I had lumbar spinal surgery with rods, screws and peek. Unfortunately , I developed haematoma owing to defective drainage system and I was compelled to undergo a second surgery for removal of blood clots collected at the surgery side. I'm still lying in bed with pain on my 10 day though I have been released from hospital. Any advice doctor?
My husband had a fusion on L4 and L5 30 years ago. Just had that removed and fused L2-L5. Now only having pain in his left thigh. I'm hopeful that the pain will dissipate. It has been 3 weeks since surgery and there are some improvements. Plan is to get off of Opiods, but they have been very helpful during the recovery. Even with this new pain, he is happier than before surgery, he had a very loose expectation. He has very good help at home and does not need to do for himself until he is ready. We have all the grab bars and walk in shower etc due to his pain and disability prior to the second surgery. This was his 5th surgery (2 fusions and 3 laminictomies) and all surgeries were successful but he went back to work. Now at 70 he won't have to do that so we are hopeful that he will enjoy much less pain for the rest of his life. Thanks for this video, good points.
Recovering from spine surgery is a long process, as you are well aware by now. Taking pain-medications appropriately, staying active and paying attention to proper nutrition are all keys to achieving a good result. Wishing your husband all the best. Thank you for sharing your experience, appreciate it. Good luck!
Doctor I understand the fear of opioids, but the pendulum has completely swung in the other direction, where no Doctor want to prescribe, the reasons are another discussion entirely! However, I was going to mention that a post op pain management plan is SO IMPORTANT! Too many times I have been post op and without an effective medication and when you are suffering it’s very difficult to navigate that and get it worked out. Having an advocate becomes SO CRITICAL! Just speaking from experience Doctor. Thank you for the great insight
Thank you for your excellent observation. You are correct. Unfortunately the opioid epidemic was fueled by the actions of a lot of doctors (some well-meaning, others not so much) who created a terrible problem which haunts us to this day. How far is the pendulum going to swing before coming back towards sanity? I don't think anybody knows.
@@SpineSurgeonSpeaks hi Doctor, your points are well taken and you are correct, we can’t answer that question. I will mention this, which is really an example and it’s horrible. There are times when I can not control my breakthrough pain at home, hence I go to the ED, and whether I get adequate pain relief depends what “provider “ happens to be there that night , so I may or may not get treated, that is SIMPLY WRONG! A hospital ED should not send a patient home feeling the same or even worse than when he (I) arrived….
I just had a fusion and it was brutal. They had me on 10 mg of morphine every 4 hours!!!! Should be more and hourly 1st day. I AMA'd and left early to wither in pain at home.
I have a high tolerance for pain, but was left with horrendous pain after breast cancer surgery (ICBN damage). I was sent home, told to take Tylenol and meditate the pain away. After 3 nights in agony with no sleep I was suicidal. My GP eventually wrote me a prescription for hydrocodone so I could sleep with the ICBN damage. I weaned myself off of the opiods within a year. I am disabled due to a back injury with 2 years of PT and now cauda equina syndrome, but would choose to go to Mexico for surgery if I have to live that horror show again. I weaned myself off within 6 months. Thank goodness medical cannabis is now legal.
I am 62 and live in Southeast Lower Michigan. I injured my lower back in a shower fall about 12 years ago. The resulting injury/condition has finally reached the point where I can no longer put off this surgery and I'm scheduled with a surgeon (Dr. Vibert) on May 29th of this year. So, just a few weeks away now. I'll admit I'm trepidatious, but it simply cannot wait any more. Thank you for this video, Doctor. I found it interesting and enlightening. Fortunately, I don't smoke, and I came off any opioids nearly a year ago. My surgeon, Dr. Vibert, has had the surgery himself 13 years ago at age 37 and has told me that even at my age, I'm a better candidate for the surgery than he was back then. We will see! Again, thank you for such clear explanations and advice!
I had L4-5 laminectomy/ Discectomy and had more pain after. after PT for six months and injections I got second opinion. They said my spine was unstable and nerve crushed so did L4-5 fusion. Still had a ton of pain for the next 2 years. I had mri n ct scans. The surgeon said everything looks great. He said maybe it's your SI joints. He said it's common after spine surgery. So I did PT for two more years and more injections. After that, I ended up with 6 ifuse rods across my SI joints. Now I'm in more pain. This neurosurgeon that did the Ifuse did an MRI and he noticed the screws in my nerve canal. He said this didn't look right. So now I went to a trauma surgeon to help me figure it out He said on your L4-5 fusion you have two screws sitting inside your nerve canal. You need to get those out and he doesn't do spine surgery. I went back to the surgeon who put them in and they said we take full responsibility. I was fused so they took the entire cage out and left the plate. Went for my follow up with the surgeon and they changed it to the PA. They said that he will not see me. When I saw the PA, he was in the office and turned away and wouldn't even talk to me on my husband. The pa said he won't see you. Now I'm in the process of getting the ifuse rods out at Mayo Clinic in Rochester MN. All my surgeries were done in the Boston area and I thought we had great surgeons. I am terrified now. I wish I had someone like you in the beginning. This has been life altering. I've got four children and two little granddaughters and I hardly ever see them and it breaks my heart. my husband and I have not gone on vacation for the last five years I am basically in bed on an ice machine, majority of the time I try to get out and walk, but it's awful. Most of this started when I had an RFA,m on l4-5 anna S 1 which put me in the hospital for five days. I also found out I am allergic to titanium. I have severe burning where the rods are. It's pure red across si joints which is reason for ice machine. I love your honesty, telling people not to jump into surgery! We need more people like you for sure this world
I am very sorry to hear about your very difficult journey: Undergoing multiple spine & orthopedic surgeries takes a toll on the body (and the mind), no question about it. It can take a long time to recover, and it is difficult to stay positive and optimistic during this time, and I understand your dilemma. I hope you have found a pain-management doc who can manage your symptoms with some medications. Wishing you all the best, take care, hope you feel better soon 🙏
I have the beginning of caudas equinas. Minimal neuropathy from bum to feet. But clearly squashed nerves at L3 - L5 (S1 has related neuropathy but not nearly as severe compression) based on my most recent MRI. Previously SI injections worked to combat the pain but the last round was minimal. I am opting to go ahead with the L3-L5 fusion now. And doing PT 3 times a week until then. I turn 59 in a week and can not see suffering into retirement knowing decompression is eminent. Prayers appreciated !
