LSS: What are the available treatments for spinal stenosis in 2023? Open surgery VS MIS for pain.

[@brianoconnell2009]

I'm a disabled vet who has considered checking out due to 24 hr pain . Entire spine damaged after explosions . Been to many doctors . VA doctors say too complex for them . Most doctors dont want to touch it .I'm moving back to fl . Going to see this doctor . He's honest and seems to actually care . Knows his stuff . Hopefully I can get my life back.

[@Eliana1949]

Sending you good thoughts and hope for a painless future.

[@RSCCTV]

Thank you for your service and sacrifice. Best wishes in your healing.

[@BCSTS]

God bless you , sir, so glad you may be helped by this obviously wonderful doctor !

[@GetMyNoteLowered]

Good luck to you bro sorry 😢🙏🙏🙏🇺🇸🇺🇸🇺🇸🇺🇸🇺🇸🇺🇸🇺🇸

[@alierem4266]

If a nation is measured by (and is proud of) how she cares for the nations vulnerable, let yours be a measure of this. Here's hoping that you are afforded the very best care and treatment available. Good luck.

[@sonnygolden9700]

I am blessed to have Dr McRoberts as my doctor

[@MrJohnnyboyrebel]

My severe stenosis at L4/L5 was completely cured following a laminectomy. I got instant relief from the numbness in my legs.

[@brianoconnell2009]

So you had this doctor perform it? What hospital was the surgery and how was the care ?

[@ClaraTimmins]

I have the same exact thing and hoping for your results. Any advice

[@ManuelPortelada]

@@ClaraTimminswell how did you make out

[@brianoconnell2009]

Thank you all for your love and support . I mean it when I say jit actually means a lot to me . We arrived back in Sarasota Florida Sunday and moved into our new home . I will be making my appointment more than likely tomorrow. Hopefully I can see him soon . It gives me hope . He is literally talking about me and my symptoms including my ability to walk .

[@sayuriera199]

Wow! I’m watching in 2024 and he is just wonderful. I’ve learned and will always come back to learn again. I hope he is teaching young doctors to follow in his style.

[@brendanmcevoy2765]

Thank you very much for the information contained in this video. I am in the process of being assest for my stenosis. I have previously seen a presentation from Jeffery Canton showing a minimal invasive procedure using ultrasonic tools. Now armed with the information from both your videos I can approach the consultant with confidence and convince him or her that I know what I'm talking about and will not be accepting the conventional laminectomy. Thank you again. Brendan McEvoy, Cornwall, UK

[@christinelaw8606]

I’m so proud to have Dr. William McRoberts as my Dr. I have a great hope for my future enduring the Minuteman procedure in my back and treatment for my knees. He is so brilliant and compassionate in what he does and why. Thank you for being here. I have learned so much listening to your videos. I can understand you totally…I will see you on Thursday and can’t wait❣️👱🏻‍♀️💞👍🙏🤗🏩🥇

[@NoBSMusicReviews]

Fantastic summary of available options. You are articulate and honest. Thank you.

[@tjmarko36]

Honestly the most informative presentation on spinal stenosis that I have seen as well as the treatment options. I wish I could copy and paste it for my treatment team to use ;)

[@tjmarko36]

Thank you!!

[@maureenjurmann1916]

Thank you, Doctor, for such a comprehensive overview of this disease. Should those who have this disease see a Spinal Specialist? I'd appreciate your recommendation. Thanks again!

[@tlloyd9325]

FINALLY a back doctor I would love to have! Unfortunately he’s in Florida and I’m in Oklahoma 😩 I am going to search for a doctor for the Vertiflex procedure. God bless you doctor.

[@TitanFlyer2015]

First and only video I have seen that goes through the options. The biggest issue with all these is that providers and payers don’t approve them. Even though some have been around for a decade and FDA approved, they still call them experimental. I am at the point now where I am searching for a cost effective way to pay for one of them on my own… not cheap. Thank you for the information!!!

[@wendymejia6902]

Thank you for a thorough presentation! It would be nice to have a second video as to what new procedures have come about in the last 10 years!

