Endoscopic Treatment of Cervical Foraminal Stenosis

[@carolbellinger]

My husband recently had this done. His left leg was almost numb 24 hours a day and had started giving out on him and he was falling. He is only 50 and is an electrician which means very bad news for him.. Anyway we found a great doctor who was doing this treatment. She got him right into surgery and within a week he was back to normal. It was a miracle. He has no pain at all anymore. I recommend it for anyone needing surgery. I myself will be having it soon.

[@carolbellinger]

***** no no no,, he had endoscopic treatment on his L4,,, not cervical, im having the cervical. Sorry i wrote it wrong

[@Rootsgal]

carol bellinger Actually, its all connected, cervical and lumbar, so anything cervical can give relief in the legs, even though that was not the case here. I had a cervical fusion and my low back pain, that lingered after an L-4-5 surgery, was relieved even more, and it was not why I went in.

[@rorolove7421]

Where did he get it done ?

[@rorolove7421]

Is it covered by Medicaid ?

[@wholeNwon]

It's not a "miracle" at all. It's simply modern surgery. These procedures have been available all over the world for a long time.

[@jacquelinescheibel1742]

This is a great technique I want to talk with this Doctor!

[@gramps5157]

A better technique is instead of using a cutting burr to trim the bone which can cut nerves and tissue, a Ultrasonic Scapel can now be used that cuts bone but it will not cut nerves or soft tissue. Amazing!

[@Matt-uj6jm]

Fighting so hard here in Scotland to get this procedure done as a disabled Veteran. NHS is on its knees here but if you have the cash to go private not a problem. Living hell same in my lumber spine 🏴󠁧󠁢󠁳󠁣󠁴󠁿

[@jilligan57]

Hi Dr. Mork Synchronicity at it's best today- just got MRI results. For years I was told I had fibromyalgia. New story: 1) Multiple levels of central stenosis, severe at C6-7 secondary to a focal disc extrusion centrally located/causes impression and narrowing of the central SC. Adv stenosis at C5-6 C4-5. 2) Multi levels of neural foraminal throughout spine 3) Multilevel deg disc disease at mid cervical Deg facet disease = foraminal stenosis. Should I get a cervical epideral? Scared in SoCal!

[@simonjones3863]

In respect to damage from Rheumatoid Arthritis, is this a suitable procedure?

[@RogueArcher24]

I have C4 nerve root trapped jn the foraminal process due to arthritis, along with some bone spurs. I think this is the procedure I need to be able to feel human again. I'm in constant pain

[@hurin_thalion11]

same. good luck

[@Fbeast01]

Hi Doctor, How is the disc “closed” in the area where the nucleus has protruded onto the nerve/spinal cord and then again in the front of the disc where the endoscope is entered? What are the risks of another herniation after this procedure?

[@DrTonyMork]

Disc cannot be closed. Recurrent disc herniations in cervical spine are rare.

[@Fbeast01]

Dr. Tony Mork, MD thanks Doctor, but what prevents the nucleus from leaking out of the original herniated area of the disc or the hole left by the endoscope?

[@DrTonyMork]

Most of the disc is ok, only the "bad" part herniated out

[@Fbeast01]

Dr. Tony Mork, MD thanks Doctor, but what prevents the nucleus from leaking out of the hole left by the endoscope? Also do you recommend prophylactic surgery for active patients under 40 with mild myelopathy symptoms from a herniated cervical disc encroaching on the lateral recess?

[@DrTonyMork]

You removed the bad nucleus, what's left to come out ? Second question too involved for this platform.

[@wolflike24124]

Is it ok to have this operation on a 25 year old like myself? I unfortunatley suffered this due to ignorant and irresponsble training in Jeet kune do, a martial art style i was studying for years now. I feel impingement on my left lower neck and somewhat on my right side, pain on my upper left trapezius, and i have numbness on the medial sides of my arms (or my pinky finger side) of the arms, and some on my lateral sides (or pinky toe sides) of my legs that i cant walk properly, but mainly affected both on the left side of my body. Please reply if you can. Thank you.

[@Dr-789]

Good demo Keep it up

[@SusanDayz3912]

Do the symptoms from this come and go, or are they constant?

[@DrTonyMork]

Will progress to constant

[@SusanDayz3912]

@@DrTonyMork OK thank you.

[@metroneuroandspinehospital6505]

hi i am a minimally invasive spine and endoscopic specialist from india .sir i would like to visit your centre .is it possibsle.pls let me know. thank

[@Rene-uz3eb]

I would like to know how you diagnose/conclude that a nerve is pinched just based on narrowing foramen imaging, which happens as we age to everybody but in most cases without impingements.

