Dr. Jho Surgery - repost from 3 yrs ago
 

I haven't frequented the forum regularly in a long while, but I just found it moved and the old archives are not accessible. The archives are incredibly valuable for future patients, so I'm reposting the report of my surgical experience from 3 years ago with Dr. Jho:

On Monday 4/7/03 I flew to Pittsburgh for a pre-surgical consultation with Dr. Jho. I developed symptoms one year earlier and MRI revealed broad central herniations at C5-6 and C6-7 and significant stenosis (6mm) of the spinal canal at both levels. The intense left-sided pain subsided within a few weeks but I was left with constant numbness in 3 fingers of the left hand, and some left triceps weakness. Of major concern was the significant spinal stenosis at both levels. My neurologist and 4 neurosurgeons I've consulted all agreed that surgical intervention was advisable due to vulnerability to significant future spinal issues due to the marked stenosis. Also, I am an avid cyclist and surgical intervention held out hope to resume spirited cycling, although this was a secondary concern.

Aided by information gleaned from the great folks on this forum and my own research (including in-person consultations with 3 other neurosurgeons), I felt that Dr. Jho's procedure held out hope of potentially correcting the problem completely, with minimal recovery, low risk, and leaving options open for any other future procedure. Although Dr. Jho was quite responsive from a distance (amazingly so compared to other doctors), he couldn't answer a few questions about his surgical intentions for me until examining me personally. A surgical appointment with him includes a personal consultation on the previous day, so I went off to Pittsburgh to meet with Dr. Jho and possibly undergo surgery. By the way, I was fortunate to find an excellent neurologist soon after my symptoms first developed who served as the focal person , and he endorsed my eventual decision.

I was overwhelmingly impressed by Dr. Jho and his staff. Dr. Jho seemed to have all the time in the world for me when I met with him and his P.A. Frank. I had done a bit of research and have some medical background, so I asked a lot of questions and received thoughtful, respectful responses. In addition to discussing my personal case, Dr. Jho shared many anecdotes and discussed the whole gamut of disc procedures. He carefully explained what he wanted to do and why: a two-level anterior microforaminotomy ('Jho Procedure'), principally for general decompression of the spinal cord but also to free up the two nerve roots. My understanding was that based on MRI films showing cord compression posteriorly as well as anteriorly (disc side), Dr. Jho felt that there were bone spurs involved which he readily deals with in his procedure. A big unresolved question before I went to Pittsburgh was whether Dr. Jho could and would perform general decompression caused by central hernation from such a lateral approach. Dr. Jho assured me that this was exactly his intention.

The procedure was performed on Tuesday and took 2-3 hours under general anesthetic (with intubation). I awoke groggy and with some soreness and stiffness, but no real pain. When I asked about when the pain medication would be wearing off, I was told that I hadn't been given any, and haven't needed any since. Dr. Jho said the procedure went very well and he had to remove a lot of bone spicules (spurs). Dr. Jho made a single 1-1/2 inch horizontal incision along a natural fold of my neck, so the scar shouldn't be too bad after the incision heals, and it's already looking much less noticeable. My throat was very sore from the intubation, and it is still pretty sore as I write but slowly getting better (cold pumpkin pie and fruit smoothies help ;-). I am fairly sensitive to medication, and effects of the general anesthetic still seem to be lingering and slowly going away. I had no problem driving two days after the surgery, although I was pretty gentle with the head turning (BTW, no collar is worn after the Jho procedure). My neck can stiffen up a bit depending on how I am sitting, but I'm noticing that this is also improved from yesterday. I've been told that many of the acute issues will resolve over the next week and I'll be pretty much healed up from the surgery in 4 weeks. In the big picture, these post-surgical symptoms are shockingly trivial considering the work that was performed. My experience of Allegheny General Hospital was also overwhelmingly positive (except the food).

The numbness in my fingers seemed to have improved slightly right after surgery, but another noticeable chunk came off the numbness on the third day perhaps it's 25% resolved already. I believe Dr. Jho will be proven correct the numbness will resolve eventually. [postscript added 11/9/2003 - I'm sorry to report that the numbness did NOT resolve any further than this]

Another comment - due to the very sore throat and effects from the general anesthetic, I didn't sleep more than a few minutes at a time until the 3rd day. I'm not entirely clear on what was going on, but perhaps some combination of 3 possible issues kept waking me up every few minutes: a constant need to swallow to clear the small amount of phlegm that constantly invaded my throat, side effects of the anesthetic on my diaphragm or inflammation from the intubation causing my windpipe to slightly close in relaxed sleep [9/27/06 postscript - I believe this last possible explanation, a temporary form of sleep apnea due to the surgery, was correct]. On the 3rd night I discovered somehow that I could sleep well on my side (I've only slept on my back for years) and this was a huge relief. By the way, I noticed a dampening effect on other smooth muscles besides the diaphragm, affecting my ability to swallow, belch, urinate, etc which improved by the 3rd day.

