Lumbar Spinal Stenosis, Cauda Equina Syndrome, Sciatica, & Disc Herniation: An Advanced Lecture. 

Thank you for this information. At 63 I have severe, debilitating stenosis. The "shopping cart" thing was classic! I have to grab a cart immediately and hunch over it. I am trying different surgeries to relieve pain.

Had a Laminectomy about 10 years ago. Successful. Dr. Hartl NY Presbyterian. Loved the direction against flexive physical therapy, lol. Exactly what several docs rx'd. And of course made it worse. Very interesting lecture. Should add the diagnosis was Caude Equina, severe stenosis.

I had severe pain in my lower lumbar. sciatica, groin down leg to knee all on my right side. Orthopedic surgeon said it was L4 and L5. I started physical therapy for 8 weeks 2 times a week and go to pain management doctor for spinal injections about every 4 months. I take Tramadal on days when pain kicks up but it definitely is about 90% better without surgery. I had all symptoms people are exhibiting. Laying in bed at night was torture I am so lucky to have found relief.

About 20 years ago I awoke with horrific back pain. I could barely leave my bed. My right foot wouldn't lay flat. I was walking on my toes. I went to my regular doctor and was referred to a spine surgeon. I went through all the conservative treatments. My wife was a Physical Therapist(PT) and she puzzled about some of the exercises and treatments I was getting. Regardless, nothing worked and a Laminectomy was scheduled. I was sent to a pain clinic for a steroid shot. I had the strange sensation of cold water being poured down my leg.. A week before the surgery the pain became more intense. The pain came in spasms which at their peaks left me unable to do anything except lie on the floor as they passed through me. I went to the ER and I was given a course of four drugs twice by IV. I fell asleep for an hour. My wife said I was going through the spasms in my sleep which was why I was run through the second time. At last it all stopped but my foot was worse. It was completely uncooperative. The steroid shot had pushed disc fragments down into the nerve bundle. The surgeon spent nearly an extra hour removing them. The pain diminished a great deal after the surgery. I walked with a limp and my leg and foot hurt. Regardless I went back to work. I owned a company installing voice and data cabling systems. My right leg was week so I used the let on to lift me up the ladder with the right one following. I was slow but I got it done. I passed more of the climbing work onto the employees and I did the equipment ends. Two years later the same thing occurred on my left leg and foot. I had another laminectomy and there was improvement. Three years later the pain had increased greatly and I had a third laminectomy. The results were minimal and I resolved not to have another ever. I'm now retired. I work in my yard raking and sweeping. I have 10 birds feeders I take care of daily. I also put out corn for the 20 or so deer that come every day. When the pain becomes too severe I stop and rest. I take a 30 mg Morphine ER tablet three times a day. I guess it helps. I've never stopped it to see the difference. A few years ago I developed Type 2 Diabetes. That has caused much swelling in my legs and feet. I also have three kinds of arthritis. Every joint hurts but I keep going. I've accepted the fact that this is my lot in life and I refuse to give in or up.

I had non-invasive surgery by endoscope for spinal stenosis and am so very happy with the results. I could hardly walk, had severe leg pain, couldn’t sleep on my sides, before the surgery. The doctor lasered off some calcified bone that was pressing on my spine to give some relief and packed the area with stem cells. I walked out of there the same day and am so much better now. Almost back to normal.

As I weigh-up the prospect of back surgery, with symptoms of right low back, groin and pain to knee level, with the inability to stand upright or walk even a few steps before excruciating pain fires up, I thank you SO much for this information. This has empowered me to speak with my neurosurgeon with a level of clarity and understanding of the situation and options. All the very best for you.

Needless to say, I'll watch this video a few more times. Excellent, thank you

Very Good and Educational! Thanks for posting Dr.Gillard

This video is helpful as I have an extensive diagnosis that I didn’t fully understand before watching. Thank you!

Thank you so much. This eased my fears and may save me money on surgery. Now I know to be patient and keep moving.

Excellent, comprehensive and easy to understand if you have a basic understanding of spinal anatomy. The Chiro Geek is a born teacher, as well as a patient, and everything he says makes sense to me as an Emergency physician and interventional pain specialist (retired).

