Do You Need A Spinal Fusion?

Dr. Kimball explains the indications for a spinal fusion surgery. Watch this short video to learn why you might need a spinal fusion.

[@johnmitchell8925]

It's a shame when you can't trust the doctors to make the proper decisions when it's all about the profits 💲and not what's right for the individual patient🤒

[@chetmarcotti4953]

I really appreciate your directness. I just don’t understand the need to go to the fusion route, if it isn’t needed. Thank you

[@jbisntme]

Besides the fact that he had the best Drs his surgery was not a fusion. They just "shaved off " a piece of disc that was impinging on a nerve. So it was not complicated. There are many different kinds of spine surgery.

[@AsadSpahic]

If all doctors stayed within guidelines of deformity, fracture, or gross instability for fusion, there would be only 10% of total fusions done in modern times. Fusion does have a home for variety of DDD symptoms, including moderate to severe loss of disc space (back pain) and recurrent disc herniations (predominately leg pain). Most perspective fusion patients fall into this “grey” area.

[@ftworthtexan9082]

Excellent video. Thank you for taking the time to share your knowledge is your entire series.

[@Seoulflava]

Wow you are special. i am so grateful to you for your videos of honesty and knowledge. These are so valuable for those of us that are dealing with these problems in our lives. Thank you so much doctor

[@imveryhungry112]

If you get a fusion make sure you get the best surgeon you can afford. My doctor is telling me I need a fusion I am trying to hold off another two years.

[@erinnsixkiller2794]

Thank you! This was just what I needed to feel confident about my upcoming 3 level fusion.

[@taurusview9]

HI....please look at the comment I put up ...I have fusion scheduled, but may cancel with the hopes of this new system will arrive to avoid fusion, if pain let's me last that is :)

[@AdityaGupta-xq3kr]

@@taurusview9 Artificial disc replacement in Germany is a much better option

[@jcaleca60]

Thank you

[@michaelsmith-lj5vj]

Dr…fantastic presentation.I’m 72 and have severe stenosis in my lower back.I have had many ablasions and I had a procedure in Dec where they put spacers in between my disk.I also saw two Neurosurgeons that wanted to do a five disk fusion.I’m trying to dodge that like the plague.My best friend had three fusions to the same area.Broken screws,broken rod just a mess.He is in Evergreen CO and I am going to give him your info.I would love for you to give me your opinion with my MRI results.Thank you for the frank overview.

[@nomadicstan]

I have arthritis in my hips. The left side is worse than the right. I have spinal stenosis that's been diagnosed for over 5 years and has only gotten worse in the last two and we're still in the last six months. I'm a veteran and going to the VA system. I have severe spinal stenosis throughout the spine at multiple levels cervical and lumbar and we've been focusing mostly on the lumbar in the last 2 years. First I went back and forth with orthopedic and neurosurgery to determine where the pain was coming from hip or the back. The orthopedic department recommended that I take care of my back first. I'm not sure this but I believe my nerves department said to check back with ortho on the hip 🤷🏿‍♂️ anyway we spent the last couple of years doing MRIs cats cans and all that you need to do emgs and the proof is in the pudding that I have multi-level stenosis and a scoliosis and the spondy going on. I've had three doctors opinions first starting with the VA that was recommending a fusion without really any more explanation and offered me conservative methods to deal with it in the meantime. I decided to get a second opinion from a HMO that I have and they came away with more of a focus on cervical but recommended I take care of the lumbar situation first. I got a third opinion from a sports doctor so to speak, his was the most thorough and he proposed a less-invasive Laminotomy and only a fusion if he saw enough of movement going on which he would have had to do if I would have followed up with him. He recommended surgery within a couple of months.I took all this information back to my final authority and they said they couldn't do the surgery and recommended me out to another doctor who is part of a well-known Healthcare system and I just saw them yesterday and they're now recommending a multi-level fusion but before they do that they think I should address my hip arthritis before dealing with the fusion. I'm so confused 🥴 I'm 62 years old this month and relatively good shape considering the problems I'm dealing with a very confident I can overcome things if I can get them addressed in a more timely manner but right now I'm only trying to get back to walking without leg pain and all those restrictions. And the reason the Doctor is recommending multi-level surgery is because he wants to do it all right at the same time. They don't want to do diffusion in two places and leave the area exposed to the weaknesses that could occur after the surgery excetera that's been the explanation to me which I understand but in this case I'm not talking directly to the doctor either. Nothing against who I did talk to the nurse practitioner but you know they reviewed my case and got back to me after I was ready to start getting ready for some type of back surgery because I'm in a lot of pain that is gotten worse over the last six months more acutely on my left side where I also have the hip arthritis but I'm not complaining about my hip but what do I do