I am very grateful to Dr. Jho for his pioneering work developing his procedures and being so accessible to new patients. I'll have a follow-up MRI in 6 weeks and hope to see amazing improvement on the films. I plan on taking one more week off from work, just to pamper myself a bit.

Cheers,
Barry

9/27/06 postscript: I have had no further issues with my neck in the 3+ years since the surgery. I had a followup MRI one year after the surgery and my neurologist was happy with what he saw. I still have numbness in 3 fingers, but no pain at all and fairly good range of motion in my neck. I was able to resume normal activity soon after the surgery and eventually built up to 100-150 miles of weekly bicycling. I still avoid extending my neck for long periods of time – that's probably the only thing that might bother me – eg., when I get my haircut and they shampoo me, I won't lean my head back over the sink – I turn the seat around and lean forward over the sink. In retrospect, I'm very happy with the surgery.

Barry:
It was partly yours and Dave Edwards positive experiences with Dr. Jho that helped me make a decision to have surgery with him. I recently posted here on a Jho thread with a link to a cached version of my post-surgical thread from the old board. I too am doing very well going on 2 yrs. I haven't had an MRI since six weeks after surgery but I have no detectable problems. I sometimes wish I could jump into an MRI and see what is going on in there to satisfy my curiosity since long terms studies of the effects of Jho's procedures had not been published when I had the surgery. Does anyone know if Jho has recently published long term results? Eric, his (former?) PA told me when I was there they they were working on the study.

Kerry

I'll repost my original account:


I’ve received so much help from this board that I thought it might be useful for other if I wrote up my experiences so others might learn from my thought processes.
I went to my PCP in May 2004 because I was getting electrical shocks down both arms when I coughed. He ordered an MRI. It showed minor disc bulges at a couple of levels in my cervical spine but a large herniation compressing my spinal cord about 50% at C5-6. My PCP told me to go to a neurosurgeon. I decided to see a neurologist first because to a carpenter everything is a nail. The neurologist first did a neurological exam and said I had no serious problems then looked at the MRI and told me to get to a neurosurgeon within 48 hrs as I had a neurological emergency. I was to engage in no activities in the meantime including no wild sex. I pressed him hard on how serious my problem was since I was not experiencing a lot of pain and wished to avoid surgery if possible. He was absolutely insistent I see a neurosurgeon, explaining that he had had a patient with a similar condition to mine that had ignored his advice and gone skiing. He fell, hit his head and was now a quadriplegic. I made an appointment with a neurosurgeon who squeezed me into his schedule the next day. He concurred that surgery was necessary although not within 48 hrs. He said I should let it go no longer than a few months. I also pressed the neurosurgeon on the necessity of surgery. He told stories of two of his patients with a similar condition to mine. One fell on ice, hit his head and was paralyzed; the other fell off his couch, hit his head and was paralyzed. One recovered after surgery, the other didn’t. The surgeon said I needed ACDF with cadaver bone and plate. I asked about other options. He said he knew of some endoscopic procedures but that he did not believe these procedures could resolve cord compression. I thought about if for a couple of days and scheduled the ACDF.
I then began researching in more detail. I learned of the domino effect and doubts began to arise in my mind. I already had a couple of bulges at other levels, which struck me as being an indicator of future domino problems. I also learned of ADR. I went for my pre-surgical consult with the surgeon’s nurse and raised my doubts. I got no satisfactory answers. Yes, ACDF could cause problems at other levels but I should be good for 10 yrs, and I wouldn’t want to be one of the first 500 who got ADR. More research ensued. ADR had been done for quite a few years in Europe so I wouldn’t be within the first 500 and I didn’t like the domino odds. At this point I came to {REMOVED}and asked people’s opinions. Opinions were split on the wisdom of ACDF but I realized I didn’t know enough and could not go under the knife given these uncertainties. I talked to the neurosurgeon, who in fact concurred that he would not operate on a person with my doubts He knew of Jho but thought his procedure probably couldn’t help me. I postponed the ACDF so I could look into it more and into MISS and ADR.

