S Spine and Nerve Hospital

[RoyLee]

I have severe stenosis at my L4-5.  Bulging disc.  My rehab dr here tried acupuncture and traction to no avail.  I inquired about stem cell and she mentioned S Spine and Nerve Hospital in Bangkok.  I believe it is new as I can't find many reviews aside from their own facebook page.  Wondering if any thaivisa members have any experience there or other words of wisdom.  Surgeon at Vichara here in Phuket wants to do microdiscectomy.  Would like to try less risky procedures such as prolotherapy or PRP (protein rich plasma) (These are all injections). Thx.

[Sheryl]

I too have seen the place (driven by it) it but don't know anything about it it.

 

Prolotherapy helps only if the cause of the lower back pain is due to weak ligaments. it will not and cannot possibly help if the pain is due to spinal stenosis.

 

PRP also cannot help if the pain is due to stenosis but can be helpful temporarily if the pain is due to herniated disc only (i.e. there is enough space for the nerve root to exit the spinal canal and it is only the pressure of the herniated disc that impinges on the nerve). The effect is temporary, 6-12 months, and mainly it is used as an alternative to steroid injection.

 

There is very little experience with either of these things in Thailand. are you sure the place you mention offers it?

 

You need to get a handle on whether your pain is due to the stenosis or to the bulging disc, it makes a big difference.  If it is due to the stenosis, none o  these sorts of things will help you and if you have no contraindication to surgery, I would recommend it (but not at Vachira. In Bangkok, with a good spinal specialist).

 

If there is enough space and the pain is just pressure from a bulging disc, these usually retract over time in which case conservative measures are worth a try.

 

I would recommend you conuslt Prof. Wicharn Yingsakmonkol    in Bangkok at either Bangkok Christian Hospital or BNH hospital (BCH is less expensive but he is there only once a week on Saturdays,  hours more frequent at BNH).

 

He is also at Chulalongkorn (govt hospital) and might be possible to see him through their after hours clinic but you have to go in person to make appointment and there may be  a wait list so maybe not so feasible for someone coming from outside Bangkok.

 

BNH you can book online.  BCH no appointment needed, just call to be sure he will there and come several hours early to register and get a place in the queue.

 

Bring Xray and MRI (if one has been done) films/CDs with you to avoid unnecessary repeat tests.

 

https://www.bnhhospital.com/find-doctor/search-result/?dname=wicharn

 

https://www.bch.in.th/find-doctor/doctor-profile/?smid=4555

 

 

[RoyLee]

Thanks Sheryl for your advice and detailed reply.  I have had central spinal stenosis for 4 months. The bulging disc is pressing on the nerve roots in the spinal canal. The nerve roots exit the foramen ok. I also have arthritic changes to my joint facets, crowding out the nerve roots even more, but the surgeon suggested the microdiscectomy was sufficient. I have no back pain. Only sciatica butt/thigh pain and numb/tingling lower leg and foot when standing.  Apparently people like me (radiculopathy and no back pain) have the best surgical outcomes but of course there are risks.

 

S Spine and Nerve only mentions the laser surgery on their website, aside from conventional surgery.  I will make an appointment and bring my MRI with me to see what they have to say.  I'll also visit Prof Wicharn at BCH. Thx again.

[Old Croc]

If your budget stretches beyond Vachira, and you don't wish to travel to the capital, the Bangkok Phuket Hospital has an excellent Orthopedic Unit & Spine-Academy:

https://www.phukethospital.com/center/orthopedic-unit-and-spine-academy/

 

I can recommend Dr Chaiyuth

 

I have suffered from lumbar (spinal) stenosis for decades, complete with loss of feeling in legs and toes, but have never braved laminectomy surgery.  (I've had other more pressing problems that have taken precedence),  I know of a local teacher who had that surgery and he went from cripple to normal walking gait within a very short time.

[smo]

I had a herniated (busted) disk at S4 - 5 I think (this was a long time ago, 2004) and had micro disketomy (spelling?) at Bumrungrad after 8 month of living hell. The operation was routine ie nothing special, no hassle and quick to get over with. My point is that you don't need a master chef to do it. 

 

2 nights of hospital stay, a follow up visit 2 weeks later and that was it. Cost was roughly 4k usd. I would recommend this surgery if all else fails and/or when it's time you faced the hard fact. Main thing is not to delay unneccessarily...  Btw, is this S Spine and Nerve hospital in Minburi? I passed it a couple of times and kinda wondered.

 

Oh one thing worth pointing out: the spinal cord stops way before it comes to my S4, I can't remember for sure but I think it wouldn't reach your L4 either.  One (major) less thing to worry about if this is the case.

[carlyai]

Sorry, I disagree with@smo and think you should go for the best dr available for consideration of back surgery.
We are all different and our bodies respond differently to medical intervention.
As Sheryl says there is a difference between stenosis and buldging disc treatment.
I'm not sure but I think there is a difference in MRI machine x-ray resolution. So you also need the best MRI machine. I recently went for MRI's for lumbar surgery entering through the front side. The x-ray resolution of the slices of the different parts of my body was so detailed and clear.

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[Sheryl]

Thanks Sheryl for your advice and detailed reply.  I have had central spinal stenosis for 4 months. The bulging disc is pressing on the nerve roots in the spinal canal. The nerve roots exit the foramen ok. I also have arthritic changes to my joint facets, crowding out the nerve roots even more, but the surgeon suggested the microdiscectomy was sufficient. I have no back pain. Only sciatica butt/thigh pain and numb/tingling lower leg and foot when standing.  Apparently people like me (radiculopathy and no back pain) have the best surgical outcomes but of course there are risks.

