5 C6 minor disc bulge.I also have L5/S1 minor disc bulge which causes me back pain and Sciatica with degenerative disc disease. I take gabapentin, diazapam and OxyContin for pain. Would this work for me and how much would it cost as l would try to set up some sort of donation site to pay for this?Thanks Dean.
and I can't even get just pain med without a major hassle. I took neurotin for tn, never helped me and is disgusting glad its helping you. (Lyrica same thing)
Do you feel that a a lift is preferable to a disc replacement? What does a disc replacement have a faster rehab and provide more motion? What would you recommend for three lumbar disc?
In general it has not found to have better outcomes than fusion depending on what study you read.
@@DrBrianSuTheSpineGuy. Do you do multi level disc replacement? What is the success rate of this surgery for over five years?
Have any videos on PLIF surgery L4 L5
I will publish that soon.
I have sent them to you two weeks ago. We have a zoom conference scheduled for April 9. It may be too late last week I lost feeling in both legs I have the same problem with my cervical disc so I’m not sure if it’s my lumbar disc or my cervical disc because recently my neck started hurting too. I don’t know what to do anymore. I have an appointment to see a local surgeon who only does fusions on April 1. This is not the direction that I want to go down but I can’t seem to get any clarification as to the success rate of other procedures that would allow motion preservation and less time in rehab. Is there anyway we can move up the zoom conference?
How far out are you scheduling surgeries for three lumbar disc, spinal stenosis, Central and foraminal stenosis? I am due for an epidural (caudal). I Understand I would have to wait two months post injection to have surgery.
Well ... I have severe disc height loss at L4-L5 now. Surgery 14 years ago to remove little bone to free up nerve. Doc has me doing PT then follow up in 6 weeks.. my guess surgery is soon and this PT is just to get me ready and probably to satisfy insurance for the go ahead? Also put me on Lyrica 75 mg, Diclofenac Sod ec 75mg and voltaren gel 4 times on low back.
Is there an age cut off point for this type of surgery? I have multi level disc degeneration, marked osteophytic spurs, central canal & foraminal stenosis, exiting nerve root compression, in fact too much varied pathology given my almost 84 years. The major pain constant pain source is basically L5/S1 bone on bone . Radicular pain from compression is intense on standing after overnight sleep, also increased on sitting. Clutching at straws here and I can make an educated guess at your comments. Great videos/explanations that those requiring such treatments/surgeries, can review at a relaxed pace at home, too much for a non medically educated person to take in during a neurological consult. Best Regards from Tasmania, the land down under.
We typically do not use chronological age meaning how old you actually are but physiological age meaning how healthy you are for your age to determine whether or not you are a surgical candidate. As a disclaimer please consult your spine surgeon
@@DrBrianSuTheSpineGuy Thank you for your reply. I do have an appt. with my spine surgeon very soon. I think we may have slightly different parameters regarding (age) suitability for significant surgical intervention, given the fairly long recovery time, which is slower in my age groups. Even a 'simple' decompression procedure may start an unwanted cascade downhill that neither of us wants!
I've had two L3/L4 micro decompression surgeries. 2019 went very well. But needed it again in 2022. That one didn't go so well. I've been told it's time to fuse that level. He wants to go through the side, what do you think?
I'm a very active 66 year old. Just today got back from a 66 mile bike ride, (triathlon type bike). Haven't golfer for 6 months, but when I do I "never" ride a cart, always walk. Use to golf 5-6 times a month. And I do light construction.
My feet are very numb. What would you do?
Thank you.
Numb feet is a challenge. I would have to look at the imaging and assess the situation.
My pain management physician has recommended the MILD Procedure for relief of pain from my spinal stenosis. What can you tell me about this procedure?
There is some data on it but my experience in seeing the outcomes is that it's not as good as what the industry funded literature shows. I think if you have mild stenosis it's something to try but the gold standard really is a decompression. If you want to try something that is short of a decompression you may want to look into the vertiflex procedure
@@DrBrianSuTheSpineGuy Thank you for your prospective. Most of the information I’ve seen is from the industry and I am somewhat reluctant to undergo a procedure that has not been truly proven.
Hey. Can you explain to read an MRI with HIZ and leakage of the disc. And lumbar fusion vs an Artificial Disc replacement?
