Setting the record for bogus treatments for Severe Stenosis: How Tom found the right path.

[@bb-nq5qc]

Doctor, you are a saint. I can't thank you enough for your benevolent and very special energy.

[@BestPracticeHealth]

You are very welcome

[@vcash1112]

You need to have these people back in few years for updates!🎉

[@BestPracticeHealth]

So right!

[@lainniecashman94]

Hi Doc, i commented to you before about a sequestered disc fragment and i too have severe spinal stenosis. Im scheduled next week for a discectomy, foramotomy and laminectomy of the dreaded L4-5 area. You made me feel even more comfortable about have my surgery in Atlanta at Emory St Joseph hospital. Thank you for these learning sessions. When i spoke with my neurosurgeon i pounded him with questions and he answered every one of them relatively the same as you have stated during sessions with people with similar conditions.

[@rachael1572]

I been there and found out that it is My hips with labrum tairs.

[@BestPracticeHealth]

I'm so sorry I just got to this comment... how did the surgery go? I hope you are feeling great by now.

[@lainniecashman94]

It went spectacular! I was up an hour after surgery walking around, I had to do stairs to show that I could do them. When I woke up in post op, no pain or numbness in my right leg and big toe! I had a laminectomy, foramotomy and Discectomy. He said there's not much of my disc left because of the big herniation and when he touched my L4-5 disc it spurted out more of the disc material. In his post op notes he stated if he removed it all I would be a chronic back pain patient, so he saved as much as he could. I'm now 18 days post op and haven't taken any pain meds since the 3rd day and even then I only took it at night to sleep. I'm just being careful as I have a tendency to push myself. I feel good and I'm pleased. Thank you for your advise and the great information. (Oh the only awful thing about this whole journey are my gardens, they look atrocious from neglect!)😊 thanks again!

[@gagarbageman]

I suffered a very large disc herniation at L4'L5 which crushed my spinal cord and was told it was a pinched nerve at hospital. A week later an MRI was done because of Cauda Equina symptoms and emergency discectomy/durotomy/laminectomy was done. 3 months later there was continued weakness and numb feet and burning in buttocks so had another MRI and said still 6 herniated discs but no compression with a seroma for spinal fluid leak. A year later and now after spinal cord stimulator trial an MRI was done of Thoracic and Lumbar reveals T10-11herniated disc with cord edema compression, myelomalacia , severe stenosis and recommended for another laminectomy at T10/11 plus another for installing stimulator. Doctor says its not from twisting my spine and falling down stairs but from old age since I am over 60. All I know is it hurts every minute of everyday. I dont like surgery and had no choice the first time. Still hurting with a total of 9 herniated discs severe stenosis spondylio some long word small osteophytes anterior and wish I could go back 40 years.

[@elicatwoman]

Dr Liberman you are so kind to help and provide you expert opinion. I love that you speak to us with such clarity…. Thank you so much. I am looking forward to meeting you soon.

[@Gina-dn6xm]

I live in Wentzville, MO. We moved here for a job relocation. I have the same exact problem, except I am having a laminectomy and a spinal fusion two weeks from today. I am in so much pain I can't function at all. This is my last resort, and at this point, I have no choice. Thanks for this channel and the information.

[@BestPracticeHealth]

Good luck! Please let me know how it turns out.

[@Gina-dn6xm]

@BestPracticeHealth I had the surgery for severe spinal stenosis and spondylitis. The surgery included a laminectomy and spinal fusion on L5 S1. I no longer have pain down my legs, but I can't tell at this time if the surgery was a success. I'm now having chronic pain that hasn't really helped much with pain meds. I'm only 12 days out from surgery. I'm hoping the pain resides. Thanks for asking...

[@Christinejs]

@@Gina-dn6xmhello- how is your post surgery?

[@Gina-dn6xm]

@@Christinejs I'm still having some back pain on and off throughout the day. I am also experiencing some neuropathy in my feet. I think I have some nerve damage because I waited so long to get surgery. I have back fatigue in the evenings and have to go to bed early. Surgery wasn't a piece of cake, but it had to be done. Thanks for asking.

[@midnight-in-tx]

Excellent video Doc. Its helping me to listen to you talk with patients. I thought I had deep vein problems but my Doc checked and he suspects I may have spinal stenosis. tbd

[@BestPracticeHealth]

Yikes! Sounds like you are headed for an MRI scan. Make sure you get the radiologists report. If you see the words "severe" or "marked" you are probably going to get to meet a surgeon. If that happens, be sure to find someone who is board certified, specialized in spine, and "minimally invasive."