Great video, I’m 72yrs old with a spinal fusion done on my L2 and L4 two yrs ago. Unbearable pain for the first year and a half. Taking 8 tramadol a day until I realize I had to slow down and take it easy. I’m off tramadol and only taking celebrex once a day now . I have been diagnosed with spinal stenosis and living with some pain even though I can go for a walk up a hill for an hour. If I had my time back, I don’t know if I would have taken surgery. I couldn’t stand for ten minutes with out my thighs burning like hell but now it isn’t to bad.

Flavum thickness,disc bulge,c.s.f leak which I had to read in my notes !!

Absolutely amazing! The clear concepts given really make it easy for us to grasp complicated topics

The most beneficial lecture about disc prolapse great thanks for you DR Douglas

Excellent lecture, doctor!

Awesome of you to keep on going with the illness you have! Hope you feel better!

Best info I've heard so far. I had that rare problematic central disc herniation on L4_5 and left lateral L5_S1. It blew one month post microdiscectomy and then I had retrolisthesis L4'5 . TLIF on both levels left me with scar tissue on nerve roots and intractable pain. Now there's central and foraminal stenosis, DDD, facet arthritis in all spine levels. Not a happy ending.

Bravo! Excellent content, either for the educated patient or interested professional .

I'm data scienist researching about MRI reading. Lecture are so good

These lectures are perhaps the most informative I have come across. I have a bit of a mess in my back and Ill upload the MRI to your site in the coming days and schedule a coaching session with you.

Good lecture, thank you Douglas.

Awesome I have some of these and its amazing that you have more info then some of the docs I have seen.

Great lecture, thank you! What a trooper- powering through, despite your cold!

Amazing teaching...thank you very much.

Thank you soooo much for this amazing presentation. As an experienced physiotherapist I learned more from that course than many other presentations that I have attended. You Sir are phenomenal. That was an awesome advance lecture indeed

Thank you so much, you are an best tutor !!!

My father suffered for years from vascular intermittent claudication of the aortoiliac vessels, both legs. Needed to stop walking and stand still to allow some blood to flow, then he could resume walking. He had bypass surgery and could immediately walk forever. Happy man!

Great information just had surgery on my L4 L5

Great spinal lectures.

Dr Gillard, just stumbled upon this Vid. I'm no doctor, but I am a sufferor of a number of spinal issues including stenosis and facet joint arthritis throughout the spine including scoliosis and chronic pain and stiffness. I have been to at least 5 different spinal and neurosurgeons during the past 3 years, seeking relief. I have done tons of my own research , not in medical journals but on line dissertations like this one and from other doctors & chiropractors who offer advice and information. I have consulted with excellent doctors at Mt. Sinai, Columbia Presbyterian, Stamford CT Spine center and White Plains Hospital Spine center. All of the surgeons said - no surgery for you. Dr. McCormick at Columbis Presbyterian in fact said "no one will touch your lumbar spine....... I'd have to reconstruct your lumbar spine.......Pain Management. I also have cervical issues of herniated discs, stenosis, and "military neck". What the hell can I do? I have a shorter right leg by 1 inch a result of a fractured femur at 15 years of age , in a body cast for 4 months and the right did not grow , but the left leg did !! I'm 69 years old now. Lots of thigh and hip weakness, calf cramping and feet problems . Bouts of bladder incontinence. What a freakin mess

To all people in the spine field (first another thank you to Dr, Gillard), as I am waiting to hopefully see or hear from Dr. Gillard, I am putting together many photos and videos onto a web page with my symptoms. I am willing to pay a reward at this point to help me figure out what is causing my burning / stabbing pain in my mid to upper back / center almost between spine and edge of left side body. I have been in agony for 17 years now and all I hear from doctors is...My pain makes no sense. Please leave a comment if you want to be notified when I finish this web page project and you would like to take a look at all my images, maybe something will jump out or maybe I need different types of scans which I am willing to do. Thank you.

Thank you so much for the lectures and very superior

I am very interested in your in your brain’s a smart talk. I will be following you permanently I recently was studying medicine and had not gotten quite this far in spinal fluid Verdie and very courios on some side effects. You definitely blow my mind. Big booms coming from all around.

Excellent! Great job!

There wasn't a single commercial for this whole lecture Dr Gillard...... nah Saint Gillard choosing education over money

Thank you very much. !!

