Lumbar Foraminal Stenosis - Fusion Surgery Options Part 2

[@lisagoldman4287]

So helpful Dr Su! I was most impressed by the story of your beautiful mom. This is inspiring for me and gives me a lot of hope for the future.

[@mb-le1un]

Excellent video and very informative. You made it easy for a layman to understand the differences in the operations and what one might expect. Thank you.

[@gosman949]

I had a TLIF on L5/L6 (yes I have an extra vertebra) 7 months ago. I couldn't walk more than a block without severe pain. After the operation, I walked a mile 2 weeks after surgery!

[@deanhunt7527]

how are you doing today ?

[@gosman949]

@@deanhunt7527 still doing fine.

[@azinkadkhodayan6262]

Dr. Su, great video again! Could you kindly make a video and explain what happens if the fusion fails in either lumbar or cervical fusion procedures.

[@DrBrianSuTheSpineGuy]

Yes I will

[@Sklipchan]

Great surgeon Dr. Su. Your parents would be so proud of you!

[@bordergirl]

Love this, especially the story about your mom! I just had L4L5 lumbar fusion with TLIF, following on a laminectomy and decompression at the same location 10 months ago that really didn’t do the job. Feeling good now

[@desgoulding7154]

I have L4/5S1 in mid August so bloody worried. Have Leminectomy 50 years ago traffic police now old 73 not young Nurosugeon advised May go in from side because back mussel problem and front ripped gut mussel Thanks for sharing video pain now groin, butt, both thighs at times both calf’s I know how mum feels very well hope mum is good now mate

[@raydisantis8021]

Excellent series of videos. In a technical professional's opinion, these are top quality.

[@lynnferguson7349]

Like the surgery your mom had!❤

[@dansklrvids7303]

Excellent video

[@happytractors780]

Dr Su- Thank you so so much for explaining these surgeries and helping me to understand the options I might have in the future to improve my health and quality of life. I am 65 and feel I am most similar to your mother. I have buttock and leg pain and L4/L5 compression of the nerve. I have also aways been totally against surgeries for myself. However I am now retired and cannot fulfil my dreams of walking through the alps and traveling. The pain has been unbelievable. Sadly health care access is stretched in my area and limits access. Even though I HAVE insurance. Of course I will need to find a surgeon in my area. Do you know anyone in Madison Wisconsin or Base Switzerland who can do this surgery well?

[@DrBrianSuTheSpineGuy]

Unfortunately I don't know of anybody there but you can certainly have a virtual visit with me by calling 415-925-8200

[@stephenrikey5496]

I had a pldf done 2 years ago for l4-5 I tried to find your video on it but couldn’t

[@DrBrianSuTheSpineGuy]

Watch the video on Lumbar degenerative spondylolisthesis The poster approach is covered there

[@marilynnmanning7099]

You are using examples of single fusion. I am going to be having L2-L5 fused. What is the best approach for you, and complications. Also patient healing experiences.

[@DrBrianSuTheSpineGuy]

A long segment fusion while it sometimes needed may not always be. It really depends on where the compression is etc. Yes many people have multi-level fusions and do well. You can always call 415 925 8200 for a second opinion with me.

[@chadcobanovich6509]

We've spoken before. I am in need of an ALIF. However I just had a full thickness rotater cuff surgery the day after Christmas. The nerve block didn't happen due to my artery being too close is ehat they told me. I am in excruciating pain all day every day 19 days after surgery. My question is how soon approx before I can undergo the ALIF?

[@DrBrianSuTheSpineGuy]

I typically let people get spine surgery 6 to 12 weeks after other surgeries but I would have to look at the case

[@Khabanelamefanpage]

Hi doctor. I am 35yrs old. The following is my MRI scan report: L5/S1 disc herniation is noted compressing on the cauda equina . Associated right neural faromina narrowing is noted. Conclusion: L5/S1 degenerative disc disease. Doctor, I have lower back and groin pain occasionally. Should I be worried ?