A high intensity zone shows up as a bright spot on the back of the disk space on the mri. Lumbar disc replacements are being done less and less. The long-term outcomes are not necessarily better than a lumbar fusion procedure. that is different than cervical disc replacements which are actually quite promising. As a disclaimer this should not be considered as medical advice and you should always consult your spine surgeon.
I would also add that surgery should not be performed for a high intensity zone.
@@DrBrianSuTheSpineGuy yes I am consulting 2 surgeons in the states and a team in Germany. As to the outcome of spinal fusion vs ADR: it's about the same in a medical point of view. But what surprises me (and is now leading) is the patients outcomes. People who have had ADR (or sometimes also a fusion on the same spine) are alot more positive about ADR than the people who have had fusions. I know it is new and long term effects are there for not yet known. But just like cervical ADR it shows more promise than fusion because of lack of the adjacent disc problem which comes with fusion and the loss of mobility. Plus it has a faster recovery. I think it's the future for people with ddd. Might be interesting for you to read up on it again for the latest research and maybe do an item about it. I think it will get alot of views and people would be very thankful. I have read so many clinical trials in medical databases. This is not reachable for non doctors and people deserve to know that there is an alternative to the more crippling fusion
Can a HBP patient do this surgery successfully without any complications , and secondly what is the best age limit For the surgery
There isn't really an age limit. It more has to do with your physiological age meaning how healthy you are.
What is the rate of adjacent segment disease?
1 to 3% per year. Meaning at 10 years 10 to 30% of patients when an x-ray is taken we'll have some degeneration above or below. It doesn't necessarily mean that it is the rate of needing revision surgery. As a disclaimer you should always consult your spine surgeon.
I've got some low grade sciatica at age 74 and PT is helping. However when I was 57 I had a cervical diskectomy and the surgeon said he gave me a half inch of height. Is this because of the disc replacement/fusion?
No the cervical spine should not affect the low back
Would this surgery be covered by BCBS insurance?
It is usually covered but you do have to check with your insurance.
what are your feelings on using a bone stim machine after a surgery like this?
If you have risk factors for non-healing that can help. as a disclaimer please consult your surgeon
I need to have three levels of my spine fused, which I don’t want because I need to preserve my motion. L3,4,5-s1.Are you saying that I will still be able to bend and twist with this procedure or would I be able to bend and twist with some restriction? And how long after the surgery would I be able to do bending and twisting? Would the recovery take as long as for a traditional fusion? Would I be able to move my hips like in ballroom, dancing, or to get on a bicycle or to turn in pivot?
I would have to look at the imaging please call 415-925-8200 for a second opinion by video
I sent imaging two weeks ago. We have a zoom conference scheduled for April 9. It may be too late as of last week I couldn’t feel my feet anymore. I also have problems with my neck I’m not sure which is causing the loss of sensation in the foot drop.
Feeling like shocks is that normal
Is it possible with such type of surgery have a normal life, I mean with screw and other material?
Yes, most patients after a successful single level fusion do not have increased stiffness and can do all of the activities they want to do. As a disclaimer that should not be considered medical advice and you should always seek the advice of your spine surgeon.
@@DrBrianSuTheSpineGuy Thank you!
My dr said Fusion is bad because it can harm the other disc above is this true and does this fusion do that?
Please see the video on surgical treatment which talks about adjacent level disease
@@DrBrianSuTheSpineGuy why do surgeons not wanna help adult scoliosis patients? Why am I supposed to just wear a back brace for the rest of my life and be ok with it?
I ve DDD stenosis spinal and cauda equina syndrome could it heal with surgery
I would suggest seeing a spine surgeon.
And when somebody take xarelto because 3 PE?
Does the box get removed after 6 months
All of the hardware stays in.
Do you have any videos on ablation procedure
Those will be coming soon so stay tuned.
ablation never helped me
Onde puedo Aser apoiment
I have this and right now I am crooked and it hurts! 😭
So replacing 3 disc doesn’t preserve motion and have a shorter recovery?
Three level disc replacements are typically not indicated but I would have to look at the imaging studies
I would appreciate that. Thank you. Do you do that surgery?
Is that kind of surgery different to a laminectomy,?