[@wportermcroberts]

I mis-spoke this was recorded in 2023.

[@morrismanley2236]

Doctor, I enjoy the knowledge that you shared with us about the different procedure that can be employed for spinal stenosis surgery. Thank you.

[@bianca4829]

Doctors really are angels sent to earth.

[@jeffwilcox5123]

He is outstanding, Highly proficient, extremely well-educated. I'm trusting him.

[@judycohen7265]

Thank you. Great, straight forward information. Very helpful.

[@carson8390]

This is a great representation of your options. I wish my doctor had been more forthcoming on the spacer potential problems. He was not so I had two Vertiflex spacers placed for stenosis. I would categorize my experience as a disaster. I had severe back spasms and pain after surgery. Two years later, I had a laminectomy L5 S1 and also removing one spacer. I would consider that surgery a tremendous success. I wish I could remove the remaining spacer. The spacer causes pain and synovial cysts that are quite large. Further complicating my stenosis.

[@kattmd8294]

Thank you for explaining this in such detail, I had my MRI up beside the one you demonstrated and unfortunately.....mine looks much the same. : ( I feel you educated me as to what options I may have. I've been in pain for 3-4 weeks now and it's time to try and get my life back...yes, I have grandchildren I want to keep up with as well as to keep walking like I have. This finally explains why some various symptoms have been popping up from time to time for many years. Now it is critical to do something! I'm grateful and will do more homework in case I can get to a livable place again in my life.

[@willroche6691]

Super video. Love the new procedures and how they fix stenosis with minimal intrusion.

[@JohnVossIII]

Great video, so much information. every doctor should be as good as you!

[@wportermcroberts]

Wow, thank you!

[@williamssinte7104]

Excellent presentation

[@pats300zx]

I love your channel. One of the most informative out there.

[@elwoodhackney5875]

You're just full of good news 😢

[@israelschurek9046]

Thank you. Great, straight forward information. Very helpful. Very professional Doctor

[@BCSTS]

What an excellent presentation! Great teaching ability here !

[@brianoconnell2009]

I’m going to see him , close to me probably go with him . Chester Donnelly at Texas back , Barrow spine in pheonix az , cedars Sinai in ca and Dr Alikhani and Peter Kim at Tampa general fl . John Wong Sarasota fl .,always get multiple top notch opinions especially in spine surgery . I trust this doctor because he is describing me . If no relief or answers I’m gone . The 24 hr pain and barely able to walk is no way to live

[@margaretcopeland7280]

Thank you for a detailed explanation of my current back condition. Excellent video!

[@wportermcroberts]

Glad it was helpful!

[@lindakirk698]

Wow thanks for all this info in 2024. Im in UK have lumbar stenosis & cannot stand for more than 2 mins or walk fir more than 50 yds without severe pain. My GP has prescribed pain killers that turn me into a zombie so i manage as best i can without it. They also have sent me to physio therapist at hospital. Does not seem to be improving anything. As usual sitting or laying improves the situation. I often bend over for some relief if im on my feet & out maybe around supermarket. Im 73 now & had this fir past 5 yrs. Wont be long before im totally in a wheelchair! 😢

[@hawk21ish]

Thank you so much for this video. Very informative for people who don’t understand some of the basic things such as reading an MRI. Video gave a basic understanding of spinal stenosis which gets nuked when others explain.

[@wportermcroberts]

I appreciate the kind words. Hopefully everyone who watches this video has a little better understanding of what they’re up against, and that these problems have solutions!

