Great video! I had this surgery over 10 years ago and it was the best decision I made. I was up and walking around a few hours after the surgery. No more electrical pain in my back and legs. The incision pain was very little when compared to the electrical pain before surgery.
Thank you for your very clear explanation. I am 3 weeks out from having exactly this procedure at L4-L5 at Mayo Clinic. The first week or so was very painful, mostly from muscle spasms. In about 1 1/2 weeks I was completely off opioids and now just take an occasional Tylenol as needed. For the next 3 weeks my only therapy is to walk as much as possible. My main advice is get off opioids as soon as possible. They are bad news and mess with your brain and digestive system.
I could not have said it better myself. You hit the nail on the head for exactly how the recovery goes. Walking is your friend and get off the opioids as soon as you are able! As time goes on you will have more good days than bad.
I am 2 weeks post op. My surgeon preform my procedure exactly like you discuss in this video.Im doing very well. My recovery has that bad at all. My surgeon prescribed a back brace for me to use the first 3 months. I also have a machine I have to do for 30 mins a day It's a magnetic field belt that helps bone growth. I think I'm ready to venture out of the house. I pray for us all to heal great and move on with life. If any of you are hesitant to getting the surgery. Don't be anymore. Just get it down. I put mind off through the holidays. But by the time Surgery day came, I was barely making it. Rt leg pain, tingling and numbness was through the roof. After surgery almost Instant relief.im glad I had it done. 🙏
Thank you doctor for such a comprehensive and easy to follow explanation. You've really helped me understand what's happening and hopefully what will help. Greetings from North Wales UK
Awesome video!!! Your explanation of the surgery took off the fear and worries about the TLIF surgery that I’m having in three weeks. Hopefully this will take the horrible pain that that I’ve been living for the last 7 years. No life with this type of injury.
As he said, it’s a marathon not a sprint. Seven months postop from L5-S1 fusion, laminectomy, and other repairs at Mayo Clinic in Jacksonville, Florida. Hands down the most insanely painful operation I have ever had and this is coming from a lady with a freakishly high pain tolerance. This operation will test you in every possible way. Surgeons tend to downplay the pain and lengthy recovery. If you do this, BE PREPARED!
I had my L4-L5 TLIF six days ago in Spain. I felt extreme pain when I wake up from the anesthesia. Three nights in the hospital. From the day four I started to walk over an hour with very low back and muscular pain. This surgery is not necessarily a torture for everybody. On the other hand this video is the best explanation I found about this surgery, thanks for educating us
@Day One Adele Fans That's crazy as heck! I wonder if Dr. Armaghani does his own reply's here or if its just a secretary..I was hoping the op would at least take some of the pain away right now..I cant sit for more than 15 minutes 😕
@* James * Interesting - if you’re getting an L5-S1 fusion you absolutely cannot BLT (bend, lift, twist) for quite a while. I can’t speak of any benefits yet. My neurosurgeon says that it will be a year and a half to two years when I notice benefits of op and should be at full fusion at that time. I get my yearly scans on January 30th.
@Day One Adele Fans Im glad youre better now. Are you glad you did it overall? Ive been through some crazy surgeries.. Hey, Dr A said I wouldn't need a "wand" and that I could tie my own shoes after surgery. You had the single level L5 S1 right?
@* James * Oh man, you’re doing it, wow. January 20th was my year “spineaversary”. Def better, but still have some pain and spasms. Ahh yes, the paperwork, lol. Get yourself a wand and a seat riser. If you can afford it, get yourself a lift recliner, it saved me. Heating pad essential as are grabbers. Ngl, this op is not for sissies, be prepared for pain James.
Fantastic, thank you. I am a gynecologic surgeon up in PC with this procedure scheduled in a month and a half. You explained it so well without oversimplifying it or rushing through it.
I am so impressed with your clarity and visuals. I’m having my third surgery soon and am sure this time it’s going to require fusion. My most recent MRI was a hot mess. My concern is that at 52, I will have a lot of years of life left with continuing issues and pain. I hope my surgeon is as steady and sure as you are!
I’ve (unfortunately) had 4 fusions and the next one in a couple days. Each surgery has been successful. I’m walking the Camino de Santiago (500 miles) in the spring. It’s all doable. Fusions have given me pain relief. Fusions get a bad name but it’s mostly from the past. I have a great surgeon and that’s critical.
Thank you for your very interesting video sir. I am myelomeningocele and I worked in a small general hospital (albeit in medical records but no one is perfect!) in UK. I have always found surgery fascinating and picked up a little knowledge in my working life even though, unfortunately (only for me!), I was not able to actively cut and sew! It amazes me to see how advances have been introduced in leaps and bounds over the years and the benefits they have brought. I am in awe of your abilities and wish you blessings and peace in what you achieve. Thank you sir.
My wife just went through this procedure. After watching this I know what she is going through is normal. Took some of the worries away. Thank you for the video.
Thankful to hear the video helped with some of your worries. Remember it's a marathon but the more time elapses after surgery, the more good days she will have than bad.
I work at the operating room providing instrumentation for surgeries. Knowing how things work tells how important they are. I feel smarter already! Thank you for the video. Have a great and successful new year!
Thank you for the great presentation!! I am 2 weeks post-op after a L-4-5 TLIF at a well known NYC hospital. I am very familiar with all the anatomy as I am an Imaging Service Manager, but your explanation of the procedure will potentially help so many patients who like myself are terrified of this procedure. I tried putting this surgery off for the past 3 years after having multiple epidurals, facet blocks, PT, massage, and even tried a Boston Scientific Spine Stimulator. I had unbearable pain in my left buttock, left thigh down to my knee. It had gotten so bad that I had to stop everytime after a few steps. After finally giving in and finding a great Neurosurgeon and Orthopedic Surgeon i scheduled my surgery for Dec 16, 2022. I am now definitely improving where the thigh and knee are better but the left buttock and surgical incision site are still painful but are much less as it is now being controlled with Tylenol and an occasional Advil. I am very optimistic that I will continue to see improvement over the next few weeks and months. thank you again for your great explanation and presentation!
Thanks Lisa, I am doing better but still have pain in lower left side but leg pain has lessened. True his presentation was excellent and I have also been in the OR during many procedures. Good luck, I wish I had done this sooner but you know we make the worst patients!
I am having L4-5 and S1 done January 9th. I'm in imaging too. Been the tech in these same procedures. None of this is explained to us in the OR. At least I have a much better understanding of what I will be having done to me now. I hope you are progressing well.
This is so well done… I need back surgery and I am scheduled in early March 2022 - S1/L5. The only problem is that I am so scared of what can go wrong. Having a hard time getting the negative thoughts out of my mind.
@Amie Morgan Surgery went fine and the recovery as well. Follow-up with surgeon every three months to ensure fusion is taking place. My leg pain is a distant memory. I strongly advise doing the PT that goes along with this surgery. And, find yourself a good surgeon.
The best and most effective explanation on the subject. I have undergone Laminectomy and TILF surgery ,thanks to this video and comprehensive explintionsI have been able to go through this with less concerns and worries with a great understanding on my recovery and what to expect.
Thank you, Rafi. Patient education is of the greatest importance. Spine surgery is a very technical, complicated thing to try and explain without figures, models, and videos for someone not in the field to understand. With all these materials, the patient is able to make the best decision possible and they are confident in their decisions.
Thank you so much for this very informative video, Dr. Armaghani. While my surgeon explained this in the office - to have this video as a reference is so helpful, as it will take multiple viewings before the information is integrated in my mind. Your teaching style is exceptional. Many thanks.
@Armaghani Spine I have had a ACdf in November woth volume loss in my cervical . I feel off my ladder and sustained a compression fracture chronic non union , they did a ketopasty in novermver and the did the rifle whatever I. In so much more pain and my right leg is numb my hands have been tugging etc when will thi get better
I agree. I am scheduled to do the same and after the step by step process explanation, I shared this video with my surgeon. He was impressive and impressed!
Damn Doc, your videos are just Awesome. You describe Exactly How & Why you do each step. Wish I knew all of this in 1987 & 2001 & 2007, if not even today. Thanx Sir, truly appreciate it.
I just had this procedure done two weeks ago at the Mayo Clinic in Phoenix. I had grade 3 spondylolisthesis, with L4 and L5 pretty much bone on bone with compressed nerve roots. That pain is gone and I’m on the road to recovery. Don’t fear the TLIF! 😀
I had this also ,I was basically helpless until I got this surgery ,also found several spinal cysts, first 5 days were painful, but walk everyday . I went back to my job as a UPS driver and have never looked back. People said I was Making a mistake. I would do it all over again.
This was very informative!! I had a Posterior lateral lumbar fusion L4/L5. I searched for videos regarding my surgery and didn’t find one that was as detailed as this. I know this is not the specific surgery I had but, it was close enough. This made it clear the healing process and time frame. I am 3 months out and have been very impatient to get back to “normal” activity. After watching this video I have a greater understanding of the healing timeframe as well as what activities I am allowed. Thank you!!!
Thank you so very much for this video! The service you are providing is greatly appreciated. My doctor blew through the explanation of the procedure and just left me with a form to sign and a bad copy of the MRI with scribbles. First, it is a rather shocking diagnosis that takes some time to digest, especially if one is on the younger side like me. And second, should be explained thoroughly to every patient before asking them to sign a consent form (as you have done here).
I appreciate the kind words. This is very technical surgery and difficult to understand without pictures, in my opinion. I create these videos for specifically this purpose. So patients and their families could go home and on their own time see exactly what we do during surgery then come back with their decision. I almost never ask a patient to make a decision during the same visit that i bring up surgery because it is too much information to process.