Cervical ADR was in clinical trials at this time in the US but available in Europe for $$$ since my insurance wouldn’t pay. I learned of MISS from Schiffer, Microspine and Jho. Microspine was not an option since their qualifications did not seem that strong (especially when compared to Dr. Jho’s) and I did not like the idea of undergoing major surgery in a facility other than a large hospital. Schiffer’s CED did not give direct visual access to the area in front of the spinal cord, so there was doubt in my mind as to how effective that procedure would be, especially given the fact that it seemed likely my herniation was about 16 yrs old since it was that long ago I’d suffered bad whiplash from a rear end collision in a car with poor head restraints. That left Dr. Jho. A number of people on{REMOVED} had had success with him. I typed my MRI report into an e-mail and awaited his reply. Within 2 hrs he responded that he thought he might be able to help me and to send him my MRI films. I Fed-Exed the films on a Thursday and on the following Monday he called. Yes he could help me and he agreed that surgery was necessary. He said his office staff would call. This was late June I believe. I decided this was the best option. It preserved most of my own disc and left open the possibility of ADR in the future.

I eventually had surgery with Dr. Jho on 2/1/05. However, the communication with his office staff between 6/04 and 1/05 was not good. In fact, they never called me at all. I had to make repeated phone calls and e-mails to get any response at all. At about the end of July his office staff promised an early December surgery date. I did not hear from them and in about mid-November I began calling and e-mailing. No return phone calls and finally in early December I got an e-mail indicating the surgery would not be in December but it would be in January. By Xmas I still did not have a date and was calling and e-mailing. Twice I was promised that the date would be fixed—next Monday. No response on those days. Finally around 1/1 I got an e-mail confirming the date of 2/1/05. This was clearly the most frustrating part of my experience. I understand his office staff is busy and fields lots and lot of inquiries but a short return phone call, or e-mail would have made my experience much more pleasant. The communication with his office did improve once the surgery was scheduled but I never received a pre-surgical information packet like some others have reported. I was left with the impression it was lost in the mail.

I was scheduled for surgery Tuesday 2/1 with a pre-surgical consult 1/31. Eric, Dr. Jho’s PA, did a neurological exam on 1/31 and then I met with Dr. Jho. He inquired about my pain levels and if I could live with the pain. I said yes, but I wanted the surgery to reduce the risk of future paralysis. We then had a long discussion about the fact that there is no empirical data verifying the idea that seriously compressed spinal cords are at higher risk of damage than non-compressed cords. The concept is just ‘common sense’ and not verified. This had been one of the hardest parts of the decisionmaking process for me, since I had become aware of this fact during my research. But I had decided that it seemed wise to act on common sense, particularly given the experiences of my neurologist and first neurosurgeon (although those anecdotal cases don’t prove a lot). Dr. Jho agreed to operate under these conditions.

He operated on 2/1 for about 3 hrs. He initially had said he thought the surgery would take only one hr. I was in recovery for a little over an hour and was up walking around my hospital room by late afternoon with an hellacious sore throat from the intubation. I flew home two days after surgery and a week later; I have only had to take a few ibuprofens for discomfort, first for the sore throat, and since then for minor soreness in my neck. The ache in my left shoulder, which I had had for a number of years, was gone when I woke up in recovery and things seem to be going well. The best measure of success will be the 6 week MRI which I’m hoping will show a cord as nicely decompressed as the ones in the MRI’s Dr. Jho showed me in the pre-surgical consult.

I had read Dr. Jho’s published studies on anterior cervical microforaminotomies while making my decision. I had also read the studies of the same procedure by other surgeons who had much lower success ratios than Jho. I also read Jho’s replies to those studies. I have become very skeptical about reported surgical success percentages in the process of making my choice but had decided that Jho’s microforaminotomy had pretty reasonable odds of success (something better than 50/50). However, there have been no long term (15-20yr) studies of the results of this surgery so in many respects it is like ADR in that it’s benefits are theoretical, or ‘common sense’. I had decided in advance that if I came out of the surgery with similar pain levels to pre-surgery (not very high to begin with. 2-3 on a scale of 10) and a decompressed cord, I’d consider the surgery a success. While it is premature to make any judgment, so far things are going well. I’ll never know if ACDF would have been equally successful in the short term (although I do know that the recovery period is MUCH shorter for a microforaminotomy), nor will I know if the long term benefits for me will/would have accrued more to ACDF or ACMF. But given these limits and the limited nature of my problem (one level serious herniation with no instability and only minor problems at other levels), it seems so far as if the decision to have an ACMF with Jho was reasonable.
I welcome your comments.

on a whim, I rediscovered this site today since I have not been on braintalk for probably 2 years. The only reason I am registering is because as coincidence would have it, I saw a thread about BarryG and Dr. Jho. I also had surgery about 2 months after BarryG (June 2003) and his advice (including asking for pumpkin pie post surgery!) was very helpful! My surgery has been a success. I had his procedure performed on C3-4, C4-C5. I have cervical stenosis at lower C levels as well and Dr. Jho was going to do those levels in a second surgery. Over the past 3 years, I have, at times, contemplated an additional procedure on the 2 lower c spine levels but then the symptoms diminish. In writing Dr. Jho, he has pretty much told me to consider an additional procedure when symptoms are truly persistent and aggravating. He is definitely one that respects the risks of surgery and does not operate just upon the 'anatomic or MRI findings'. For that, I greatly respect him.