[@joejacobcopeland7689]

Excellent and Honest

[@kenjoneslee]

63 male, lean, fitness oriented with a strong ballet background. Had sciatica before and now it's chronic for at least 6 months. I surmised it was stenosis since walking is worst and sitting is best. Dancing is actually OK likely because of proper hip alignment. Watching this detailed overview of stenosis was exactly what I needed to understand the mechanics and physiology of the problem. I now know what position to always hold my hips, especially when standing and walking. I do sit ups, BUT without knowing the optimum hip placement and always being aware of it, all the ab muscle in the world won't help. Basically the hips should be tilted backwards while standing, sitting and walking. This removes the natural S-curve of the spine and creates more of a C- curve, as when doing an ab crunch. The top front pelvic bones are drawn closer to the lower ribs, which tilts the hips backward. While walking, hold the rib cage stationary, so that the rib cage is not dropped. So it's more like an isolated lower ab crunch and not a total ab crunch, where the rib cage is also moved.

[@wportermcroberts]

Spot on!

[@debrahenze5734]

Thank you for explaining so well Dr.

[@KTravRuNEr]

This is a wonderful video for patient education! Thank you for putting this out. Will send my patients here for additional information.

[@wportermcroberts]

Thank you KT!

[@LhkLkj]

@@wportermcroberts 98

[@kattmd8294]

I am sending good thoughts your way as I know firsthand how debilitating having this condition can be. I hope you come back here and relay your outcome and thoughts. Kathy

[@kumarsabaratnam4787]

Thanks a lot for the clear explanation.

[@ahiredman]

Very educational and informative. Thanks

[@swimfit57]

That was very interesting! I’ve been thinking I had sciatica . I’m a cosmetologist and I sit and stand most of the day! Last year I had Piriformis now that was very painful like lightning bolts . I start taking PT it helped so much plus the pt told me to get a rollalater in a half a day I felt so much better, then I was inflaming the Piriformis myself by trying to walk in the morning! I was holding on to the wall and furniture as not to fall. Thank God I got over that ! Now it is just tiredness or getting up from chair ! Bending over and picking something off the floor isn’t fun either. 71 is not the golden years! Lol

[@charliepugh9436]

Excellent video doctor. Thank You

[@wportermcroberts]

Glad it was helpful!

[@AS-bm9ok]

Hello Doctor. I just watched this video, and you gave me some hope. My last MRI showed that I have severe stenosis, and the Doctor told me that I'm not a candidate for non-invasive surgery, only laminectomy surgery. I would like to explore all my options before surgery, and I will be very interested in one of the last treatments. Do you know an orthopedic surgeon performing these treatments in Kansas City? Thank you.

[@RayMrRobert]

I’ll be in your office on 10/28. I can barely walk. I wish I could get in faster

[@karunakaranveerabadran293]

Dr. Your presentation was very good. What is the normal saggital diameters of the spinal canal at various levels L1, L2 L3, L4 ad L5 for persons above 60 years of age. If spinal stenosis is there whatwill be the saggitaldiameters of the spinal canal at the L1, L2 L3, L4 L5 leveld

[@TruthAlways59]

Excellent video, thank you for sharing Dr!

[@wportermcroberts]

Glad you enjoyed it!

[@Deba7777]

Doc, at time-stamp 28:58-29:00, you said this is "2013, March," so, is that when you recorded this video or is that when the latest gadget was developed for the back surgeries? Thank you, this was an incredible teaching & presentation, it made so much sense! You are a very gifted communicator! 🎉

[@wportermcroberts]

I mis-spoke. few catch it. but I recorded the video in 2023. it’s current.

[@merlevankampen4585]

😢 Interesting but very scary at the same time! I’ll finally need to make a decision soon. My walking is deteriorating by the day and suffering with everyday pain and on painkillers about everyday. JohnvK

[@wojtek2u]

Why endoskopic surgery was not mentioned?

[@Davidsavage8008]

Heavy lifting did me in. Working harder just to keep my job . Jumping from the flight deck to the catwalk all day and night fueling jets on aircraft carriers. Carrying around my welding machine and tanks. I'm done . My L5,S1 I herniated 7 millimeters in 1997.and the doctors all from India said it was a muscle. So with out light duty I went to work the next day. I continued to destroy my disc until 2012 I took out my L4, L5. I thought I was loosing my legs . A year later I tried to go back to work and kept making it worse. It's scarry how easy it is to become paralysed today. I want to be completely repaired. Im only 60 . what should I do.?

