Surgical Options for Cervical Myelopathy
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- Опубліковано 13 лип 2022
- This video will summarize the different surgical methods that can be used for cervical myelopathy. Surgial techniques, risks, and outcomes are looked at in detail.
#thespineguy #ACDF #CDR #laminoplasty #laminectomy #fusion #spinesurgery #cervicalmyelopathy
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
Yelp:
www.yelp.com/biz/brian-su-md-...
Contact two locations:
www.caorthospine.com/
415-927-5300
2 Bon Air Road, Suite 120
Larkspur, CA 94939
7100 Redwood Blvd, Suite 200
Novato, CA 94945
Curriculum Vitae:
www.caorthospine.com/brian-su...
FTC: This video is not sponsored.
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.
I'm a nurse by the way Dr. I found your videos and being a nurse for many years....I can honestly say I've NEVER seen a Dr provide help to people like you have. The lay person can understand you and I completely enjoy them..God bless you Dr. You have no clue how much you've helped us...I'll let you know the outcome!!
I agree. Thank you Dr. Su! It's greatly appreciated.
I am retired anesthesiologist (about 35 yrs) and your presentation is just superb. You remind me of med school teacher. Just EXCELLENT.
Thank You for this, very informative. I really don't know how a layman could research the subject better than your videos. You are doing a valuable and much needed service. I think the expression( giving back) is used today flippantly and nonchalantly, not so in your case. Thank you for your unselfish and humble attitude and the information you freely give.
I was a neck surgery person. I got my surgery on 2013. I don’t know whether it laminoplasty or something else. But there is a fusion. Now I cannot turn my neck properly and always a bit pain. I was watching your video and big surprise how much convenient the new laminoplasty surgery is. I’m thinking what a great surgeon you are. Wish you all the best.
I am in awe of the compassion and knowledge of physicians like you. I was diagnosed with Cervical Myelopathy this week, and I have been very depressed. I have 10 Grandchildren I still want to be around for. I am also a nurse who worked on a neurosurgery unit for 20 years, and saw patients newly post-op, and at their worst for pain. I am terrified. But, your videos are giving me hope! Thank you. ❤
My Dad has had this operation in October, 2022. Things didn't go well, the cage collapsed so he had to have another operation and they went in from the back of his neck this time. He was in hospital for weeks, he is 79 years old and is still needing carers, he can do very little and struggles to stand up (he has a frame) and he is struggling with exhaustion. We do not know if this is related or not, nobody seems able to tell him anything.@@cglaspirant1234
I ¹@@cglaspirant1234
Grateful to you, Dr. Su for making it easy to understand degenerative cervical diseases and treatment options! You are such a blessing to those of us looking for relief!
My older brother was one of those very rare few. He was rushed into emergency surgery after collapsing at work. He lost partial function but is slowly improving. He has multiple surgeries yet to go.
Both of my brothers and I have spinal problems, and I know that it runs on both sides of my family.
My uncle has some kind of stimulator in his back that basically changed his life.
Thank you for your videos. I have multiple herniations at c4,c5 c5-c6. I've been desperately trying to avoid surgery but it is inevitable. Your videos give a clear understanding of what to expect and the road ahead.
Another brilliant video sir! You have an elegant manner for explaining complex medical procedures in completely comprehensible terms.
You have helped us so much Dr. My husband has been going through so much for 5 years...Thanks to you, he just got the x-ray you recommended for the spinal compression today...We have an appointment with a Dr who actually called us back after he initially said he couldn't understand the "why" my husband had pain . Thank you for being humble and so very very kind...
Thank you! Very well explained. After seeing several surgeons, none have the time or inclination to provide this detailed, easily understood explanation of options. Please keep up these critically needed videos, you are doing tremendous service to those of us suffering from these conditions!
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
I know...I'm using this to pre-educate myself. It should save time for him having to explain it and it lets me know they are evaluating all options.
Thank you so much for taking the time to make these videos. I am having laminoplasty (3 levels C4-C6) in a week. This gave me more confidence and reassurance. Excellent pedagogy and very (!) credible information. Dr. Su, you made a positive difference for me!
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
This video is amazing. I have had 2 anterior, and 2 posterior cervical fusions, C2-T1 , 2 failed fusions...I wish I would have seen this sooner . Good job with this for the lay person, I'm in the medial field 29 years and it was hard to understand even then... thank you
beautifully presented doc....thank you👏🏾
Really interesting. I am having an main scan soon. I know I have trapped nerves but pain is getting so much worse. I learnt so much. Thanks, uk
Thank you for your great videos. God bless.