@kathleensarmiento932 I had the beginning as well, with drop foot. Had my surgery , L4/5 decompression with fusion, 4 weeks ago. Pain managed after surgery with Lyrica that was replacing Dilaudid gradually as I was lowering dose of Dilaudid, and stopped Dilaudid 2 days before discharged, 3 weeks after surgery as I got transferred to Rehabilitation after surgery. I was determined to stop Dilaudid, we as patients should not be seeing these kind of medications as a miracle pill, as often some other medication can control the pain as much as this one if not even better depending what kind of pain it is. my plan is as Time goes to lower the dose of Lyrica gradually as well if possible. Time at Rehabilitation Centre was a blessing , if it is possible for you to have it right after surgery that would be great. I also got brace that would help with drop foot when I am at work especially . I still have a drop foot but I am working on it trying to strengthen muscles on my foot, as there is still ability in my foot to move down and to sides. Prayers for you to have successful surgery and recovery as well !
Thank you for sharing. Glad to see that you are on the path to recovery. I hope you keep up with the therapy and stay optimistic. Wishing you the best of luck and the best of health 👍
*So, I had also the beginning with drop foot, and had L4/5 decompression with fusion 4 weeks ago. I was determined and was able to get off Dilaudid about 3 weeks after surgery , 2 days before getting discharged from Rehabilitation Centre, where I was transferred after my surgery. Lyrica was gradually going up replacing Dilaudid while Dilaudid dose was going down and stopped. It is very important for patients to not think od narcotic pain killers as a miracle pill because some other medications can replace and in some cases work even better than narcotics. I hope to be able as recovery goes gradually reduce the dose of Lyrica as well. There is some pain now still , but well managed , and drop foot as well, after surgery , but I am working on it , trying to strengthen muscle and give time for my nerve to hopefully heal. I am not sure about you, in regards to my drop foot , I am strengthening specidic muscles little by little with exercises, as my foot is able to go down and to the side. I got also brace that for my foot that would be helping me at work. If is possible to get Rehabilitation Centre, as inpatient , that would be excellent, as I feel really blessed for getting that. It was huge help for being able to move on after surgery , physically, but mentally as well as feel and see your progress. Prayers for you, and best of luck!
Thank you Dr. Khan. That is a awesome presentation. I have had two Doctors in Orthopaedics, and I learned that it take one to really focus on what you hear and learn. I decided to change doctors for what I think was my equivalent of getting a good second opinion. I have not gotten any surgery at this point, but in the meantime, and for whatever reason, the pain level has receded by a factor of about 60 to 70%. So when I get to see my surgeon, I hope he can explain what could have happened.
Thank you for your kind words, I am happy that the video was helpful to you. Getting a second opinion is usually very helpful to patients. I have a similar video which you may find interesting: ua-cam.com/video/ovSTtD08Olw/v-deo.html Wishing you all the best, and good luck to you 👍
I think for me, because surgeon wants to do this asap due to signs of myolopathy, (been waiting 5 years for appointment) it doesn't matter if pain improves or not, just that the pressure is off the spinal cord. Oh gosh he didn't say anything about recovery. Have no idea what I will be able to do or not do and for how long... One thing I don't understand is as I have degenerative disc disease and all joints in cervical spine are also arthritic with degrees.of stenosis, why can't I have a disc replacement instead of a fusion? As I understand it, joints above and below fusion degenerate faster and they are already degenerative, so wouldn't a disc replacement be better? Thank you for helping us with these videos.
There's a ton of patient videos from pre surgery to years out chronicling their expectations. Of course everyone is different....but many of the experiences are similar. And the suggestions are extremely valuable.
The new titanium spacers have give and space for bone growth. Replacement discs only serve about 5% of issues and can worsen arthritis. (I asked that too !)
I have been suffering from disc bulge for the past 2 months. This bulge caused canal stenosis and I am unable to stand for more than 5 minutes due to shooting pain in my left leg and 2 of my left feet fingers are already having less sensations. I am unable to do any activity and completely bed ridden. I don't know if i should go for surgery or wait for some time ?
We all know sir that there is no 100% better even an 80% is a great outcome better than having strangled feet legs thighs and even hips. Those same things you mentioning I can no longer do
Awesome video! Thanks for all the input! 😮 just wanted to know who a doctor goes about fixing a bulge disc since it hasn’t really ruptured. Would it still be similar to a micro discectomy? Or is a bulge disc and herniated disc interchangeable terms? 😮 thanks again 🙏
That's a good question. Most surgeons will be reluctant to operate on a disc that is bulging but not ruptured/ herniated. Unless a disc is causing a direct nerve compression, in general surgery should be avoided (obviously, with rare exceptions).
3 years without any relief,,failed all injections physical therapy,meds,,still the drs in my area turn their heads with no clue,,after several mri reviews every dr has told me to get a discogram and see if theres a tear not showing on mri that could be leaking causing nerve pain,,low back pain down into my butt down my legs and my feet are killing me and i cant lify anything without pain and numbness shooting into my feet
Do lateral lumbar nerve compressions ever get better to where the sciatica goes away. From what I know, this has a lot less of an opening for the disc to avoid the nerve
Most sciatica symptoms will improve over time, but the MRI findings may or may not improve (despite the clinical improvement). The decision to perform surgery is based on the patient's symptoms more so than the MRI findings themselves. Sometimes a patient with a large disc herniation will have mild symptoms, and a patient with a small disc herniation will have severe symptoms.
Hello doctor my name is Jose Mendoza let me explain my case in big steps in 01/2020 I've been diagnosed with L3-L4-& L5 L5s1 bulged discs one doctor performed the Laminectomy on 02/21/21 but it just helped the sciatic pain for awhile so in 11/20/24 they decided to perform the fusion surgery which helped for a couple of months then I started to feel pain once again on my lower back with inflammation and radiation to my right leg and after more than 80 physical & acupuncture therapies they make another MRI with contrast they didn't found anything abnormal but the doctor said that due to the long wait to perform the fusion some nerves and muscles are messed up and that the pain it's going to be forever what is you opinion to this diagnostic. Thank you for your time.