Thank you for this video! it makes the surgery so clear. This procedure was recently recommended by my surgeon. I'm a 32yo M ultra marathon runner. I previously ran 50-70 miles per week but now I can barely run one mile once per week over the past 6 months. It is a hard decision on having the surgery because I only have mild pain and no neurological symptoms when I'm not running (if I run my leg gets weak and my foot goes numb, I pay for it with back pain for a few days after). Do you tend to see patients return to running eventually after a fusion?
Omg! Son you are awesome explaining all these procedures. If I ever have to get an operation for my spine I would want someone like you performing the surgery! It sounds scary but I would take my chances with you! I think I have spinal stenosis, I had a severe sciatica issues last year in April . I could not walk for about 8 weeks, I had so much pain I don't wish this pain on anyone I was so scared, I felt ashamed and went into a deep depression I did not like to depend on anyone to do anything for me I am a very independant grandma! I would like to know if I can do anything natural to help me with this or natural supplement. Thankyou so much god bless! Namaste❤
@Nan's Global Kitchen, Without knowing your age or level of range of motion(ROM) I still feel confident in recommending you check-out "Foundational Training" on YT. Of course, it would be even better if you could locate a certified therapist near you where you could be assessed and guided in person. Exercises consist of specific postural stances that increase joint and muscle strength while addressing posture and breathing. One of the best all around exercises that works every muscle is swimming, with proper form, of course__short of that, next one is walking__again, being aware of posture, correcting any discrepancies during the process. There are numerous bodywork methods that may help relieve pressure in the lower back, sacral and glute areas, too! If you can get on the floor(and up again on your own 😛) there is a great book you could use with tennis balls called, "Acupressure Warm-Up" by Marc Coseo. Simple diagrams and explanations for the 'layman', yet very effective in outcome! Make sure you're drinking plenty of clean fresh water, too! Lubricates everything as well as, helps the cells perform all functions. Hope some of this has been helpful. Love, Light, and Healing Blessings. 🙏😇✨💫🌱🌿🌻🐝🌳🌎💖🙌🙌🙌😺
Thank you for this thorough explanation of the procedure. It will be good to know what the success rate of this surgery is. Few people comment on that. I'm also wondering, after one year, how careful do people still need to be about bending, lifting, and twisting?
What would we do without your efforts sir? This surgery is quite a mystery, particularly for an older chap like me who was always told as a child to studiously avoid anyone working near the spinal column due to the proximity of so many important nerves. With the development and perfecting of new techniques, new tools, adhesives, metals etc things have advanced enormously, and at my initial consultation with the surgeon yesterday (here in the UK) he told me that this is now a very common procedure for him to perform. It all reminds me of the first heart transplant carried out by Dr Christian Barnard in the late 1960s (?), whose name became known across the globe. Now hearts are flying out of warm dead bodies and into live ones at an insane rate (I may be prone to exaggeration, but you get my point). Thank you so much for this beautifully made and clearly explained video, helping to colour-in some of the mysterious aspects of your amazing work. Bless your heart from every effort you make.
From my experience of having four knuckles replaced , both hips & knees replaced and being off all meds an week prior and an week after before being able to take NSAIDs for all surgeries with the exception of my last surgery which I did get back on my NSAIDS like roughly 24 hours after surgery and a lot of my pain did leave within an hour : the constipation (actually was constipated before surgery due to being off NSAIDs) and my leg was no longer so swollen that my skin was pulling on my sutras . So I would recommend coming off the drugs that inhibit healing like : leuflunomide , methotrexate , humira , and etc and I would think that since the NSAIDs do fight inflammation they would be beneficial to the healing process and they definitely do help make it feel better . So I wouldn't recommend coming of the NSAIDs prior or immediately after surgery and they can be used in conjunction with asprin if need be , said my Rheumatologist . Although this may not be for everyone but just those of us that have stomach conditions , like gastritis , chrohns , IBD , etc.....
Thank you very much for this very clear explanation. I am due to have this procedure at the end of January and I was scared to be honest but I feel a lot better after watching this. I have L4/L5 Spondylolisthesis and am looking forward to having some relief from my leg pain and hopefully to get back to hiking and skiing again eventually. Many thanks again!
Hi Kate, Glad you had your surgery done and behind you. I feel for you with the pain as I know how it hurts. They got me up to walk as well and even took me for x-rays to make sure all was well. That hurt. Been 3 months now and I look back and it is a slow process but you will get better. The first month will be the hardest but you will get through it one day at a time. I am sorry you are dealing with pain and hopefully you are being given meds to help with that. Also I am sure they were able to repair the damaged vertebrae and make room for your nerve roots to function properly. Sounds like they will be taking good care of you for several days before you go home. Here in America with Covid we are sending people home after only 2 days in the Hospital. But I needed a Big Burger King Burger anyway :) Take care Kate.. Ron@Kate Makeup Looks
Had the surgery yesterday and it went well. There were however some complications (because my L4 and L5 vertebrae were very badly damaged and the foramen was so narrow that the nerves and thecal sack were very squashed indeed). I also lost a lot of blood. The pain at the operation site is very bad but it seems that the terrible pains I had in my right leg before the operation are already gone. I got up to walk today, which was interesting to say the least! Because of the bleeding I’m still in ICU with a drain in the wound. Here in Germany they like to keep you in hospital a long time so I’ll probably be here another 6 days, during which time I’ll start physiotherapy. Thanks again for the great explanation and best of luck to all having this procedure!
You had a 3-level TLIF? I was told by my doctor this is not a possibly surgery. Multi level fusions are not successful. I’d be interested to know how yours went?
I had an L4-S1 TLIF and the surgery was technically successful, but I developed epidural fibrosis at the nerve roots and permanent nerve damage. The nerve stayed compressed for a long time after an initial microdiscectomy on L4-5 that failed due to post op disc herniation and retrolisthesis at same level. Had both surgeries within a year. So I ended up with FBSS, 2 spinal implants for pain, countless of injections and ablations, and arthritis/facet degeneration and central canal/foraminal stenosis on multiple levels.
Excellent video. I am a doctor (pediatrician) but have been confused about the procedure from reading and other videos. The quality of the graphics and Dr. Armaghani's description has made the procedure understandable. Thank you.
Wow, I have never watched such an informative video!! Your explanations of everything was mind blowing! So easy to understand! Thanks so much for the information!
Thank you so much for the explanation. As a new Neuro surg-tech, it helped me A LOT to understand the procedure. I really appreciate your video! Thank you!
Thank you. Very helpful video.Just had an MRI scan...last week. Last one before my Op. Living in the Uk so all Ops on hold until Covid 19. Im not looking foward to the Op but I know its got to be done. This Video has helped me understand the procedure. Thanks again.
Had my tlft 3 weeks ago. This was way easier than I anticipated from YT vids of other patients' experiences. I sold Celebrex for over 12 years. My surgeon has me on Celebrex and Tylenol. Celebrex is a safe pain med that doesn't thin blood. I was a le to stop my pain med prescription the 4th day after my surgery. My pain is gone, and my legs are still not working well. I'm confident my nerves need healing. Hopefully, it will improve after my 12th month...
My surgery is scheduled for Feb 6th 2023... L4/L5 TLIF. Very bad sciatica pains and my L4 is tipping over L5 by about 5mm. I would move surgery up if I could, the pain is so bad. Regarding Celebrex... I was told to STOP my current Celebrex (600mgs/day) two weeks before surgery as it's an anti-inflammatory and would retard healing and bone growth. Perhaps someone can comment on this...
Thank you for these very easy to understand images of this procedure. My procedure was done (minimally) at L4/5 four weeks ago. The first 2 weeks were rough, but I feel pretty good right now. I have to remember though, that complete recovery is still a long way off. When it comes to exercise, I’ll have to remind myself to not go overboard just because I feel better. Thank you
I am a territory manager responsible for BoneScalpel, an ultrasonic blade many surgeons are using that reduces blood loss, is soft tissue sparring, preserves more autologous bone and can save time when doing TLIF’s , laminectomies, fusions… etc Do you have any familiarity with BoneScalpel or ultrasonic technology for spine procedures? Love your videos!
Hi Doc! I had a minimally invasive TLIF at L4-L5 levels two weeks back. I am mostly pain free now (apart from changing position from lying to sitting up and finally standing which is still extremely painful). I am being able to walk for one hour at a stretch without any pain. My surgeon has said that PT is not needed. I have been an avid trekker. What is you opinion on the no PT part? Also, when can I safely get back to trekking? Thanks in advance.
I had this done to me at Cleveland Clinic a little over a month ago. I was not explained in this detail how this was going to be done at that time. I am pleased with what was done but wanted to know various things, I have had a follow up visit with the dr and was finally shown what was done to my back and the various hardware that was put in my back. I had the cage as well as the rods & screws your explanation was much better & now I realize it will take some time I wanted to start working out but now realize the best thing I can do is walk for six months, with some core exercises at the local Y for now, I can use the stepper, walking machines, & eplicatial for some variety. Thanks for your help
Thank you, Chuck. It's important to me that patient's understand what we are doing in there because it is their bodies and they need to be comfortable and confident with their decision to undergo surgery. You hit on the key thing. Recovery is a marathon not a sprint. It takes time to recover from this but keep pushing and slowly but surely you will see improvements. I tell my patients that how they feel in a year will be how they feel long-term. During that year though recovery can very much feel like a 2 steps forward, 1 step back but the more time elapses from surgery the more good days you will have than bad. Good luck!
Excellent description, thank you doctor. My wife had the surgery done at Cedars Sinai and I didn't truly understand it until viewing your clear description. Even more important, the recovery process in its entirety was not explained in advance at all. You have done a true service with this explanation. I'll be telling everyone who needs it to review your fine work.
Thank you so much, George. Hope your wife is recovering well. It's a marathon not a sprint. How patient's feel at 1 year is about how they will feel long term. About 65% of the total recovery potential is within the first few months and the rest of the time is needed to get to that individual patients maximum recovery potential. We don't know what the maximum recovery potential is until the very end. Example) If a patient has about 85% recovery at 1 year post-op it probably means the remaining 15% is permanent damage. Most patients will get at least 65% and many more much higher but this is based on numerous factors.