[@rheaceebelle8130]

I have similar issues. Ive been to a neurosurgeon at st lukes in kcmo. Am currently going thru PT (medicare apparently has hoops before one can get surgery), and neuro wants to do targeted injections next. I just want the pain and life inhibiting effects to go away. I KNOW that laminectomy is the target, just having yo go through all the other steps to get there. I also have a slipped dosk right above my l4/l5 stenosis. I have numbness and pain all through my left leg and horror story leg cramps at night in the right leg. It gets worse daily and i cannot stand or walk for long at all.

[@signalfire6691]

I had much the same symptoms - the key to getting surgery right away is if you are having symptoms of cauda equina syndrome - inability to fully empty bladder, bowel control issues or sexual function; also a 'saddle' region numbness. I also had S1 nerve root damage and cannot rise up on my right toe, heel off the ground. Make sure your doctor knows of ALL of your symptoms; Medicare paid for almost all of the cost of an almost immediate surgery, scheduled within days of seeing the neurosurgeon - Knoxville.

[@rheaceebelle8130]

@@signalfire6691 I'm on the cancellation list for the neurosurgeon. If no one cancels, I will see him in Nov. Seems like forever. I do have saddle issues.

[@BestPracticeHealth]

Well said! Thanks so much.

[@jacktanner7738]

M.I.LD. (minimally invasive lumbar decompression) seems to be one of the newer techniques with good results. Any word on that? I hear it is similar to an injection.

[@rachael1572]

I have had surgery for it...and I have had great success with mine... could be your hips... I have been there... found out that it is my hips

[@BestPracticeHealth]

Thanks for your comment!

[@supernova44]

What options do you have for multi level degenerative central canal and foraminal thoracic and lumbar stenosis

[@anitahendrix7573]

Just watched this video. I had commented on another of your videos and you replied to take care of my DDD and stenosis before I get in I'll health. I am 80yo and in good health now so am going to pursue this issue now live in rural western PA south of Pittsburgh I did a search on your web site and it came up with nothing near me. If you could help me with that I would appreciate it. Also am going to my GP this week and ask for a new X-ray and MRI if he okay this I will contact you for a consult.thank you.

[@BestPracticeHealth]

Wonderful! We are now taking questions and doing reviews for people on the youtube show. Please submit your case by video through bestpracticehealth.tv. I look forward to meeting you!

[@paulinesalter7452]

I am having an MRI on Sunday, uhave severe oain in lower dpine from scoliosis and gaveng been able to walk without crutches for over a year would a laraectomy help the specialist i saw recently wouldnt do an opp said too dangerous

[@sthildas4857]

Every long term patient is looking for a solution or improvement in quality of life. Interesting that ineffective treatments are suggested. I had a laminectomy in 90 a fusion a year later. It never got better, I have lost some of my bladder control recently been in hospital with Cauda Equina. With my fusion they cannot see the suspected areas with my Hartshill Rectangle located. I went to residential PM similarto Walton Clinic Liverpool. I thank you for your compassion understanding and pro active stance. Uk.

[@BestPracticeHealth]

i’m so sorry to hear of your continued troubles, despite having undergone laminectomy, and then a secondary fusion. I’m also sorry to report that I hear the story a lot, that the first surgery failed, and then, instead of looking at the real source of the pain, a second surgery was done, which was also inappropriate. Hang in there. You’re in a difficult situation, but it sounds like you’re a thoughtful person. Do your research. I’m wishing you healing, and resolution of your pain.

[@virusscopes948]