[@lduranceau8046]

Hello Dr Mork, I've been diagnosed with spinal stenosis in cervical c3-c7. I'm 73 now (male), but have a history of controlled blood pressure. Lately, this BP is spiking at completely innocent times, like sitting down reading a book, or upon waking up in the morning. I played football at ages 13-14 and had a history of headaches in high school. Also, I have lightheadedness all day long, but especially when walking. Would your stenosis surgery help a person like me? Thanks. I would like to send you my cervical MRI, taken last year.

[@DrTonyMork]

I would suggest a good medical evaluation before doing anything else.

[@earthbodyofficial2603]

Do you push the spinal cord aside? I have a hypertrophic Luschka that is creating some pinching.

[@markl4861]

Dr. Mork I have Mild C4-C6 spinal canal stenosis. Moderate to severe neural foraminal stenosis nearly throughout cervical spine. Moderate pain in left shoulder. MRI shows narrowing for foraminal canal C4-C6. Would this procedure be appropriate? Two other physicians have recommended an ACDF. I'd rather a less invasive surgery. When questioned, they claim they have not been trained in the procedure.

[@IIReplayzHD]

Very good video thanks

[@gramps5157]

There is a Doctor in Florida, Dr. Cantor who does this but he doesn't use a burr to trim the bone, he uses an Utrasonic Scalpel which cuts bone but will not cut tissue or nerves. I believe this is the way of the future.

[@DrTonyMork]

It might be

[@DrTonyMork]

It’s commercially available, do many others use it ?

[@Venkat2811]

@@DrTonyMork Yes kzbin.info/www/bejne/hXXYiGqvlJaBbLcsi=_cERdrrDyDnYw_GB

[@Lord_Don]

Does ACDF address this too?

[@DrTonyMork]

@@Lord_Don ACDF addresses foraminal stenosis by inserting a spacer in the disc that “jacks open” the disc space which fuses the level and creates space in the foraminal canal.

[@ilknurumay8366]

I was wondering if the physician's hand movements might give some damage to the nerve? Would a little movement at the end of the device the physician is working with cause a larger movement at the end of the device which is inside the body?

[@DrTonyMork]

Injury maybe if wrong hand movement - experience counts

[@gorgeousbrandent.9224]

Anything NOT done correctly can cause damage. Use common sense

[@whatsit2ya247]

Hi I've had my cervical spine fused from 4-6 fifteen years ago with horrible results, terrible arm and shoulder pain. Now I have bad scalp pain and recently had an MRI that showed Moderate to severe right C3-4 neural foraminal narrowing. Mild C3-4 spinal stenosis, do you think this procedure could benefit me? BTY, first time I've heard of this. Thanks!

[@treelore5100]

Is this a Foraminotomy? or is Endoscopic Treatment different from Foraminotomy? if so how? thanks!

[@renato113]

Hi Dr Mork, i had an MRI done recently. I was diagnosed with Spinal Stenosis. Can you review my MRI and see if i am a candidate for Decompression surgery?? or XLIF fusion..Many thanks, RA

[@vmkoz]

i have bobblehead do i need this

[@scheirerjeanie1]

I have a question I got hurt back on OCT 31 2021 falling ladder came down and crash hit the back of my neck and head ok, I have a lot of pain, so this is what the test I got on the first of March 2022. this is what they told me? Cervical spine MRI demonstrates moderate left foraminal narrowing at C3-4. C4-5 spondylolisthesis with bilateral foraminal narrowing. C5-6 is degenerative with reversal of the curvature, retrolisthesis, moderate spinal and mild bilateral foraminal stenosis. C6-7 moderate bilateral foraminal stenosis. So I have a lot of pain all the time.

[@shamakuma1967]

The procedure you just now described, sounded like foraminotomy rather than foraminoplasty. Does it mean the same.

[@DrTonyMork]

Very similar meaning

[@SH-jg5zq]

Thanks 😊

[@Rootsgal]

I have a 4 level cervical fusion. 5 years later and now I have neural foriminal narrowing on levels C-2 - C-6 + C-7 & T-1 have a subluxation, that is super sharp pain, and spurring on the same levels where the narrowing is. My left shoulder is now dropping and popping and grinding. I have severe headaches up the back of my skull. I sit in a reclining chair all day long., Riding a bike or even swimming, are things I did in the past. They aggravate it now to the point, of me just being worn out from enduring this so long! 20mg of oxycodone BID masks the pain a little. My osteopath is helpful, but his relief only lasts a couple of days now. What could I do at this point? That 4 level fusion was tough to recover from.

[@Rootsgal]

REALLY? I have the CT-CD and I have the written report. The neurosurgeon who did my last (4) level ACF, does not call back. I was referred to someone else, and still, nobody is calling me back. I do not understand why this is happening. I am in Connecticut and it seems like your number is in NY? I read about that surgery and I am very interested in getting some type of quality of life back. Should I still contact your office? Medicare became primary, because I have been disabled for more than (2) years. I have ANTHEM/BC as secondary. I just turned 55. Thanks for responding.