I have Degenerative Disc Disease at L4-L5 level and have partial sacralization at L5-S1 level. I have been having back pain mostly on the left side for the past 3 years and the reason for the onset of pain was placing down a 5kg barbell in gym. I never had pain in my legs though. In the initial stage the pain used to go till the buttocks and in the recent MRI it shows I have a tear in my annulus. My surgeon sugested TLIF, is it necessary ? Please help sir 🙏
Amazing clear explanation!! Thank you! I am now more scared than ever ahahaha!! I need a graft-fusion following 4 surgeries due to 5 severe stenosis that weren’t fused and ended up with a 77% lumbar scoliosis 🙄 All these bones shaven or removed without a simultaneous fusion…!Wow! I’m so glad I saw this video- It was amazing to understand in detail. Thank you So much 🙏 I wish you were my surgeon
My TLIF was 4 weeks ago. Right after the procedure there was an increase, not a decrease, in the numbness of toes and tip of foot bilaterally. About 6 to 7 days postop, I began getting severe sciatic pain on left leg, much worse than I had ever experienced pre-op. Also, I have developed new onset weakness on my left leg, and weakness on right toe, since the surgery, which is all worse than prior to surgery. Prior to surgery, I had only very mild numbness of some toes, and only mild weakness of left toe. Now, compared to prior to surgery, I have much worse sciatic pain on left leg, significantly worse numbness of toes, and significantly worse weakness, especially on left leg. In summary, everything related to my lower extremities seems to be worse post-op compared to pre-op. Another thing I noticed, on the post-op x-ray last week at doctor's office: compared to pre-opr, the intervertebral distance has increased on the anterior sides of the joint (L5-S1), but on the posterior side of the vertebral joint, there is very, very little distance between the two vertebrae. In other words, the intervertbral distance is not even - looks like the spacer separates the vertebrae anteriorly by several millimeters in distance, spacing out the discs nicely anteriorly, but the rods in the back are acting to separate the discs on the posterior side only very minimally, if at all - only about 1mm or less of space exists between the two discs on the posterior side. I am wondering why my surgeon would not have separated those two vertebrae farther apart from one another on the posterior side during the operation before securing the screw caps to the rods. I am seriously discouraged by the unexpected negative results so far in regards to my leg symptoms having all gotten worse. Do you think this is likely a failed operation? What are my chances that the new onset weakness, numbness, and pain will go away?
Very helpful video, Dr. Armanghani, thank you. Excellent explanations pre, during, and post procedures, very thorough summary of all the separate research I had done before making a decision. I am 7 days after MIS TLIF fusing S4+5 at HSS in NYC, for severe stenosis from disc protrusion, a cyst, and arthritic spurs in that area (53 year old previously active male). Home the same day of surgery, next day was the roughest with 2 oxy pills, none since then and no tylenol for past 4 days. All the old pre-op severe and chronic pain is gone, replaced by the healing pain from the screws and incisions. Feeling very good and walking slowly more and more every day, mostly unassisted but sometimes with trekking poles. Long way to go to full recovery, but very hopeful and optimistic (both of which I lacked a month ago). Happy to answer questions from others considering this.
@Michelle Cassidy See reply to @Marc above. To your questions, -- drove about 3-4 weeks after, but bumpy roads and longer rides (an hour or more) were painful for a few more weeks. Drove 5 hours this morning and was fine. -- depends on what you mean by "go back to the gym". i was doing some exercises after 5-6 weeks post-op. cleared to do PT after 8 weeks and gradually doing harder exercises after that, and at 14 weeks now I can do maybe 70% of what I was doing before, even benching and other weights. but mostly still focused on core and leg exercises. trying to take it slowly though because of over-doing it so many times before. Best of luck to you, hope every day (mostly) is better than the last.
@Marc Richter (Purple Barn Pottery of Vermont) Thanks Marc, sounds like many similarities, but as you well know, we're all on different journeys. Hope your tapering has worked over the last 2 months since you wrote this. Couple thoughts to note, with much guesswork: - My only complaint with the post-op care was that no one mentioned that “Vasovagal syncope” was a thing, or screened for it, or prepared me or my caregiver at home in any way for it. I was very happy to not spend a night in the hospital, but passed out twice with no warning the day after the surgery, while standing in the bathroom. Was lucky to have landed the way I did, but it could have caused serious damage. Google it. -- Because i was off meds so early and felt well, I was super optimistic and probably did too much on many occassions. Everytime I thought I learned my lesson because I had to spend a whole day or two recovering in bed from too long a walk or too much lifting, I did it again, like 30+ times. It's a fine line between rehabbing aggressively with progressively longer and faster walks and PT, and pushing too far and I found it very hard to find that line. Best example was after my first post-op xray showed all was good at 8 weeks and I was clear for PT (I had already been doing PT for 3 weeks on my own before that), I flew to FL to visit elderly parents and carried a heavy bag and did way too much because I felt great. Had to shut myself down completely afterwards for 2-3 days and take tylenol daily for a week. Got an xray right after to make sure I didn’t do any damage to the harder and it was fine, but maybe did some soft tissue damage cause it took 3-4 weeks to get back to feeling as good as I was before taking the trip. I encourage the more active people to slow yourself down and give yourself time, even if you think you don’t need it. - The most pain I’ve experienced was about 6 weeks post-op when I sneezed for the first time. Sneezing and coughing for the next 3-4 weeks was a terror of extreme pain. Getting up or down (transfers as they call it) was very hard too most of the time. - I am a little over 3 months post-op now and feel very good most of the time. Been doing a daily PT regiment for about 6 weeks, and seeing the physical therapist once every week or two so she can observe, correct my technique, and make the exercises harder if I can take it. The PT at first focussed on building back the inner core muscles. After 2-3 weeks of that I was able to get up and down better and sneezing/coughing was no longer extremely painful. - Did a 6 mile hike up and down a mountain 2 days ago. The last mile was rough, muscle pain at one of the incision and hardware points, but with a little rest I felt good. Tiring, but manageable. Bending over many times repeatedly (mushroom foraging) is still tiring and painful after a while. Hope that helps, and happy to answer specific questions if you have them.
Do you mind me asking how you are feeling now 3 mo on. I’m just after this procedure I’m from Ireland. I seem to be doing good. How soon after we’re u driving when can you go back to the gym. I’m a 53 yr old female. Fairly active
My mom just had surgery and I think this is the one she had. I have a question about the exposed spinal cord though. Once you remove most of the bone, does that leave the spinal cord at a higher risk of getting damaged if you fall? I might need this surgery too, thank you for the informative video!
Good question. After bone removal, there is plenty of muscle and other soft tissue that is repaired to protect the underlying structures. Even in the thinnest of patients, the distance from the skin to the nerves is at least 3-4 inches so ample protection is provided. In my career, I have never seen or heard of a patient having a problem with a direct impact to the back following one of these surgeries.
Hi Peter! In general, if you are healed from your fusion at 1 year (roughly 85+% will be) you can do any and all activities that you would otherwise enjoy doing. Check with your surgeon to confirm you are fully fused.
Excellent. You can learn to do anything on youtube. After I repair the shutoff switch on my motorcycle’s side stand, I’ll get those two vertebra fused that have been bothering my wife! 👍👊 I have my exacto knife set, headlamp, and Dremel. It looks pretty easy.
Brilliant explanation.I am a 76 year old retired Urologist with findings of advanced spinal stenosis at L4-5 due to facet atrophygrade 1 anterolisthesis L4-5, diffuse disc bulge,thickened ligament.Clinically I have mild low back pain able to stand 20-30 minutes with no pain and walking 7-10000 steps a day,only symptoms are weakness in legs with some loss of strength in the leg muscles.Consult with Mayo neurosurgeon recommendation are to wait or consider surgery with emphasis on waiting.Any thoughts or recommendations.Thank you
Your lesson on TLIF is both clear, and frightening. I had stenosis of my spinal canal at L4/L5 with the presentation of sciatica and all the pains, numbness you mentioned. I went for surgery ten years ago and am struggling with all the horrifying effects from that botched surgery to this day. I didn't know the details of the surgery until your video, the surgeon gave a simplified version of the procedure which gave me confidence. Your description of the procedure lists at least 6 stages with each stage having the possibility of something going wrong. Imagine going through 6 tasks with 0% error. In my case, I lost all ability to pee almost immediately after the surgery. A doctor (not the surgeon) later told me my spine was like a serious car wreck with severe spinal cord injury. The brain lost all communication with the bladder, like a phone line totally snapped. I have to use a catheter to drain the urine to this day. I also had numbness to my cheeks, thighs, knees to my ankle, and feet. I have pain and muscle spasms from my arse down to my ankle. My groin is totally senseless, if I shoot water to my genital region, I feel no sensation of heat, pressure, nothing. It is like shooting the spray of water into empty space. My point to potential patients with this spinal problem is to seek and exhaust all other options before going for surgery. I hope your surgery ends in complete success.
It was very kind and courageous of you to provide such graphic details of the unfortunate outcome of your own procedure and to warn potential candidates of the need to first exhaust all possible nonsurgical options. I had a spinal surgery and now live in agonizing pain. The surgeon completely avoids any contact with me knowing full well that he has put me in misery for life. It's unfortunate how spinal surgeons mislead patients about the high and dangerously permanent complications that can arise from this procedure.
I understand what you are going through. my back surgery went wrong big time. bowel bladder issues.. loss the use of my left leg..and the pain is worse..on total disability.. God bless everyone here..
Thank you for the kind words, Robin. The surgery takes anywhere from 90 mins to sometimes 3 hours depending on how much compression there is and if there was prior surgery.