Again, my reason for registration and posting here is to provide yet another positive and successful experience with Dr. Jho. His specialized procedures are not always helpful and appropriate for certain patients but for those who are good candidates, I would highly recommend him.

Dr. Jho
 

Hi,

I am glad you all had a positive experience with Dr. Jho but I did not. I had surgery on a T7 herniation about 2 1/2 years ago and my pain increased 5 fold. At the time of my surgery, a woman was suing him for a bad t-spine surgery and he warned me that I'd better not follow her example!!!

If I had to do it all again, I would not. I am much worse off now than I was before I started!!

Lisa

I think it is important to note too that he chooses his patients carefully. I would not be a candidate for his procedure. The surgeon that did my cervical fusion told me Jho would never consider me because he is very statistic conscious as most of them are, but Jho more so. I was warned by other medical professionals that know him not to use him and steered clear. I was also told by one surgeon that there are people that studied with him and for some reason cannot duplicate the success he claims with his procedures. I think if you had a great outcome with him and are happy that is wonderful, but I went with a traditional fusion and had a good outcome too and happy that I went that route as well. I hope you both continue to do well. I have heard too that if you have problems it is difficult to have any follow-up care with him. True? I do not know...I just know I experienced poor post-op care with my first lumbar surgery and did not want to go through that again with the cervical spine.

Dr. Jho's Minimal Invasive Lumbar Stenosis Surgery
 

I just had Dr. Jho's Minimal Invasive Lumbar Stenosis Surgery on L4-5. I have had Lumbar Stenosis for about 4 years. The symptoms have continued to get worst over the last four years; the symptoms included leg pain, pins and needles, and weakness in my legs. I could not stand or walk for more than a few minutes without pain.
The local doctors I talked with in the Dallas area wanted to do standard decompression surgery which is called Lumbar Laminectomy. My father had Lumbar Laminectomy surgery about 20 years ago, took him three months to fully recover.

I found Dr. Jho on the internet, I liked what I saw and he accepts my insurance, which is Blue Cross/Blue Shield. With my plan the whole thing cost me the $150 co-pay.

Had the surgery the week before Christmas, that way I could recover over the holidays.

The discussion with Dr. Jho was that I have Lumbar Stenosis at L2-3, L3-4, and L4-5; this could be seen via my MRI, the worst being L4-5. Symptoms were common Lumbar Stenosis, but not specific enough to give Dr Jho confidence that performing decompression on only L4-5 would relieve all my symptoms. I tried to talk him into doing all three levels at the same time. But he stated that doing three levels raises the risks a lot, recovery is much longer and being under anesthesia for a long time is risky. He also stated if that doesn’t relieve all of the problems, I could come back to have other levels done. So I went with the doctor’s advice and agreed to do just L4-5.

The surgery started the next day at 7:30AM, I when under right at 7:30 AM.
I woke up at 10:30 in recovery. I then arrived at my room at noon. Lying on the bed I had very little pain. Getting up and walking to the bathroom was painful but nothing I could not take for a few minutes. The incision is ¾” and covered with a small band-aid. There is an area of about 5" around that is black and blue near the incision.

The doctor told my wife that the surgery went much longer than expected because I am very big boned and the channel was very tight, so they had to remove a lot of bone. I am 6’4” 250 lbs and have played basketball 3 times per week for 40 years.

Right after my surgery my stenosis symptoms were 95% gone, the only symptom that remained was a slight tingle in the heal of my left foot.

I had planned to fly back to Dallas three days after surgery, but I was feeling so good that I changed my flight to fly out on the second day after surgery at 7 AM, so I was on a plane less than 48 hours after the surgery. My wife pushed me thru the airport in a wheel chair, and I had no problem sitting in the plane.

Now 10 days after surgery I have no pain sitting, lying down and some pain when standing. Getting in and out of a chair or bed is some what painful; I would say it is 5 or 6 on a scale of 10. My stenosis symptoms are 98% gone. I can also stand up completely straight for the first time in years. If the post surgery pain goes away as expected I will be very happy with the work that Dr. Jho has done. I will submit an update in the next few weeks.

