I'm confused! Laminectomy? Coflex? Fusion? Every doctor says something else | spinal stenosis.

0:00 I've seen several doctors, and everyone recommends something else: Laminectomy, Coflex, scoliosis, fusion, etc. Which one is right?
00:37 Coflex is a device that can be placed between the spinous processes to open up the spine.
00:57 Fusion is not generally needed for decompression of spinal stenosis.
01:35 Think of spine problems as having options not single solutions. Your job is to select the best options.
02:00 Spinal stenosis results from ligament thickening and joint enlargement, not exercise.
02:30 What is spinal stenosis? Spinal stenosis is narrowing of the spinal canal which can be seen well on MRI.
02:30 What is scoliosis? A deformity in the coronal (middle) plane of the body
03:22 Severe scoliosis should be fused when you are a teenager as it much harder to recover and riskier as an adult.
04:01 Will spinal stenosis get worse? Always. Spinal stenosis only get worse as time goes by. The only issue is how fast it progresses.
04:58 Spinal stenosis is narrowing of the spinal canal that can be seen on MRI as the loss of fluid in the spinal canal.
05:47 In cases of spinal stenosis the spinal canal shows up on MRI as a triangle instead of an almond.
06:27 Stenosis goes from mild to moderate to severe to marked.
06:50 Arthritis of the spine affects the FACET joints and causes a specific pattern of low back pain.
07:24 Diagnostic medial branch block and radiofrequency ablation are the preferred treatment for low back pain due to injured of arthritic facet joints.
07:50 Low back pain due to facet joints is treated by pain management doctors who do diagnostic medial branch blocks.
08:13 Spinal stenosis is treated by orthopedic spine surgeons or neurosurgeons, not pain management doctors.
08:47 Minimally invasive spinal orthopedic and neurosurgeons perform laminectomy using the METRX retraction tube.
09:16 Pain management doctors do epidural injection for nerve root pain or radiofrequency ablation for low back pain, but they don't have any treatment for stenosis.
09:55 Scoliosis makes laminectomy surgery higher risk, but the risk still favors the surgery and not avoiding it.
10:17 Spine surgeon or neurosurgeons who perform minimally invasive laminectomy use tubular retractors.
10:40 how to find a minimally invasive spine surgeon or neurosurgeon in your area.
11:22 Spinal stenosis can be cured by laminectomy surgery which opens up the spinal canal.
11:59 Nerve problems (neuropathy) are not related to spinal stenosis.
12:38 Spinal stenosis reduces the "innervation" of the muscles and leads to muscle atrophy.
12:59 Atrophy caused by spinal stenosis can be reversed by exercise. Find one which has no impact.
13:41 Pian management doctors perform radiofrequency ablation for low back pain.
Why does spinal stenosis happen?
Can spinal stenosis be cured?
Are spinal stenosis and neuropathy related?
What does spinal stenosis feel like?
When is spinal stenosis serious?
Where does spinal stenosis cause pain?
How does spinal stenosis cause muscle atrophy?
If YOU have a question, you would like answered fill in the question submission form at:
BestPracticeHealth.tv
We get you answers!

[@robbbarnett4978]

Excellent! Explicit! This is what I call not putting the cart before the horse in every detail. This is a true doctor who puts sensibility into the matrix of the human frame. I'm scheduled to have the ablation next week and would have had it sooner and with a lot less anticipation and deliberation if I had seen this earlier. Thank you!

[@BestPracticeHealth]

Thank you so much. Good luck with the ablation. Please let me know how it turns out.

[@bpjr1899]

Thanks Doc for helping so many with your advice!

[@BestPracticeHealth]

You are so welcome! I hope it helps. Thanks for watching.

[@thinkingimpaired5663]

I'm glad that I came across your video. Your information helps me read my MRI.

[@hshasho]

I decided on the Coflex and I am very glad I did it. I picked a doctor who has done hundreds of them.

[@BestPracticeHealth]

Awesome! I'm so glad you had a good result. Thank you for sharing.

[@jillhickey6036]

I just wanted you to know that acupuncture is helping me. Epidural injections and nerve ablation didn’t work for me. You’re so right about having a good acupuncturist. The one I go to has been practicing for 20 years.