[@Christine-dg1rc]

Exactly the question I asked! My doc answered in a big way. My disc wasn't the only problem but above and below were in need of a makeover. I asked again about a disc replacement and he kinda yelled at me the same thing. Although I still don't buy it. I have a little slippage of L4 over L5. That would be a valid reason for fusion you are saying, and my doc said too. However, I recently found an Xray from a visit to City MD 4yrs ago. I almost forgot about it since the back pain resolved itself. But I looked on the Xray and the diagnosis was exactly the same as it is today! Of course that Xray can't be compared to a recent MRI. Or can it? There is probably more degeneration as I'm older. 71 now. But I can't help wondering why the spondy I have now needs fusion. It appears the same as 4 yrs ago. The big difference to me is that have been in more or less constant pain that has changed my life. I know fusion is not supposed to be for pain relief. I don't want the fusion, and am terrified of it, but can hardly stand the pain. I wanted my doc to tell me he could do a disc repair/replacement and a laminectomy and I would be better.

[@gosman949]

what did you end up doing? My spondy is moving slightly and I have decided to get the fusion along with a laminectomy.

[@Christine-dg1rc]

@@gosman949 Hi Jay- That was 6 mos ago right before I made my date for surgery (Spinal fusion, laminectomy etc) I cancelled it 2 wks prior because I was feeling better. I haven't looked back. I am not crying /sobbing with pain on a regular basis! TG. At first I thought I was feeling better trying to convince myself I didn't need it. But I continued to feel better and had to make the decision. That was early January. I still have trouble sitting & getting up. Can't travel. Have done PT, swimming, acupuncture, exercise. Had 2 epidurals about 3 wks apart back in Sept/Oct at my worst. The second one gave some long lasting relief. Recently I went to a chiro. I had 2 visits. I'm supposed to have another tomorrow. I have been in more pain in the last 4 days since starting with him than I have since before I cancelled surgery! I am debating whether I will go.... I don't know if I should give it another try...or if I'm worse I will be sorry!. Since yours is moving even slightly... is cause for concern. That's the movement of one vertebrae over the other- right? Are you L4/L5? If I can ask- how old are you? My primary told me if I was going to get it done, don't wait because of ageing issues. I'm 72 next month. I feel like I aged 10 yrs the last 2! So I think he has some good advice there. I hope it works out for you...

[@gosman949]

@@Christine-dg1rc I'm 73 and have been fighting back pain for about 15 years. I had both knees replaced during the pandemic. It was a good time to be in rehab- couldn't do much else. So, it is time now for my back! I hate the thought of adjacent problems upstream later. Yes, this is my L5/L6! I actually have an extra vertebra!

[@BW12149]

I’ve been to 3 spine surgeons, all with different conclusions. The last one recommended fusion on L4-L5. I have multiple stenosis, spondy, facet joint disease, scoliosis, resulting in bi-lateral sciatica all the way to feet. I’ve been seeing a pain management doc and have had multiple RFA and lumbar epidural injections since 2019. The L4 foramen has zero space for the nerve and they are really pinched. L5 has some space for the nerves. So I’m tasked with deciding what I need to do. I’m a 74 year old male, non smoker, no diabetes or any other disorder, and wonder if at my age I should subject myself to a very long and painful recovery from a fusion,,or just live with the leg pain and instability.

[@mattgohlke8216]

Get the surgery.