Thanks for your videos - they are so helpful! I've commented in your other videos. I have major compression at C3/4, a good C4/5, and major disc herniations at C5/6 and C6/7. I'm fortunate enough to have been able to consult with two of the top surgeons (both contributors to the study you cited!). One recommended a C5-7 ACDF, then posterior C3 laminectomy, C4-C5 laminoplasty, and rods+screws posterior to support C5-7 from the back. The other surgeon, who is local to me, is saying my case is quite unique but is initially recommending a 4 level ACDF C3-7 (he is going to review my case with his colleagues at Jefferson U this week).
I'm leaning towards the ACDF if it is confirmed to be the recommendation. Even though I am only 50 years old and the thought of a 4 level fusion and the likely mobility reduction that comes with it scare me, the first recommendation (both front and back with different techniques) seems fraught with risks, not to mention the recovery is surely MUCH more painful. Again - thank you so much for your videos - they are so helpful.
Very helpful Doctor
Thank you !
Your videos are so informative. I have been viewing them in preparation for my appointment with a Neurosurgeon for cervical radiculopathy. I feel like I know so much more about my condition and can formulate questions for my appointment. Thank you so much!
You should watch the cervical radiculopathy videos
@@DrBrianSuTheSpineGuy My Neurosurgeon is recommending a 3-level ACDF for C3-5. The concern is the muscle weakness in my left arm is not improving and She indicated that epidural injections would not help nor P.T. at this point in consideration for more conservative approaches. Not the best news but I am not surprised. I plan on obtaining a second opinion from an Orthopedic Spine surgeon and if he concurs then I will consent to have surgery. Thankfully, no myelopathy is present. She was very impressed with the question I had and asked if I had a medical background. No. I don’t but I like to learn and be informed and I want to thank you for the informative videos because they helped me address questions/concerns that I have about this condition. BTW, the Radiculopathy videos and the video on the ACDF procedure are just excellent! Thank you so much!
Love this doctor
Interesting thank you
Very educational. Can you do one on cervical endoscopy and when it is appropriate?
thanks
Thanks so much for these great videos! If only you were practicing where I live, and you were my surgeon! 😀
You can make a virtual appointment by calling California orthopedics and spine.
@@DrBrianSuTheSpineGuy Thanks Dr Su. I see a spine surgeon next week and I might make an appt with you for a second opinion!
I had single-level ACDF at c6/7 on June 16 for cervical radiculopathy/myelopathy. The recovery was amazingly easy and pain was minimal. My pre-surgery symptoms have not disappeared entirely yet but they’ve improved dramatically. My range of motion is fantastic.
Do you do ultrasonic surgery where a tool shaves the bone and just opens up the channel without hardware
Thank you for the options... rarely do you get these today. The effort just isn't there ... 👍👊
Nice 😊
Thank you for the information. As I consult with my doctor on how to proceed with my osteophytes causing spinal chord compression. Can you discuss ultrasound techniques used to remove the osteophytes thus reducing chord compression.
Your videos are very informative. I am a 74 year old former athlete and avid golfer who has had through and MRI in May 2022 been diagnosed with severe stenosis of the left-sided neural foramina at C2-C3 and C3-C4. I have no numbness in my arms and legs and still have my strength with the limbs. I do get though a burning and stabbing pain in in my left neck and left shoulder especially after golf. For the last nine months I have been treated by a pain management clinic and have had epidural injections, nerve bocks, and and an ablation in October. I also am taking Gabapentin daily and have purchased a cervical home traction machine which I use daily following some of your insightful suggestions in the non-surgical video. I would like to avoid surgery because in 2016 I had a neck dissection operation to remove a cancerous tumor from the back of my tongue and 41 lymph nodes were removed. Over the last seven years I have developed secondary lymphedema and fibrosis in my neck and need physical therapy for this very uncomfortable condition. After consulting with a few neurosurgeons, they recommend an ACDF procedure with the assistance of an otorhinolaryngologist. I would really appreciate your input on my situation and also about an ultrasonic cervical procedure. As mentioned this condition is going on it’s ninth month.