In November 2020 I was told I have “At L4-L5, there is a subtle left posterolateral annular tear and leftward eccentric disc bulge. Mild left neural foraminal stenosis and mild left lateral recess narrowing.” Which was only looked at for foot numbness at night while they were doing a neck MRI for arm issues which found- 1. At C3-C4, there is a disc bulge and central disc protrusion with mild spinal canal stenosis, mild to moderate left neural foraminal stenosis, and mild right neural foraminal stenosis. 2. Straightening of the normal cervical lordosis, which may be seen with positioning or muscle spasm. I ended up have two ulnar nerve transpositions which after a year alleviated 95% of my issues other then the neck kink I’d get, foot numbness pretty much dissipated. Had a fall incident july 24th this year where I was lifting machinery and the handle broke causing me to go backwards ~3ft onto my pelvis. My right quad initially locked up and I had immediate right knee, right thigh and right hip pain and slight back right hip area pain. Knee mri was negative, quad alleviated somewhat and hip pain went away after two weeks off work. Came back and 3 days in got hammered with pain, 5/10 in the knee and hip with “sharp pain”, inner thigh by my knee on the right leg would have an ache pain, lower back pain (dull ache), right foot felt stiff and had a dull ache, both groins were tight and I had sharp pain in my left leg on the inner thigh from groin to knee(hadn’t had until this point). I was told I had PFPS from a slight tilt in my kneecap. Workers comp rejected orthopedic specialists referral and I started doing out of pocket appointments and lawyered up. First ortho I saw said the same thing and said get a new career, offered cortisone shots and pt. Got a second opinion and they did a physical test where they twisted my right leg inward and not even two minutes after I got hit with pinpoint pain (6-8/10) on my waist line just to the right of my spine, the pain was so brutal it made me stand up off the the bed and lean against it also felt sick to my stomach, the nurse came back and said that was a different issue and gave me a shot of toradol. they ordered a hip and thigh mri and I saw a pt the same day from the first opinion prescription. Pt rejected a right knee session and did the evaluation and basically stated I’m showing a mild posteriorly rotated pelvis, no PFPS or maltracking or tilt, moderate loss of movement for extension in the lower spine while the rest were minimum, positive right lumbar test for PSLR, slump test, fabers test and decreased LE sx’s. He said clinical signs and symptoms consistent with lumbar ivd disorder and radiculopathy into R LE and recommended a case comparison study which I got a referral for Wednesday. He also said he recommended the hip mri due to nature of injury. So currently waiting for mris but doing PT and one thing that is personally bothering me is they Hooked me up to a traction machine on my back the first day and it caused a sharp pain in the back and the lowered the weight then went into stretches. Had about 20 minutes of relief but the pain came back (tightness in back and sharp pain in knee and hip) while driving to work. 2nd session this morning traction happened on my stomach due to reaction last time and it was more intense but not as sharp, constant pressure and muscle spasms in the lower back, hip pain etc. since that I’ve had tightness and pain from what I was say is my sacrum up about half a foot, some actions flare it more, also had tingling in the outer half of my left foot which I haven’t had in a while and tingling in my left leg. Hearing that stenosis doesn’t go away concerns me that pt could have retriggered the left or made it worse and possibly whatever new injury I’ve accrued. Also prior to out of pocket I’ve had- 14 sessions of PT for my right knee, thigh and hip, numerous medications- ibuprofen, naproxen, diclo something(stronger then naproxen), muscle relaxers, steroid pack, and a steroid shot in the back of the butt/hip. First opinion gave me meloxicam and i rejected a cortisone shot in the knee because of what I was told about them leading too and it being a mask for the pain. Really just stuck where I am, anxiety kicks in. I’m 26, injury happened on my 26th birthday, and the last 7 years of my life has been trades and throwing it away is just not applicable. Single dad and busted my butt off to make a good living, supposed to start a new department in a big corporation for a specialized trade and it shows huge potential for the future. Just need advice. Thank you.

[@BestPracticeHealth]

What did the MRI of your hip show? Your problem is obviously complex, but a hip labral tear would explain a lot of it.

[@virusscopes948]

@@BestPracticeHealthwaiting to get the lower back and hip/thigh mri scheduled at this time

[@virusscopes948]

@@BestPracticeHealthRight hip mri impression- 1- anterior superior right hip labral tearing as above(undersurface fraying anterior superior labrum from the 12-2 positions with early undersurface tearing at the 1 position). This is in settings of features of the right hip which can be seen with cam type femoroacetabular impingement and predispose to the labral pathology. 2- right hip alpha angle 59 degrees. Right hip center edge angle 36 degrees 3- no advanced OA of the right hip 4- other findings as above(listing below) Low grade gluteus medius and minimum insertional tendinosis. Hamstring tendon origins are unremarkable Increased anterior convex morphology of the femoral head neck junction, as can be seen with cam type femoroacetabular impingement. I understand what this is saying and it stresses me out. I’ve never had hip pain or the other issues as listed above until the fall happened. The way the radiologist worded it basically made it sound as wear and tear from hip impingement which will screw me in the case. My back mri is Sunday and I’ll have the results by Tuesday. If it answers the groin and hip pain I’m fine with this. But I still have back of the hip, some thigh and knee pain. Sat in the work van for 5 minutes the other day and when I got out both of my legs went immediately numb or pins and needles? And I felt like I could barely walk (30 seconds), seriously debated going to the er from how sketchy it was for me to feel like that. Didn’t get light headed but immediately felt sick to the stomach with that sensation.

[@virusscopes948]

@@BestPracticeHealth got my lumbar mri results today as previously listed above was ~2.5 years ago. T12-L1: 3 mm left paracentral protrusion indents the left ventral thecal sac with mild left lateral recess narrowing, similar to the prior. No spinal canal narrowing or neural foraminal narrowing. L1-L2: Unremarkable L2-L3: Unremarkable L3-L4: 2 mm bulge. Mild bilateral facet arthrosis. Mild bilateral neural foraminal narrowing, left greater than right, similar to the prior. No spinal canal narrowing. L4-L5: Minimal disc space height loss and disc desiccation. 3 mm left eccentric bulge with stable mild-to-moderate left neural foraminal narrowing and mild right neural foraminal narrowing. Minimal left lateral recess narrowing. No spinal canal narrowing. Mild bilateral facet arthrosis. L5-S1: Minimal disc space height loss and disc desiccation. Mild bilateral facet arthrosis. 2 mm bulge. No stenosis. Definitely not what I was expecting on the report and haven’t heard of this. See my pcp on Wednesday for a follow up.

