Lumbar Foraminal Stenosis - Surgical Options and Non-Fusion Surgery

[@AnnemarieMytka]

In the real world, if you’re poor old , you cannot even afford to see a specialist, can muscle tightness cause compression of the spine thanks

[@MrsTiffanyMartinez]

I'm in so much constant off the chart pain, it feels hopeless at this point. I can no longer walk with both feet flat. The numbness is scary and the other side effects are too much. Especially the frequent urination and not making it. Every 2 hours. The depression is real.

[@lynnferguson7349]

What about disc replacement…rather than fusion?

[@DrBrianSuTheSpineGuy]

That is a viable option. In the lumbar spine the outcomes have not been as good as in the cervical spine. The other problem in the lumbar spine is that it is challenging to revise and there is a good track record for single level fusions

[@Just_MHO_thomasina]

This would be an amazing series! I hope to hear more of the fusion options... should that be my only choice. Thank you!! 👌👏👏👏👏

[@lynnferguson7349]

What are your thoughts on the 3 Spine Motus device that is undergoing phase 3 testing?

[@DrBrianSuTheSpineGuy]

That device is not approved in the United States I've not seen any clinical data on it

[@jaym1224]

My mother has spinal stenosis and is 68 and her l2 l3 cushin is gone and the bones are touching, she has severe pain in her but and left thigh severly hurts her , getting out of bed she has pain , going down the stairs she has severe pain , tingling from her thighs to her feet lile pins and needles , but idk if she has to get lamanctamy or lamanctamy fusion , every day her legs are getting weaker and affecting her daily life im scared because idk which one should she have done please respond back.

[@jaym1224]

And only when she bends over she has relief or shopping cart syndrome as they call it

[@stevenciesiel777]

I’m considering surgery I have severe stenosis on C4 C5 left side and moderate right. I’ve tried corticosteroid shots and done 2 RFA. First time the RFA worked which was a yr ago but my stenosis was mild now that it’s gotten severe the RFA which was weeks ago didn’t do much. My symptoms are pain in my neck that radiates to my arms and sometimes even chest pain and pins and needles sensation,tingling in hand,and it’s gotten to the point where it’s hard to be comfortable when laying down because of the discomfort in my neck and sitting down long. I’m also a bellman for 16 yrs and my profession has exacerbated my condition and it’s getting to the point where I can’t do my job anymore. I do have an appointment with a neurosurgeon next month see how it goes.

[@DrBrianSuTheSpineGuy]

You should watch the playlist on cervical radiculopathy

[@stevenciesiel777]

@@DrBrianSuTheSpineGuy watching part 3 now watched one and two very informative

[@Sklipchan]

Dr. Su, please make a video about spinal osteotomy. Thanks.

[@AmyBenson-w4f]

Dr. Su, can you please make videos about indications for various interventions, such as TF ESI, interlaminar ESI, and MBB, etc. Thank you for your awesome videos.

[@DrBrianSuTheSpineGuy]

Those are usually in the non-operative care videos of stenosis, lumbar disc herniation, spondylolisthesis.

[@bradleyyoung6673]

Lumbar stenosis surgery

[@karinwest919]

Thanks for this great patient-friendly explanation! Could the new technology of ultrasonic instruments lessen the risks associated with this type of surgery?

[@DrBrianSuTheSpineGuy]

There's no evidence that ultrasonic based surgery is beneficial or affects outcome

[@khawlaelayyan4942]

Thanks dr for your informative video. I would like to ask about muscle weakness when can it resolve after indirect decompression and fusion if there was no nerve damage

[@DrBrianSuTheSpineGuy]

It really depends if there is significant weakness and for how long the weakness has been for. You can call 415-925-8200 for a second opinion

[@neurochirurgarturbalasa]

Hello, could I ask for articles on stability when 50% of the joint is removed?

[@DrBrianSuTheSpineGuy]

Please search on PubMed you will find it

[@Berrylucy50]

What about my knee?

[@Deanosthegreat]

Do you have any exercises to prevent foot drop? I have pins ans needles in my left foot. I have mild exiting bilateral neural foraminal stenosis with compression on thr left exiting nerve.

[@DrBrianSuTheSpineGuy]

You would have to ask the physical therapist

[@neurochirurgarturbalasa]

and do you always recommend a corset after microdiscectomy/foraminotomy? all the best !

[@DrBrianSuTheSpineGuy]

I do but there's no data behind it I do it more for comfort

[@kirgan11]

When I was reading about TOPS implant to treat regular lumbar stenosis, I came across Premia Spine ProMIS fusion. It claims to be a newer fusion method that has smaller incisions, less muscle damage and all around faster recovery time. Any thoughts on this? Or is it to new to know if it is a good system or not?

[@DrBrianSuTheSpineGuy]

It is not yet indicated and there is no data behind it

[@TheMellies]

Hi Dr Su 😊 my mum had an Anterior Cervical Discectomy Fusion and I want to make home as comfortable as possible and would appreciate any tips thank you! ❤️

[@TheMellies]

Dr Su she can’t move her left arm/shoulder since the surgery 😔

[@gbosearcher-3686]

Interesting discussion. Six years ago, I contracted Lyme Disease ( awful disease ) and my balance was affected, which resulted in a bad fall. After 6 years with my long time orthopedic doctor, my PC sent me to a spine specialist. I was diagnosed with facet joint arthrosis, after MRI and CT . Believe me, I tried everything..7 months of PT, Sims, Tens unit, foam roller, yoga and two unnecessary and totally no help spinal steroid injections. The new doctors recommended MBB before RFA. The MBB gave me the first pain relief in 6 years. I am now in the recovery phase of the RFA. So waiting for the pain signals to die. I did it in the office and was offered sedation in an outpatient setting. In the office was not a good choice, extremely painful on the second nerve due to inflammation. Next time, sedation will be the way. Keep giving the public good information and choices.

[@gbosearcher-3686]

@@TheRealCheckmate MBB is a medial branch block RFA is radiofrequency ablation. Most insurance companies and doctors require 2 MBB, this is a nerve block, if it helps the lumbar pain , then you are a good candidate for the RFA. The nerve block ( for me anyway) was 6 shots, three to numb the back area and three to numb or block the nerve. Was the first pain relief I had in 6 years. Both are uncomfortable to have done, but I am hoping that radiofrequency ablation will help the pain in my L 2-4 be more manageable. Because right now, I had to give up kayaking, hiking and limit daily activities.

[@JP6961]

What about ultrasonic surgery of the facet?

[@DrBrianSuTheSpineGuy]

Please look at the episode for lumbar facet joint syndrome

[@heikedeubner9073]

Dr. Su, thank you for this informative series. Realizing you can't give specific advice here, but is there any hope with any of the therapeutic modalities for a 64 y/o woman whose primary symptom is numbness, started out just on plantar surface of feet, now also ankles (feels like a slightly tight sock) and right anterior knee/thigh? Minimal, transient back pain, no leg pain but some calf tightness after longer walks or prolonged standing. Xray shows scoliosis, anterolisthesis and osteophytes. MRI scheduled for next month.

[@DrBrianSuTheSpineGuy]

You can call 415-925-8200 for a virtual appointment

[@heikedeubner9073]

@@DrBrianSuTheSpineGuy Thanks. Will consider that, if I don't get satisfactory answers as my workup here proceeds.