Amazing presentation Dr, I know you have helped many who are facing this procedure, many surgeons are men/women of few words. I have a question for you. My husband 55 had TLIF and ALIF L4-S1 ( the rotisserie chicken) he healed/fused well. He still has foraminal nerve pain from L4 ( only one side the RT) If there is so much newly created space how can there be more stenosis? The vast majority of the other back pain is gone. The pain Mgt epidurals don't seem to help at all . He's 18 months post op. Is there any other procedure given the hardware is in there that you can recommend generally speaking. ( Also he ended up 3 mo post op with SIJoint severe pain due to the load transfer and has since had both sides fused successfully with no SI pain remaining.
Dr.Armaghani, I have a question. What makes the bone grow in between the transverse processes? Do you have to scrape the bones to allow for vascularization there? Thanks, it was a great explanation of the procedure.
we rough up the transverse processes so there is some bleeding. when you put bone or bone graft substitute that is man made on the transverse processes and between them the body sends cells to that area that makes it solidify and heal much like a broken bone would heal back together.
You have explained it so well! Thank You for sharing this information; it helps. I am waiting to be seen by a neurosurgeon and I hope to get some much needed relief of nerve compression.
Just had an open L5-S1 tlif for recurrent disc herniation and need for complete facetectomy b/c of horrible leg pain. Two weeks out, apart from muscle pain and spasms, no nerve pain whatsoever. If you can gut out the early post op period, it should be worth it.
That's awesome! You're so lucky, I wish I could say the same. I can't remember what it's like not being in pain (I posted my experience here). God speed on your recovery and take it easy, ok?
Hi Doc, Great explanation of the procedure. I was wondering if it was possible for you to take a look at my images to determine whether a spine fusion is necessary. However I am not from Florida so I was wondering if a virtual visit would suffice. Or even a small phone call. Just anything to get your opinion. Short summary of my health: degenerative discs (practically gone) L4-L5, L5-S1, Par fracture, slight bulge L4-L5, genetically small foramen, nerve pain and can’t sit for more than 10 minutes. Age: 22, had a L4-L5 microdiscectomy at 18.
What you have is very similar to what I have I am two weeks post op and im doing good im hoping for a better quality of life. I was unable to stand for more than 10 mins at a time. I hope you get relief. It’s awful
Hello Dr., my husband has undergone a laminectomy + discectomy surgery recently (2.5 months ago) & now when his MRI was repeated with a different surgeon he has advised for an urgent surgery as the disc has prolapsed and is compressing the nerve, the Dr. has advised for a TLIF, can you please advise if there is any risk to undergo this surgery so soon and what are the risks associated to it if he undergoes this surgery and if we delay it. Awaiting your response ASAP as this will help us to take the right decision.
Thank you for this amazing and detailed video. I am two weeks postop from Mayo - I don’t really have any back pain that’s intolerable from the surgery - but what I DO have is incredible right side pain which is literally making me scream 1 to 2 hours in the morning. Am useless without walker, can barely stand on my own. Is this gonna go away? I signed up for back surgery, not to feel like I have a broken hip. Thank you.
Difficult to say without knowing your case but in general, patients can feel different pains from surgery in the very early post-operative period but I like to tell patients that eventually the "dust will settle" and that takes about 4 weeks time.
Thanks for all the great information. Dr, do you recommend PT after surgery? (For someone had rest 70% of the time during the last three months before surgery) If so, when do you suggest to start PT? Thanks again!
Good question! In general, for my patients, I tell them to take the first 6 weeks to just let their body heal. They can walk as much as they like but not much more because we need their muscles and nerves to continue to heal. After 6 weeks we start loosening up what they can do and that includes initiation of PT if they would like. I don't like to allow exercises that involve bending or twisting at the waist, however, for at least 3 months after surgery and sometimes longer depending on the patient and surgery done.
I'd be very assured with this surgeon. Quite a procedure but one i think has been well practiced. Have to wait what for what i need doing...very grateful for this excellent presentation. Question: how to choose the best surgeon - does going private equal a better outcome? Probably it will be done on the NHS - unfortunately i'm in an area that's hyper congested and the hospital i'm referred to i'm worried about. However, this really very good explanation has given me confidence - thank you very much.
Very good question. On a personal level, feeling comfortable and confident with your surgeon is the most important thing. Do you feel that the surgeon listens to you and do they take the time to answer your questions. If you feel like your surgeon isn't listening to you and doesn't answer your questions to your satisfaction, it is unlikely they will after surgery in the unlikely case you have something wrong. If you are comfortable and confident in your surgeon, you will have a great result.
Hi doctor, After many videos I have seen for me your explanation is considered the best of all Question: Which method is considered more advanced ALIF OR TLIF ? its seems that AILF is more advance and more safer than surgery from the back. is that so?
It all depends on the patient and where their trouble is coming from. For some patients with certain conditions and compression in certain areas, TLIF is better, but for others, ALIF is better. It's more important to find a surgeon who is comfortable with multiple ways of treating a condition so they can tailor the best surgery for you.
Hi, I have been operate 2 times for the same herniation L5S1 (14 days between operations). But almost 5 day after the second operation I stared to feel the same nerve problem (I have the same herniation again) so I think my disk has no chance to repairment. My doctor said that to make a disk implant is no good idea because implants has high probability to fail, so he recommends fusion. What do you think about disk implant? What can be more secure to do, fusion or implant?
I’ve watched your video about the minimally invasive TLIF and heard about an open TLIF. Do you have a link a video to an open TLIF? What are the pros and cons to the two different TLIF procedures? Thanks in advance!
That's actually the video for open TLIF. The general steps of both MIS And open TLIF are essentially the same. The difference is in most MIS TLIFs a large decompression isn't done. It is my belief that the main reason to even be in surgery is to get the pressure off the nerve(s). If that can be done my minimally invasive means - great. But if it requires a standard open incision (less than 2.5 inches in most cases) to get the job done then i suggest doing it that way. The worst is if you don't get adequate decompression of the nerves because then you won't get the improvement you are looking for.
Great video! I had this surgery over 10 years ago and it was the best decision I made. I was up and walking around a few hours after the surgery. No more electrical pain in my back and legs. The incision pain was very little when compared to the electrical pain before surgery.
Thank you for your very clear explanation. I am 3 weeks out from having exactly this procedure at L4-L5 at Mayo Clinic. The first week or so was very painful, mostly from muscle spasms. In about 1 1/2 weeks I was completely off opioids and now just take an occasional Tylenol as needed. For the next 3 weeks my only therapy is to walk as much as possible. My main advice is get off opioids as soon as possible. They are bad news and mess with your brain and digestive system.
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I could not have said it better myself. You hit the nail on the head for exactly how the recovery goes. Walking is your friend and get off the opioids as soon as you are able! As time goes on you will have more good days than bad.
I am 2 weeks post op. My surgeon preform my procedure exactly like you discuss in this video.Im doing very well. My recovery has that bad at all. My surgeon prescribed a back brace for me to use the first 3 months.
I also have a machine I have to do for 30 mins a day
It's a magnetic field belt that helps bone growth. I think I'm ready to venture out of the house. I pray for us all to heal great and move on with life. If any of you are hesitant to getting the surgery. Don't be anymore. Just get it down. I put mind off through the holidays. But by the time Surgery day came, I was barely making it. Rt leg pain, tingling and numbness was through the roof.
After surgery almost Instant relief.im glad I had it done. 🙏
Great to hear you had such a good result! good luck!
Thank you doctor for such a comprehensive and easy to follow explanation. You've really helped me understand what's happening and hopefully what will help. Greetings from North Wales UK
Glad it was helpful!
Awesome video!!! Your explanation of the surgery took off the fear and worries about the TLIF surgery that I’m having in three weeks. Hopefully this will take the horrible pain that that I’ve been living for the last 7 years. No life with this type of injury.
Glad it helped, Guillermo!
As he said, it’s a marathon not a sprint. Seven months postop from L5-S1 fusion, laminectomy, and other repairs at Mayo Clinic in Jacksonville, Florida. Hands down the most insanely painful operation I have ever had and this is coming from a lady with a freakishly high pain tolerance. This operation will test you in every possible way. Surgeons tend to downplay the pain and lengthy recovery. If you do this, BE PREPARED!
I had my L4-L5 TLIF six days ago in Spain. I felt extreme pain when I wake up from the anesthesia. Three nights in the hospital. From the day four I started to walk over an hour with very low back and muscular pain. This surgery is not necessarily a torture for everybody. On the other hand this video is the best explanation I found about this surgery, thanks for educating us
@Day One Adele Fans That's crazy as heck! I wonder if Dr. Armaghani does his own reply's here or if its just a secretary..I was hoping the op would at least take some of the pain away right now..I cant sit for more than 15 minutes 😕
@* James * Interesting - if you’re getting an L5-S1 fusion you absolutely cannot BLT (bend, lift, twist) for quite a while. I can’t speak of any benefits yet. My neurosurgeon says that it will be a year and a half to two years when I notice benefits of op and should be at full fusion at that time. I get my yearly scans on January 30th.
@Day One Adele Fans Im glad youre better now. Are you glad you did it overall? Ive been through some crazy surgeries.. Hey, Dr A said I wouldn't need a "wand" and that I could tie my own shoes after surgery. You had the single level L5 S1 right?
@* James * Oh man, you’re doing it, wow. January 20th was my year “spineaversary”. Def better, but still have some pain and spasms. Ahh yes, the paperwork, lol. Get yourself a wand and a seat riser. If you can afford it, get yourself a lift recliner, it saved me. Heating pad essential as are grabbers. Ngl, this op is not for sissies, be prepared for pain James.
I had this surgery 7 weeks ago and I am glad I did. All the pain, tingling sensation & numbness have all gone.
Fantastic, thank you. I am a gynecologic surgeon up in PC with this procedure scheduled in a month and a half. You explained it so well without oversimplifying it or rushing through it.