You may want to try an epidural injection. You may be a surgical candidate I would have to look at the imaging. You can make a virtual appointment with me at California orthopedics and spine
@@DrBrianSuTheSpineGuy HELLO Dr. Su I need surgeon ASAP for cervical Myeomalcia...Please help me with your contact information and whether you accept Aetna insurance from Washington DC
Hey Doc that was very very informative indeed and what an amazing UA-cam channel you've got there! Thank you!
I have a question: if myelopathy isn't treatable once you got the symptoms why are you not recommending the treatment for it as a preventative measure? To me it will make more sense that if you are prone to a degenerative condition or indeed heading towards myelopathy, why not preemptively have surgery to prevent it in the first place so that you actually never get any symptoms and you never get to have a condition that can only be halted but not reversed? Thank you for your reply in advance.
It's a good question. The majority of patients with spinal cord compression do not develop symptoms at all. When patients develop symptoms their chance of having reversal of those symptoms is actually quite good if the symptoms are mild. For that reason we suggest watchful waiting in a few develop symptoms to consult a surgeon. If we decompressed everybody's spinal cord that was compressed and they did not have myelopathy 25% of the population would be getting spine surgery
Thank you for your videos doc!!
Could you do a video on your thoughts regarding lumbar and cervical artificial disc replacement?
I’ve heard that there’s been great success so far!
There's a video on cervical disc replacement already
I have not been as happy with lumbar disc replacements nor the outcome studies so my preference is a fusion in the lumbar spine over disc replacement
Oh alright! Are there any specific reasons why? I’m going online and seeing tons of testimonials and high success rates compared to fusion both short term and long term. My mom got an lumbar artificial disc 25 years ago and is still doing well.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
Hello Dr. your video is by far the most well explained that I have found on this subject….. I had C4 C5 C6 fused with plates and spacers in September of 2021 do to myelopathy…my symptoms subsided for about 6 months but began to return and have been increasing ever since the surgeon has since retired and really just ignored me for the most part regarding these issues…..what can a patient do if you have already had a fusion procedure performed? I have had a post surgery mri and it was found that disc in the fusion area between C5 and C6 was left behind and not removed which seems to be causing another myelopathy have you ever encountered a patient in this situation that had surgery done and was apparently not performed correctly? If so is there any surgical procedure that can be performed to repair this? I hope you are able to comment on this the best way you can and again a very well done video
How do you can make a zoom appointment with me by calling California orthopedics and spine.
Excellent Video! I'm an orthopaedic surgeon (hip & knees) in Germany who might need surgery for cervical spinal stenosis one day as well. One question: What is the patient satisfaction and quality of life after having a laminoplasty? How often do you this procedure, is this a very common procedure? Thank you!
It's a common procedure and quite good for the right patient
Great info would love to get to talk to you I had 5 back surgeries from sacrum to t4 now I have c7 to c4 with nerves pinch on exit i am incomplete paraplegic need advice
Asking if there is a video on the "MILD" procedure. I have an L5-S1 issue.
Thanks for your very informative videos.
That is a procedure done by interventional pain physicians not surgeons. I have seen mixed results with it. I will try to do a video on it.
What about treating the pain in cases in which otc pain meds, epidural are either ineffective or contraindicated. Sx include feeling like an ice pick has been heated to glowing fiery hot then repeatedly stabbed into the cervical spine. There is significant arm pain and numbness. Pt experiences incontinence. The pt walks with a cane due to unsteady gait and falls. This pt is 65 yo female, lives alone and is unwilling to have surgery due absent pain treatment flowing prior surgeries.
Jeffrey Cantor, MD has a UA-cam video about the new ultrasonic technology. I am surprised you did not include this in the options. It’s basically a dremel tool bit designed to be safe around soft tissue, that can be used to remove bone material on the inside edges of the spinal canal to make it larger. Seems like it has good potential, already being used successfully, and can be initiated at early onset of myelopathy symptoms.
It is a very good tool I have used it before but unfortunately I think a lot of it is marketing. The tools we use are not end cutting and are diamond based which is also very safe. At the end of the day you have to trust that the surgeon is using what they are most comfortable with.
@@DrBrianSuTheSpineGuy My curiosity with the ultrasonic technology, while it seems great to just shave back to bone spurs, would the bone spurs grow back again and cause more problems due to no cage or screws keeping the cervical neck stable? Would it be a redo in a few years? I absolutely love your videos Dr Su.