Very informative Lecture, a must watch for anyone really interested in MRI findings of various spinal conditions and requirement of spinal surgery and its outcome. It is also of great interest to radiologists who want to report on MRI of spine.

The best presentation about sciatica and herniated discs I have ever seen. Thank you very much

Thanks for sharing🙏 this is VERY informative and helpful ✍️👍👍

Greatest lectures. Thank you.

I'm paraplegic and lying in BLK-MAX SUPER SPECIALITY HOSPITAL PUSA ROAD india due to neurosurgery of thoracic and lumber spine tumor ( myxopapillary ependymoma). Pray for me brethren

Even though I’m not in the medical field, what brings me here of course if my progressive back problems, I find this so interesting. I have curiosity for any kind of learning. Listening to educational and intelligent discussion is also calming. Thanks for you’re posts!

Excellent lecture! Perfect review on some things I already knew, but presented in a way that firmed up the reasons why behind certain theories or outcomes . And then Dr. provided a wealth of information about things I had always had questions about or had never known before. Done in a clear, logical manner that is so easy to understand. One of the best videos on RU-vid and so valuable to medical staff, students, and patients alike. Everyone can get a nugget of gold out of it. Thank you so much for sharing your time and expertise! Fully enjoyed!

Great! Thank you!

Hello, I noticed you saying not to do McKenzie excercises. Is that a rule of thumb in general or just for certain cases? Are there cases where it could help? Thanks!

Thank u doctor...nice explaination ...

Hi sir, whats the difference between radiating pain up to above knee level vs radiating down to lower knee level up to the sole?

I would like to ask a question. Am a 52 year old man I have been diagnosed with back problems. Because of family situations I had to work I started working in construction and tree removal at 12yrs old stopped going to school in mid 4th grade I have had pain since I was a child I would like to find out if there is help for me I spent many years addicted to oxycontin but I quit in 2012 but the pain with my back neck and shoulders is horrible! I have been told I have stenosis and narrowing but other than that have not had much done about this as my insurance and money are not great.

I had an MRI scan they found I spinal canal stenosis , and they also found a blockage which they don't know what this is yet . I have had difficulty walking for the few years but worsened 2yrs ago there is a weakness in the right leg , and I know I'm suffering from claudication as I have numbness and heaviness in upper and lower limbs the blood pools on my ankles and feet also my hands , I live in Britain and they dont know whats causing this I have been awaiting another scan for over 1 yr I'm worried they are missing something

Thank you Doctor for your brilliant and precise explanations. I love you, you don't talk very fast. Perfect. But the only thing is your board, it can't be read. The letters can't even be seen. VERYVERY tiny. But the pictures are very good XXXX

So many PT etc recommend the Cobra pose( back extensions) for sciatica - very dangerous. I am sure I got my herniation from extending back - in the gym - overhead pressing - Cobra pose made it worse - and also squatting with a weight on my shoulders. Deadlifting is ok if I do not extend backwards. Today got an epidural, after Nsaids and Prednisolone failed.(just hide the pain)

This is so interesting, I've got sciatica and waiting for epidural injection for L5 nerve block, and if that doesn't work then surgery, I believe the problem all simply came about by too many years sitting at computer, thank you for great explanatory video

I’m 80 year old woman who has had stenosis for many years. The past 4 or 5 have been the worse. I saw 5 or 6 doctors, over the last 3 years, all said I needed fusion. Laminectomy would not help me. I have beginnings of osteoporosis, and at the last minute my planned surgery was cancelled due to a bone density. I was told I need a hyperbolic doctor for shots. I went to a doctor who said at my age, it wouldn’t work. Back to square one and pain. I tried injections, after a year or two, didn’t work anywhere. I went to another back surgeon, he suggested a laminectomy; I had pain in. Uttocks, thigh, calf and outside foot. Numbness, I stability, shooting electric shocks an low back pain. He said in 85% of patients will be helped with the remainder a mixed bag. I had no other choice, so I took the chance one month ago. I find that my thigh, and calf has regained feeling; no more numbness. Y foot is the same. It gives. E hope. The doctor said that if I’ve had this pain a long time, it will take me longer to heal. I heard you say that if you’ve had sciatica more than one year, nothing will work.what are my chances for healing? I’m such an active person, but I can’t walk 1/2 block that I have to stop. I’m at my wits end. Please help with guidance.😊

Ugh story of my life. Blown disc's, spinal stenosis chronic injury, new symptoms: thighs and hips going numb now with severe inflammation. I'd give anything for surgery.