I waited 2 years as I had type 2 diabetes and my surgeon wanted me to bring my hba1c down. I did that and lost 28 pounds. I’m 3 weeks post op now and still have sciatica now and again. I’m taking paracetamol and ibuprofen. Will this get better or should I take strong pain meds? My doctor (I live in the uk) gave me oxycodone but I’m frightened to take it.
re. realistic expectations: how to ask about possible outcome of the spine surgery? patients usually are interested about the outcome. Is it possible to say that some symptoms/procedures can be healed/works better, close to 100%? If yes, which one?
I was forced to wait 9 years in constant pain taking lots of pain meds doing physio. My back just got worse all the time. Im lucky surgery has been the best thing for me. But I have suffered an heart attack 2 year before surgery I am struggling to get my fitness up. I needed a lot of pain killer's before sugery I was able to stop them soon after surgery, I did have withdrawal for 2 weeks but I no longer needed them so stopped.
Excellent advice! I had a 360° surgical fusion C3-C6 & was compressed too long resulting in Myelomalacia at C4-C5. The result of now living with a spinal cord injury has caused significant pain in my arms & bilateral thumb pain to the point of 24/7 pain as well as gait issues & terrible nerve pain. Having something that is irreversible is devestating especially when it causes pain. Thank you for touching on important things to think about when having spine surgery. 🩻🙏🏻
Thank you for your kind words, appreciate it. I am glad you recognized that you were dealing with a serious problem and you took the steps to address it. Good luck!
I was diagnosed with RSD/CRIPS several yeara ago. I had a laminectomy microdisectomy a month ago. It wasn't successful. Surgeon wants to do a fustion L4/5. I had very bad pain, difficulty walking and standing. This being week 4 I am a little better but not i wbere I can do much without pain. I am 74. I am considering not going forward with the 2nd surgery. I am taking 2 oxycodone 5 mg so twice a day along with muscle relaxer. I am considering pai management. I hope there is another option. I have herard Lyrica and Gabepentin are optins. I have other issues with blood clots have to take lovanox injections before surgery and several days after. Any advise would be appreciated.
I had spine surgery s1 L5 L4 fusion seemed to be recovering fine stared work after 3 months driving tarmac and dirt tracks have slight pain and discomfort left hip side with tingerling sensations left foot is this normal after this period in time my surgeon it's normall needs more time
I am due to have disk replacement surgery C4,5,6 and am not due my pre op for another month. I am 37 years old had symptoms many years and tried all the non surgical treatments but the last two days my symptoms have intensified, I am waking up with totally numb arms and very heavy legs/ weakness. Should I inform the surgeon that I am getting worse or just wait for my pre op in a month. ?
Thank you for reaching out. Obviously I don't know the particulars of your condition, so I can't make any diagnostic or treatment recommendations. Having said that, I think if there is a substantial change in your condition, it would be wise to tell your surgeon about it, since it may have significant implications down the road. Good luck to you 👍👍
I've had a fusion/Laminectomy on L4-5. The surgeon cut through the dura-matter trying to free a nerve because I have Arachnoiditis. I also have Scollois (40< angle), 7 ruptured discs, 6 bulging discs, and my new Neurosurgeon wants to fuse me from T-1, to L-5. I really thought I could just get my spinal cord stimulator removed and replaced with a morphine spinal cord injector. I don't like opiates but am in a high level of constant pain. Do you think the fusion is a good idea?
Thank you for reaching out. The situation you described sounds quite complex, and since I have not had a chance to examine you and review your imaging studies, it is not possible for me to recommend a treatment. Having said that, if you are not sure about the recommendation of the surgeon, it would be very helpful for you to consider getting a second opinion from another surgeon. Wishing you good health and good luck in the future 👍
I gotta get a ACDF surgery in a few weeks. I’m extremely nervous. I’ve been feeling dizzy, have vertigo, have balance issues and legs and arms hurt. Would the surgery help me regain my balance and leg and arm strength and would it stop my Vertigo or dizziness?
Hello I have to tarlov cysts on my spine and one Neurologist tells me it Sitting on a Nerve and I saw a Neurosurgeon and tells me tha is my Leg nerves My symptoms tinkling numbness and burning. Please tell me your opinion. Thank you
Thank you for your question. Most spine surgeons/ specialists believe that Tarlov cysts are (most of the time) benign and do not cause significant symptoms. Numbness/ burning pain in the legs may be related to a different matter, about which I previously made a video: ua-cam.com/video/X9JMMaeBUJc/v-deo.html You may need a second opinion. Good luck to you 👍
Yes doctors need to state that we can't guarantee your outcome. Unrealistic? People are going to the doctor to feel better not worse? If you don't have the way to do that, you shouldn't do the surgery either. Many of these patients have LYME disease and untreated or diagnosed. Why do they not get more involved with diagnosis of arthritis and LYME disease?
I've had 2 cervical spine fusions with titanium plates & screws , one in the mid 90's the other 2007 . I now have myelomalacia. Its getting worse ,pain , tremors ,muscle spasms , nerve pain in sides of neck so excruciating I've been to the ER several times , to the point i could hardly walk . I have various symptoms every day now . Tremors get so bad my own daughter accused me of being a meth addict, against my knowledge & permission told the ER Dr. to run drug screen on me .
Thank you for reaching out. Every case is different, so I cannot comment on your specific situation. However, it is not unusual to develop disc-problems above/below a previous fusion. In that case surgery may be a reasonable option. However this is something that you need to discuss with your spine surgeon. Here is a video which might be helpful to you: ua-cam.com/video/ovSTtD08Olw/v-deo.html Good luck.
re. waiting too long: are there any spine problems which have stronger indication that waiting or relying on the rehabilitation is not a good option and should be treated with surgery rather sooner than later? (not talking about severe prob. with cauda equina)
This is a very difficult question to answer, because spine surgery in the setting of AS carries a lot of risks, and complications are very common. You should seek consultation with a very experienced spine surgeon who has a lot of experience with AS spine surgery. If the surgeon's recommendations are not satisfactory, it may be helpful to get a second opinion from another surgeon. Wishing you good luck and the best of health 🙏
Salam, thank you for reaching out. It is not possible to make a diagnosis or recommend a particular treatment for your condition without obtaining history, performing a physical examination and obtaining the appropriate imaging studies. Therefore, I suggest an in-person evaluation with a spine-specialist. Having said that, I have a video about sciatica which may provide you with some useful information: ua-cam.com/video/X9JMMaeBUJc/v-deo.html There are good treatment options for patients with sciatica, and most patients do not need surgery. Wishing you all the best 🙏
The risk of spine-infection after surgery is higher in patients with diabetes. The better controlled the diabetes before and after the surgery, the lower the chance of subsequent complications.