[@Rootsgal]

***** THANK YOU VERY MUCH.

[@Rootsgal]

I found a neurosurgeon who is connected to Laser Spine Institute. I see him November 3rd and I went to him in the past. Dr Aferzon is great neurosugeon. Thanks for the comments and your time.

[@Rootsgal]

It is a consult for an S-I joint problem that has plagued me for over a decade.

[@Rootsgal]

What happened when you had Laser surgery if you do not mind telling me?

[@mykellrae1554]

Hi dr mork my mri said hpertropic left c4-c4 uncovertebrsl joint producing neura foraminal stenosis😓 can you fix this dr?

[@Deemcdonnacha]

I had a ACDF C5/6 due to disc bulge with bilateral nerve compression in Nov 22 but one week post op was hit by most intense pain and then weakness / paralysis of left arm. Was told it was swelling / “the nerves waking up” / routine and give it time. Anyway after 2 months I’m still in agony. Worse pain than before the operation. Had MRI and CT last week and found SEVERE bilateral foraminal stenosis with neural compression at C6. Is this common? Did my neurosurgeon not decompress the nerves as he was supposed to? He is now offering this foraminotomy procedure. I’d like to know if you’ve had patient’s like this? Seems I’m worse now than before surgery and in the two months I thought I was “healing”, I was actually getting worse.

[@DrTonyMork]

Yes I have seen this after ACDF - not common It can happen Foraminotomy should help you though

[@Deemcdonnacha]

@@DrTonyMork help or cure? I’ve just turned 50 and I’m a medical coder and transcriptionist. I need to get back to work. This condition has had me limited for nearly 14 months now.

[@Deemcdonnacha]

@@DrTonyMork sorry I also posted on Twitter. Didn’t realise you’d reply so quickly 🙏

[@whatsit2ya247]

I don't want to be a discouragement but I had the same surgery 4-6 fifteen years ago and it completely ruined my life! Have horrible arm and shoulder pain, now on disability after a successful 25 years a auto body tech., Now I have bad scalp pain and came across this procedure, never heard of it before, I'm intrigued to say the least.

[@earthbodyofficial2603]

Hey what did you end up doing? How are you now?@@Deemcdonnacha

[@markfonner723]

Can this be done on a patient with protein C deficiency who is on Warfarin and has a history of 7 PE's?

[@wholeNwon]

Yes, in consultation with a hematologist, of course.

[@варяибрагимова-и5т]

do you actually see with camera what you do on vertebra or you just blindly make a hole? Good video, thanx!

[@DrTonyMork]

See with camera

[@tjlazer71]

I have a question. Is the surgeon able to remove all bone fragments when they cut the bone doing this? What happens if some bone fragments are left inside? It would seem it would be very difficult to remove all the crumbling bone fragments when using the bur to cut the bone and remove them all from that small hole.

[@Dr-789]

😂.... No bone fregment remains...

[@qigong1001]

Is patient intubated? Is patient awake, what kind of sedation?

[@ajitkapadia8950]

God bless you.

[@PetsNPatients]

Ouch!

[@hollyconger9037]

I would rather do it ultrasonically.

[@danielhigdon2646]

Mel Gibsons brother

[@ramachandranbalakrishnan2843]

Surgery is never an option, a majority of Orthopedicians, Chiropractors, Physiotherapists, neurologists say, except surgeons, your comments please ....

[@wholeNwon]

Don't use both Dr. and M.D.; it's a redundancy.

[@DrTonyMork]

Perhaps, but there is more than one type of doctorate.

[@wholeNwon]

@@DrTonyMork Of course. That's why using M.D. alone would be most appropriate. That eliminates the obvious potential confusion of using only "Dr.". Using both is an awkward redundancy.

[@Deemcdonnacha]

@@wholeNwon depends which country you are in. We don’t say M.D. at all in Australia or NZ. It is assumed if you are seeing a specialist such as a neurosurgeon they are a medical doctor.

[@wholeNwon]

@@Deemcdonnacha It's a redundancy in the British and British-influenced systems, too. There medical practitioners only relatively rarely hold M.D. degrees. There they usually have an MBBS (bachelor's degrees). Their title of "doctor" does not refer to their specific degrees. Many surgeons are still addressed as "Mr"., "Miss"., "Mrs." rather than "Doctor". In writing, when someone holds a doctorate of any kind, placing both Dr. before the name and the degree after the name is a redundancy and to be avoided.

[@whatsit2ya247]

​@@wholeNwon As a person who is in serious pain looking for answers that doctors in my area can't seem to help me with.... I'M SOOO F**KING GLAD I CAME ACROSS YOUR COMMENTS! Now I know how to address a Dr in Europe 🤦