Terrible Experience with Dr. Jho - Neurosurgeon, Pittsburgh
 

About a year ago I had L5-S1 , for foraminotomy related to lumbar spondylolisthesis.
I bought into the Dr. Jho story! Simple endoscopic procedure and 80-90% have immediate and significant pain relief.
After surgery, my pain was much worse and I developed foot drop instantly and lost my achilles reflex. Dr. Jho's surgical team came out after surgery and told my family member that they had to "manipulate the nerve" to complete surgery, and it took longer than expected as a result. The next morning they told me the same thing... but at that time, I thought little of it. The pain was the worse thing about the experience, and it lasted at a high level for about 7 weeks.
I went back to my home, out of state, because Dr. Jho was certain that after a course of Medrol Dosepak, I would fine. In initial phone conversations, he could not believe I was in that much pain. His statements were of extreme disbelief (almost like, you must be crazy). The percocet Dr, Jho prescribed, would not touch the pain. My wife called for me on a Sunday, and had Dr. Jho paged. He was extremely rude and critical for paging him on a Sunday. He had little to say that was helpful. He insinuated that I must be crazy and he has never had this degree of pain after any of his surgeries.
I went to a local pain doc and was put on a fentanyl patch. There was little improvement in pain. After a few days, the fentanyl patch was increased to 50mcg. At that dose I has some pain relief, but no where near complete relief.
I called Dr. Jho (although he always would try to pass off phone calls to his PA, who was nice, but not helpful with my issues), and he suggested we drive back. I told him that I would like to, but my pain was so extreme, I could not handle the drive. Again, he talked down to me, suggesting I could my level of pain was not possible. I mentioned the "nerve manipulation", and he shot back "I never manipulated your nerve!". I told him that his surgical team told me and my family member (seperately) that he did manipulate the nerve. He said, "I don't care what they said, I did not manipulate your nerve."
I went to my local primary care doc, a neurologist, and a couple of orthopedic surgeon. After several weeks, the pain was so bad, that I contemplated another surgery (fusion), with a local orthopedic surgeon. I resisted, since one particular surgeon told me 2 surgeries on the same area within 12 weeks was too risky. And the 2nd surgery was extremely invasive...
so I declined the surgery.
I was torn about what to do. I was in alot of pain (lost 15 pounds), and could not sit or stand for very long.
At around 9 weeks, I started to a little better. I proceeded with a nerve block (which I had tried a few times prior to surgery), and that also had helped. Since I did not want to go on disability, I went back to a moderate work schedule after 10 weeks.
I had a about a 50% improvement (vs. my post surgery low point) in early summer) so I went through physical therapy for about 12 weeks. I thought this would keep the progress moving. It did not work.
Hesistantly, in the fall, I went to a chiropractor (I had tried this once before, unsuccessfully), and he immediately spotted a significant leg length discrepency. Over the next 4 mpnths, I procreeded with 1-2 chiro visits per week. Today, I am at about 75% and I believe the chiropractor (and a diagnoses only he made) are the reason for my success. I hope to get this up to about 90% on a consistent basis.
Although I know a few people have had some good experiences with Dr. Jho, mine was quite the opposite. I would encourage everyone, to think closely about any procedure that they think will help their back, based upon Dr. Jho's work on my back!!!!!

I really don't have any experience with Dr. Jho. I am like GZH and had two standard fusions of the cervical spine. And I went with a reputable surgeon from my area. I will say when I first started experiencing occipital neuralgia and/or cervicogenic headaches, I read up on his technique(s) for this. And what I read made no sense to me whatsoever; totally opposite from what my NS and spinal PM told me I needed to have done. Not only that but that specific technique had the potential to cause even more permanent pain. And come to find out, the C2/C3 was NOT my pain generator; it was the C3/C4 which was a bit unusual. So chances are, if I had gone to Dr. Jho, he may have insisted and operated on the WRONG level! So, yep, some of his techniques sound too good to be true to me and/or false claims from what I have read.

Hello
 

How long ago did you have the procedure?

Dr. Jho surgery update 5 weeks after surgery.
 

Please see my post above regarding the surgery and the first week.

I am completely pain free, now that I have returned to normal activities some of the symptoms have returned. I would say the surgery fixed 80% of the symptoms, the remaining symptoms are mild.

Prior to surgery Dr Jho said I have Stenosis at three levels, L5-4, L4-3 and L3-2. Before the surgery he said the worst point was L5-4 and he will work on that level only. He said it does not look that bad on the MRIs. He did mention that I may need to come in again to have another level done if the work on L5-4 doesn't releave all my problems. A few hours after the surgery he said that L5-4 was very tight and required a lot more work that expected; most likely I would need to have the other two levels done.

BTW...I played an hour of basketball in an over 50 league a few days ago with no ill effects...four weeks after the surgery.

I am thinking of having the L4-3 level done just before Christmas, so I can recover over the Christmas holidays as I did for the first surgery. It's nice having all the relatives waiting on you and I can watch all the bowl games ;-)

I will update again in a month or so

Terrible Experience
 

The failed spondo procedure (L5-S1 formanotomy) was performed in late January 2007!
I think there are many other people that have had similar experiences with Dr. Jho, but they do not post.