[@BW12149]

@@mattgohlke8216 I’ve never worked with or known anyone to have had successful spine surgery where they were better off than before the surgery. Until these doctors come up with a better way to effect necessary repairs without fusion, then I might agree. But after 3 office visits with 3 different doctors, it doesn’t seem possible because I will not allow a fusion.

[@jefferyshepherd7376]

Spinal fusions are out of date for degeneration. Get artificial disk replacement. I have to in lower back. They did them outpatient and I walked 6 blocks the next morning. I flew home from California to Ga on the 3rd day. Amazing. Do your research and don’t let Drs talk you into fusion

[@robertkleinschmidt1029]

What about a degerated disc l4 l5 crushing the nerve as well as arthritis in rhe area as well ?

[@debbiehartmann6755]

4:30pm 6/23 Thank you Dr. It is so incredibly comforting to know that it doesn’t always have to be a fusion. I have beetyold that I need to fuse 3,4,5. My husband has had 3 fusions at different yrs. January this yr. 2023 and has unrelenting pain. He has had MRI, CAT scan , Aspiration of the L5/S1 area and the Doctor ( in another city) can’t seem to figure it out. It is scary and devastating!!! Thoughts?? Thank you!!!

[@JCMasterCraftsman]

Interested in what was resolved in your case? I have the same situation.

[@paulwitmer7138]

Cost and procedure for image review

[@jcaleca60]

I had lumbar laminectomy 67 years old Have mild scoliosis. One surgeon wanted to do a 2 level fusion. The one I had had done said. Leave it alone. But I still have some pain. Doing physical therapy now. Do I need a 2 level fusion?😮😊

[@sth4678]

I'd just like to find a spine Dr to help with my spine I have ankylosing spondylitis and would love surgery but not many will do any surgery since I have ankylosing spondylitis

[@BABYKAY2033]

Dr: My neurosurgeon did a lumbar laminectomy and it didn't help me at all. I have severe pain in my lower back and into both legs. I can barely walk anymore..now they are send me to a spine surgeon who will probably recommend spinal fusion..I have severe arthritis in all areas of my back. In your opinion should I have the fusion

[@Thatsprettiemuchit]

What about tumors?

[@Kai-el7rw]

What about retrolethesis? I know I spelled that wrong.

[@tonysorice5142]

doctor i have a L4 L5 S1 i just got my new i had 3 MRI but this one says L5 S1 broad posterior disc hernation which is slightly more prominent than on the prior study deforms the ventral epidural space and there is left greater than the right foraminal extension with abutment of exiting left L5 root and narrowing of the foramina diminished disc space height ventral extension of the disc remains and discogenic chages and scmorl;s node in the end platates.mild facet hypertrophic changes remain L4L5 S1 ,,,,,doc my friend told me narrowing part of stenosis ,doctor can you help me out with this ,,thank i been watching ur video;s there very good ,,thank you,,ps my doc can be fixed with endoscopic laser surgery,doc what do you think,

[@KBradAdams]

Anthony what are they your doctors saying now? have you had an surgery or anything for your L5S1 disc herniation?

[@pamelahoyes3337]

Would you recommend fusion in a patient that has confirmed slippage at L-5, but also has with osteoporosis (-3.6 in spine), if treated with IV infusion of Reclast prior to surgery?

[@imveryhungry112]

Doctors say it is all about symptoms not about imaging. If a person had these spine problems but is able to walk and function then why do a fusion? However if they are bedbound then consider the surgery. Its not about the imaging its about how the person functions.

[@maysmith7994]

Thanks doctor. I have had back pain for 4 years, seen many doctors in England and Germany. Only two told me I have degenerative disc and I need a fusion surgery. I also seen man chiropractors and all say that I have SI joint problem. I can easily raise my leg to the 90 degree, no pain at all but I have pain all the time. Specially first thing in the morning, can't stand for more than 10 mins. I think myself I have lordosis problem as my spine is too deep, the arch. Not sure what to do . Fusion is too scary. I am 49 female.

