Lumbar Spinal Stenosis

[bunnaag]

as quite a few oldies are members here maybe some were treated for this painful state.If so please give some information on hospitals and performing doctors.

[Who, me ?]

I would highly recommend you to go to BNH, and to meet Dr Wicharn or Dr Eakpatipan...

[bunnaag]

I would highly recommend you to go to BNH, and to meet Dr Wicharn or Dr Eakpatipan...

Thanks I will contact them.Bangkok-Had-Yai charges approximately 250,000 Bath inclusive a five day hospital stay one day ICU.

[Who, me ?]

I had a L5-S1 fusion performed there ....Absolutely happy with everything. Great surgeons, providing full explanations before the operation. They offer a couple of different options depending of the pathology.

I know my insurance company paid 500k Baht.

I have recommended the place and doctors to a couple of friends in need of treatment, and they were more than pleased as well...

[lopburi3]

Be aware that BNH is one of the most expensive hospitals in Thailand so if that is a consideration may not be your first choice.

My wife has had two surgeries in the last decade at Chaulalongkorn Hospital to remove lumbar calcium deposits with good results by below team leader who has excellent English ability and is often in the US. He also works at the private Bumrungrad Hospital two times a week but expect that would be about the same price as BNH.

Assistant Professor Surachai Khaoroptham, M.D.Department of Surgery, Chulalongkorn University, for receiving the Best Surgeon Awards 2010 for Central Thailand. The award is given out by the Association of General Surgeons of Thailand under the Royal Patronage of His Majesty the King.

[bunnaag]

Be aware that BNH is one of the most expensive hospitals in Thailand so if that is a consideration may not be your first choice.

My wife has had two surgeries in the last decade at Chaulalongkorn Hospital to remove lumbar calcium deposits with good results by below team leader who has excellent English ability and is often in the US. He also works at the private Bumrungrad Hospital two times a week but expect that would be about the same price as BNH.

Assistant Professor Surachai Khaoroptham, M.D.Department of Surgery, Chulalongkorn University, for receiving the Best Surgeon Awards 2010 for Central Thailand. The award is given out by the Association of General Surgeons of Thailand under the Royal Patronage of His Majesty the King.

I know they are expensive.How did your wife contact the good doctor long waiting at this famous government hospital?I live near Had Yai.

[lopburi3]

Her sister was a senior nurse at Hospital during that period and considered him the best choice. Original operation had to be delayed a week to get him as he had to travel to US and return first.

[lopburi3]

We had a report from someone here recently who stayed in a lower priced private hospital while having operation (by ambulance) at Chula as rooms there are the most difficult thing to obtain normally.

As PSU in Hat Yai has a medical collage I suspect there might be a good team of surgeons available outside of the private hospital you mentioned.

[Sheryl]

I second the recommendation of Dr. Wicharn at BNH. Operated on my sister and is whom I would go to if I needed to. There's none better IMO.

[bunnaag]

I second the recommendation of Dr. Wicharn at BNH. Operated on my sister and is whom I would go to if I needed to. There's none better IMO.

What were the costs?

[Sheryl]

Total was around 250,000 baht for fusion of 2 vertebra (some people may need more than that which would affect cost) and this was about 2 years ago, costs may have risen. It was not done at BNH, it was done by Dr. Wicharn at Bangkok Christian Hospital where he also practices. His fee remains the same but all the hospital related charges are significantly less than at BNH. If you are thinking of going that route to save $ consult him there rather than at BNH, he's there once a week only I think Sundays. (Like most private hospitals, BNH frowns on doctors referring patients elsewhere for the op).

Is it sure you need surgery? If not, I'd start by getting clear on that before getting too worried about cost comparisons. Indications for surgery would include presence of bone spurs impinging on nerves (since nothing but surgery is going to alleviate that), and/or weakness or numbness in the legs 9indications of spinal or nerve root compression). Pain alone may sometimes be managed non surgically especially if disk herniation is a factor. So a thorough evaluation by a spinal specialist is essential. Sometimes special nerve conduction studies are worth doing to be certain exactly what the cause of the ysmptoms is, as a number of structural abnormalities (stenosis, herniated disks etc) can be present but not necessarily be the cause of the symptoms -- in fact a high percentage of older people have these things and are completely asymptomatic.

One of the things to ask the doctor is what the "natural progression" of your condition is likely to be i.e. what is likely to happen without surgery, whether the pain is might resolve with time and/or physical therapy. (If in addition to pain you also have weakness or numbness then likely surgery is unavoidable, but if it is pain only, worth asking).

This is a good overview of the condition and treatment options http://orthoinfo.aaos.org/topic.cfm?topic=a00329

[bunnaag]

Thanks Sheryl.I will find out when I can get an appointment at the Bangkok Christian Hospital.Probably a MRI will have to be made first.

[Sheryl]

And an Xray, if not already done. Bone spurs don't show on MRI. If you've already had an xray, bring the film with you.

I advise getting there earkly as it's first come-first seen, and he's there only once a week so you want enough time to see him, be refrred for MRI, get the result and see him again with it all in the same day. You'll need to register and get a patient card if it's your first time at this hospital, so all told I'd arrive at least 2 hours before the doctor' hours start.

[msg362]

Does anyone have recommendations for doctors /hospitals in Chiang Mai and any idea of costs?

Thanks

[bunnaag]

Did anyone had an operation on the spine in the St.Louis hospital?

[bunnaag]

Total was around 250,000 baht for fusion of 2 vertebra (some people may need more than that which would affect cost) and this was about 2 years ago, costs may have risen. It was not done at BNH, it was done by Dr. Wicharn at Bangkok Christian Hospital where he also practices. His fee remains the same but all the hospital related charges are significantly less than at BNH. If you are thinking of going that route to save $ consult him there rather than at BNH, he's there once a week only I think Sundays. (Like most private hospitals, BNH frowns on doctors referring patients elsewhere for the op).

Is it sure you need surgery? If not, I'd start by getting clear on that before getting too worried about cost comparisons. Indications for surgery would include presence of bone spurs impinging on nerves (since nothing but surgery is going to alleviate that), and/or weakness or numbness in the legs 9indications of spinal or nerve root compression). Pain alone may sometimes be managed non surgically especially if disk herniation is a factor. So a thorough evaluation by a spinal specialist is essential. Sometimes special nerve conduction studies are worth doing to be certain exactly what the cause of the ysmptoms is, as a number of structural abnormalities (stenosis, herniated disks etc) can be present but not necessarily be the cause of the symptoms -- in fact a high percentage of older people have these things and are completely asymptomatic.

One of the things to ask the doctor is what the "natural progression" of your condition is likely to be i.e. what is likely to happen without surgery, whether the pain is might resolve with time and/or physical therapy. (If in addition to pain you also have weakness or numbness then likely surgery is unavoidable, but if it is pain only, worth asking).

This is a good overview of the condition and treatment options http://orthoinfo.aao...fm?topic=a00329

Result of MRI:spondylosis,retrolisthesis of L5 on S1 grade I.Compromised both L5 and S1 nerve roots.

L5/S1 Decreased disc space is observed.Central disc herniation is observed.Moderate narrowing of left neural foramen and moderate to severe narrowing of right neural foramen are resulting in compromised nerve roots.

Recommended operation posterior decompression and pedicle screw fixation L4-S1.He did not mention fusion.