Watch UA-cam videos from patients that have gone thru the same or similar surgery. Everyone has a different post Op experience..... but you may gain some insight. Keeping control of the pain is way better than falling behind and playing catch up. Think pain "management" not "drugs".
Sorry to hear about your difficulties. An evaluation by a spine-specialist (spine surgeon and/ or pain-management physician) would be a reasonable place to start. Good luck to you.
I am very realistic about surgery but my spine surgeon was terrible. Offered no post op follow and just made his medical assistant tell I'm fine, no pain management, I had to beg for a follow up absolutely no follow up.
I’m sorry you had such a horrible experience hope you did get some pain management. Reading your words just made me realize my neurosurgeon has no bedside manner and I’d HAVE YOUR SAME EXPERIENCE.
I have 3 herniated discs at L3-L4, L4-L5, and L5-S1. I've been dealing with this problem for 2 years now, but I've only just now started seeing an orthopedic surgeon because it's gotten so much worse. I've been doing physical therapy for the last 6 weeks, but it's not getting better. My back is still locking up on me and giving me problems. I had to quit a job where I was making $2,500 a week because I literally couldn't get through a day without my back and legs giving out on me. 2 surgeons have recommended fusion surgery if my symptoms don't improve and that terrifies me, but I think that's where I'm headed. I'm only 28 years old. I shouldn't be dealing with this 😢
Thank you for your thoughtful comment. The situation you describe is undoubtedly very difficult, and I see patients with your dilemma routinely. It seems that you have done your due diligence by getting opinions from two different surgeons. Sometimes, after all other options have failed, surgery may be a reasonable option. Good luck 👍
I just had my second back surgery a little over 2 months ago. I can't stress this enough: RESEARCH, RESEARCH, RESEARCH. Choose your surgeon wisely. My first surgeon only ground down one of my discs and claimed the other one wasn't bad enough to operate yet. I was in worse pain after. 2.5 years later, this surgeon replaced the discs from L4-S1 with spacers, cut some of the vertebrae out to open up the nerve canal and put rods and screws in to fuse it. I'm in my 40's now but have been dealing with this for over 20 years. I still have radiating pain. Likely from waiting so long. I'm just some guy on the internet but I'd highly recommend getting that taken care of asap. It's only going to get worse. I've aged 25 years in the last 5 years and have been in excruciating pain for years. Get it fixed while you're young and healthy.
@@Mark-vi3qr I totally say you should not b dealing with that your age. Me at 43 years old I started with back issues now am 56 years old. I had 5 minimally invasive laser surgeries of one inch incision . Those bought me 9 years of only getting tractions laser ultrasound waves tents unit, heat or cold exercises and massages. Those 9 years did not need pain medicines. I eliminated sugar from my diet Also learned herbs to help and keep Inflammation to a minimum. I had no other choice than applying for disability due to failing to keep jobs for those 9 years. Disability took 7.5 years to accomplish. Be encouraged Also understand a complete change have to occur in your life. Do not Lift Do not get together with anyone Too healthy because they will not understand and will tempt you to mess up your back Yo need to protect yourself as much as possible Once they do put fusions and hardware it all goes downhill. Meaning one level after another starts giving you problems. Careful when neck levels break down the worst one are C 2 C3 C7 ( these ones have to do with balance and hand arm strength. I wish I could tell you more, but I’d a lot to write. Be selective on surgeons must be board certified Ortho Spine also fellowship trained. It will make the difference. Doctors now days act as if they are humans, But you will need them .
I'm 3 weeks out from a revision surgery due to fusion non union. My original surgery was August 2023. I started experiencing severe pain from my left hip down my outer thigh. Once the problem was diagnosed I was scheduled for surgery withing 2 weeks. When ai woke up inbthe recovery room and realized the searing/shooting pain in my leg was gone, I sobbed. I'm just trying to take it easy and NOT do the things I'm not supposed to do to ensure success. It's boring as hell, but I'll take boredum over pain any day. Don't keep putting yourself through the pain..
Expectation should be related to treating the actual pathology. Many surgeons fail the surgery from a technical perspective (pseudoartrosis, insufficient decompression, etc.) and then weasel out on taking responsibility by mentioning the unrealistic expectation of the patient. Funny.
Dr. Khan just performed my back surgery Wednesday and I already feel great 3 days later without any pain killers. Amazing!!!
I am honored by your kind words, thank you! 🙏
@@SpineSurgeonSpeaks Day 4 after spine surgery and went for a 1 mile walk and 7 mile bike ride without pain killers! Life changing!!!!!
What state is Dr Khan in?
My practice is located in Milwaukee.
For contact information please visit:
www.MustafaKhanMD.com
I had lumbar spinal surgery with rods, screws and peek. Unfortunately , I developed haematoma owing to defective drainage system and I was compelled to undergo a second surgery for removal of blood clots collected at the surgery side. I'm still lying in bed with pain on my 10 day though I have been released from hospital. Any advice doctor?
My husband had a fusion on L4 and L5 30 years ago. Just had that removed and fused L2-L5. Now only having pain in his left thigh. I'm hopeful that the pain will dissipate. It has been 3 weeks since surgery and there are some improvements. Plan is to get off of Opiods, but they have been very helpful during the recovery. Even with this new pain, he is happier than before surgery, he had a very loose expectation. He has very good help at home and does not need to do for himself until he is ready. We have all the grab bars and walk in shower etc due to his pain and disability prior to the second surgery. This was his 5th surgery (2 fusions and 3 laminictomies) and all surgeries were successful but he went back to work. Now at 70 he won't have to do that so we are hopeful that he will enjoy much less pain for the rest of his life. Thanks for this video, good points.
Recovering from spine surgery is a long process, as you are well aware by now. Taking pain-medications appropriately, staying active and paying attention to proper nutrition are all keys to achieving a good result. Wishing your husband all the best.
Thank you for sharing your experience, appreciate it. Good luck!
Doctor I understand the fear of opioids, but the pendulum has completely swung in the other direction, where no Doctor want to prescribe, the reasons are another discussion entirely! However, I was going to mention that a post op pain management plan is SO IMPORTANT! Too many times I have been post op and without an effective medication and when you are suffering it’s very difficult to navigate that and get it worked out. Having an advocate becomes SO CRITICAL! Just speaking from experience Doctor. Thank you for the great insight
Thank you for your excellent observation. You are correct.
