What to expect=spinal canal stenosis,particularly severe at L4-5,

[THAIPHUKET]

Weeks ago I fell on my smaller back, ever since severe pain, walking , bending. I ordered today MRI

The Impression reads = Multilevel spinal canal stenosis , particularly severe at L4-5, severe at L3-4 levels

Causing bilateral nerve root compression.

Because I did not want to be tight to the McCormick Hospital, C.M. I did not ask any doctor about a treatment.

What do I have to expect? Is a non-invasive treatment possible? Absolutely no desire to be hospitalized .

Spine area is a zero tolerance zone for errors. Where , by whom to have it done? In Chiang Mai only one spine specialist is mentioned

Dr Surat Tanprawate, Sriphat Hospital

[Sheryl]

First of all, would not put too much emphasis on what the MRI report says. This was completed by a radiologist; it needs a good spinal specialist to really read it properly.

Secondly, what treatment you will need can vary from just medication and physical therapy to surgery, and it will take a skilled spinal specialist to know which. Surgery is necessary if the space for the nerve roots to exist is permanently constricted. If on the other hand pressure on nerve roots is due to bulging disks, this will improve over time with conservative measures. If surgery is indicated there are a variety of techniques again depending on the problem.

The best spinal specialist in Thailand is in Bangkok, Dr. Wicharn at BNH Hospital (also at Bangkok Christian once a week). Hours at BNH are more frequent/convenient but if surgery needed, would cost less at Bkk Chrisitan.

Dr. Surat Tanprawate as far as I know is a neurologist, not an orthopedic surgeon so would not be appropriate for this type of problem. There are some good general orthopedists in CM but I don't know of any specializing in spine. The closest to it is probably Dr. Paiboon Wongcharoen, who is at both Sripat and the Ram, but he is getting up there in age (probably around 70). Dr. Sudhee Sudasna is also a very renown orthopedist (but nit specifically specializing in spine) but likewise up there in years, retired already from govt but may still be working privately.

Personally I think it well worth a trip to Bkk. If you do decide to consult Dr. Wicharn at Bkk Christian be sure to arrive several hours early - he is there just once a week, in heavy demand and it is first come, first see.

[THAIPHUKET]

As usual, Sheryl very comprehensive info, thanks! Dr Wicharn at BNH sounds perfect. I think the MRI film + report says enough for him to render judgment. How can that be done? Through a CM hospital or doc on a consulting basis? Could spare me 1 painful trip.

Rather fly down and get done whatever needs to be done.

[Sheryl]

I'm afraid you will need to go there, don't think it can be done remotely. He needs to talk to you face to face and also do some physical exam (seeing what positions elicit the pain, testing nerve function etc). But bring the MRI (and Xray if done) films with you, that will avoid the need for repeat tests.

[THAIPHUKET]

You are right, was looking for a short-cut

[THAIPHUKET]

Already the web site of BNH Spine Center and the testimonials give a good impression. And, if it should be applicable, BHN offers non-invasive treatment, or Minimal Access Spine Surgery (MASS)

Is that by any chance "our Shirley" who testifies here ? = http://goo.gl/Eoy58b

[Issangeorge]

Our Shirley, is Sheryl, and I think she is American.

Edited September 19, 2014 by Issangeorge

[Sheryl]

Yes. And prettier

[THAIPHUKET]

Perfect advise again Sheryl! Called on Friday, Monday in BKK saw Dr Wicharn. He looked at my MRI which were done by McCormick Hospital in CM, RAM CM had treated me on the basis of X Rays only. Wicharn said= It looks good..........you got two broken vertebra of your spine but it has been healing 30%.

My short impression of BNH was much more favorable than Bumrungrad, which to me is just an enormous factory. But ultimately I will decide always on the basis of the doctor