Lumbar Foraminal Stenosis - Surgical Options and Non-Fusion Surgery
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- Опубліковано 2 чер 2024
- This Video focuses on non-fusion surgical options for patients with foraminal stenosis. Symptoms often include buttock and leg pain and when a patient's quality of life if effected and all non-surgical options have been explored, surgery may need to be considered. There are 2 surgical ways to treat foraminal stenosis, directly decompressing the nerve and indirectly decompressing the nerve. This video focuses on the direct decompression of the nerve. The next video focuses on the types of fusion surgery for Lumbar Foraminal Stenosis.
#thespineguy #drbriansu #foraminalstenosis #nonfusionsurgery #directdecompression #decompressionandfusion #risksofsurgery #discheightcollapse #bonespur #facetectomy #Partialfacetectomy #indirectdecompression #laminotomy
Dr. Brian W. Su, MD
Spine Surgeon
Chief Development and Strategy Officer | California Orthopedics and Spine
Medical Director of Spine Surgery | Marin General Hospital
Director | Marin Healthcare District Board
Chairman | Marin Specialty Surgery Center
Timestamps:
0:00 - Start
0:25 - What is Foraminal Stenosis?
0:45 - When to get surgery for foraminal stenosis
1:08 - Ways to treat foraminal stenosis
1:25 - Direct Decompression
2:40 - Symptoms of nerve compression
3:30 - How long is direct decompression surgery
3:40 - Risks of direct decompression surgery
4:30 - Downsides of direct decompression surgery
5:25 - Direct decompression surgery with fusion
6:18 - Intro to next video
6:25 - End
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Contact two locations:
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Larkspur, CA 94939
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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Information obtained from this video should not be taken in lieu of your own medical provider's advice and treatment plan. Please consult directly with a physician or other healthcare professional regarding any diagnosis or treatment plan options. Content provided on this UA-cam channel is for informational purposes only and should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose , treat, cure or prevent disease.
This would be an amazing series! I hope to hear more of the fusion options... should that be my only choice. Thank you!! 👌👏👏👏👏
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
What about disc replacement…rather than fusion?
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
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.
@@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.
Dr. Su, please make a video about spinal osteotomy. Thanks.
What are your thoughts on the 3 Spine Motus device that is undergoing phase 3 testing?
That device is not approved in the United States I've not seen any clinical data on it
Thanks for this great patient-friendly explanation! Could the new technology of ultrasonic instruments lessen the risks associated with this type of surgery?
There's no evidence that ultrasonic based surgery is beneficial or affects outcome
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.
You can call 415-925-8200 for a virtual appointment
@@DrBrianSuTheSpineGuy Thanks. Will consider that, if I don't get satisfactory answers as my workup here proceeds.
and do you always recommend a corset after microdiscectomy/foraminotomy? all the best !
I do but there's no data behind it I do it more for comfort
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! ❤️
Dr Su she can’t move her left arm/shoulder since the surgery 😔
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.
You would have to ask the physical therapist
Hello, could I ask for articles on stability when 50% of the joint is removed?
Please search on PubMed you will find it
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.
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?
It is not yet indicated and there is no data behind it
What about ultrasonic surgery of the facet?
Please look at the episode for lumbar facet joint syndrome
What about my knee?
Lumbar stenosis surgery