A laminectomy surgery is to take pressure off of the nerves. Did you have this disease surgery is a fusion. They are different surgeries. I will be posting a video on surgical treatment of lumbar stenosis which is a laminectomy surgery soon.
Well I have degenerated discs due to ostheoarthitis, are degenerated discs replaced or do they do laminectomy or something else?
Doctor, is it standard procedure to have a vascular surgeon on site during surgery in the event an artery collapses?
Also, do you remove the nerves altogether ever?
And why do I have air pockets in my degenerated spine? All the way up to my neck!
Typically a vascular surgeon or general surgeon helps with the exposure.
what happens if the bone is too osteoarthritic to be able to screw into?
It would be osteoporosis that is the problem so we typically make people increase their bone density with medications prior.
Last year my doctor found protein in my urine and they thought it was coming for my kidney but it was for my lower back disc
what about fusing two vertebra?
Sometimes we do that.
What if I need a fusion of three levels of my lumbar spine? Will this work? What if I have osteopenia?
Yes that can be done you should talk to your surgeon
How much is this surgery
If you could I kno you are very busy if u could reply or make a video on the best ways to keep ur disc from degenerating even more & just gettin a more healthy back if that made sense
Core strengthening, weight loss, smoking cessation.
They would not approve bmp on my surgery! I'm pretty sure it was a cost factor! I had a level 10 fusion November 16 2021! I fell on my back 8/3/22 had some extra pain so x-rays we're done to show I have a broken rod! I hope it's not a huge process! Any info Dr. would be appreciated. Thanks for all your amazing information and videos.
I would have to look at the imaging.
Don’t give up my friend there’s a permanent solution to your problem visit Doctor Ani John on his CZcams channel he cured mine completely with his natural herbal remedies
I had a failed tilf 1yr ago feb 26th I have did with spondylitis and arthritis... all materials are in place bones show no fusion.. so I have been sent to a pain mgmt dr.. they're suggestion is scs ..I have severe lower back pain upon walk more than 1/2 block or standing for more than 15 mins... pain that's debilitating.. what's your opinion please... you sound so well informed... and your explanations are well explained and informed
If you don't have a successful fusion your issue may be the non-union and you can have that revised. I would recommend seeing a spine surgeon. as a disclaimer please consult your surgeon
@@DrBrianSuTheSpineGuy thanks so much
J'ai le canal lombaire retreci disques degeneratifs pour ça veulent pas m'opérer mes disques se touchent ils sont usés je peux pas marcher longtemps et je prends ma béquille ça me soutient le soir ma bouillotte ça me soulage mes douleurs Docteur j'ai que 68ans merci pour vos explications ❤❤❤
Does it last a lifetime?
Yes once it's fused it's solid
In Germany, the doctors see 2 degenerated discs+hernia, they say the pain is in your head.... No joke here. I dont know what to do
In Australia too! One of my GP's says it's more likely my environment that is causing the stress that is leading to my pain and I should take a personality test!! My multiple MRI/CT scans prove my back is in a mess.
@@no2thenwo737 Health profession is full of people with no vocation. Zero empathy and no care at all. It was proven on the pandemic time.
That’s what I have, is it better to see a neurosurgeon or orthopedic surgeon?
Please see my video on how to choose a spine surgeon it is pretty well explained there
Is this surgery possible if the patient has osteoporosis?
It depends on how severe it is. We typically recommend referral to endocrinology. You can call 415-925-8200 for a virtual appointment with me
@DrBrianSuTheSpineGuy I should add that the reason I'm not taking the injections is because I can't afford them and we don't qualify for the free ones
plasma therapy is very expensive. for my neck and back $30,000. not covered by insurance
There is no good level one evidence that PRP replacement works for lumbar degenerative disc disease. There are a few case series which show that it may be beneficial. This should not be considered medical advice and you should always consult with your spine surgeon.
@@DrBrianSuTheSpineGuy I checked it but I can not afford it
Won’t the screw eventually losen up?
The screw typically does not loosen because there is no stress on the screw after the fusion
So the plastic that’s replacing the disc won’t brake over time either ? Does it reduce mobility on your lower back after the surgery?
Sorry for the questions I’m just so nervous about this surgery I’m not sure if I should take it