[@DrBrianSuTheSpineGuy]

Please call 415-925-8200 for a second opinion video visit

[@Khabanelamefanpage]

@@DrBrianSuTheSpineGuy I’m not in the US. I just want your take on the report i posted.

[@ianmatts3030]

I had an operation for this exact same thing about 5 weeks ago, I had to have a bilateral discectomy, laminectomy and foramenotomy... not fully sure what they actually did because I dont get to see the surgeon until the 12th week of recovery, so far so good, pressure mid flow of peeing is weak but my legs are almost completely pain free!

[@kerryfunmaker4389]

If I'm not mistaken, it seems like any hardware inserted always creates more problems later. If i'm hearing correctly !

[@DrBrianSuTheSpineGuy]

That's not true. There are pluses and minuses to each.

[@indigovoxofficial]

Thank you 🙏

[@frankpalo209]

Dr Su wish you were here in NJ. I have been dealing with stenosis at the L3-L4. I want to treat it with minimally invasive surgery not a fusion, which is what most dr’s want to do. I have lower back pain, leg cramping in the hamstrings and calfs. Do you know a Dr in the NY, NJ area who does what you do?

[@DrBrianSuTheSpineGuy]

Try hospital for special surgery, Columbia, or sinai

[@nimbustuba]

I have moderate formaminal stenosis at L5-S1 along with some central stenosis. I have radiculopathy to my toes and a fair amount of pain down my leg. I’ve been getting by with epidural steroid injections about 3x per year which offer good pain relief but are getting to be less effective. I spoke to a spine surgeon a few years ago and he said I could get the surgery but it would be an anterior approach with rods because my scoliosis (22 degrees at the lumbar region) would otherwise make my spine unstable . I also have osteoporosis. Do you think that I’m not a surgical candidate at this point ?

[@DrBrianSuTheSpineGuy]

I would have to look at the images. Please call for 415 925-8200 for second opinion by video visit

[@kpwaterfield]

What kind of blood loss is normal on the TLIF?

[@DrBrianSuTheSpineGuy]

Typically less than 200 ml

[@kpwaterfield]

Thanks. Would this require a transfusion?@@DrBrianSuTheSpineGuy

[@frankschultz2382]

I had Alif and Plif its 3 years post op and absolutely no relief but got worse.

[@Kreacher1974]

I had L2-S1 fused 3 weeks ago. Still having nerve pain and burning sensation in the hip, is that normal? Not having pains at the fusion site only in my hips and down my legs. He also put screws in my sacrum and fused it to another bone I can't remember the name of it. The surgery took 7 hours

[@DrBrianSuTheSpineGuy]

You can take up to one year for the nerves to heal

[@Kreacher1974]

@DrBrianSuTheSpineGuy I take 300mg Lyrica daily, will that help the nerves heals faster?

[@Deanosthegreat]

My MRI says I have bilateral neural foraminal stenosis L5 S1 with compression on the left nerve. I also have LLD due to my left hip being hiked up. I don't have any disc bulges or degenerative disease. Could the stenosis be caused by the hip hike causing the compression?

[@DrBrianSuTheSpineGuy]

You can certainly tell by doing a selective nerve root injection over the affected nerve and see if it helps you. I would defer to your doctor.

[@Deanosthegreat]

@DrBrianSuTheSpineGuy Thanks, I've put an orthopaedic insole on my shorter leg, my pelvis is now straight and the pins and needles in my left leg have gone (for now). Instant relief... Thanks for replying 🙂

[@khawlaelayyan4942]

dr you didn't talk about olif .

[@DrBrianSuTheSpineGuy]

It's basically the safe as alif which is why I didn't include it in terms of risks etc.

[@DrBrianSuTheSpineGuy]

I generally prefer alif because of the ability to get a better correction of the deformity. The downside of the deformity. Some spine surgeons like OLIF mostly because of the need to not have a exposure surgeon

[@ciarano.2490]

Not sure why surgeon feels the need to speak so quickly - to fit the video in to 15 min ? - just let it go to 30 min. Anyone who needs to watch will watch it all

[@DrBrianSuTheSpineGuy]

You can certainly play it at half speed under settings on KZbin