recommend back surgeon / spinal orthopedic doctor in Chiang Mai ?

[lsemprini]

 

My long-diagnosed herniated disks (lumbar, L5/S1) are getting way worse and I need a new MRI and investigation.  Quite likely surgery, hopefully the minimally invasive type (laminectomy as opposed to ACDF/Fusion or worse).

 

Can someone recommend a doctor/surgeon they've had actual good experience with in Chiang Mai?

 

Ideally someone who doesn't immediately jump to assume surgery is the best but who also has well-researched knowledge about the likely long-term effectiveness of more conservative treatments.

 

Thanks.

 

 

[pgrahmm]

I'm going to refer you to this Dr....He did my hip & salvaged a friend's shoulder & arm from 0% to 80%+....Pre COVID he rotated between TH, Dubai, & Japan every month - very high world-wide standing ....

My feeling is, if he does not do spinal, he can refer you to the the best in CM....

As you're not getting much response, this should be a solid lead/choice .... English speaking....His office is close to Ravajet (sp) hospital....

Edited Friday at 01:26 AM by pgrahmm

[lsemprini]

Thanks!  Yes odd no other responses to a topic that has historically been popular on this forum. 

[dinsdale]

My recommendation is put up with. How long ago did this happen? Is the herniation in or out and how severe is it. 25  years ago I had a severe herniated disk L4 L5. Internal to the spinal cord not external. I was referred to a well respected surgeon. He said I can fuse it or you put up with it for the rest of your life. I chose the latter and it still plays up every now and again some 25 yrs later. The surgeon actually recommended not to fuse. Of course every situation is different but I've talked to people who have had fusions done and they've regretted it. I strongly suggest you look into this before you have any surgery. There are some simple back muscle exercises that might help. Disk fusion should be the absolute last option. Maybe try dope. It helped with my pain during the worst of it. When my disk herniated it was like someone had a full on run up and smashed my spine with a hammer. As I say some 25 years later it still plays up now and then but I think I made the right choice of no surgery.

Edited Saturday at 03:12 PM by dinsdale

[lsemprini]

20 minutes ago, dinsdale said:

My recommendation is put up with. How long ago did this happen?

 

Thanks for the useful advice.  I was diagnosed 10 years ago and the back pain used to just act up now and then and go away after 1 month.  But now it seems permanent (9 months and running) and really interfering with my life.  Not hammer-slamming pain but enough that I can't lift stuff or be useful and even just sitting/typing work can be a challenge.  I've tried many of the exercises that are supposed to strengthen muscles to relieve disk pressure on the spine but no difference so far. 

 

I'm hoping my case is mild enough that I would only need a bit of "shaving" (laminectomy) and not fusion, but I'll find out.   I've talked to some people who regretted fusion because after fusion the vertebrae next to the fused vertebrae are more likely to start having problems, thus needing more fusion years later, then more, ....   Companies have invented flexible artificial disk replacements to address this problem (e.g. https://m6disc.global/m6-l-lumbar/ ) but not sure if they've made it to Thailand yet.

 

[dinsdale]

5 minutes ago, lsemprini said:

 

Thanks for the useful advice.  I was diagnosed 10 years ago and the back pain used to just act up now and then and go away after 1 month.  But now it seems permanent (9 months and running) and really interfering with my life.  Not hammer-slamming pain but enough that I can't lift stuff or be useful and even just sitting/typing work can be a challenge.  I've tried many of the exercises that are supposed to strengthen muscles to relieve disk pressure on the spine but no difference so far. 

 

I'm hoping my case is mild enough that I would only need a bit of "shaving" (laminectomy) and not fusion, but I'll find out.   I've talked to some people who regretted fusion because after fusion the vertebrae next to the fused vertebrae are more likely to start having problems, thus needing more fusion years later, then more, ....   Companies have invented flexible artificial disk replacements to address this problem (e.g. https://m6disc.global/m6-l-lumbar/ ) but not sure if they've made it to Thailand yet.

 

It's nice and sadly not always the case to get a reasoned and adult response on here. For this I thank you,  I'm guessing but I reckon it's a fair chance you're not young. I really do suggest trying dope and again I'm guessing you're not a dope smoker/eater/drinker. It's very good for chronic pain. Try absolutely everything before you have someone do surgery on your spine even if it's a bit of shaving. It's guaranteed you already have osteoarthritis in your spine and this degenerative process will continue. Chronic pain is a very bad thing  (and here I know I'm preaching to the converted) but you have to ask yourself will invasive surgery on your spine be worth it, will it make things better for your quality of life both short term and long term (however long that may be) and do you trust the medical advice. Best of luck.

p.s. Only those who have suffered from and continue to suffer from spinal disc injuries and problems truly know the pain.

[lsemprini]

On 11/23/2024 at 11:18 PM, dinsdale said:

It's nice and sadly not always the case to get a reasoned and adult response on here. For this I thank you,  I'm guessing but I reckon it's a fair chance you're not young. I really do suggest trying dope and again I'm guessing you're not a dope smoker/eater/drinker. It's very good for chronic pain. Try absolutely everything before you have someone do surgery on your spine even if it's a bit of shaving. It's guaranteed you already have osteoarthritis in your spine and this degenerative process will continue. Chronic pain is a very bad thing  (and here I know I'm preaching to the converted) but you have to ask yourself will invasive surgery on your spine be worth it, will it make things better for your quality of life both short term and long term (however long that may be) and do you trust the medical advice. Best of luck.

p.s. Only those who have suffered from and continue to suffer from spinal disc injuries and problems truly know the pain.