Thanks for video as ever I wish you were here in Ireland are there any contraindications re opening the space if the discs are already compromised? My neck is getting worse root nerve blocks worn off and new MRI CT and SPECT all show bad deterioration.. waiting to meet nurosurgeon again he says I don't need surgery although symptoms getting worse.. laminoplasty to me seems an option.. not wanting ACDF as want to preserve movement..
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
I have numbness in both legs and walking difficulty from 6 months and from last few days I can't walk and can't move my leg. MRI shows extramedullary hematopoiesis mass in spine from T2-T8 which cause spinal cord compression sir please give some advice regarding this situation
dr stu im danny i have cervical stenois n bone spurs n my postier ligument is copressed n my c 4 c 7 ni have 3 rupted dic in my neck my back i have ddd all my dic are ate up i have bone spurs in back n i have spondlisis n anklois in my back n my spinal cord n im seeing dr chu next month for surgial options i learned a lot from your video thankyou danny god bless i have a lot of pain
Should have read mri scan. I shall watch more because I have so many problems with spine.
k, again really helpful (I subscribed!) I have cord compression and bone spurs with mild myelopathy. my surgeon says he wants to do a C3-4 laminectomy but tells me he won't use any screws or plates but will go in the back because a throat surgery on my vocal cords was done about 20 years ago (scar tissue?). Does this mean he will be using the fairly new ultrasonic technology to remove the spurs? Will I still be able to hold my head up high? 😅
It's hard to know without me seeing the images.
Hello doctor. Numbness and tingling in both hands with mild loss of sensation along with diagram tightness. Hyper reflexes and mild balance issues.
I think I have this diagnosis but I won’t do surgery. I can’t do scared I am. Will I survive whiteout surgery. Is there any possible for it to heal by it’s own?
Plz answer. I’m frightened and desperate. Thank you
I have so much going on with my spine. I have went to two neurosurgeons both said the same thing.. no surgery due to 50/50 with or without surgery. On my syringomyelia in my thoracic spine. Help please
What about patients with large bone spurs, along. With moderate herniated disc pushing mild compression on the cord? Can a person just have large spurs removed without disc replacement and without removing disc
Thanks doctor for your informative videos .Is it better to have a larger number of vertebrae fused in an ACDF to prevent adjacent segment disease?
It's a good question. In general we only fuse the levels that have to be treated and we don't fuse them preventatively
@@DrBrianSuTheSpineGuy Thanks doctor for your reply.
Hello. What causes anterolisthesis of C4C5? Also what causes auto fusion in the cervical spine? How common are these findings? Thank you Dr.Su.
Auto fusion is quite common it can also be a congenital issue meaning you were born with it. If you want me to look at the imaging you can make a virtual appointment with me at California orthopedics and spine
Thank you for clarity on myelopathy. I’m 67, osteoarthritis and osteoporosis and having mild symptoms of it. Candidate for laminoplasty?
My recent MRI shows this:
C4-C5: Bulging disc osteophyte complex at the C4-5 level. No disc herniation. AP
diameter of the spinal canal at this level measures 6 mm.
C5-C6: Bulging disc osteophyte complex at the C5-6 level. No disc herniation. AP
diameter of the spinal canal at this level measures 8.7 mm.
C6-C7: Bulging disc osteophyte complex at C6-C7 level. No disc herniation. AP
diameter of the spinal canal at this level measures 10 mm.
C7-T1: Bulging disc osteophyte complex at the C7-T1 level. No disc herniation. No
spinal canal stenosis.
T1-T2: Broad-based disc bulge or protrusion at the T1-T2 level.
Cervical spinal cord normal in signal intensity and caliber throughout. Craniocervical
junction is normal. No intradural abnormalities.
Multilevel facet and uncovertebral joint arthrosis. No significant foraminal narrowing
at the C2-3 level. Mild bilateral foraminal narrowing C3-4 level. Moderate bilateral
foraminal narrowing left greater than right at the C4-5 level. Bilateral moderate to
severe foraminal narrowing at the C5-6 and C6-C7 level. No significant foraminal
narrowing at the C7-T1 level.
Prevertebral soft tissues are normal.
Additional findings: None
IMPRESSION:
1. Bulging disc and/or disc osteophyte complexes at multiple levels within the
cervical spine. See discussion above.
2. Multilevel cervical spondylosis and disc degenerative disease.
3. Acquired spinal canal stenosis at multiple levels. Finding most pronounced at the
C4-5 level.