[@katygirl9221]

What's your diagnosis? The epidural and nerve ablations didn't work as much as I had hoped. But I've got an awesome doctor here in Texas. Which is a blessing rather than traveling to Arizona ❤

[@jillhickey6036]

@@katygirl9221 I have a bulging disc ion a nerve root.

[@user-uh7ms9fb9q]

how do I get u to look at my MRI

[@bonniej0]

I had a coflex clamp pins put in me L 2 in 2016. Good for a few years but I noticed now I walk hunchback and I can't stand it and I'm now having serious pain just this past year has been really bad. And I didn't know you had to check on it and maybe replace it every three to five years I heard that to why we searched. What can be done?

[@gosman949]

I've been wondering what the name of the tubular inserts were until you mentioned Metrx by Medtronic. Are there other companies that carry similar systems? I will ask my surgeon what he uses.

[@BestPracticeHealth]

Hi, Jay. There are a number of similar products that surgeons can use. The other products are very similar, and it comes down to surgeon preference. From your point of view, I would see them all as equivalent. The important thing is to find a surgeon who uses a tubular retractor of some kind for the surgical approach.

[@ee7369]

Hello Doctor. This is what my MRI result for my lumber says “Severe degenerative disc disease at L5/S1 with small central disc protrusion noted. At this level there are bilateral spondylolysis of the pars interarticulares of L4 leading to grade 1 anterior spondylolisthesis of L4 on L5 and severely stenosis of bilateral neural foramina which could compress the L4 nerve roots.” What do you suggest I do please?

[@BestPracticeHealth]

The MRI is describing low-grade spondylolisthesis with significant nerve root compression. Spondylolisthesis occurs when one vertebra slips over the one below it. This can compress the nerves and cause pain, numbness, or weakness in the legs. The severity of spondylolisthesis is graded based on the extent of the slip, and the symptoms can vary significantly. Most people with spondylolisthesis do not require spinal fusion. Non-surgical treatments like physical therapy, traction, medications, and transforaminal epidural injections can be effective in managing symptoms for most. Surgical intervention is generally considered when conservative measures fail to relieve symptoms or if there is significant or worsening nerve compression. Choosing a surgeon who is certified and meets specific standards (like BPH.tv certification) is essential. Certification often means the surgeon has met certain education and training standards and is proficient in specific surgical techniques. You can start by searching BPH.tv for spine fusion surgeons in your area. If we don't have someone, contact us and we can help you find the right doctors. Whichever treatment path you choose, regular follow-up with your surgeon is important to monitor the progression of the condition and the effectiveness of the treatment plan. Adjustments can be made as needed based on how you respond to treatment. Before your appointments, watch my content on spinal fusion. Understand the potential risks and benefits of any suggested treatments. Being well-informed will help you make the best decisions for your health.

[@ee7369]

@@BestPracticeHealthhow about the spondylitis? That fracture that caused the spondylothesis. Does that mean instability hence needing the fusion?

[@DoctoremiHolisticHealth]

What's the doctor's name and where is he located?

[@lindamorgan5928]

Please warn patients that laminectomy can cause nerves to get very angry and cause excruciating shooting pains. I just had it on L3-L4 and for a week I was screaming, crying, and cursing because the pain was so bad. They called in a prednisone for me to take but it took a few days to kick in.

[@dsa4931]

Both levels being severly stenotic i would advice for doing decompression at both levels in one sitting . No fusion is needed ....

[@BestPracticeHealth]

Very interesting. Thanks for the comment!

[@jcaleca60]

I am same as this guy omg 😮

[@BestPracticeHealth]

Ok. Ok. So, do you know what to do now?

[@jcaleca60]

​@@BestPracticeHealth getting laminectomy and coflex 😮

[@jcaleca60]

L4. L5 laminectomy 😮😮😮

[@jcaleca60]

@@BestPracticeHealth yes I did it

[@BobSchecter]

This is all so confusing. Doesn't a laminectomy involve fusion?

[@BestPracticeHealth]

Yes, it is confusing. And no, laminectomy does not involve fusion. Laminectomy is relieving the pressure on the spine by removing the lamina bone which is the roof of the spinal canal. Fusion is surgically jointing 2 level of the spine together. In the bad old days, some surgeons never did one without the other. That turned out to be wrong. But a source of consistent confusion!

[@rastaptc]

It looks like he has modic type 1 changes which can mean inflammation. His stenosis looks bad. Laminectomy for sure.

[@BestPracticeHealth]

Thanks for your input!