Unfortunately the opioid epidemic was fueled by the actions of a lot of doctors (some well-meaning, others not so much) who created a terrible problem which haunts us to this day. How far is the pendulum going to swing before coming back towards sanity? I don't think anybody knows.
@@SpineSurgeonSpeaks hi Doctor, your points are well taken and you are correct, we can’t answer that question. I will mention this, which is really an example and it’s horrible. There are times when I can not control my breakthrough pain at home, hence I go to the ED, and whether I get adequate pain relief depends what “provider “ happens to be there that night , so I may or may not get treated, that is SIMPLY WRONG! A hospital ED should not send a patient home feeling the same or even worse than when he (I) arrived….
I just had a fusion and it was brutal. They had me on 10 mg of morphine every 4 hours!!!! Should be more and hourly 1st day. I AMA'd and left early to wither in pain at home.
I have a high tolerance for pain, but was left with horrendous pain after breast cancer surgery (ICBN damage). I was sent home, told to take Tylenol and meditate the pain away. After 3 nights in agony with no sleep I was suicidal. My GP eventually wrote me a prescription for hydrocodone so I could sleep with the ICBN damage. I weaned myself off of the opiods within a year. I am disabled due to a back injury with 2 years of PT and now cauda equina syndrome, but would choose to go to Mexico for surgery if I have to live that horror show again. I weaned myself off within 6 months. Thank goodness medical cannabis is now legal.
I am 62 and live in Southeast Lower Michigan. I injured my lower back in a shower fall about 12 years ago. The resulting injury/condition has finally reached the point where I can no longer put off this surgery and I'm scheduled with a surgeon (Dr. Vibert) on May 29th of this year. So, just a few weeks away now.
I'll admit I'm trepidatious, but it simply cannot wait any more.
Thank you for this video, Doctor. I found it interesting and enlightening.
Fortunately, I don't smoke, and I came off any opioids nearly a year ago. My surgeon, Dr. Vibert, has had the surgery himself 13 years ago at age 37 and has told me that even at my age, I'm a better candidate for the surgery than he was back then.
We will see!
Again, thank you for such clear explanations and advice!
Thank you for the compliment; I am honored to be able to help you in a small way. Best wishes to you, good luck on your upcoming surgery 👍
Am in hospital now I hard surgery l5 s1
Wishing you an excellent recovery ❤️
I had L4-5 laminectomy/ Discectomy and had more pain after. after PT for six months and injections I got second opinion. They said my spine was unstable and nerve crushed so did L4-5 fusion. Still had a ton of pain for the next 2 years. I had mri n ct scans. The surgeon said everything looks great. He said maybe it's your SI joints. He said it's common after spine surgery. So I did PT for two more years and more injections. After that, I ended up with 6 ifuse rods across my SI joints. Now I'm in more pain. This neurosurgeon that did the Ifuse did an MRI and he noticed the screws in my nerve canal. He said this didn't look right. So now I went to a trauma surgeon to help me figure it out He said on your L4-5 fusion you have two screws sitting inside your nerve canal. You need to get those out and he doesn't do spine surgery. I went back to the surgeon who put them in and they said we take full responsibility. I was fused so they took the entire cage out and left the plate. Went for my follow up with the surgeon and they changed it to the PA. They said that he will not see me. When I saw the PA, he was in the office and turned away and wouldn't even talk to me on my husband. The pa said he won't see you. Now I'm in the process of getting the ifuse rods out at Mayo Clinic in Rochester MN.
All my surgeries were done in the Boston area and I thought we had great surgeons. I am terrified now. I wish I had someone like you in the beginning. This has been life altering. I've got four children and two little granddaughters and I hardly ever see them and it breaks my heart. my husband and I have not gone on vacation for the last five years I am basically in bed on an ice machine, majority of the time I try to get out and walk, but it's awful. Most of this started when I had an RFA,m on l4-5 anna S 1 which put me in the hospital for five days. I also found out I am allergic to titanium. I have severe burning where the rods are. It's pure red across si joints which is reason for ice machine.
I love your honesty, telling people not to jump into surgery! We need more people like you for sure this world
I am very sorry to hear about your very difficult journey: Undergoing multiple spine & orthopedic surgeries takes a toll on the body (and the mind), no question about it. It can take a long time to recover, and it is difficult to stay positive and optimistic during this time, and I understand your dilemma. I hope you have found a pain-management doc who can manage your symptoms with some medications. Wishing you all the best, take care, hope you feel better soon 🙏
@@SpineSurgeonSpeakswhat is the alternative material if the patient has allergy to titanium?
@@rosettireyes4572I know you are waiting for Dr to reply but the alternative metal is cobalt chromium
Sorry to hear your story. How you feel nowadays?
I have the beginning of caudas equinas. Minimal neuropathy from bum to feet. But clearly squashed nerves at L3 - L5 (S1 has related neuropathy but not nearly as severe compression) based on my most recent MRI. Previously SI injections worked to combat the pain but the last round was minimal.
I am opting to go ahead with the L3-L5 fusion now. And doing PT 3 times a week until then.
I turn 59 in a week and can not see suffering into retirement knowing decompression is eminent.
Prayers appreciated !
My prayers are with you.
Good luck.
Wishing you a successful surgery and a fantastic recovery ❤️🙏
@kathleensarmiento932
I had the beginning as well, with drop foot. Had my surgery , L4/5 decompression with fusion, 4 weeks ago. Pain managed after surgery with Lyrica that was replacing Dilaudid gradually as I was lowering dose of Dilaudid, and stopped Dilaudid 2 days before discharged, 3 weeks after surgery as I got transferred to Rehabilitation after surgery. I was determined to stop Dilaudid, we as patients should not be seeing these kind of medications as a miracle pill, as often some other medication can control the pain as much as this one if not even better depending what kind of pain it is. my plan is as Time goes to lower the dose of Lyrica gradually as well if possible. Time at Rehabilitation Centre was a blessing , if it is possible for you to have it right after surgery that would be great. I also got brace that would help with drop foot when I am at work especially . I still have a drop foot but I am working on it trying to strengthen muscles on my foot, as there is still ability in my foot to move down and to sides.
Prayers for you to have successful surgery and recovery as well !