 

Of course the other side of the coin is that if the spine is being compressed for so long it is quite possible for there to be permanent damage that surgery could avoid.  One friend of mine's leg went numb and she only sought treatment at that point. The doctor told her the damage was permanent and she should have done surgery earlier.  Hard to say which conditions lead to permanent damage vs. damage which can heal.  Scary either way.

[chiang mai]

My recommendation also is to put up with it and I say that as somebody with exactly the same issue for the past 35 years.

 

I was offered a discectomy in the UK 35 years ago and instead opted for chropractics, which meant avoiding the knife.....I in no way regret that decision. A year ago I was in hospital for an operation in Chiang Mai and my back was also problematic at the time  Since I was already there, I asked for an MRI and a consult with a spinal doctor (Sriphat). The MRI showed the same old problems along with age related spinal degeneration. The doctors immediate reaction was to say, we need to operate, to which I said thank you but no thank you. Note: he works out of Sriphat and Bangkok Hospital and does over 150 spinal ops per year (mines was quoted at 300k/400k so go figure).

 

When I got home I went to see an orthopedic doctor at his clinic opposite Nakorn Ping Hospital. He's a spinal doctor who has worked there for the past 40 years but he reckons operations are the last resort. The problem is, if you fix one disk, a year later you have to fix the next one up, and so on. He told me that back exercises and pain tolerance for three to four months is the best approach, if it doesn't repair itself after that time, an operation might be considered. Heat pads, ice packs, exercises, ultrasound and meds, are all effective to some degree. Gaba 100 at night ensures a good nights sleep and also helps heal nerve issues.

 

It's been a year now since I last saw him and my back has been fine ever since. The MRI still shows lots of nasty stuff but I've avoided the operation......because, you can't un-operate if it doesn't work out properly.

[lsemprini]

19 hours ago, chiang mai said:

My recommendation also is to put up with it and I say that as somebody with exactly the same issue for the past 35 years.

 

I was offered a discectomy in the UK 35 years ago and instead opted for chropractics, which meant avoiding the knife.....I in no way regret that decision. A year ago I was in hospital for an operation in Chiang Mai and my back was also problematic at the time  Since I was already there, I asked for an MRI and a consult with a spinal doctor (Sriphat). The MRI showed the same old problems along with age related spinal degeneration. The doctors immediate reaction was to say, we need to operate, to which I said thank you but no thank you. Note: he works out of Sriphat and Bangkok Hospital and does over 150 spinal ops per year (mines was quoted at 300k/400k so go figure).

 

When I got home I went to see an orthopedic doctor at his clinic opposite Nakorn Ping Hospital. He's a spinal doctor who has worked there for the past 40 years but he reckons operations are the last resort. The problem is, if you fix one disk, a year later you have to fix the next one up, and so on. He told me that back exercises and pain tolerance for three to four months is the best approach, if it doesn't repair itself after that time, an operation might be considered. Heat pads, ice packs, exercises, ultrasound and meds, are all effective to some degree. Gaba 100 at night ensures a good nights sleep and also helps heal nerve issues.

 

It's been a year now since I last saw him and my back has been fine ever since. The MRI still shows lots of nasty stuff but I've avoided the operation......because, you can't un-operate if it doesn't work out properly.

 

Thanks, very helpful. 

 

During your interaction with various doctors, did you learn anything about how to tell which types of conditions (such as pinching the spine) are causing permanent damage vs. which types of conditions are things that you can heal from?

 

Also, at some point did you opt for an epidural injection (anesthetic plus steroid) for temporary relief and how did it go?

 

[chiang mai]

4 minutes ago, lsemprini said:

 

Thanks, very helpful. 

 

During your interaction with various doctors, did you learn anything about how to tell which types of conditions (such as pinching the spine) are causing permanent damage vs. which types of conditions are things that you can heal from?

 

Also, at some point did you opt for an epidural injection (anesthetic plus steroid) for temporary relief and how did it go?

 

As far as I can tell and @Sheryl can correct me, you can recover from most prolapsed (bulging or herniated) disks, it just takes time. Ruptured disks and disks that impinge on the central nervous canal are a different matter entirely and there appears to be no way to escape an operation in those circumstances. I understand that you will know if there is a rupture or impingement because of loss of function and control. eg bladder/bowel if in lumbar. From what I have read and been told, the most common spinal problems after middle age are in the lumbar region, most are prolapses and the majority of them can be managed.

 

I haven't tried the epidural because that's only a temporary fix, after three months it's rinse and repeat.

 

Age related spinal degeneration is common in older people, mine can easily be seen on and MRI. It is possible to build a scaffold support that will last about one year. Thi is because the load changes to the next vertebrae up which in turn will also need support, in time....and so on.

 

Three months of coping with a lumbar/prolapsed disk is no fun but if you're determined, it can be done. Muscle relaxants, sleeping aids, muscle strengthening exercises, ultrasound, hot and cold packs, you have to try them all and see what works for you. Mostly you have to learn about your posture and try to correct yours, sitting up, getting up from laying flat etc, remember nose over toes at all times. Also whilst I think of it, if you're overweight, shedding some kgs helps because it relieves pressure on the spine, you'll see a large improvement from this.

 

I'm 75 and have been dealing with these problems for 35 years. When it's bad, it's not good but it does get better. By way of example, I've just finished shovelling 6 cubic meters of soil and lifting 30kgs back of stone and my back feels perfect.