Dr. Jho
 

I am headed for Dr. Jho on April 2 for my consultation. I already saw Dr. Kang at UPMC who was HIGHLY recommended and researched, but I really don't want the "bone from the hip" for the cervical fusion thing and hope Dr. Jho is my man. From what I have read in most cases it seems some people go in to surgery forgetting the warnings they were given about what "could happen", but most likely won't. Sometimes the surgeries are not a success or things can get worse.

Dr. Kang already warned me as I am sure Dr. Jho's office will. Then some people tear Dr. Jho down with out all the facts so I am weighing things myself. I have read a few unfortunate situations with Dr. Jho that I have no explanation for, but I guess I will follow my heart and common sense and pray for the best what ever I decide. Any more Dr. Jho stories of success I would like to hear them. thanks, david

If the "bone from the hip" is scaring you, then why don't you ask about a cadaver bone? My own NS prefers NOT to take bone from the hip. I have had a cadaver bone instead for both fusions and I did well. My concern and I could be wrong, that with all the levels that are involved and having the minimally invasive surgery would set you up for more instability. It SOUNDS like, from what you have said in other posts, that it is a foraminotomy. And to have that many levels done would frighten me. I would lean more towards what your Dr. Kang has said. Just my own opinion though. :) I guess what I am trying to say is that no matter what; I would go more for STABILITY rather than worrying too much about what TYPE of surgery. If your neck is as arthritic as you and your doctor have said; then roto rootering out the bone spurs, etc., might NOT be the appropriate course of action. Anyway, get the second opinion but I would proceed very cautiously. You wouldn't want to have all that work done only to find out later that you need fusions. :eek:

that is very wise advice that I will consider. It was the same concern of Dr. Kang, but another doctor of the Minimally Invasive type did not have that concern. I will truly weigh all thoughts and pray I make a good decision. thank you for the advice to think about.

Update - Dr. Jho's Lumbar Stenosis Surgery
 

Please note I have two other posts that go into details regarding my surgery above. This is update #2

I had the surgery on Dec 20 and it's about 10 weeks after the surgery. The surgery relieved 95% of my problems. The only issue I now have is tingling in my left foot, the tingling is very mild. I have resumed playing basketball a few times a week, with no ill effects. I can stand for long periods of time, and walk for extented time. All of these activities I could not do before the surgery.

I am considering get the next level done, which would be L3-4. hopefully this would relieve the tingling in my left foot. The tingling is nothing I could not live with at this point. But I think it would be better to have it done when I am active and relatively young.

From my experience I would highly recommend Dr. Jho for Stenosis Surgery. I traveled halfway across the country to have it done by him, and would have it done by him again.

anterior microforaminotomy at one level
 

I had an anterior microforaminotomy at one level 3 weeks ago. All the pain in my neck, trap, shoulder and bicep is gone. It's still early, but I'm trying to stay optomistic. I got to a point where I was no longer able to work and had to do something. i read as many posts as I could on this site, and I did some research online about anterior microforaminotomies. The procedure to many docs is still new, but outside sources other than Jho state that the initial results are better than fusion. Additionally, from what I have read, this procedure is better than a posterior approach because the surgeon is able to access the front part of the spine which is generally where the lesions are located.

I also me another patient at Dr. Jho's office who was having an anterior micro before my surgery date and spoke with him. His surgery thus far has been very successful. I hope this helps. I know how nerve racking this process can be and good luck.