[@gwynforo3415]

Wonderful explanation. Unfortunately, I seem to fit the bill for my lumbar issues. Already had two surgeries 4 years ago and am now looking at another. :(

[@brianoconnell2009]

I move to Florida in January . I will then go see this doctor . Hopefully he can help . Unfortunately I just had vocal cord cancer surgery last week . It's from chemical agents called "Russian Coctail" Russians made it and sold it to militaries around the world . Nerve agent, organophosphate , and Bilogical together .

[@ivantoxie]

I'm a bit confused. At 27:48 are you referring to a endoscopic laminotomy?

[@randykoeller5256]

I’m only 55 been a waitress since I was 15 I can barley walk this pain is incredible!!!!! So idk about PPLE with age. !!!!

[@larrys2080]

Thank you so much. This is so helpful. I know ESI’s don’t “fix it” but what are your thoughts on how long injections can be used if they help ? I’ve had 3 in a year and got major relief.

[@wportermcroberts]

have a look!: kzbin.info/www/bejne/qXvTdWqAmtFml9Esi=thn-Ak4IjcZIq8DE

[@berthahust3038]

Do your treatments matter how bad the stenosis is whether or not the treatments work or not

[@wportermcroberts]

yes. more stenosis, somewhat harder to treat.

[@chickchanteuse1]

I am 69 yo and live in the Asheville, NC area and was just diagnosed with a synovial cyst on my S1 nerve root, plus lots of stenosis and degenerative disc disease in my lumbar and cervical regions. The ortho I am seeing wants to do surgery to remove the cyst but has told me there is nothing he can do, short of fusion, for my lumbar region and that he cannot promise this surgery would relieve my lower back pain. I am leery of any kind of surgery on my spine. I've had an epidural steroid injection and a medial branch block and neither relieved my pain, which is significant when I stand for more than 5 minutes or do anything that requires me to walk a lot or bend at the waist. Is there anyone you can recommend in or near my area? This pain has caused me to become less and less active which is not the norm for me as I have always been extremely active. I am bummed!

[@signalfire6691]

I haven't had an MRI yet but I'm sure I have LSS - all the symptoms fit to a Tee. I'm in Crossville, TN, about halfway between Knoxville and Nashville. Ft. Lauderdale would be problematic; either a long plane ride or very long drive - if I phone your office can I get a referral to an experienced surgeon closer to me, or alternatively, are patients able to schedule to see you for the surgery and have F/U, suture removal closure to home? And does Medicare cover this? This is an excellent presentation both for what's currently available as well as explaining the symptoms. I've been telling myself 'it's just sciatica' and self medicating with daily visits to an indoor pool but I realize now, it's getting worse, not better and the prospect of it getting any worse if frightening. I watched all your videos and when you asked patients how far they could walk 'before', I realized I don't even want to go as far as the bathroom - I'm afraid my legs will buckle under me. My partner is doing far more of the housework than is fair and he's 10 years older.

[@edselgirard4521]

What a great video

[@wportermcroberts]

Glad you enjoyed it

[@wojtek2u]

Is it status from 2013 or 2023???

[@Thaojennyduong]

Hi Doctor, I am 44 years old Asian . And start to have this issue. It so hurt where I can not walk , it so pain. Cause leg sciatic left leg pain . My doctor order me a walker to walk but sometimes it just so hurt to walk , even a short distance to grocery store . I ended up have to use the electric cart to able to buy some groceries stuff . I have L4/L5 bone growing larger press down the nerve and cause it narrow . And both my arms/ finger is started to numb/tingling. My surgeon order MRI and it ended up show that I have C4/C5 nerve pinched . And because of unbalance? I fall down 9/10/23 . It cause me brain frog /recall my memory / can’t sleep because the pain on my shoulder/finger numb/tingling at night time sleep too . My surgeon is order both pain management shot on both area . I hope that will help before the decision is going to surgery that she have explained to me . If shot does not work . So I think this diseases can happen on any age . Young or after 50. The pain management told me that I should go for surgery because I was so much in pain and can’t walk normal/limp so much in pain . I can not seat to long and can not walk to long or stand to long ? It just not a good situation.