@@SpineSurgeonSpeaks Thank you for your videos Dr.Khan and the help provided.!
Thank you for sharing.
Glad to see that you are on the path to recovery. I hope you keep up with the therapy and stay optimistic.
Wishing you the best of luck and the best of health 👍
*So, I had also the beginning with drop foot, and had L4/5 decompression with fusion 4 weeks ago. I was determined and was able to get off Dilaudid about 3 weeks after surgery , 2 days before getting discharged from Rehabilitation Centre, where I was transferred after my surgery. Lyrica was gradually going up replacing Dilaudid while Dilaudid dose was going down and stopped. It is very important for patients to not think od narcotic pain killers as a miracle pill because some other medications can replace and in some cases work even better than narcotics. I hope to be able as recovery goes gradually reduce the dose of Lyrica as well. There is some pain now still , but well managed , and drop foot as well, after surgery , but I am working on it , trying to strengthen muscle and give time for my nerve to hopefully heal.
I am not sure about you, in regards to my drop foot , I am strengthening specidic muscles little by little with exercises, as my foot is able to go down and to the side.
I got also brace that for my foot that would be helping me at work.
If is possible to get Rehabilitation Centre, as inpatient , that would be excellent, as I feel really blessed for getting that. It was huge help for being able to move on after surgery , physically, but mentally as well as feel and see your progress.
Prayers for you, and best of luck!
Thank you very much Dr Khan.👍👍
It is my pleasure, glad to be of help! Thank you for your kind words, appreciate it.
Is shorts better than surgery
Thank you Dr. Khan. That is a awesome presentation. I have had two Doctors in Orthopaedics, and I learned that it take one to really focus on what you hear and learn. I decided to change doctors for what I think was my equivalent of getting a good second opinion. I have not gotten any surgery at this point, but in the meantime, and for whatever reason, the pain level has receded by a factor of about 60 to 70%. So when I get to see my surgeon, I hope he can explain what could have happened.
Thank you for your kind words, I am happy that the video was helpful to you.
Getting a second opinion is usually very helpful to patients.
I have a similar video which you may find interesting:
ua-cam.com/video/ovSTtD08Olw/v-deo.html
Wishing you all the best, and good luck to you 👍
Very pertinent and helpful video ! Thanks
Thank you for your kind words, appreciated 🙏❤️
I’ve had 4 fusions and I am that fortunate person who has had 90-100% relief of symptoms. But yeah, it took awhile and PT.
Hope you do not mind me asking, what levels? Had l4 and l5 fusion, magnificent.
I think for me, because surgeon wants to do this asap due to signs of myolopathy, (been waiting 5 years for appointment) it doesn't matter if pain improves or not, just that the pressure is off the spinal cord.
Oh gosh he didn't say anything about recovery. Have no idea what I will be able to do or not do and for how long... One thing I don't understand is as I have degenerative disc disease and all joints in cervical spine are also arthritic with degrees.of stenosis, why can't I have a disc replacement instead of a fusion? As I understand it, joints above and below fusion degenerate faster and they are already degenerative, so wouldn't a disc replacement be better? Thank you for helping us with these videos.
There's a ton of patient videos from pre surgery to years out chronicling their expectations. Of course everyone is different....but many of the experiences are similar. And the suggestions are extremely valuable.
The new titanium spacers have give and space for bone growth. Replacement discs only serve about 5% of issues and can worsen arthritis. (I asked that too !)
What kind of fusion are you talking about since replacement of disks is also called fusion?
I have been suffering from disc bulge for the past 2 months. This bulge caused canal stenosis and I am unable to stand for more than 5 minutes due to shooting pain in my left leg and 2 of my left feet fingers are already having less sensations. I am unable to do any activity and completely bed ridden. I don't know if i should go for surgery or wait for some time ?
We all know sir that there is no 100% better even an 80% is a great outcome better than having strangled feet legs thighs and even hips.
Those same things you mentioning I can no longer do
Awesome video! Thanks for all the input! 😮 just wanted to know who a doctor goes about fixing a bulge disc since it hasn’t really ruptured. Would it still be similar to a micro discectomy? Or is a bulge disc and herniated disc interchangeable terms? 😮 thanks again 🙏
That's a good question.
Most surgeons will be reluctant to operate on a disc that is bulging but not ruptured/ herniated. Unless a disc is causing a direct nerve compression, in general surgery should be avoided (obviously, with rare exceptions).
@@SpineSurgeonSpeaks awesome! Makes sense! Thanks so much! 👏
3 years without any relief,,failed all injections physical therapy,meds,,still the drs in my area turn their heads with no clue,,after several mri reviews every dr has told me to get a discogram and see if theres a tear not showing on mri that could be leaking causing nerve pain,,low back pain down into my butt down my legs and my feet are killing me and i cant lify anything without pain and numbness shooting into my feet
Do lateral lumbar nerve compressions ever get better to where the sciatica goes away.
From what I know, this has a lot less of an opening for the disc to avoid the nerve
Most sciatica symptoms will improve over time, but the MRI findings may or may not improve (despite the clinical improvement). The decision to perform surgery is based on the patient's symptoms more so than the MRI findings themselves. Sometimes a patient with a large disc herniation will have mild symptoms, and a patient with a small disc herniation will have severe symptoms.
Hello doctor my name is Jose Mendoza let me explain my case in big steps in 01/2020 I've been diagnosed with L3-L4-& L5 L5s1 bulged discs one doctor performed the Laminectomy on 02/21/21 but it just helped the sciatic pain for awhile so in 11/20/24 they decided to perform the fusion surgery which helped for a couple of months then I started to feel pain once again on my lower back with inflammation and radiation to my right leg and after more than 80 physical & acupuncture therapies they make another MRI with contrast they didn't found anything abnormal but the doctor said that due to the long wait to perform the fusion some nerves and muscles are messed up and that the pain it's going to be forever what is you opinion to this diagnostic.
Thank you for your time.
I waited 2 years as I had type 2 diabetes and my surgeon wanted me to bring my hba1c down. I did that and lost 28 pounds. I’m 3 weeks post op now and still have sciatica now and again. I’m taking paracetamol and ibuprofen. Will this get better or should I take strong pain meds? My doctor (I live in the uk) gave me oxycodone but I’m frightened to take it.
re. realistic expectations: how to ask about possible outcome of the spine surgery? patients usually are interested about the outcome. Is it possible to say that some symptoms/procedures can be healed/works better, close to 100%? If yes, which one?