I had an anterior microforominotomy with Dr. Jho
 

I have never done this before but felt I should after reading some of these posts. I have cervical spinal stenosis at 3 levels and degenerative disc disease at two. Started having neck and shoulder pain right side and numbness in left arm and fingers with tightness. I live on the west coast and went to see the local orthopedic clinic where this was diagnosed with MRI and xrays. Told I would need a 3 level fusion. So I searched out a second opinion at the St. Marys spine center in San Francisco same diagnosis.
They offered to let me into a 2 disc replacement study with half of the people getting fusions and half getting replacements. I said I would think about it and found Dr. Jho on the web looking for a miracle I started calling. I had a similar experience where no one would return my calls. Finally after consistently calling for 6 months I saw Dr. Jho and had surgery 2 levels c5-6 6-7 on the left side. He was very vague during my meeting with him the day before my surgery in fact my husband wanted to leave and think about it.
But I had come all that way and was looking for anything that would avoid a fusion. I was told the surgery went well I think this whole time Dr. Jho spoke 10 words since I had seen him to begin with. I always felt like I was bothering someone or asking questions I shouldn't dare ask. I did get the feeling back in my left hand and fingers at that time. Left the hospital the next day immediately started running a fever 104 in my hotel room. No answering service at Jho's office survived until the next morning have never felt so sick. Went in to Jho's office next day he gave me 3 minutes of his time and a prescription for antibiotics. He said I should have just gone to emergency. Had a reaction to the antibiotics same story. They informed me they would not be in over the weekend not to call and have a nice trip home. To make a long story even longer the numbness has returned and I never heard from them again. I emailed the office manager and told her it was a horrible experience from beginning to end. I couldn't even get my script for my 6 week post op MRI. Finally had my local Dr order it for me. He looked at the MRI and said he noticed very little was done to help my condition. I am now seeing another neurosurgeon who is calling it a failed surgery and says I need to have a fusion at three levels still. I contacted Jho's office and they sent me an email saying they were sorry I wasn't one of the success stories sorry.
Dr. Jho didn't ever call he had his physicians assistant call and recommend we do 2 more surgeries. The pain in the right side of my neck and right shoulder has been 10 times worse since the surgery. My pain was always on the right side to begin with. I don't feel Jho's office was honest about the way they presented the surgery, the outcome, or what it could do for me. And they do not care about the patient That has been proven. I don't know which Dr. Jho these other people who say he had all the time in the world for them have seen. But it was not the same Dr. I unfortunately had to deal with.

Bottom line is...a GOOD NS would explain the pitfalls; something Dr. Jho obviously doesn't do. I checked out his procedures a long time ago and backed off pretty fast. They made no sense to me and caused me to have further questions. Those questions I took to my own NS and he explained everything thoroughly. So, my thing is...beware people...once bone is removed and not replaced or stabilized you run the risk of having even more surgery. I would NEVER consider a microdisectomy based on my own cervical spine issues. No way...give me a fusion any day of the week!

I was warned by very informed physicians and medical personnel to stay away from Jho...He was originally with U of Pittsburgh Hospital System...He is no longer with them, but instead with Drexel University, Allegheny Hospital....There is a reason for that and I suppose it might be the way he handles problems with patients or rather from what I am reading here, "does not handle problems, he ignores his patients." Again, I repeat, my physicians have stated that his statistics can not be repeated by anyone. I think if you have some minimal problem, you might be helped by him, but if you are told by other surgeons that you need a fusion, stay away....I agree with everything Kathi is saying...

I have a three level cervical fusion and a six level lumbar fusion and have no regrets with either surgery.

Gloria,

Thank you. I agree, if it is one level than minimially invasive surgery MIGHT be okay. I think people are looking for something "simple" to fix their pain. And we ALL want or wanted pain relief. But two very well known and respected NS's told me a fusion would be necessary and WHY. If Dr. Jho's procedures were "all that'; just about every NS would be doing them. And they aren't! There are reasons for that. I would have just hated to have something minimally done in my cervical spine only to have it all collapse like a house of cards! At least the fusions and the hardware are STABLE. That was my goal besides pain relief. And, nope, we don't always get relief even with ANY kind of surgery. And yes we can have the dreaded domino effect. But I don't and won't mess around with the cervical spine. If my NS said tomorrow that I needed another fusion, I would hate it...but I would LISTEN to him. He is and was very thorough when he explained it all to me and even why I wouldn't be a candidate for an ADR. I just want to say...people...if your NS or OSS is saying fusions; then listen to them. Dr. Jho is just one of thousands and as I said before...his procedures do NOT make any sense to me and actually alerted me to more trouble down the road.

Kathi,

I was set to see Dr. Jho as my brother lives in Pittsburgh...I saw the surgeons in my local area, Philadelphia, Baltimore, etc...Then I talked to a woman who had surgery with Jho on one of the other forums...She was from the Philadelphia area. She did not have good results and told me off line she would never return to him. Not only did she not have good surgical results, but there was no post surgical care. If you have a good outcome, you have no problems getting through to Jho's people, but if you have complaints, they do not return calls. I guess that is why his statistics are so high...He just does not report the failures. There are many people who are afraid to speak up publicly on the boards...

I talked to medical people that know Jho from the Pittsburgh area and after speaking to some of those people...Though they did not speak in specifics...other than to say stay away.....I decided to stay within the norm and saw docs at the U of Pittsburgh; though in the end I went to Baltimore, U of Penn, and then NYC for surgery..Surgeons in Philadelphia told me that they worked with surgeons that studied with Jho and they could not repeat his statistics, so that tells me something is wrong...His procedures work for some...probably if you have something that can be fixed with a very minimally invasive procedure. I was told he would not accept me as a patient because he screens his patients carefully.