 

S Spine and Nerve only mentions the laser surgery on their website, aside from conventional surgery.  I will make an appointment and bring my MRI with me to see what they have to say.  I'll also visit Prof Wicharn at BCH. Thx again.

 

From what you describe I don't think  prolotherapy - even if you can find it - would be of any use and PRP (again, if you can get it) would at best give some temporary relief.

 

Stenosis occurs over a period of years, not months.

 

If there are arthritic changes, may be bone spurs pressing in nerves as well as the disc. In which case surgery is unavoidable and can likely be done using minimally invasive approach.

 

While your desire to avoid surgery is understandable you need to understand that any nerve damage that occurs prior to surgery will be irreversible, the surgery can only relieve pain and avert new nerve injury. Waiting too long can leave you with permanent nerve injury, I have seen many people make that mistake.

 

 

 

 

 

 

 

 

[TimBee]

I had a L5-S1 laminectomy and discectomy at Pyathai I in 1999, cost was 49,000 baht. I recently developed severe S1 sciatic pain, which didn’t get any better over two months; I came across S Spine and Nerve Hospital on the internet and was impressed by the website’s standard of English and the up-to-date technology that the centre boasts. I thought I would get an assessment there, suspecting that I needed further surgery, which I wouldn’t immediately commit to. My wife called ahead and was told the MRI cost was 8,000 baht, which I thought was reasonable. At the time I could not stand upright or lie flat. When I arrived at the centre, none of the staff spoke any English, other than a Philippina nurse. I asked for a full assessment. On my patient record, I was tagged “foreigner” and told the MRI cost was 12,500 baht .... Uh-oh, been here before! Having thus started badly, things immediately got worse when they had to make five attempts to obtain a blood pressure reading from their cuff machine; as I couldn’t stand straight, they could neither weigh nor measure me. However, the pain was so severe I resolved to push on, as I needed attention. I was wheeled into x-ray but was not able to stand in all the positions they required. I was charged 5,040 baht for four. When it came to the MRI, which was a flat one with no tunnel, I could not recline sufficiently, so a nurse came with two syringes of pain killer, which they said would permit me to lie flat within ten minutes. The nurse injected these very quickly into my hand; she went straight through the blood vessel and all the medicine ended up making a purple hematoma all over my hand, lasting two weeks. I was still unable to fit in the MRI. I was next seen by a junior doctor, who had to ask a senior nurse what to do. He couldn’t identify the precise problem from the xrays, which really only confirmed my first operation. He said they could give me an anaesthetic and then do the MRI. At that point I decided to bail out and instructed them (literally) to prescribe me pain killers, anti-inflammatories and a sleeping pill (I hadn’t slept in four days), resolving that I’d go to BNH the next day. S Spine charged me 8,659 baht for three days’ medicine; the total was 19,185 baht, basically for nothing, not even a doctor’s letter or diagnosis. I thought at least I would be able to save further xray costs and asked for mine on a CD, only to be told that that would take 3-5 days. I am truly disgusted by this place, enough said. Two days later I had a two level (L5/S1 and L4/5) MIS TLIF at BNH with Dr Wicharn, stayed three nights, and a month later am walking around pain free. BNH used CT, no MRI, assessment costs were 20,000 baht, surgery cost was 630,000 baht, 90 minute operation. Draw your own conclusions from this salutary tale!

[dddave]

Apologies for my ignorance.  I always thought CT Scans & MRIs were pretty much the same thing, obviously, I was wrong. 

How do they differ? 

[RoyLee]

Thx TimBee.  630,000 baht!  May I ask why you didn't return to Pyathai ?  

 

As for me, I still have not had surgery. I decided to wait until I returned to Canada, as we have ("free") government health-care. Unfortunately I am getting the run-around. Some procedures, like back surgery , have extremely long wait times. Actually, I can't even get a referral for   surgery, so I am not even in the queue.  Sooo, I am again looking at getting it done in Thailand.

[cheeryble]

I was diagnosed in UK 17 yrs ago with spinal stenosis via MRI.
The spasm I was undergoing was bad enough that i still have atrophy of the inner calf.
I was offered a laminectomy but on discussion said let’s hold off a while.
I improved and have had the best years of my life as far as my back is concerned, though unfortunately now Parkinson’s weakness combined with the atrophy has now given me a limp but that won’t occur to you.


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[Sheryl]

A post linking to a medical tourism site in India has been removed.

[TimBee]

@dddave - If you haven’t already found out, it’s true CT’s and MRI’s do similar things, but basically a CT uses xrays whilst MRI’s use magnetic waves.

 

@RoyLee - Wouldn’t it be great if you could still pay what I did at Pyathai 20 yrs ago? Sadly, not even in India. I was working at a Thai life and health insurer at the time, so that’s why it cost so little. Post-op I got a 2nd opinion from an Australian consultant at Bumrungrad who told me it would only last 5 years and I’d regret it; according to him I should have spent A$40,000 in Australia and had the job done properly! He was wrong, thankfully. But during June’s operation, I discovered that the first operation on my L5 had not replaced the excised disc material, and in the interim 20 yrs, my L5 had fused to my L4, resulting in the S1 compression I was feeling before the operation. Today’s TLIF technique, with screws, rods and a replacement disc (made from the bone matter they drill out of you), avoids that shortcoming, and you’ll have the proper inter-vertebral spacing maintained by the hardware they put in. Yes, it was more expensive than in both our home countries, but for all the waiting reasons you gave, it was the only emergency way that I could go here, given that I could barely walk or sleep. All my fault for letting it get to that point, granted, but I would encourage anyone to step fearlessly into operating theatres at any of the major Thai hospitals, boasting a patient endorsed spine department. Per my earlier post beware of small clinics. This forum is an excellent place to research user experiences and to source patient endorsements!