Thank you for the kind words and best of luck!
What an unbelievably easy to understand video. Thank you for putting this together!
you're very welcome!
This is a fabulous presentation - thank you for your time & detail provided!
I am so impressed with your clarity and visuals. I’m having my third surgery soon and am sure this time it’s going to require fusion. My most recent MRI was a hot mess. My concern is that at 52, I will have a lot of years of life left with continuing issues and pain. I hope my surgeon is as steady and sure as you are!
I’ve (unfortunately) had 4 fusions and the next one in a couple days. Each surgery has been successful. I’m walking the Camino de Santiago (500 miles) in the spring. It’s all doable. Fusions have given me pain relief. Fusions get a bad name but it’s mostly from the past. I have a great surgeon and that’s critical.
Thank you for the kind words
Thank you for your very interesting video sir.
I am myelomeningocele and I worked in a small general hospital (albeit in medical records but no one is perfect!) in UK. I have always found surgery fascinating and picked up a little knowledge in my working life even though, unfortunately (only for me!), I was not able to actively cut and sew!
It amazes me to see how advances have been introduced in leaps and bounds over the years and the benefits they have brought.
I am in awe of your abilities and wish you blessings and peace in what you achieve.
Thank you sir.
Thank you so much for the very kind words
My wife just went through this procedure. After watching this I know what she is going through is normal. Took some of the worries away. Thank you for the video.
Thankful to hear the video helped with some of your worries. Remember it's a marathon but the more time elapses after surgery, the more good days she will have than bad.
Great outstanding presentation Doc. You made me feel much more comfortable doing my procedure in a few weeks Thank you very much
@Armaghani Spine7yyhb
hello, how are you now sir, how's your recovery
You are most welcome!
I work at the operating room providing instrumentation for surgeries. Knowing how things work tells how important they are. I feel smarter already! Thank you for the video. Have a great and successful new year!
thank you so much! you all provide a great service to the patients and us
Thank you for the great presentation!! I am 2 weeks post-op after a L-4-5 TLIF at a well known NYC hospital. I am very familiar with all the anatomy as I am an Imaging Service Manager, but your explanation of the procedure will potentially help so many patients who like myself are terrified of this procedure. I tried putting this surgery off for the past 3 years after having multiple epidurals, facet blocks, PT, massage, and even tried a Boston Scientific Spine Stimulator. I had unbearable pain in my left buttock, left thigh down to my knee. It had gotten so bad that I had to stop everytime after a few steps. After finally giving in and finding a great Neurosurgeon and Orthopedic Surgeon i scheduled my surgery for Dec 16, 2022. I am now definitely improving where the thigh and knee are better but the left buttock and surgical incision site are still painful but are much less as it is now being controlled with Tylenol and an occasional Advil. I am very optimistic that I will continue to see improvement over the next few weeks and months. thank you again for your great explanation and presentation!
hope youre doing well! thank you for sharing.
Thanks Lisa, I am doing better but still have pain in lower left side but leg pain has lessened. True his presentation was excellent and I have also been in the OR during many procedures. Good luck, I wish I had done this sooner but you know we make the worst patients!
I am having L4-5 and S1 done January 9th. I'm in imaging too. Been the tech in these same procedures. None of this is explained to us in the OR. At least I have a much better understanding of what I will be having done to me now. I hope you are progressing well.
This is so well done… I need back surgery and I am scheduled in early March 2022 - S1/L5. The only problem is that I am so scared of what can go wrong. Having a hard time getting the negative thoughts out of my mind.
@Joe PublisherWhat did you do to find a good surgeon? How am I supposed to know whose good and whose not?
Such an amazing video. This should be a resource for all spine surgeons to give to their patients .
@Amie Morgan Surgery went fine and the recovery as well. Follow-up with surgeon every three months to ensure fusion is taking place. My leg pain is a distant memory. I strongly advise doing the PT that goes along with this surgery. And, find yourself a good surgeon.
how was your surgery?
I'm having this procedure done soo
I very much appreciate the clear and concise explanation of what to expect! Thank you!!
The best and most effective explanation on the subject.
I have undergone Laminectomy and TILF surgery ,thanks to this video and comprehensive explintionsI have been able to go through this with less concerns and worries with a great understanding on my recovery and what to expect.
Thank you, Rafi. Patient education is of the greatest importance. Spine surgery is a very technical, complicated thing to try and explain without figures, models, and videos for someone not in the field to understand. With all these materials, the patient is able to make the best decision possible and they are confident in their decisions.
It is wonderful being a student when the teacher presents information with such transparency, clarity, and intelligence.
(Deep Bow)
Thank You, Sir !
Thank you for the kind words!
Thank you so much for this very informative video, Dr. Armaghani. While my surgeon explained this in the office - to have this video as a reference is so helpful, as it will take multiple viewings before the information is integrated in my mind. Your teaching style is exceptional. Many thanks.
@Armaghani Spine I have had a ACdf in November woth volume loss in my cervical . I feel off my ladder and sustained a compression fracture chronic non union , they did a ketopasty in novermver and the did the rifle whatever I. In so much more pain and my right leg is numb my hands have been tugging etc when will thi get better
I agree. I am scheduled to do the same and after the step by step process explanation, I shared this video with my surgeon. He was impressive and impressed!
Thank you, Cheryl. I'm glad to provide an additional resource to help patients in their decision making!
Damn Doc, your videos are just Awesome. You describe Exactly How & Why you do each step. Wish I knew all of this in 1987 & 2001 & 2007, if not even today. Thanx Sir, truly appreciate it.
most welcome
Thank you Dr. for these videos you put out. As a Medical Coder it helps me understand the procedures.
Wonderfully done! Thanks for your time and patience!
You are most welcome
I just had this procedure done two weeks ago at the Mayo Clinic in Phoenix. I had grade 3 spondylolisthesis, with L4 and L5 pretty much bone on bone with compressed nerve roots. That pain is gone and I’m on the road to recovery. Don’t fear the TLIF! 😀
I had this also ,I was basically helpless until I got this surgery ,also found several spinal cysts, first 5 days were painful, but walk everyday . I went back to my job as a UPS driver and have never looked back. People said I was Making a mistake. I would do it all over again.
@Joe G. Okÿÿ
@Susan Licon I hope you are good now...any updates you want to share.
@Susan Licon I hope you are good now..any updates you want to share
@Joe G. Often that is all it takes
This was very informative!! I had a Posterior lateral lumbar fusion L4/L5. I searched for videos regarding my surgery and didn’t find one that was as detailed as this. I know this is not the specific surgery I had but, it was close enough.
This made it clear the healing process and time frame. I am 3 months out and have been very impatient to get back to “normal” activity. After watching this video I have a greater understanding of the healing timeframe as well as what activities I am allowed.
Thank you!!!
This is what I have scheduled to have done on Aug 8, how are you feeling?
You're most welcome. Good luck!
Thank you so very much for this video! The service you are providing is greatly appreciated. My doctor blew through the explanation of the procedure and just left me with a form to sign and a bad copy of the MRI with scribbles. First, it is a rather shocking diagnosis that takes some time to digest, especially if one is on the younger side like me. And second, should be explained thoroughly to every patient before asking them to sign a consent form (as you have done here).
I appreciate the kind words. This is very technical surgery and difficult to understand without pictures, in my opinion. I create these videos for specifically this purpose. So patients and their families could go home and on their own time see exactly what we do during surgery then come back with their decision. I almost never ask a patient to make a decision during the same visit that i bring up surgery because it is too much information to process.
This is the most educational video I have ever. My mother is going have that surgery in 3 week. It was a very outstanding video. Many thanks.
Thank you for this video! it makes the surgery so clear. This procedure was recently recommended by my surgeon. I'm a 32yo M ultra marathon runner. I previously ran 50-70 miles per week but now I can barely run one mile once per week over the past 6 months. It is a hard decision on having the surgery because I only have mild pain and no neurological symptoms when I'm not running (if I run my leg gets weak and my foot goes numb, I pay for it with back pain for a few days after). Do you tend to see patients return to running eventually after a fusion?
i find that patients that are so motivated as yourself don't let anything get in the way of them doing things.
Omg! Son you are awesome explaining all these procedures. If I ever have to get an operation for my spine I would want someone like you performing the surgery! It sounds scary but I would take my chances with you! I think I have spinal stenosis, I had a severe sciatica issues last year in April . I could not walk for about 8 weeks, I had so much pain I don't wish this pain on anyone I was so scared, I felt ashamed and went into a deep depression I did not like to depend on anyone to do anything for me I am a very independant grandma! I would like to know if I can do anything natural to help me with this or natural supplement. Thankyou so much god bless! Namaste❤
@Nan's Global Kitchen,
Without knowing your age or level of range of motion(ROM) I still feel confident in recommending you check-out "Foundational Training" on YT. Of course, it would be even better if you could locate a certified therapist near you where you could be assessed and guided in person. Exercises consist of specific postural stances that increase joint and muscle strength while addressing posture and breathing.
One of the best all around exercises that works every muscle is swimming, with proper form, of course__short of that, next one is walking__again, being aware of posture, correcting any discrepancies during the process.
There are numerous bodywork methods that may help relieve pressure in the lower back, sacral and glute areas, too! If you can get on the floor(and up again on your own 😛) there is a great book you could use with tennis balls called, "Acupressure Warm-Up" by Marc Coseo. Simple diagrams and explanations for the 'layman', yet very effective in outcome!
Make sure you're drinking plenty of clean fresh water, too! Lubricates everything as well as, helps the cells perform all functions.
Hope some of this has been helpful.
Love, Light, and Healing Blessings.