4. Multilevel facet and uncovertebral joint arthrosis with associated foraminal
narrowing.
5. Normal prevertebral soft tissues.
I would have to look at the imaging studies. You can make an appointment with me at California orthopedics and spine
@@DrBrianSuTheSpineGuy I did call to make a video consult appt. so you could explain my images but receptionist said I’d have to be seen in person since I’d be a new patient. I’m 67 and on social security and can’t fly to California. Can you recommend any neurosurgeons in Michigan? Thank you. Your videos are very clear and good.
Thank you for this video. May I ask, why, when there is so much literature linking C5/6 herniation to miosis, do I keep being told by spinal surgeons that it's not possible my C5/6 is causing my right pupil to constrict? Vision problems are often reported with C5/6 neck herniations but rarely get mentioned.
I have not seen literature in that respect
Dr. Su could you do a video on surgery for lumbar myelopathy.
That doesn't exist since there's no spinal cord in the lumbar spine by definition there cannot be myelopathy
Would you please do a video on non-fusion after ACDF? I had 3-level fusion just over a year ago and the lowest level did not fuse and the screw might be loose in the top level. The Dr mentioned a possible "door stop" surgery because the bottom level is also slipping, I think he said 4 mm on flexion/extension. Thank you.
Not all fusions that become non-unions are symptomatic. It's a complicated question. You need a CT scan and opinion from a spine surgeon. You're welcome to make a zoom appointment or virtual appointment with me at California orthopedics and spine.
Thank you Dr Brian for putting out these informations. My stiff neck is started in September 2021 I went to emergency cause it was painful. In 2022 I made 4 trips in emergency the results always arthritis in the neck. In December 2022 a neurologist gave me 200 unit of Botox 2 days later I experienced the worse pain in my life. In January 26, 2023 I went to emergency cause my neck was dropping in my body. My right shoulder was dropping too. They gave me two shots and went back later to the neurologist he told me that I need more Botox. I said no and I went to see a neurosurgeon last week he looked at the MRI report, the CD and the last X-ray. He told me that I need surgery cause I have a spinal cord compression. I asked him about epidural shot he told me it’s putting ice on a cake. They set a date for the surgery but I’m very skeptical. I’m getting a second opinion from an other doctor. I was doing my research online and found you, Dr Brian I listened to your videos over and over again. I wish I knew what I know now when I was in his office. Thanks for the informations Dr Brian and God bless you always.
Doctor please answer me? I’m desperate. Can I make it without surgery? Or at least what’s your thoughts? Help plz...
I am currently being worked up for multi-level spondyltic myelopathy. C3-T1. Significant spurring already in place both anteriorly and posteriorly, C5-C6 already naturally fused. I am most likely looking at a multi-level fusion needing both anterior and posterior approaches. My question for you, Is there a point where you would feel more comfortable handing this case off to a neurosurgeon?
Spine surgeons are Neuro or Ortho so no distinction there for this.
Thank for the full information, I learned a lot. Can I talk to you about my condition? I was diagnosed with cervical spondylic myelopathy from c2-c6 and a lumbar spondylosis L4-L5.
Please call California orthopedic and spine for a virtual appointment with me
Did you get surgery?? Are you better now??
Hi
I am sending my mri report can you explain me some thing er series because I have neck pain,shoulder blade forearm pian and sevier headache and sleeping problems. Tell me please solution.
Moderately degenerated and height-reduced disc C5/C6 with spondylotic deposits along the cover plates. Deposits and broad-based bulging disc with impression in the dural sac. Tangier medulla
Hi Dr, thanks for your video. What about the D-TRAX method is?
That is used for a posterior cervical fusion.
@@DrBrianSuTheSpineGuy Thanks for reply, Dr. I have a cervical stenosis and I searched for different techniques, laser treatment included, as we have in Italy a Dr trained by D. Choy. However, in my case is not effective enough. I read in some studies that the ACDF technique may cause some issues in deglutition and lowering in voice for about 10% of sample in some grade permanently.. I'd like to have your email, Dr and some advice after I can explain my case...
Please help me understand OPLL with severe spinal cord compression surgery.
It is bony growth behind the vertebral bodies that compress the spinal cord. Surgical options are very similar except patients are not as good candidates for laminoplasty. I will do an episode on OPLL
I had cervical stenosis fusion surgery . After one month I started getting pain in my right hand. It is like electrical current and pricking needles. Mostly pulsating when it comes. Any suggestions.