[@jeffwilcox5123]

Outstanding < see 07/19/23 Shoot me up Doc. Have an Honorable 4th.

[@fayefire8793]

Can I do a consultation on my spinal problems? I have an MRI that I could share with you.

[@wportermcroberts]

yes. email me if you wish. happy to help. [e-mail]

[@berthahust3038]

What happens after you remove the bone? Does it grow back

[@wportermcroberts]

rarely.

[@charleswetterman4381]

I have watched your videos and your symptoms of LSS, this is what I have and no Doctor in my area "San Antonio, TX" uses Ultrasonic Technology. I just called your office for information and waiting for a callback. If you can clean out the bone growth around the L joint this would be life-saving for me. Hope to hear back ASAP. Thanks

[@chuckjweissman]

Terrific presentation. You are in a league of one as a teacher and proven expert in this field. All of your prior publications showcase that ability. Question: Did you, or could you, perform the Vertiflex procedure on the 80 some year old patient whose MRI you presented? Stated differently, this patient would appear to me to be labeled as having severe or very severe stenosis in an MRI narrative. The Vertiflex supplier/company says for moderate stenosis. Thinking that Insurance would not approve the procedure because of that? (Obviously, I'm asking because I have severe at L2-L3 and don't want a Laminectomy). Thanks much, Chuck Weissman

[@wportermcroberts]

Thank you for your question. LSS is a disease of millimeters. The vertiflex could improve symptoms. It's designed for old folks: minimal anesthesia requirements, minimal recovery etc. The main question which predicts success: do all the symptoms (buttock thigh and or calf) abate when the patient sits down? If so: that position of sitting is what we will achieve at the index level with the spacer, and success is most likely. Lastly: frank back pain is less likely from stenosis: in this scenario the back pain is likely a function of facet arthritis: also easily treated, but with radiofrequency rhizotomy, another, but yet even more minimally invasive procedure.

[@wportermcroberts]

That said re the Vertiflex: there is not an insignificant risk of subsidence over time. The question will be: will the minuteman, or something that increases surface area to the bone, over time, prove to diminish or eliminate the subsidence risk.

[@chuckjweissman]

@@wportermcroberts Your response is consistent with your style - detailed, real world - and without fluff. Makes total sense to me. If I may ask another question; In the event of a spinous process fracture with Vertiflex during the procedure, what type of fracture do you - or does the data show - to be the most typical? Do MRI images offer the clarity to afford an expert like yourself with a reasonable degree of confidence that the vertebral bones (Processes) are potentially structurally capable of supporting a spacer? I guess I am an old guy (71). I meet the criteria that you outlined, however, would it be an outlier that I have relatively no limitations or pain when standing? A quick digression if I may, wouldn't a Vertiflex + mild combo be viable for a proper candidate (I think I'm one) - ever do one? Can one have too severe of LSS that would preclude an EPI? Lastly, just curious, as you do not mention the Via disc procedure, my gut tells me that are not a proponent. Sorry about the novel but your words to me are gospel, and its hard to resist not asking you ☺

[@wportermcroberts]

@@chuckjweissman Most typical fracture is at the spinous process. Where it rests on the implant. Typically we simply brace and the fractured segment either fuses and heals or remain a bony island. Either way it's usually of minor consequence. We can either do nothing if the pain abates, or do an ION facet core fusion to stabilize the segment. If the whole circumstance fails, laminectomy, the ever-lurking fall-back plan remains intact. The DEXA scan: predicts fracture risk. If osteoporotic, it's a concern, if not, then vastly less so.

[@wportermcroberts]

@@chuckjweissman Re viadisc. Totally different procedure with different indication. I'll do a video on that too.

[@syndeebennett3722]

I was diagnosed with spinal stenosis at age 37.

[@wportermcroberts]

it can happen. hopefully you’ve been well treated!