Thank you, my hip needs replacing and my lower back l4 l5 needs removing. I am looking for anything that can give me the relief I hurt all day and night it wakes me from my sleep with a sharp and burning in my groan.

Fantastic lecture and great channel. Subbed.

I suffer from spinal stenosis degenerative disk disease.. Just got thru with spinal cord stimulation trial.. I seemed to help with lumbar/ sciatic nerve pain..

Very informative, thank you for sharing.n

Informative lecture and makes some great points. But I could not disagree more that time and mother nature are the best treatments for sciatica. In my 40 years of professional practice, time and nature alone will not correct sciatica and discogenic radiculopathy. Just the opposite, it can lead to lifelong pain and disability. If the disc is not decompressed the pain and motor weakness will persist. I believe this may be where the expression "once you have a back problem you always will have a back problem " comes from. However, there are successful nonsurgical spinal decompression treatment protocols that can end this lifelong pain and disability. These protocols include nonsurgical surgical decompression along with anti-inflammatory adjunctive treatments as needed. Lance C Durrett MD DC

Very interesting this video gave me a very good in site into what is causing my hip and leg pain. I have spinal canal stenosis as well as bilateral neural foramin stenosis on 3 levels with various severities. Thank you. I am looking into artificial disc replacement been looking for data from studies on that.

amazing.

I can't stand still for more that a minute, depending on the day, 30 seconds. I just plop down to my knees due to severe low back pain. Spinal stenosis, sciatica and quite a few other things. Is there anything that will help me stand longer? I have pretty much everything. My disks are herniated or just the other one with the black stuff over grown. My family Dr is not sure if back surgery is worth it, since I have so much going on. Thanks! Can you recommend a safe exercise?

Great to read. Can bilateral foraminal exiting at l5 s1 cause cauda equina?

Thank you

Could you comment on psudomeningocel and the possible effects of a screw into the disk space. L2- 3 Had ant. and post long spinal fussion with pinning 2009 had pain since. Now it is really bad. Had to retire early from nursing. Nerve pain mostly R leg. Numbness to L foot and lower leg Sever back pain and muscle spasms. Difficulty sitting and standing. Walking a little better. Laying flat is my only relief. My spine surgeon said he could not do anymore. Had second opinion he wont touch me. I do have an appointment with a neursurgon who specializes in complex spinal conditions for a 3rd opinion. I have a dx.of scoliosis. Love your videos!!! Thanks for sharing your expertise.

Can you help me possibly or direct me to help. I have been suffering for close to three decades. I have chronic compression fx of thoracic vert. MRI 06/07/2018: T4,5,6,7,8 and 9. Vertebral loss of losses as follow: T4 10% mid, T5 30% mid 50% anterior, T6 no significant loss, T7 50% mid and anterior, T8 greater than 50% both mid and anterior and T9 25% mid and anterior. Accentuated Kyphosis of the Thoracic Spine. T5-6 Minimal posterior central disc bulge, T9-10 Minimal disc bulge, T11-12 minimal disc bulge. I just had an ACDF on 10/03/2018 of C4,5,6 on Oct. 3rd, 2018 for herniated C4/5 abutting the cord with myelitis at C5 and disc bulges at C5/6 and C6/7. Foraminal and Canal Stenosis and uncovertebral joint hypertrophy contributing to the bilateral foraminal stenosis. The ACDF seems to have helped the neuropathy in the arms but is still present. Now on to the Lumbar. MRI 10/02/2018: L1/2 Minimal broad based disc bulge, L2/3 Broad Based Disc Bulge extending into the bilateral neuroforamina. Moderate to Severe facet degenerative changes, Mild central canal stenosis and mild bilateral neuroforaminal stenosis. L3/4 Broad based disc bulge and moderate to severe facet degenerative changes. Moderate central canal stenosis and moderate central canal stenosis and mild bilateral neuroforaminal stenosis. L4/5 Broad-based disc bulge. Moderate to severe facet degenerative changes. There is mild bilateral neuroforaminal stenosis. L5-S1 Minimal disc bulge. Moderate facet degenerative changes. History of a 40-60 foot fall on 03/31/2005 in which the right fibula was fractured and dislocated. Had an open fixed reduction and internal fixation with a distular plate and ten screws. History of Grand Mal Seizures adult onset of idiopathic origin started in 1996. Pediatric history of Viral Spinal Meningitis and Encephalitis with Petit Mal Seizure at age 9. Septic thrombphlebitis and septic thrombosis from infected iv catheter while having a broken rib evaluated in 2008 and MRSA, DVT, Septic Pulmonary Emboli, and acute renal failure. Bursitis of the hips bilateral. Sciatica and other neurogenic conditions. I need a doctor who cares and will help me. Social Security denied me at the ALJ level back in March of 2018 despite all of these. Also, I suffer from Stressor Effective Disorder (PTSD), Depression, Anxiety, Panic Attacks, ADHD, inability to urinate effectively, suicidal ideation and thoughts with previous failed attempts, idiopathic cardiomyopathy, hypertensive disorder, previous history of acute pancreatitis, non-cardiac specific chest wall pain, previous ventricular tachycardia and more. Yet I cannot get proper help and Social Security will not approve me for disability. I am beyond myself after typing all of that out and realizing the list of disorders and impairments that I suffer from. I need help soon because I am not planning to stay alive much longer in this world without help because I just cannot take it much longer. I have suffered since childhood and I have seen people have more compassion for sick dogs and animals than they do for humans like myself. Brandon Kachmar, ytech1758@gmail.com