This video was very helpful.
Glad to hear that! Thank you for watching 👍
I was forced to wait 9 years in constant pain taking lots of pain meds doing physio. My back just got worse all the time. Im lucky surgery has been the best thing for me. But I have suffered an heart attack 2 year before surgery I am struggling to get my fitness up.
I needed a lot of pain killer's before sugery I was able to stop them soon after surgery, I did have withdrawal for 2 weeks but I no longer needed them so stopped.
Excellent advice! I had a 360° surgical fusion C3-C6 & was compressed too long resulting in Myelomalacia at C4-C5. The result of now living with a spinal cord injury has caused significant pain in my arms & bilateral thumb pain to the point of 24/7 pain as well as gait issues & terrible nerve pain. Having something that is irreversible is devestating especially when it causes pain.
Thank you for touching on important things to think about when having spine surgery. 🩻🙏🏻
Thank you for your kind words, appreciate it. I am glad you recognized that you were dealing with a serious problem and you took the steps to address it. Good luck!
I was diagnosed with RSD/CRIPS several yeara ago. I had a laminectomy microdisectomy a month ago. It wasn't successful. Surgeon wants to do a fustion L4/5. I had very bad pain, difficulty walking and standing. This being week 4 I am a little better but not i wbere I can do much without pain. I am 74. I am considering not going forward with the 2nd surgery. I am taking 2 oxycodone 5 mg so twice a day along with muscle relaxer. I am considering pai management. I hope there is another option. I have herard Lyrica and Gabepentin are optins. I have other issues with blood clots have to take lovanox injections before surgery and several days after. Any advise would be appreciated.
MRSA spine abscess here. Septic. One hour away from ER. So sleepy
Hi
I broke my L2
I was told i need an operation cause it could break and fall on my nerves.
I amin tomorrow ❤
Wishing you good luck and good health. Hope you make an excellent recovery.
I had spine surgery s1 L5 L4 fusion seemed to be recovering fine stared work after 3 months driving tarmac and dirt tracks have slight pain and discomfort left hip side with tingerling sensations left foot is this normal after this period in time my surgeon it's normall needs more time
I am due to have disk replacement surgery C4,5,6 and am not due my pre op for another month. I am 37 years old had symptoms many years and tried all the non surgical treatments but the last two days my symptoms have intensified, I am waking up with totally numb arms and very heavy legs/ weakness. Should I inform the surgeon that I am getting worse or just wait for my pre op in a month. ?
Thank you for reaching out.
Obviously I don't know the particulars of your condition, so I can't make any diagnostic or treatment recommendations. Having said that, I think if there is a substantial change in your condition, it would be wise to tell your surgeon about it, since it may have significant implications down the road.
Good luck to you 👍👍
I've had a fusion/Laminectomy on L4-5. The surgeon cut through the dura-matter trying to free a nerve because I have Arachnoiditis. I also have Scollois (40< angle), 7 ruptured discs, 6 bulging discs, and my new Neurosurgeon wants to fuse me from T-1, to L-5.
I really thought I could just get my spinal cord stimulator removed and replaced with a morphine spinal cord injector. I don't like opiates but am in a high level of constant pain. Do you think the fusion is a good idea?
Thank you for reaching out.
The situation you described sounds quite complex, and since I have not had a chance to examine you and review your imaging studies, it is not possible for me to recommend a treatment. Having said that, if you are not sure about the recommendation of the surgeon, it would be very helpful for you to consider getting a second opinion from another surgeon.
Wishing you good health and good luck in the future 👍
@@SpineSurgeonSpeaks Thanks
I gotta get a ACDF surgery in a few weeks. I’m extremely nervous. I’ve been feeling dizzy, have vertigo, have balance issues and legs and arms hurt. Would the surgery help me regain my balance and leg and arm strength and would it stop my Vertigo or dizziness?
Dr Khan,
Do you have offices in Florida??
Thank you
Thank you for asking. Unfortunately I don't have an office in Florida; I am based in Wisconsin.
Hello I have to tarlov cysts on my spine and one Neurologist tells me it Sitting on a Nerve and I saw a Neurosurgeon and tells me tha is my Leg nerves My symptoms tinkling numbness and burning.
Please tell me your opinion.
Thank you
Thank you for your question.
Most spine surgeons/ specialists believe that Tarlov cysts are (most of the time) benign and do not cause significant symptoms.
Numbness/ burning pain in the legs may be related to a different matter, about which I previously made a video:
ua-cam.com/video/X9JMMaeBUJc/v-deo.html
You may need a second opinion.
Good luck to you 👍
Yes doctors need to state that we can't guarantee your outcome. Unrealistic? People are going to the doctor to feel better not worse? If you don't have the way to do that, you shouldn't do the surgery either. Many of these patients have LYME disease and untreated or diagnosed. Why do they not get more involved with diagnosis of arthritis and LYME disease?
I had a thoracic spine tumor surgery a year ago.. d5 d7 nd left rib extension.
But still I have severe pain. Difficult to do day to day simple work.
Thoracic spine surgery with rib resections can be very painful. Wishing you all the best 👍
I've had 2 cervical spine fusions with titanium plates & screws , one in the mid 90's the other 2007 .
I now have myelomalacia. Its getting worse ,pain , tremors ,muscle spasms , nerve pain in sides of neck so excruciating I've been to the ER several times , to the point i could hardly walk . I have various symptoms every day now . Tremors get so bad my own daughter accused me of being a meth addict, against my knowledge & permission told the ER Dr. to run drug screen on me .
Superb.thank you
Thank you, glad you found the video helpful
my age 54yrs ist ACDF surgery at may 2021 C5C6 but agents problems atC3C4 and C7 dr Advised surgery MRI Report
Thank you for reaching out.
Every case is different, so I cannot comment on your specific situation. However, it is not unusual to develop disc-problems above/below a previous fusion. In that case surgery may be a reasonable option. However this is something that you need to discuss with your spine surgeon.
Here is a video which might be helpful to you:
ua-cam.com/video/ovSTtD08Olw/v-deo.html
Good luck.
re. waiting too long: are there any spine problems which have stronger indication that waiting or relying on the rehabilitation is not a good option and should be treated with surgery rather sooner than later? (not talking about severe prob. with cauda equina)
Appreciate this info Dr. I’m scheduled to have a ACDF next week
Best of luck!