🙏😇✨💫🌱🌿🌻🐝🌳🌎💖🙌🙌🙌😺
Thank you for this thorough explanation of the procedure. It will be good to know what the success rate of this surgery is. Few people comment on that. I'm also wondering, after one year, how careful do people still need to be about bending, lifting, and twisting?
you're most welcome. once a patient is fused, they can return to any activity they would like to do or feel comfortable doing.
What would we do without your efforts sir? This surgery is quite a mystery, particularly for an older chap like me who was always told as a child to studiously avoid anyone working near the spinal column due to the proximity of so many important nerves. With the development and perfecting of new techniques, new tools, adhesives, metals etc things have advanced enormously, and at my initial consultation with the surgeon yesterday (here in the UK) he told me that this is now a very common procedure for him to perform.
It all reminds me of the first heart transplant carried out by Dr Christian Barnard in the late 1960s (?), whose name became known across the globe. Now hearts are flying out of warm dead bodies and into live ones at an insane rate (I may be prone to exaggeration, but you get my point).
Thank you so much for this beautifully made and clearly explained video, helping to colour-in some of the mysterious aspects of your amazing work. Bless your heart from every effort you make.
Thank you so much for the kind words.
This is the most educational video I have ever seen. My mother is going have that surgery in 3 weeks. It was a very outstanding video. Many thanks.
Best of luck to your mother!
Just had this done last week. Rough recovery but this was an amazing explanation!
Hang in there! It's a marathon not a sprint.
From my experience of having four knuckles replaced , both hips & knees replaced and being off all meds an week prior and an week after before being able to take NSAIDs for all surgeries with the exception of my last surgery which I did get back on my NSAIDS like roughly 24 hours after surgery and a lot of my pain did leave within an hour : the constipation (actually was constipated before surgery due to being off NSAIDs) and my leg was no longer so swollen that my skin was pulling on my sutras . So I would recommend coming off the drugs that inhibit healing like : leuflunomide , methotrexate , humira , and etc and I would think that since the NSAIDs do fight inflammation they would be beneficial to the healing process and they definitely do help make it feel better . So I wouldn't recommend coming of the NSAIDs prior or immediately after surgery and they can be used in conjunction with asprin if need be , said my Rheumatologist . Although this may not be for everyone but just those of us that have stomach conditions , like gastritis , chrohns , IBD , etc.....
I had TLIF 7 weeks ago. Wish I had watched this prior. This is really good information.
Hang in there! Recovery is a marathon, not a sprint.
Thank you very much for this very clear explanation. I am due to have this procedure at the end of January and I was scared to be honest but I feel a lot better after watching this. I have L4/L5 Spondylolisthesis and am looking forward to having some relief from my leg pain and hopefully to get back to hiking and skiing again eventually. Many thanks again!
Hi Kate, Glad you had your surgery done and behind you. I feel for you with the pain as I know how it hurts. They got me up to walk as well and even took me for x-rays to make sure all was well. That hurt. Been 3 months now and I look back and it is a slow process but you will get better. The first month will be the hardest but you will get through it one day at a time. I am sorry you are dealing with pain and hopefully you are being given meds to help with that. Also I am sure they were able to repair the damaged vertebrae and make room for your nerve roots to function properly. Sounds like they will be taking good care of you for several days before you go home. Here in America with Covid we are sending people home after only 2 days in the Hospital. But I needed a Big Burger King Burger anyway :) Take care Kate.. Ron@Kate Makeup Looks
Had the surgery yesterday and it went well. There were however some complications (because my L4 and L5 vertebrae were very badly damaged and the foramen was so narrow that the nerves and thecal sack were very squashed indeed). I also lost a lot of blood. The pain at the operation site is very bad but it seems that the terrible pains I had in my right leg before the operation are already gone. I got up to walk today, which was interesting to say the least! Because of the bleeding I’m still in ICU with a drain in the wound. Here in Germany they like to keep you in hospital a long time so I’ll probably be here another 6 days, during which time I’ll start physiotherapy. Thanks again for the great explanation and best of luck to all having this procedure!
@Armaghani Spine Thank you very much, Dr Armaghani! My surgery is on Friday next week with Professor Oliver Linhardt in Munich, Germany.
My neurosurgeon in Cody was Dr. poffenbargar
Was your surgeon in Cody, WY Dr. Clint Devin?
Best explanation and animation on the net! Thanks so much.
Agreed! Thank you!
Glad it was helpful!
This is by far the best presentation that i have found. it is a real comfort for me going into my L1-4 .TLIF in several days
You had a 3-level TLIF? I was told by my doctor this is not a possibly surgery. Multi level fusions are not successful. I’d be interested to know how yours went?
Any update? Hope all is well!
Thank you, Martha. Good luck on your surgery!
Great effort doctor. Really useful for patients and clinicians.
Thank you!
I had an L4-S1 TLIF and the surgery was technically successful, but I developed epidural fibrosis at the nerve roots and permanent nerve damage. The nerve stayed compressed for a long time after an initial microdiscectomy on L4-5 that failed due to post op disc herniation and retrolisthesis at same level. Had both surgeries within a year. So I ended up with FBSS, 2 spinal implants for pain, countless of injections and ablations, and arthritis/facet degeneration and central canal/foraminal stenosis on multiple levels.
I would not consider that successful surgery. Yikes!
Thank you for an excellent and well-thought-out presentation. You clearly laid out the procedure and the recovery.
I wish I had found your video before my procedure on 6/14! my Dr. explained,but not as thourghly! thanx again!
Glad it was helpful!
Excellent video. I am a doctor (pediatrician) but have been confused about the procedure from reading and other videos. The quality of the graphics and Dr. Armaghani's description has made the procedure understandable.
Thank you.
Thank you for the kind words, Dr. Hertenstein!
Excellent breakdown and video! Thank you for your work.
My pleasure!
Beautifully explained, I am so impressed and I am a spine surgeon
Thank you for the kind words especially coming from another colleague!
I am prob. going to have this one and you have reduced my fear a lot! Thank You!! Great video! Excellent!!👍
Wow, I have never watched such an informative video!! Your explanations of everything was mind blowing! So easy to understand! Thanks so much for the information!
thank you so much!
Thank you so much for the explanation. As a new Neuro surg-tech, it helped me A LOT to understand the procedure. I really appreciate your video! Thank you!
You're very welcome!
Thanks Doc! Going in for my TLIF next week on July 20, 2021. This was very informative.
I've super fine after 3 years L5-S1 TLIF, nothing any problem good luck 🤞
@Irwin how are feeling now .. my doctor is suggesting TLIF for L4 L5 S1 .. please share how you are recovering .. it will be very helpful
Best of luck!
Thank you. Very helpful video.Just had an MRI scan...last week. Last one before my Op. Living in the Uk so all Ops on hold until Covid 19. Im not looking foward to the Op but I know its got to be done. This Video has helped me understand the procedure. Thanks again.
Thank you for the kind words, Mark. Good luck with your procedure
Had my tlft 3 weeks ago. This was way easier than I anticipated from YT vids of other patients' experiences. I sold Celebrex for over 12 years. My surgeon has me on Celebrex and Tylenol. Celebrex is a safe pain med that doesn't thin blood. I was a le to stop my pain med prescription the 4th day after my surgery. My pain is gone, and my legs are still not working well. I'm confident my nerves need healing. Hopefully, it will improve after my 12th month...
My surgery is scheduled for Feb 6th 2023... L4/L5 TLIF. Very bad sciatica pains and my L4 is tipping over L5 by about 5mm. I would move surgery up if I could, the pain is so bad.
Regarding Celebrex... I was told to STOP my current Celebrex (600mgs/day) two weeks before surgery as it's an anti-inflammatory and would retard healing and bone growth. Perhaps someone can comment on this...
Great presentation, easy for anyone to understand. Thanks doctor!
Hi Alex! I just watched this too .., after surgery!
You are welcome!
Thank you for these very easy to understand images of this procedure. My procedure was done (minimally) at L4/5 four weeks ago. The first 2 weeks were rough, but I feel pretty good right now. I have to remember though, that complete recovery is still a long way off. When it comes to exercise, I’ll have to remind myself to not go overboard just because I feel better. Thank you
@Marc Richter (Purple Barn Pottery of Vermont) 0m
Well said. I am reading your words over and over to myself!!!!! LOL.
well said and good luck!
I am a territory manager responsible for BoneScalpel, an ultrasonic blade many surgeons are using that reduces blood loss, is soft tissue sparring, preserves more autologous bone and can save time when doing TLIF’s , laminectomies, fusions… etc
Do you have any familiarity with BoneScalpel or ultrasonic technology for spine procedures? Love your videos!
Hi Doc! I had a minimally invasive TLIF at L4-L5 levels two weeks back. I am mostly pain free now (apart from changing position from lying to sitting up and finally standing which is still extremely painful). I am being able to walk for one hour at a stretch without any pain. My surgeon has said that PT is not needed. I have been an avid trekker. What is you opinion on the no PT part? Also, when can I safely get back to trekking? Thanks in advance.
Can you provide update on your ability to go trekking now?
I had this done to me at Cleveland Clinic a little over a month ago. I was not explained in this detail how this was going to be done at that time. I am pleased with what was done but wanted to know various things, I have had a follow up visit with the dr and was finally shown what was done to my back and the various hardware that was put in my back. I had the cage as well as the rods & screws your explanation was much better & now I realize it will take some time I wanted to start working out but now realize the best thing I can do is walk for six months, with some core exercises at the local Y for now, I can use the stepper, walking machines, & eplicatial for some variety. Thanks for your help
Thank you, Chuck. It's important to me that patient's understand what we are doing in there because it is their bodies and they need to be comfortable and confident with their decision to undergo surgery. You hit on the key thing. Recovery is a marathon not a sprint. It takes time to recover from this but keep pushing and slowly but surely you will see improvements. I tell my patients that how they feel in a year will be how they feel long-term. During that year though recovery can very much feel like a 2 steps forward, 1 step back but the more time elapses from surgery the more good days you will have than bad. Good luck!