fascinating! You are so great at explaining MRI I would love to get your opion on mine.

I think your best work was with Garfunkel !!t. The sound of silence was one of the greatest songs ever written and recorded.

Bravo. Very good

I would like to know if that artery I side the tail sprout could cause some intermittent signs of vascular with mainly Neurogenic stenosis in a failed fusion of L5&L4 misaligning L3 and herniated the L3 disc?

I am 47yr old and was previously working as a food delivery rider using motorcycles. To a start, I have numbness on & off on my groin area and down along my both leg if I sit too long on the bike, or when I stand still for a minute or so, numbness appear. Later part, I experience extreme right calf pain, tiredness, pull on my right thigh as well. I also could not press myself up using my right feet. Despite taking an MRI and got a steroid jab at my L3, 4 & 5 lumber after consulting a musculoskeletal doctor at a local hospital. Till date, I still have yet to make significant improvement. Please advise.

Excellent job describing teaching and explaining assessments and diagnosis always trying to learn more myself just had my eighth back surgery third fusion genetically have less annular fibrosis rings very prone to herniated disc

Thank you so much for this lecture! Awesome work

Proceduralist are in the cyst and leak business correct? Dont know about nerve dilation and prolapse in regards to scoliosis though.

Good, thanks

I'm L5-S1 spinal stenosis,have already had fusion at L4-L5 , I recently mentioned to my ambulatory specialist,that I was having bladder issues and he kind of sluffed it off,i;m on the wait list for some rods and screws,another fusion,and praying for a miracle

What's the best treatment then for contained, broad based disk protrusion?

50:33 Optimal time for surgery for CES (CESI, CESR) is until 4-6 hours. Later surgery is also helpfull, but RR(relative risk) is bigger - prognose is worse. Look at works from NV. Todd 2005, 2008, 2014, 2015, 2017, 2019, or Igor Sulla on animals or from other authors, but no at Ahn 2000, which one is mistake and source of lots of disabled persons. Last year was published Hogan 2019 on 20000 patients, who says also death rate is lower with earlier surgery. Attention, Hogan at all was maded from insurance or medical stats and they have info only about date of surgery and they can not do from these numbers stats for 6 or 12 hours, but from DeLong 2008 You can be sure. 😉

1:04:27 Fantastic. I didn't even read about that! 1:04:50 Where is list of sources with ids [14],[22], also for a slide before this one? :) 1:06:13 Big true!!! But also source [95]?

Great

Great !

Please do a series on transverse myelitis 😊

please drs Ihave aswelling on the side of my spinal,i only have pain when i over sit then around the neck whever ichew hard stuff. it as lasted for 5yrs now. what could my problem be plis help.

Please how do I upload pics to you xx

Thanks! What is SNRBS?