Sounds like you need to talk to your surgeon. I would get imaging studies including an MRI and CT scan as well as an EMG to look at the nerve. It could just be inflammation and you might be a candidate for an epidural. As a disclaimer please consult your spine surgeon
Dr. Su, how do you decide between ACDF and laminoplasty?
It's complicated and it would involve me looking at your imaging. You can make a virtual appointment with me by calling California orthopedics and spine
Id just like to know if you do like 5 minute consults after viewing an mri.. just so i walk in to my consult well informed… im freakin terrified.
Yes I do virtual appointments call 415-925-8200
I am confused, can you please clarify. If someone has a herniated cervical disc which causes cord compression, it often leads to myelopathy, right? All videos I watched say that myelopathy usually progresses over time. And at the same time they say that 97% of people get better by their own over time and herniated disc can dissolve by itself. So... Which one is true? Shall I expect the cord compression symptoms to get worse or better over time? Thanks!
If the cord compression is symptomatic then surgery is an option. If it is not we do not do surgery and see if it resorbs or causes symptoms
Thank you for this! I had a posterior cervical LAMINECTOMY w/o fusion on Jan. 17, 2023; the surgery you just said is ONLY DONE in “special occasions”, because you all have learned from the history of this.
I want to say, I had two discectomy’s and they went great, this surgery however has left me in severe pain and very exhausted. I am hoping there will be a way to fix me. Your video makes so much sense and explains why I feel worse off. My arm pain in gone, but my neck pain and headaches are MUCH, MUCH WORSE!
I have been feeling hopeless and very insecure WITHOUT having the FUSION!
would like to see about anterior foraminotomy no fusion
Are there high risks for age 67 year old getting paralysis if avoiding surgery for spinal compression with symptoms that score 15-16 according to your video?
That is mild myelopathy. If there's worsening surgery is needed. You can also observe it over a few years. The chance for paralysis is exceedingly exceedingly small. As a disclaimer please consult your spine surgeon
What kinda possible complications a patient might face after having both anterior and posterior surgeries?
You will have to watch each separate video on anterior and posterior surgeries
I have severe spinal deformity...is it possible to get your opinion on what surgery is best
You can call California orthopedics and spine and schedule a zoom appointment with me
Been to couple local nerve surgeons for my myleopathy with kyphosis neck curve..
This 1 surgeon recommends only replacing discs with 3 level mobility discs (C3-4, C4-5, C5-6)...
While the other surgeon recommends a 2 level ACDF on C4-5, C5-6 to decompress the spinal cord and also to fix my neck curvature from kyphosis to lordosis. Which method do you think is the best procedure for my case?
(There is spinal cord compression on C3-4,C4-5,C5-6. And I'm mild myleopathic)
I would be I would have to look at all the imaging. You can call California orthopedics and spine and make a virtual appointment with me so I can give you a second opinion if you would like.
@@DrBrianSuTheSpineGuy Thank you doc. I have already made a virtual appointment for early October, but is it possible to have the appointment at earlier date, maybe sometime within this week or next week?
4 and a half months post ACDF C4-C7. Congenital spine, hypermobile Ehler Danlos syndrome. I still cannot feel most of my left hand, the left side of my torso, across my stomach and right pinky. My spinal cord was almost severed. I'm starting to think this is my new normal and not sure I'll be able to return to work. It all seems permanently damaged.
😢
It can take up to a year to improve. It depends on where the compression is. I could look at the images if you would like a second opinion by calling 415-925-8200.
My mother who is 79 years has spine compression at Thoracic T11-T12 and multiple levels at lumbar level.Since the the muscle power has decreased in right leg and not able to walk properly even with walker and has difficulty in bowel movement
.Please suggest as want your opinion regarding surgery at T11-T12 LEVEL to decompress nerve.Should we get it done for my mother or is it too risky?
It depends on the situation I would have to look at the imaging. Thoracic spinal cord compression can cause issues with walking. As a disclaimer please consult your surgeon.
My Dad was also 79 when he had his spinal fusion. He couldn't walk properly either, he had numbness, weakness and his foot was dragging. Since surgery, he is in a terrible state and it is now 9 months since his operation. I am tempted to say that things are now worse for him than before the operation.
Do any of these options allow for a return to an active lifestyle? Activities like Skiing, roller coaster, or soccer? Will running be ok? Thanks.