Thank you so much for this information! Awesome job!
I just went through the Posterior Cervical Laminectomy Fusion and Surgeon and Hospital Staff!
good luck in your recovery!
it is comforting how detailed you are about what this procedure involves.
Thank you very much for the kind words
Excellent description, thank you doctor. My wife had the surgery done at Cedars Sinai and I didn't truly understand it until viewing your clear description. Even more important, the recovery process in its entirety was not explained in advance at all. You have done a true service with this explanation. I'll be telling everyone who needs it to review your fine work.
Thank you so much, George. Hope your wife is recovering well. It's a marathon not a sprint. How patient's feel at 1 year is about how they will feel long term. About 65% of the total recovery potential is within the first few months and the rest of the time is needed to get to that individual patients maximum recovery potential. We don't know what the maximum recovery potential is until the very end. Example) If a patient has about 85% recovery at 1 year post-op it probably means the remaining 15% is permanent damage. Most patients will get at least 65% and many more much higher but this is based on numerous factors.
Doc, would you recommend fusion over the total disc replacement for the L5-S1 level ? Thank you so much for your work, great videos!
it all depends on the surgeons confidence with each. i think if motion preservation is an option it should be seriously considered.
Thank you for your wonderful explanation of an operation I'm due to have in 4 days time. It has alleviated my concerns greatly.
Glad it was helpful!
I have Degenerative Disc Disease at L4-L5 level and have partial sacralization at L5-S1 level. I have been having back pain mostly on the left side for the past 3 years and the reason for the onset of pain was placing down a 5kg barbell in gym. I never had pain in my legs though. In the initial stage the pain used to go till the buttocks and in the recent MRI it shows I have a tear in my annulus. My surgeon sugested TLIF, is it necessary ? Please help sir 🙏
Amazing clear explanation!! Thank you! I am now more scared than ever ahahaha!! I need a graft-fusion following 4 surgeries due to 5 severe stenosis that weren’t fused and ended up with a 77% lumbar scoliosis 🙄 All these bones shaven or removed without a simultaneous fusion…!Wow! I’m so glad I saw this video- It was amazing to understand in detail. Thank you So much 🙏 I wish you were my surgeon
Glad it was helpful!
My TLIF was 4 weeks ago. Right after the procedure there was an increase, not a decrease, in the numbness of toes and tip of foot bilaterally. About 6 to 7 days postop, I began getting severe sciatic pain on left leg, much worse than I had ever experienced pre-op. Also, I have developed new onset weakness on my left leg, and weakness on right toe, since the surgery, which is all worse than prior to surgery. Prior to surgery, I had only very mild numbness of some toes, and only mild weakness of left toe. Now, compared to prior to surgery, I have much worse sciatic pain on left leg, significantly worse numbness of toes, and significantly worse weakness, especially on left leg. In summary, everything related to my lower extremities seems to be worse post-op compared to pre-op. Another thing I noticed, on the post-op x-ray last week at doctor's office: compared to pre-opr, the intervertebral distance has increased on the anterior sides of the joint (L5-S1), but on the posterior side of the vertebral joint, there is very, very little distance between the two vertebrae. In other words, the intervertbral distance is not even - looks like the spacer separates the vertebrae anteriorly by several millimeters in distance, spacing out the discs nicely anteriorly, but the rods in the back are acting to separate the discs on the posterior side only very minimally, if at all - only about 1mm or less of space exists between the two discs on the posterior side. I am wondering why my surgeon would not have separated those two vertebrae farther apart from one another on the posterior side during the operation before securing the screw caps to the rods. I am seriously discouraged by the unexpected negative results so far in regards to my leg symptoms having all gotten worse. Do you think this is likely a failed operation? What are my chances that the new onset weakness, numbness, and pain will go away?
Very helpful video, Dr. Armanghani, thank you. Excellent explanations pre, during, and post procedures, very thorough summary of all the separate research I had done before making a decision. I am 7 days after MIS TLIF fusing S4+5 at HSS in NYC, for severe stenosis from disc protrusion, a cyst, and arthritic spurs in that area (53 year old previously active male). Home the same day of surgery, next day was the roughest with 2 oxy pills, none since then and no tylenol for past 4 days. All the old pre-op severe and chronic pain is gone, replaced by the healing pain from the screws and incisions. Feeling very good and walking slowly more and more every day, mostly unassisted but sometimes with trekking poles. Long way to go to full recovery, but very hopeful and optimistic (both of which I lacked a month ago). Happy to answer questions from others considering this.
@Michelle Cassidy See reply to @Marc above. To your questions,
-- drove about 3-4 weeks after, but bumpy roads and longer rides (an hour or more) were painful for a few more weeks. Drove 5 hours this morning and was fine.
-- depends on what you mean by "go back to the gym". i was doing some exercises after 5-6 weeks post-op. cleared to do PT after 8 weeks and gradually doing harder exercises after that, and at 14 weeks now I can do maybe 70% of what I was doing before, even benching and other weights. but mostly still focused on core and leg exercises. trying to take it slowly though because of over-doing it so many times before.
Best of luck to you, hope every day (mostly) is better than the last.
@Marc Richter (Purple Barn Pottery of Vermont) Thanks Marc, sounds like many similarities, but as you well know, we're all on different journeys. Hope your tapering has worked over the last 2 months since you wrote this. Couple thoughts to note, with much guesswork:
- My only complaint with the post-op care was that no one mentioned that “Vasovagal syncope” was a thing, or screened for it, or prepared me or my caregiver at home in any way for it. I was very happy to not spend a night in the hospital, but passed out twice with no warning the day after the surgery, while standing in the bathroom. Was lucky to have landed the way I did, but it could have caused serious damage. Google it.
-- Because i was off meds so early and felt well, I was super optimistic and probably did too much on many occassions. Everytime I thought I learned my lesson because I had to spend a whole day or two recovering in bed from too long a walk or too much lifting, I did it again, like 30+ times. It's a fine line between rehabbing aggressively with progressively longer and faster walks and PT, and pushing too far and I found it very hard to find that line. Best example was after my first post-op xray showed all was good at 8 weeks and I was clear for PT (I had already been doing PT for 3 weeks on my own before that), I flew to FL to visit elderly parents and carried a heavy bag and did way too much because I felt great. Had to shut myself down completely afterwards for 2-3 days and take tylenol daily for a week. Got an xray right after to make sure I didn’t do any damage to the harder and it was fine, but maybe did some soft tissue damage cause it took 3-4 weeks to get back to feeling as good as I was before taking the trip. I encourage the more active people to slow yourself down and give yourself time, even if you think you don’t need it.
- The most pain I’ve experienced was about 6 weeks post-op when I sneezed for the first time. Sneezing and coughing for the next 3-4 weeks was a terror of extreme pain. Getting up or down (transfers as they call it) was very hard too most of the time.
- I am a little over 3 months post-op now and feel very good most of the time. Been doing a daily PT regiment for about 6 weeks, and seeing the physical therapist once every week or two so she can observe, correct my technique, and make the exercises harder if I can take it. The PT at first focussed on building back the inner core muscles. After 2-3 weeks of that I was able to get up and down better and sneezing/coughing was no longer extremely painful. - Did a 6 mile hike up and down a mountain 2 days ago. The last mile was rough, muscle pain at one of the incision and hardware points, but with a little rest I felt good. Tiring, but manageable. Bending over many times repeatedly (mushroom foraging) is still tiring and painful after a while.
Hope that helps, and happy to answer specific questions if you have them.
@Michelle Cassidy Sorry, just saw this, i don't check youtube messages much. Will reply shortly.
@Marc Richter (Purple Barn Pottery of Vermont) Sorry, just saw this, i don't check youtube messages much. Will reply shortly.
Do you mind me asking how you are feeling now 3 mo on. I’m just after this procedure I’m from Ireland. I seem to be doing good. How soon after we’re u driving when can you go back to the gym. I’m a 53 yr old female. Fairly active
Love his explanation, very clear
My mom just had surgery and I think this is the one she had. I have a question about the exposed spinal cord though. Once you remove most of the bone, does that leave the spinal cord at a higher risk of getting damaged if you fall? I might need this surgery too, thank you for the informative video!
Good question. After bone removal, there is plenty of muscle and other soft tissue that is repaired to protect the underlying structures. Even in the thinnest of patients, the distance from the skin to the nerves is at least 3-4 inches so ample protection is provided. In my career, I have never seen or heard of a patient having a problem with a direct impact to the back following one of these surgeries.
Thanks for that video doc, you really help me and other people thanks a lot 🙏🙏
Great video!! All patients should have access to this type of information. Thanks Doc! Will all practices did this type of thing!
Thank you, Scott!
I can tell this video required a tremendous amount of work and preparation. Commendable work.
Yes, thank you!
Thank you Dr. A,I just had this procedure done 5 weeks ago,and have felt so much better!
Thanks for the explanation!
Have a BLESSED Day!🧡💙🧡
Glad to hear you are doing well!
Doc, after one year could we resume snow skiing, running, dancing and similar activities? Best detailed explanation of TLIF I have seen. Thank you.
Hi Peter! In general, if you are healed from your fusion at 1 year (roughly 85+% will be) you can do any and all activities that you would otherwise enjoy doing. Check with your surgeon to confirm you are fully fused.
Hi there, thank you for the great video. I'm having surgery in 2 days, can I expect to be taller or shorter after? I'm 6ft1 so I'm not fussed!
Excellent description of the processes and also the post-op expectations.
Thank you, Ronald!
Excellent. You can learn to do anything on youtube. After I repair the shutoff switch on my motorcycle’s side stand, I’ll get those two vertebra fused that have been bothering my wife! 👍👊
I have my exacto knife set, headlamp, and Dremel. It looks pretty easy.