[@khawlaelayyan4942]

Hi dr ,my daughter had olif surgery for isthmic spondylolisthesis l5s1 she suffered from neurological claudication in her left leg .now it's been one and half year and still can't walk more than 10 minutes because she has a heavy leg .so what do you think

[@rachael1572]

Hey I love your channel

[@BestPracticeHealth]

I love to hear that! Thanks so much for the comment. You made my day.

[@jonaugspurger3716]

How can I do a consult with you please?

[@BestPracticeHealth]

Call Phebe at 602 256 2525 and ask to appear on the show. I'd love to meet you.

[@g-man5820]

Question what would cause muscle wasting on the left side of the body? Spine? Help

[@BestPracticeHealth]

Doctors like to start with a list of what could be wrong. We break that down into system. Muscle wasting can have multiple underlying causes, and a thorough evaluation by a doctor is necessary for an accurate diagnosis. I would start with your primary care doctor. In the meantime, here are some potential causes to consider: Nerve Compression or Injury: Conditions like nerve impingement, nerve compression syndromes (e.g., carpal tunnel syndrome or sciatica), or peripheral nerve injuries can lead to muscle weakness and wasting in specific areas. There are also neurological disorders like motor neuron diseases (e.g., ALS), peripheral neuropathy, or muscular dystrophy can result in muscle atrophy which can present on one side. Orthopedic Issues: Conditions like osteoarthritis, joint instability, or fractures that affect the mobility and use of a limb can lead to disuse atrophy or muscle wasting. Vascular Problems: Reduced blood flow to a limb, often due to arterial disease or deep vein thrombosis, can cause muscle atrophy. Autoimmune Diseases: Some autoimmune disorders like myositis can lead to muscle inflammation and subsequent wasting. Infections: Certain infections, especially those affecting nerves or muscle tissue directly, can lead to muscle atrophy. Metabolic Conditions: Conditions like diabetes or thyroid disorders, if poorly controlled, can result in muscle wasting. Cancer: Localized tumors or metastatic cancer can affect nearby muscles and lead to muscle wasting. Trauma or Injuries: Prior injuries, surgeries, or trauma to a specific area can result in muscle atrophy if rehabilitation is inadequate. Inflammatory Conditions: Inflammatory diseases like rheumatoid arthritis or lupus can affect muscle tissue. Malnutrition: A lack of essential nutrients can contribute to muscle wasting. Medications: Some medications, such as corticosteroids, can cause muscle atrophy as a side effect. Idiopathic Causes: In some cases, muscle wasting may occur without an apparent underlying cause, and further investigation may be needed.

[@Bepositive42day]

Is there a high chance of Reherniation from discectomy? Will it be possible not to get another surgery when it reherniate?

[@BestPracticeHealth]

there is a risk of repeat, or recurrent herniation after microdiscectomy surgery. The risk generally ranges from 15 to 40%, depending on the study. If a disc herniated, the second time, while microdiscectomy is certainly an option, many surgeons recommend total discectomy and fusion at that point.

[@Bepositive42day]

Thank you Doc. for your response. Reherniation is the one that's scarying me on pushing for the procedure. I have Moderate herniation with Lumbar radiculopathy on my S1. What would be the complication for not going for surgery? No incontinence on both bowel and bladder. Its been 3 mos. now with FESI 3wks ago., mild relief. Continuously exp. mild tingling and numbness on the right upper leg causing limping on ambulation. No medical Hx. 45/F.

[@anitahendrix7573]

Won't a liminectomy without fusion cause weakness in the spine and cause it to collapse??

[@BestPracticeHealth]

Post laminectomy instability is a risk, but thankfully not common. The risks of fusion generally outweigh the risk of becoming unstable without fusion after laminectomy. So, most doctor today don't recommend routine fusion with laminectomy surgery.

[@ee7369]

Hello Doctor. Do you read MRI that I can send to you?

[@BestPracticeHealth]

Contact me if you want to come on the show. [phone]. Ask for Phebe.

[@rachael1572]

How do I get you to view my issues...

[@BestPracticeHealth]

Submit your questin at BestPracticeHealth.tv and we will get back to you.

[@anitahendrix7573]

Sounds like my case!

[@BestPracticeHealth]

Sorry! Hang int here. I hope you feel better now.

[@terrirasmussen2442]

*Promo sm*

[@BestPracticeHealth]

???