[@slickpick2203]

Have you done any treatment since this video? Your symptoms are very similar to mine

[@maysmith7994]

@@slickpick2203 recently i had a xray showing Spondylolisthesis as well . My dr doesn't know what causes the pain. DDD, slipped vertebra or facets joints. Tomorrow I am getting injection in the facets joints. Hopefully will find out if they cause the pain. Now I have pain almost everywhere. All right side of my body, my neck, my knee, my hip( badly) my shoulder. I am getting close to decide to go for surgery.

[@Seoulflava]

Im a 58yr old male veteran. Ive lost several jobs...Semi-truck driver amd heavy equipment operator due to both cervical amd lumbar pain. Ive been in pain management for 4yrs. Ive had a growth removed from my lumbar. Ive done PT. Ive had two ablations recently. I still suffer moderate-severe pressure, stiffness and pain. Hard to be on my feet. Hard to sit or lay for long without stiffness and pain. Its a constant exhausting battle. Its my entire life. Its debilitatating exhausting amd life chamging. I have disability case open. Has anyone ever felt Disability was strong-arming them to get fusion or be disapproved for ssdi? For me, with all these fusion horror stories, my days are spent in constant pain management trying my damndest to delay the hell of fusion as long as humanly possible. Any thoughts or feedback?

[@huasirr]

Hi Doctor, just curious, In the video you said you would like people to comment and would reply, yet I see no replies to the comments? Just wondering before I spend the time to write a long winded message

[@johnmitchell8925]

don't bother,he's not giving out any free information

[@beacons_of_light]

the comments boost his algorithm; they help him get more views.

[@KBradAdams]

Tiger Woods gets his back fixed.. right away.... the rest of us... get the run around.... or treated like we are 70 to 80 years old.

[@vortex21rainz26]

I agree I was thinking about it today 🤢 because we are not famous and no money 💴

[@stitch2499]

amen. so sad..on total disability now. because of a bad back surgery..

[@GelliSolo]

@@stitch2499 what did you have done? Lumbar fusion?

[@stitch2499]

@@GelliSolo hello. Thank you. Yes I had a lumbar back surgery. They went thur the front then the back. Screws rods plates.etc..woke up and realized I had no left leg. Got about 25 percent back.. back pain is worse.... I guess it could be worse.. Again thank you for asking. Are you getting a back surgery soon.. Take care. God bless...Stitch...

[@johnmitchell8925]

@@stitch2499 They are wanting to do it for a second time on me

[@963ag]

What about cases of moderate to severe 3- level cervical stenosis?

[@vortex21rainz26]

I have spondylitis grade 2 bad back pain sometimes my foot getting numb 😔 hopefully spine surgery fixes me

[@sutkos3288]

U will be fine i had my couple months ago. Do therapy then injections if that doesn't work then surgery

[@HypotheticalZ]

hello doctor, I am 27yrs old male. I’ve severe back pain. The back pain is so intense that it hinders me from doing anything practically. I can’t sit or stand for more than 5min and walk for 15min. My MRI shows a broad based L4-5 disc bulge and complete desiccation of the disc but disc height is maintained. My L5-S1 is also slightly desiccated and bulging broadly ultimately leading to canal stenosis. My doctors recommended fusion surgery. Is it the proper treatment? please tell me

[@StrugglingIdiot]

I have all the symptoms of Cervical Radiculopathy (age: approaching 70 yrs). I got my XRay and am waiting to have an MRI done. I've used AI to decipher my neck XRay in the time-being. My bot says that I have evidence of arthritis. "...there are signs of degenerative changes in the cervical vertebrae that could indicate cervical spondylosis or stenosis." I'll know more after my MRI. I want to avoid fusion if I can per your lecture. It would be great if you can send me a link so I can send my images to your for your analysis and opinion.

[@jefferyshepherd7376]

Spinal fusions are out of date for degeneration. Get artificial disk replacement. I have to in lower back. They did them outpatient and I walked 6 blocks the next morning. I flew home from California to Ga on the 3rd day. Amazing. Do your research and don’t let Drs talk you into fusion