Just had this procedure about two weeks ago. I know understand why and what has been happening thus far.
Hope you are doing well!
Brilliant explanation.I am a 76 year old retired Urologist with findings of advanced spinal stenosis at L4-5 due to facet atrophygrade 1 anterolisthesis L4-5, diffuse disc bulge,thickened ligament.Clinically I have mild low back pain able to stand 20-30 minutes with no pain and walking 7-10000 steps a day,only symptoms are weakness in legs with some loss of strength in the leg muscles.Consult with Mayo neurosurgeon recommendation are to wait or consider surgery with emphasis on waiting.Any thoughts or recommendations.Thank you
Your lesson on TLIF is both clear, and frightening. I had stenosis of my spinal canal at L4/L5 with the presentation of sciatica and all the pains, numbness you mentioned. I went for surgery ten years ago and am struggling with all the horrifying effects from that botched surgery to this day. I didn't know the details of the surgery until your video, the surgeon gave a simplified version of the procedure which gave me confidence. Your description of the procedure lists at least 6 stages with each stage having the possibility of something going wrong. Imagine going through 6 tasks with 0% error. In my case, I lost all ability to pee almost immediately after the surgery. A doctor (not the surgeon) later told me my spine was like a serious car wreck with severe spinal cord injury. The brain lost all communication with the bladder, like a phone line totally snapped. I have to use a catheter to drain the urine to this day. I also had numbness to my cheeks, thighs, knees to my ankle, and feet. I have pain and muscle spasms from my arse down to my ankle. My groin is totally senseless, if I shoot water to my genital region, I feel no sensation of heat, pressure, nothing. It is like shooting the spray of water into empty space.
My point to potential patients with this spinal problem is to seek and exhaust all other options before going for surgery. I hope your surgery ends in complete success.
@Haruna P. i
It was very kind and courageous of you to provide such graphic details of the unfortunate outcome of your own procedure and to warn potential candidates of the need to first exhaust all possible nonsurgical options. I had a spinal surgery and now live in agonizing pain. The surgeon completely avoids any contact with me knowing full well that he has put me in misery for life. It's unfortunate how spinal surgeons mislead patients about the high and dangerously permanent complications that can arise from this procedure.
I understand what you are going through. my back surgery went wrong big time. bowel bladder issues.. loss the use of my left leg..and the pain is worse..on total disability.. God bless everyone here..
Do not worry . This is work of a surgeon
The video described is very detailed, seems complex and required experience surgeon to operate. How long does the surgery takes. Great job Doctor.
Thank you for the kind words, Robin. The surgery takes anywhere from 90 mins to sometimes 3 hours depending on how much compression there is and if there was prior surgery.
Amazing presentation Dr, I know you have helped many who are facing this procedure, many surgeons are men/women of few words. I have a question for you. My husband 55 had TLIF and ALIF L4-S1 ( the rotisserie chicken) he healed/fused well. He still has foraminal nerve pain from L4 ( only one side the RT) If there is so much newly created space how can there be more stenosis? The vast majority of the other back pain is gone. The pain Mgt epidurals don't seem to help at all . He's 18 months post op. Is there any other procedure given the hardware is in there that you can recommend generally speaking. ( Also he ended up 3 mo post op with SIJoint severe pain due to the load transfer and has since had both sides fused successfully with no SI pain remaining.
@BRAD ADAMS yes both SI joints are fused, that has recovered well no more SI pain what so ever.
When you say both sides fused do you mean he has his SI Joints fused as well? man I hope he feels better soon! Keep us updated please.
You have a very good demeanor, your patients must love you! Good job Dr.!
Thank you!
Dr.Armaghani, I have a question. What makes the bone grow in between the transverse processes? Do you have to scrape the bones to allow for vascularization there? Thanks, it was a great explanation of the procedure.
we rough up the transverse processes so there is some bleeding. when you put bone or bone graft substitute that is man made on the transverse processes and between them the body sends cells to that area that makes it solidify and heal much like a broken bone would heal back together.
This is exactly what I needed as I prepare for my TLIF
Good luck!
You have explained it so well! Thank You for sharing this information; it helps. I am waiting to be seen by a neurosurgeon and I hope to get some much needed relief of nerve compression.
Best of luck!
Just had an open L5-S1 tlif for recurrent disc herniation and need for complete facetectomy b/c of horrible leg pain. Two weeks out, apart from muscle pain and spasms, no nerve pain whatsoever.
If you can gut out the early post op period, it should be worth it.
Great to hear, Tom!
That's awesome! You're so lucky, I wish I could say the same. I can't remember what it's like not being in pain (I posted my experience here). God speed on your recovery and take it easy, ok?
Hi Doc,
Great explanation of the procedure. I was wondering if it was possible for you to take a look at my images to determine whether a spine fusion is necessary. However I am not from Florida so I was wondering if a virtual visit would suffice. Or even a small phone call. Just anything to get your opinion.
Short summary of my health: degenerative discs (practically gone) L4-L5, L5-S1, Par fracture, slight bulge L4-L5, genetically small foramen, nerve pain and can’t sit for more than 10 minutes.
Age: 22, had a L4-L5 microdiscectomy at 18.
What you have is very similar to what I have
I am two weeks post op and im doing good im hoping for a better quality of life. I was unable to stand for more than 10 mins at a time. I hope you get relief. It’s awful
That was so informative thank you so much it was clear easy to understand and in simple medical language. Cheers
Thank you!
Very clear and maximum points covered, is it possible to cover physical therapy tips on getting back on feet and recovery process
Hello Dr., my husband has undergone a laminectomy + discectomy surgery recently (2.5 months ago) & now when his MRI was repeated with a different surgeon he has advised for an urgent surgery as the disc has prolapsed and is compressing the nerve, the Dr. has advised for a TLIF, can you please advise if there is any risk to undergo this surgery so soon and what are the risks associated to it if he undergoes this surgery and if we delay it. Awaiting your response ASAP as this will help us to take the right decision.
Outstanding teaching video. Kudos and Appreciation for such an exemplary video
Thank you, Deirdre!
Thank you for this amazing and detailed video. I am two weeks postop from Mayo - I don’t really have any back pain that’s intolerable from the surgery - but what I DO have is incredible right side pain which is literally making me scream 1 to 2 hours in the morning. Am useless without walker, can barely stand on my own. Is this gonna go away? I signed up for back surgery, not to feel like I have a broken hip. Thank you.
@Armaghani Spine Thank you for the response.
Difficult to say without knowing your case but in general, patients can feel different pains from surgery in the very early post-operative period but I like to tell patients that eventually the "dust will settle" and that takes about 4 weeks time.
Brilliant - found it I think. SO useful doctor. Again, very good graphics and explanations. THANKS!
Thanks for all the great information. Dr, do you recommend PT after surgery? (For someone had rest 70% of the time during the last three months before surgery)
If so, when do you suggest to start PT? Thanks again!
@Armaghani Spine At what time points post surgery do you recommend x-rays to assess healing/bone fusion process?
Good question! In general, for my patients, I tell them to take the first 6 weeks to just let their body heal. They can walk as much as they like but not much more because we need their muscles and nerves to continue to heal. After 6 weeks we start loosening up what they can do and that includes initiation of PT if they would like. I don't like to allow exercises that involve bending or twisting at the waist, however, for at least 3 months after surgery and sometimes longer depending on the patient and surgery done.
I'd be very assured with this surgeon. Quite a procedure but one i think has been well practiced. Have to wait what for what i need doing...very grateful for this excellent presentation.
Question: how to choose the best surgeon - does going private equal a better outcome? Probably it will be done on the NHS - unfortunately i'm in an area that's hyper congested and the hospital i'm referred to i'm worried about.
However, this really very good explanation has given me confidence - thank you very much.
Very good question. On a personal level, feeling comfortable and confident with your surgeon is the most important thing. Do you feel that the surgeon listens to you and do they take the time to answer your questions. If you feel like your surgeon isn't listening to you and doesn't answer your questions to your satisfaction, it is unlikely they will after surgery in the unlikely case you have something wrong. If you are comfortable and confident in your surgeon, you will have a great result.
Thank you for the it was very knowledgeable more than other videos. I’m still nervous but not as bad at least I know what to expect thank you
You can do it!
Hi doctor,
After many videos I have seen for me your explanation is considered the best of all
Question: Which method is considered more advanced ALIF OR TLIF ?
its seems that AILF is more advance and more safer than surgery from the back. is that so?
It all depends on the patient and where their trouble is coming from. For some patients with certain conditions and compression in certain areas, TLIF is better, but for others, ALIF is better. It's more important to find a surgeon who is comfortable with multiple ways of treating a condition so they can tailor the best surgery for you.
Great work, very well explanation. Cheers Dr.
Thank you, Mr. Martins!
Hi, I have been operate 2 times for the same herniation L5S1 (14 days between operations). But almost 5 day after the second operation I stared to feel the same nerve problem (I have the same herniation again) so I think my disk has no chance to repairment. My doctor said that to make a disk implant is no good idea because implants has high probability to fail, so he recommends fusion.
What do you think about disk implant?
What can be more secure to do, fusion or implant?
I’ve watched your video about the minimally invasive TLIF and heard about an open TLIF.
Do you have a link a video to an open TLIF?
What are the pros and cons to the two different TLIF procedures?
Thanks in advance!
That's actually the video for open TLIF. The general steps of both MIS And open TLIF are essentially the same. The difference is in most MIS TLIFs a large decompression isn't done. It is my belief that the main reason to even be in surgery is to get the pressure off the nerve(s). If that can be done my minimally invasive means - great. But if it requires a standard open incision (less than 2.5 inches in most cases) to get the job done then i suggest doing it that way. The worst is if you don't get adequate decompression of the nerves because then you won't get the improvement you are looking for.
Really great-easy surgical view. Thank you.
You are welcome!