All of these options including fusion allow you to return to full sport. As a disclaimer please consult your surgeon.
@@DrBrianSuTheSpineGuy thank you so much for the response!
Also, your videos have helped me and my loved ones immensely in understanding my condition and potential options for remedy.
You really are making a positive impact in the world.
Hi Doctor, i have left neural foramen narrowed by uncovertebral joint hypertrophy. Is this the same as cervical myleopathy. And would it affect the neck, thats where im having issues. Thank u.❤
No that causes foraminal stenosis
Watch the videos on cervical radiculopathy
DO you know a good pain doctor I live in Franklin county No AND I am having a hard time finding one I had one that was a good one for 19 years but he retired I have back trouble all my dis ARE budging my S joint has always been my trouble
Unfortunately I do not.
hello Dc Su thank you a bout all of your video information .
what is your opinion a bout laminectomy of c4 (or c5 and c5 )this need to be fused laminectomy just c4 or c4 and c5 (it is need to be fused ?
c4 or c4 c5 laminectomy needed to fused the articular pillar for stability or for avoid post laminectomy kyphosis ?
i have symptoms of c stenosis(one year of numbness and weakness in lower extremity,last months sexual problem . (MRI of 2022 show c3-4 ligamentum buckling and has not CSF behind c3-4 level (in 4 slice of 1 mm axial
most of the Dc I see don't think sure this cause my symptoms and dont think it is enough to be fix.
thank you.
I would have to look at the imaging. You can make a zoom appointment by callling California orthopedics and spine
@@DrBrianSuTheSpineGuy thank you about that.
I do a zoom with one dr from us,and also with a nother on calling consultant.
You have very a lot off video ,and create UA-cam videos dedicated to spine.
I m learning also from your channel also from other.
I m cervical stenosis very mild,it is located in c3-4
Ligament flavum some buckling dorsal but not really compression the cord .
But who knows what now ,i need to do a new MRI OF C,.
I have mild symptoms of cervical stenosis myelopathy, started before 1 years, problem with walking faster, decreased in steps for a minute.
I have medical history for trauma dedicated to the cervical spine.
And chronic neck pain from 2015to 2022
More severe in last 3 years from facet upper arthritis.
But in last year i have less pain but i m started to losses some function.
Walking fast decrease from 130-140 steps to 100 step today,have heavy legs.
Numbness in lower limbs , tingling also .
From November 2021 the problem with walking started.
If i was on US maybe i will come to your office.
I live in middle East.
Thank you a bout your videos and also some comments you answer me .
Zoom it is better appointment, also if we can looked on all images from my history and the slices of axial.
@@DrBrianSuTheSpineGuy I do a lot of consultations (more then 7 spines and neurosurgeon,2 from US )
i can share with u (a video of my cervical spine MRI (via 2016 to 2020 and 22/23) i have trauma in 20 years old (in a swimming pool crash my head on a wall in backstroke swimming (this was very powerful what you can get in swimming )
I know i have arthritis on facet upper (this is causes by the disc degeneration (tear on rings causes by my trauma )
ua-cam.com/video/49aoHHrIzt4/v-deo.html
my JPOA it is 15-16 points .
but i have had cervical stenosis symptomatic over a year (it is in a small area pinching the thecal sack and little compress on the cord )
maybe my symptoms come from other issue (but i have a problem with neck ,disc disease,facet arthritis ,trauma to the neck (this was big trauma to the spinal disc multi level )
(MRI BRAIN is not found anything like MS or other )
thanks
What are your thoughts on a surgeon wanting to do a cervical corpectomy due to two levels with cervical Myelopathy?
It depends on the situation. You can do a zoom appointment with me by calling California orthopedics and spine
You didn't mention corpectomy (with fusion). Is there any reason you don't perform this type of surgery?
It is less common but it is a procedure that I do perform. It is done when there is compression of the spinal cord behind the vertebral body
I have degenerate disc disease spinal stenosis bulging disks and sciatica down both legs all from 2008 diagnosis. My arms go numb and i loose feeling constantly depending on if laying down or raising arms. I am now 46 years old and my sciatic nerve flared up recently again but yesterday my feet ankles and legs started swelling feeling as if they would burst. I have pain in my feet and aching all up my legs. Also numbness tingling and spots when i feel cold inside my feet. Please tell me what you think might be going on it's got me really nervous. Thank you
Sounds like you need to see a spine surgeon.