I sure wish i could get a doctor to frickin listen......i can take much more....lord help me

great. great

Իմ որդին գոտկատեղից չի զգում վիրահատվել է 3 տարի առաջT4 T5 ողերը կոտրվել են փոխարենը դրված է իմպլանտ այժմ չի քայլում բայց ձեռքերը շատ լավ շարժվում են ։Խնդրում եմ պատասխանեք կոգնեք իմ որդուն որ քայլի

11:27 it seems unreasonable to call anything below 12mm stenosis. In the lower spine, there are fewer signals that have to be sent up or down, so should need less space. Even though the lower spinal canal has a wider diameter than upper, this may be by design to allow for more damage. 22:03 standing/walking tests for claudication 29:19 maybe ‘conservative care’ leads to the need for widening the canal/decompression? 37:17 aren’t we mixing up things in these studies? You said in the beginning the major problem with stenosis was claudication, which isn’t really pain related but about weakness etc. Also you said the pain would be coming from the facet joints. The studies would mostly be treating pain, not so much claudation as the former is much more common. In any case I’ve never seen a big study that wasn’t centered on pain. So why is pain now suddenly a stenosis problem? Clearly, doing decompression and spacer have one thing in common, which is taking the facet joint out of the equation, so no surprise the result is the same. Let me check you said their didn’t do foramitomy? Well they only said they included traditional decompressive surgery. I would guess that the clever surgeon would extend that to the superior spinous processes if he knows there is pain in that region. I just looked at a random study which did a comparison, and they included ‘all traditional’ decompression such as ‘laminotomy with undercutting’, which is a euphemism for removing part of the facet joint. Percutaneous Interspinous Spacer versus Decompression in Patients with Neurogenic Claudication: An Alternative in Selected Patients? 2017 42:02 intrathecal venous plexus I take it, not epidural plexus. Now it makes a lot of sense why concussion type events would impair blood flow for a while, with this loose web of veins. 43:38 if the blood vessels swell in front of blocked sections, I’m not sure that would cause an issue, rather hypoxemia of the nerves seems more relevant. But weak blood vessels could not only swell but rupture, so I’m guessing micro hemorrhage is a bigger problem. Which would not be stenosis related, but be caused by weak blood vessels, which would of course rupture exactly in locations where there are additional problems like a bit of stenosis pressure. But blood vessel issues could be addressed independently of stenosis, and maybe that fixes most stenosis related issues, if micro hemorrhage is prevented. 57:18 hemorrhage can also cause radicular pain. Repeat hemorrhage seems a lot more likely to me than repeat spilling of nucleus pulposa, because there is only so much of the latter before it dries out. 1:02:46 piriformis being over diagnosed when it’s rare 1:05:38 exception to the rule: unhospitalized patients recover. 1:09:06 sciatica (radicular pain in sciatic nerves) eventually non-surgery patients healed to catch up with the patients who had surgery (3 years). Speed up healing: walking, swimming, do not stretch. 1:13:49 you have cited that 85% being herniating disc number numerous times, and I can’t find that paper even searching the journal directly. F porchet does not show up as the lead author in any article in journal of neurosurgery. 1:14:06 some missing anatomy I found: there are ligaments attaching the longitudinal anterior ligament to the dural sac. The anterior dural (Hofmann) ligaments, 2004 1:19:31 so disc material has eaten away at the vertebra, on the left cut? I thought only tumors do that. 1:22:39 discectomy is contraindicated for a bulging disc. 1:25:33 micro discectomy only for herniation radicular pain. For low back pain only 40% chance of success. Fusion: the gold standard for everything spine surgery related, like disc herniation back pain from disc and dura pain nerves. 1:34:31 great study: 15 patients who were all referred for emergency surgery for huge herniation but couldn’t afford it. All healed on their own. 1:37:38 example of PT/chiro being worse than walking. 1:39:32 you should only do a discectomy for extreme leg pain or progressive motor loss/cauda eq syndrome 1:40:50 example of fully reabsorbed disc herniation.

i have L4-L5 disc problem

I have a lumbar disc rupture compression nerve inflammation caused by itching, itching for more than a year, ask for treatment

Very good. Atypical means possibly the image is untrue. Smells like victory. A sacral tarlov cyst awaits though. Now your in the ring with Ali. This is fun.

Does unilateral chronic L4,5 pain with a history of central disc prolapse imply lateral stenosis? Pain does not radiate to buttock or legs. Comes with pelvic twist when sitting for a long time, leaning towards one side, goes away when exercising, moving, walking.

