Doctor insights on:
Posterior Decompression And Fusion
A type of spine : Surgery where implants which are usually several screws that attach to the bones of the spine and are then interconnected over one or more levels with usually a pair of metal rods -this is the instrumentation. A fusion is a healing together of two or more spine bones or vertebra with the use of bone material or synthetic substitutes. ...Read moreSee 1 more doctor answer
A fusion gets rid of a joint or disk between to bones, getting the bones to join together with bone between them. If successful, it eliminates almost all the motion between the bones. Sometimes fusion simply occur as a result of disease, rarely from aging. Most of the time ...Read more
Different surgeries: Spinal decompression surgery is performed nerve root impingement-usually from bone or ligaments in the spinal canal or where the nerve roots exit-the neuroforamena. Generally called a laminectomy, it involves removing bone and ligament from the spine. A spinal fusion locks together two or more segments of the spine, usually with screws and rods. Bone is added as well to allow the bones to knit. ...Read moreSee 2 more doctor answers
What are the pros/cons of a 3 level cervical laminectomy w/o fusion vs a keyhole endoscopic decompression for stenosis(disc &spurs compressing nerves?
Complex: It is a little complex to fully discuss in such a forum; but a for amounting would be appropriate if you are just having symptoms of foraminal stenosis causing pain in the arm, where a laminectomy may be needed if you have problems related to central cord compression. Definitely would need to discuss face to face with your surgeon. ...Read more
Lots of variables: Most doctors wait about four weeks before starting physical therapy after an acdf. Depending on the level of the surger, yphysical therapy activities will vary. Because of the long period of convalescence after a fusion like this, patients usually have compromised stamina, so treatment may include exercise to improve core strength. This is a good place to learn more: http://tinyurl.Com/p2z8ud. ...Read more
What is the prognosis for lumbar stenosis with bulging discs at l4/l5 and l3/l4 with spinal cord effacement and bilateral facet joint hypertrophy.
Mixed: Facet hypertrophy is a common change as people age; the amount of joint enlargement is more important than the fact that it is present. Stenosis is an issue if it is symptomatic. Weight control and exercise can help. Surgery can help in cases that don't respond to other treatment. The spinal cord usually ends at l1-2, so if it truly goes down to l5, there are other issues that need to be addressed. ...Read moreSee 2 more doctor answers
Neurosurgery : Only surgeon who evaluated you have access to your health profile and he is the best suited to make this call or get 2 nd opinion. ...Read more
Neuropathy : Bilateral peroneal mononeuropathies are commonly seen in patients with mononeuritis multiplex secondary to diabetes, polyarthritis nodosa, nutritional deficiencies, and critical illness polyneuropathy. Bilateral and symmetrical presentation rises the possibility of lumbar radiculopathies or lumbar stenosis. Neuroimaging like MRI and electrophysiological studies like EMG and nerve conduction study could help in sorting this out. ...Read moreSee 2 more doctor answers
What are the long term outcomes of posterior cervical foramenectomy and ACDF For cervical RADICULOPATHY from foraminal/spinal stenosis C4 thru C7?
ACDF outcomes: Even a surgeon can not answer that question. Long term can be pain relief all the way to more pain. I would say if you haven't found a good interventional pain specialist to consult with prior do so now and see what other options there are besides surgery. This is if it is just for pain, if you are having any neurological deficits surgery might be your option. ...Read more
With degenerative disc disease, facet arthrosis, nerve compression, buldging discs lumbar and cervical regions, synovial cyst posterior lumbar region in spine, continueum spasms, the need of surgery is the option as of now. I have been through all treatme
Unsure of question: Most surgeons exhaust non-operative care before recommending surgery. Non-operative care can include medications (anti-infammatory arthritis type medicine or pain medications), physical therapy, activity modification, exercise, bracing, chiropractic care, interventional pain management (injections), or alternative medical approaches. ...Read more
Compressed right ventral cord @ C4/5 due to disc protrusion. Spinal column 9mm. Severe bilateral foraminal stenosis. Pain. Risks to forgoing surgery?
C4/5 surgery risks: Compressed right ventral cord @ C4/5 due to disc protrusion. Spinal column 9mm. Severe bilateral foraminal stenosis. Pain. Risks to forgoing surgery? ANS: Only you and your team in LA can properly assess risks and benefits of surgery vs watchful waiting in you. You may want to get second opinion as well. Sounds serious to me though. So work with them now. ...Read more
The approach: Anterior lumbar fusions utilize an approach through the abdomen called a retro peritoneal approach. This approach actually never enters the cavity containing the intestines, rather goes around it. This approach will allow access to the lumbar spine for fusion. The approach carries risks because the large veins and arteries need to be moved. ...Read moreSee 1 more doctor answer
Had an MRI and dont understand results. "large posterior disk extrusion contacting the anterior spinal cord and causing severe spinal canal stenosis.
Spinal Stenosis: Did a doctor explain to you the results or did you just obtain a copy? In general you have a protruding disc (not sure if neck or back) that is impinging on the spinal canal and resulting in narrowing of the canal. I would imagine you are having pain, weakness, numbness? ...Read more
Is a laminectomy or minimally invasive foramenectomy w/o fusion better for mixed foraminal and spinal cervical stenosis?
Ask your surgeon(s): They'll review your imaging with you and discuss your options. But before further surgeries, you mention physical therapy and cymbalta, (duloxetine) but there may be other non-surgical options including other medications, pain psychology and interventional pain procedures that may be helpful for your condition. Good luck! ...Read more
What are the possible risks of NOT having surgery when anterior lumbar interbody fusion with posterior fixation is indicated (ALIF L4,L5,S1,fix L5-S1?
Depends: Have you tried nonsurgical options? Surgery is typically indicated if you're having neurologic dysfunction and/or chronic intractable pain from a serious disc herniation and have failed to improve with conservative options. At your age make sure that you've had a couple of opinions and have tried nonsurgical options including physical therapy, medication, and possibly injections ...Read more
Depends on reason: This depends on the reason for this type of surgery, the number of levels involved. , whether this is a repeat surgery, the health and age of the patient, the smoking status of the patient, their weight and nutritional status and other co morbidities or problens like diabetes, thyroid disease, etc.. The bone density can also play a role, ie, osteoporosis. ...Read more
What is a right lateral disc extrusion at l3-l4 level that abutted the right L3 nerve root sleeve within neural foramen mean? I had spine MRI done.
Broad based disc protrusion at l4-l5 level compressing anterior thecal sac and bilateral travers nerve root and narrowing neural reces
Prefer no surgery: Sounds like a fairly large disc protrusion, but if no progressive muscle weakness, atrophy or bladder involvement, might be able to get conservative PT, stretching, exercise, acupuncture, and try to allow disc to desiccate and shrink, which it may well do over 8-9 months. Key issue is presence or absence of neurological involvement. Steroids may help. ...Read moreSee 1 more doctor answer
Having scoliosis surgery and fusion to thoracolumbar spine to pelvis and l5/s1 decompression with multilevel osteotomies. What happens in surgery ?
Lumbar scoliosis: Simple. Incision made in back to visualize spine to be fused. Length of incision appropriate for fusion. The facet joints are removed and the bone prepared for fusion. At l5-s1, facet and disk removed, and spacer placed into disk along with bone graft. Multiple laminectomy and facet excisions (osteotomy) to make spine more flexible. Rods/screws placed to maintain correction. Bone graft placed. ...Read moreSee 1 more doctor answer
Post fusion 2009: now l4-5 right facet joint arthrosis, severe neural foriminal stenosis with some compression. Surgery needed?
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