@@DrBrianSuTheSpineGuy thank you I appreciate your feedback. Also your videos are great.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
oh, neg comments blocked. i see...well, i gave you a compliment then told what my surgeon did. Not good. there's 2 other options you aren't saying and you will never do a laminectomy right?: stem cells (out of U.S. are FAR more effective and Mel Gibson went on Joe Rogan just to tell the world among many other celebs like Tony Robbins etc.), and "endoscopic" surgery which is truly minimally invasive" and no hardware installed people= Simpliy disc is made of ALUMINA in the core and the company hides the fact along with any way to ensure you don't get one of the 10s of thousands of Knock off devices. Keep up the great work Brian
Some spinal surgeons advertise using "minimally invasive" techniques, and/or the use of ultrasonic instruments. Do you ever use these techniques?
Yes. Many are marketing gimmicks. Ultrasound is just a way to cut bone.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
What are the chances of neck pain after surgery where there was none before.?
It is possible to develop neck pain after surgery depending on what kind of surgery you should consult your surgeon or make a zoom appointment by calling California orthopedics and spine with me
Hi doc….I’m amazed watching you explaining everything so well. My dad is 67. He’s having moderate to severe compression and has to undergo cervical decompression surgery. The surgeon here has suggested that he will drill the bones and won’t do any instrumental fixation considering his age. Other surgeons have suggested laminectomy. I need your help to know which one I should go for.
I would have to look at the imaging. He can make a virtual appointment with me at California orthopedics and spine
@@DrBrianSuTheSpineGuy
I’m from India. Could you please let me know how to make an appointment as per the timings there.
My father who is 65 also is diagnosed with cervical OPLL and spinal cord compression at C2 to C6. One surgeon suggested C2 undercut and C3-C6 posterior cervical instrumentation and decompression procedure and the other doctor suggested only C2 dome and C3- C6 Laminectomy
Please suggest which surgery to be done
Where are you located at. I have so much going on in my spine. The syrgenomegia is the worst 2 nurosurgens said surgery usually fails. There is a 50/50 of failure. And without surgery is 50/50 I didn't ask does that mean death???? I use to be a nurse, nor Nuro. So I am really worried and want to know the truth. It also has retrolytheses. I have kyphosis and scoliosis. The rest of my spine has herniated discs . He said basically my spine would have to be caged even if we could put a drain in the syrgenomegia. I also have an problems with my right hip, it's horrible. Help please
California orthopedics and spine.
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
my father has cervical comression at c5-6 ...he is 69 years old is surgery only option?
It depends on the situation I would have to look at the images you can make an appointment with me by zoom at California orthopedics and spine
Is there a difference between myelopathy and myelomalacia?
Myelopathy is the clinical manifestation of spinal cord compression. I reviewed that in my other video. Myelomalacia is a radiographic finding which is essentially the spinal cord dying and represented as a white spot inside the middle of a spinal cord on imaging.
@@DrBrianSuTheSpineGuy Thanks Dr. Su! Will you be able to talk about non-invasive treatments like epidural or RF ablation next time?
Please talk about opll ??????
Opll is a very specific condition I can do a separate video on that it's very rare
@@DrBrianSuTheSpineGuy i have this doctor . C3 c6 disctomy 4 and 5 corpectomy with kyphosis at c4c5c3 . I want acdf 3 levels . Corpectomy sounds really heavy .
My opll seems mild it has not grown into a big bulge . Im very stressed doctor . We dont many surgeons on my island like america so many i have seen on the internet
Any chance you take Unicare??
I want you to do this.
I need so much done.😬
Please call California orthopedics and spine
@@DrBrianSuTheSpineGuy
I will. Thank you.🙃
Corpectomy ???
I have a problem of cervical spine for 6 month I am using collar till now
pain is over every side but vertebrae body is not in place yet
Alignment issue what should I do Please suggest me sir
I would see a doctor
@@DrBrianSuTheSpineGuy it's retrolisthesis problem
Is it dangerous?
Suggest me doctor please
Giving thanks to Doctor Ani John is something I will always take personal because he brought me back to my full health he is a good man and trustworthy so kind to every patient,
contact Dr.Ani John on UA-cam channel now for help for Any kind of health issues.
What about laser technology?
The laser spine institute went bankrupt several years ago and the North American spine society did not recognize it as a scientific treatment
Thank you.