Dr Khan if a person has ankylosing spondylitis they back is hunch shud they go for surgery
This is a very difficult question to answer, because spine surgery in the setting of AS carries a lot of risks, and complications are very common. You should seek consultation with a very experienced spine surgeon who has a lot of experience with AS spine surgery. If the surgeon's recommendations are not satisfactory, it may be helpful to get a second opinion from another surgeon.
Wishing you good luck and the best of health 🙏
Assalamu alaikum Dr Khan. I have back pain, tingling and numbness in both my legs with sciatica. What do I do?
Salam, thank you for reaching out.
It is not possible to make a diagnosis or recommend a particular treatment for your condition without obtaining history, performing a physical examination and obtaining the appropriate imaging studies. Therefore, I suggest an in-person evaluation with a spine-specialist.
Having said that, I have a video about sciatica which may provide you with some useful information:
ua-cam.com/video/X9JMMaeBUJc/v-deo.html
There are good treatment options for patients with sciatica, and most patients do not need surgery.
Wishing you all the best 🙏
How fast can you heal with diabetes?
The risk of spine-infection after surgery is higher in patients with diabetes. The better controlled the diabetes before and after the surgery, the lower the chance of subsequent complications.
is pain level which requires pain killers necessary to have spine surgery? Or moderate level of pain but almost permanent is also and indication?
You may find this video helpful:
ua-cam.com/video/9ObaE8_sNBM/v-deo.html
Watch UA-cam videos from patients that have gone thru the same or similar surgery. Everyone has a different post Op experience.....
but you may gain some insight. Keeping control of the pain is way better than falling behind and playing catch up. Think pain "management" not "drugs".
All I’m expecting is a large % decrease in my PAIN PLEASE?🙏🙏🙏
Sorry to hear about your difficulties. An evaluation by a spine-specialist (spine surgeon and/ or pain-management physician) would be a reasonable place to start. Good luck to you.
I am very realistic about surgery but my spine surgeon was terrible. Offered no post op follow and just made his medical assistant tell I'm fine, no pain management, I had to beg for a follow up absolutely no follow up.
I’m sorry you had such a horrible experience hope you did get some pain management. Reading your words just made me realize my neurosurgeon has no bedside manner and I’d HAVE YOUR SAME EXPERIENCE.
Great information. Do you consider chewing tobacco to have the same negative impact on healing?
Yes, nicotine by itself is a toxic substance.
I have 3 herniated discs at L3-L4, L4-L5, and L5-S1. I've been dealing with this problem for 2 years now, but I've only just now started seeing an orthopedic surgeon because it's gotten so much worse. I've been doing physical therapy for the last 6 weeks, but it's not getting better. My back is still locking up on me and giving me problems. I had to quit a job where I was making $2,500 a week because I literally couldn't get through a day without my back and legs giving out on me. 2 surgeons have recommended fusion surgery if my symptoms don't improve and that terrifies me, but I think that's where I'm headed. I'm only 28 years old. I shouldn't be dealing with this 😢
Thank you for your thoughtful comment.
The situation you describe is undoubtedly very difficult, and I see patients with your dilemma routinely. It seems that you have done your due diligence by getting opinions from two different surgeons. Sometimes, after all other options have failed, surgery may be a reasonable option. Good luck 👍
I just had my second back surgery a little over 2 months ago. I can't stress this enough: RESEARCH, RESEARCH, RESEARCH. Choose your surgeon wisely. My first surgeon only ground down one of my discs and claimed the other one wasn't bad enough to operate yet. I was in worse pain after. 2.5 years later, this surgeon replaced the discs from L4-S1 with spacers, cut some of the vertebrae out to open up the nerve canal and put rods and screws in to fuse it. I'm in my 40's now but have been dealing with this for over 20 years. I still have radiating pain. Likely from waiting so long. I'm just some guy on the internet but I'd highly recommend getting that taken care of asap. It's only going to get worse. I've aged 25 years in the last 5 years and have been in excruciating pain for years. Get it fixed while you're young and healthy.
How are you feeling now?
@@Mark-vi3qr I totally say you should not b dealing with that your age. Me at 43 years old I started with back issues now am 56 years old.
I had 5 minimally invasive laser surgeries of one inch incision . Those bought me 9 years of only getting tractions laser ultrasound waves tents unit, heat or cold exercises and massages.
Those 9 years did not need pain medicines.
I eliminated sugar from my diet
Also learned herbs to help and keep
Inflammation to a minimum.
I had no other choice than applying for disability due to failing to keep jobs for those 9 years. Disability took 7.5 years to accomplish.
Be encouraged
Also understand a complete change have to occur in your life.
Do not Lift
Do not get together with anyone Too healthy because they will not understand and will tempt you to mess up your back
Yo need to protect yourself as much as possible
Once they do put fusions and hardware it all goes downhill. Meaning one level after another starts giving you problems.
Careful when neck levels break down the worst one are C 2 C3 C7 ( these ones have to do with balance and hand arm strength.
I wish I could tell you more, but I’d a lot to write.
Be selective on surgeons must be board certified Ortho Spine also fellowship trained. It will make the difference.
Doctors now days act as if they are humans, But you will need them .
I'm 3 weeks out from a revision surgery due to fusion non union. My original surgery was August 2023. I started experiencing severe pain from my left hip down my outer thigh. Once the problem was diagnosed I was scheduled for surgery withing 2 weeks. When ai woke up inbthe recovery room and realized the searing/shooting pain in my leg was gone, I sobbed. I'm just trying to take it easy and NOT do the things I'm not supposed to do to ensure success. It's boring as hell, but I'll take boredum over pain any day.
Don't keep putting yourself through the pain..
dr khan help please thanks
I can afford the conservative or surgery I’m in so much pain and also have m s 😢I would love to do acupuncture and cyropratic
Yes, this can be a very difficult situation, I feel for you. Wishing you all the best 👍
🙏🙏🙏🙏
Thank you 👍
Expectation should be related to treating the actual pathology. Many surgeons fail the surgery from a technical perspective (pseudoartrosis, insufficient decompression, etc.) and then weasel out on taking responsibility by mentioning the unrealistic expectation of the patient. Funny.
What about weed smoker
You think people around 30+, never smoke and drink will recover pretty well from fusion?
Yes, most healthy people will do very well.