[@syndeebennett3722]

@@wportermcroberts Can you PLEASE 🙏 tell me why BAK INTERBODY FUSION CAGES are no longer used? I had lumbar fusion L4-5, L-5-S-1, posterior, lumbar fusion in 1999. I was 37 yrs.old. I have walked with a walker in chronic severe pain ever since. I'm on methadone around the clock since 1999. No functionality besides the very basics.

[@Thaojennyduong]

Wow , sorry to heard at age of 37 years old and started to have this problem . I am 44 years old Asian . Everyone said you are young ? Who you already have this issue I said I don’t known it may disease’s at early age to I guess . I walk with a walker now and so much pain on both leg . Both hand/finger numb . I have a hard time to drive more than 30 minutes I will get dizzy, anxiety both Meg start numb/shooting down pain . And hand too , so I can not even drive more than 30 minutes. . How are you now? Did you have surgery?

[@krazitreehuggeronetribe2058]

My arms go numb almost completely and very weak when I sit, but standing is almost unbearable without medication ☹️😖😭

[@ClaraTimmins]

Please give me advice. All they say is surgery now. I am scared to death hearing the results

[@BobSchecter]

Is the ultrasonic scalpel the newest technology?

[@wportermcroberts]

no. the ultrasonic scalpel was introduced last century. It was in 1998 that Ethicon brought the harmonic scalpel to market. It’s been used widely since then.

[@BobSchecter]

@@wportermcroberts It seems like the ideal solution. Do you use the technology?

[@BobSchecter]

It appears I have a TLIF ahead. So, like it or not, I'm going to have to have all sorts of hardware installed. Not sure which is worse - the persistant pain, or the fear of the surgery.

[@Bonijays37]

I live in Tacoma, Washington . I live on low budget. From Soisl Security. I can't fly out to Florida. Can you tell me of a doctor out here in Washington that I could trust. A doctor like yourself to do this surgery for me. Thank you, God Bless you.

[@wportermcroberts]

try Ed Jung. and Daniel Nelson.

[@Alan-ws1wd]

Do you know of a doctor in the Detroit Mich area that does the ultrasonic surgèrÿ

[@brianoconnell2009]

Go to the crab boats . One captain could not walk out at sea . Young guy . Doctor at university of Washington did good job on him

[@123Goldhunter11]

Sounds like total disc replacement is the way to go. Come in from the front - no bone removal. Tiger Woods swears by it.

[@sheilamase2558]

Did you say this video was made in 2013 but just uploaded? I was searching for current info.

[@wportermcroberts]

Made in 2023

[@randykoeller5256]

Every dr says oh well I am in sooooooooo much pain I’ve had 3 LAMONECTOMYS

[@randykoeller5256]

Did nothing I’m in horrible pain. No pain meds I’m in PT on n off 4 ever

[@jcaleca60]

I have spinal stenosis operation soon laminectomy

[@Thaojennyduong]

Hi can you update more information if you will going to surgery? My surgeon order pain management for me to try it first ? Before surgery will be the lasted decision. If the shot does not work ? For some reason? Than I have to go go surgery

[@jcaleca60]

@Thaojennyduong had operation I am ok work out good

[@Thaojennyduong]

@@jcaleca60that is good to heard

[@scarroll656]

You say this was done in March 2013 ??? But title says new for 2023. ?

[@wportermcroberts]

Thank you! I mis-spoke! appreciate the catch.

[@gabygibson8169]

@@wportermcroberts I thought I’m hearing wrong, rewinded it… also can you please can you talk about the new procedure called 3D Motus spinal disc replacement. It’s done with Medtronic equipment. Keeps the spinal mobility without the fusion. Is it possible next year in 2024 to become best known for vertebral joint replacement. Can you train and do it?

[@joycearmendaris1594]

What is minimally invasive ??

[@carolmartin3028]

I dissagree i spoken to many younger people diagnosed with stenosis

[@wportermcroberts]

They too can have the problem, but it is much more common in older individuals.

[@TE-7302-]

Doom and gloom