I have great photos of my disc ruptured and cauda equina syndrome. I am willing to share my MRI photos.

vascular intermittent claudication, do you often find the other findings of smooth shiny hairless legs as well with poor wound healing? Thanks

I’m looking at another back surgery, the surgeon who is the one in my area is in the Denver area and has refused to operate due to a subluxation of L2 L3 L4 and stenosis on most of the lumbar spine. Also I had a fusion of the T7 T8 in 98 after auto accident. My symptoms are numbness in my left leg mostly in my foot and great toe up my leg and into lower left back region it’s the sciatic nerve. I also have a spine cord stimulator installed and a pain pump from an accident that nearly removed my left arm. Had a ct Myelogram and it revealed that it was stable by comparison to the last ct taken in 2020. Could you give me at least one opinion hopefully not what I’ve heard already why nobody will fix the subluxations? Thanks Steve

Best Regards

Leaving the heart the blood flows through the arch of the aorta, into the thoracic aorta and into the abdominal aorta. The abdominal aorta is the distal third and final portion of the descending aorta. The abdominal aorta travels inferiorly running along the posterior abdominal wall, as well as the anterior borders for the last thoracic vertebrae to the fourth lumbar vertebra. Once the abdominal aorta has reached the fourth lumbar vertebrae, it divides into two terminal branches. These two terminal branches are the right and left common arteries. Branching off of the abdominal aorta, there are four pairs of lumbar arteries. Some people actually have five pairs of lumbar arteries branching off of their abdominal aorta. The left lumbar arteries originate on the left posterolateral surface of the abdominal aorta, while the right originate on the right posterolateral surface. The right and left lumbar arteries provide the arterial supply to the right and left posterior and anterior parts of the abdominal wall as well as a number of muscles and overlying skin. Some of the muscles that have an arterial supply from the lumbar arteries are: quadratus lumborum, psoas minor, and psoas major. The lumbar arteries also help to supply blood to the overlying skin of these muscles. Branching off of the lumbar arteries are four pairs of dorsal branches. The dorsal branches originate from the corresponding lumbar arteries, for example, L2 dorsal branches off of the L2 lumbar artery. The dorsal branches then, run along the posterior abdominal wall. The dorsal branches of the lumbar arteries help supply blood to both the left and right aspects of the lower back as well as the spinal cord, vertebral column and the skin of the back. Some of the muscles that are found in the lumbar region that are supplied by the dorsal branches of the lumbar arteries are: lumbar intertransversarii, interspinales lumborum, longissimus thoracic, ileocostalis lumborum and latissimus dorsi. Another artery branch to make note of, is the lumbar branch of the iliolumbar artery. The lumbar branch is one of the two branches of the iliolumbar artery, the other being the iliac branch. The lumbar branch originates along the posterior and medial surface of the psoas muscle and travels superiorly and laterally to the lower lumbar of the vertebral column. On the lumbar branch, there is a spinal branch that goes to the intervertebral foramen between the fifth lumbar vertebrae and the sacrum. This artery provides a blood supply to psoas major, quadratus lumborum, the fifth vertebrae and the sacrum. The veins found in the lumbar region are similar to the arteries. There are four, or sometimes even five, pairs of lumbar veins that accompany the lumbar arteries. These veins can be found posteriorly and over the muscle, quadratus lumborum, as well as anteriorly between the transverse abdominis and internal oblique muscles. The lumbar veins are responsible for draining the blood from the posterior abdominal wall, muscles and the lumbar vertebral venous plexuses into the ascending lumbar vein, inferior vena cava as well as the iliolumbar vein. Another important vein to make note of is the ascending lumbar vein. There is a right and left ascending lumber found that in the body. These two veins run on the anterior aspect of the vertebral spine. They arise from the sacral veins and run until they reach the subcostal veins. There is also the iliolumbar vein, which is a side branch of the internal iliac vein. This vein receives its blood from the fourth and fifth lumbar veins and drains into the inferior vena cava. Figure: Lumbar ArteriesFigure: Abdominal AortaFigure: Dorsal Branches of Lumbar ArteriesFigure: Lumbar Branch of Iliolumbar Artery Previous: Joints, Ligaments and Connectiv

My MRI didn't show the numbers