My own surgeon, Fabien Bitan, in NYC, does minimally invasive procedures. He apologized for not being able to offer something minimally invasive ...All surgeons would like to be able to offer us something that does not require a long incision, rods, screws, cages, and grafting....but it is not always possible...so be very, very, careful...Do not go into surgery for just pain relief...Those of us that have been on the forums for a long time, know that surgery is not done for just pain relief...It is to provide stability of the spine as well or to ease compression of nerves, etc...so know why you are having surgery and why you are signing a consent form...BE VERY LEARY OF ANY SURGEON THAT PROMISES PAIN RELIEF AS A REASON FOR SURGERY, OR COMPLETE RELIEF OF PAIN...Most of us know that is not going to happen...

I have no regrets about either of my fusions.....I do not know why people have such a fear either of the harvesting of bone from the hip area...I only had pain once after that surgery...and have had them go in there three times for bone....The pain that I felt was not unbearable...I think people worry too much about things that are not really a concern.....A bandaid covers that area after the surgery...I repeat if Jho's statistics can not be repeated, there is something that is not right...and I would be just a bit leary of a doc that does not follow-up with his patients when they have problems after surgery; rather blows them off and acts as though they are a bother....I bet he does not hesitate to cash the check from their insurance company...I had my cervical fusion three years ago and the lumbar fusion two years ago. I am still seeing those docs...I see the doc that did the cervical fusion once a year now and the doc that did the lumbar fusion every six months now...If I have a problem, they are only a phone call away...

Bravo Gloria! Very well said! And I am in full agreement.

I think what people are looking for again, is something simplistic that may or may not solve their problem. But they are NOT thinking of STABILITY...or so it seems. As you know I pretty much hang out at BT and I do so because SOME of the posts here are just complete voodoo in my opinion. But I know you are a "seasoned veteran". :) So, please folks...listen to Gloria because she knows what she is talking about. And I hear ya Gloria, my NS is only a call away as well. As a matter of fact my own spinal PM had his fusions done by my NS as well. Now that tells me a lot! You know when a spinal pain management doctor has cervical fusions done by a particular NS, he has done his homework! :)

GJZD >> you had Lumbar Laminectomy -L3, L4, L5, S1, S2 and then Lumbar Fusion - L1, L2, L3, L4, L5, S1, whose are life changing surgeries. Lumbar Laminectomy leads to instability of the spine, which leads to fusions. In the long term, fusions lead to more fusions. My father had Lumbar Laminectomy 25 years ago; it took him 4 months to recover. You have not mentioned anything about your recovering time or why you needed fusions.

The aforementioned is exactly why I went to Dr. Jho. He relieved most of my problems; I was back to work in 12 days, and playing sports in 4 weeks.

It is true Dr. Jho is not the most outgoing guy. He is Korean; I think it is mostly cultural. I have had many surgeries; I had more post op visits in the hospital from Dr. Jho and his staff than any other of the surgeries that I have had. The hospital staff was outstanding and had nothing but very positive things to say about Dr. Jho.

Your comment regarding Dr. Jho changing hospitals is interesting. I wonder why the hospital he joined sent out several press releases announcing Dr. Jho joining the hospital. These press announcements basically stated they were giving him a wing of the hospital for minimally invasive surgery with several of his own operating rooms.

I am truly sorry that there are people that did not have good results from Dr. Jho. But I think it is more helpful for everyone to stick to the facts.

Dallaskibby,

I have not posted anything that is not true...Others have posted their stories about Jho to this thread and to other forums...I think if Jho were as good as the few people that post to a few threads say he is we would see more stories about him on the Internet...I have done a search and just do not find that many people singing his praises...There are as many good stories as bad...

The fact that you were back to work in 12 days and playing sports in 4 weeks tells me that you did not have extensive problems before the surgery.

I think you can tell by my signature that my spinal problems are extensive. I would never waste my time by contacting Jho. I sought only the best surgeons at the best hospitals in the world. I started at Johns Hopkins and then went into NYC. I admit my laminectomy failed...We knew it might at the onset...I wanted to try something that was not as extensive as a fusion at first...The problems with my spine start at the top and go to the SI joints...I doubt that Jho would ever entertain the thought of helping me...or could...He does not have the expertise or the time. He is in and out of the operating room with most patients in hours. My lumbar fusion was 16 hours and took two days...It took the skill of a highly trained OSS....Someone who had done many multi-level fusions..Most spinal surgeons have not done more than a three level or will not do more than a three level fusion....There are not many of surgeons in the US that can do a multi-level fusion and do it with success....I am not pain free, but my spine is stable and my pain is better that it was before my surgery.

I am glad that you had a good outcome with Dr. Jho...I do not know how far out from surgery you are...but I think you should read some of the testimonials at Healthboards...There seemed to be more people there that posted about failed surgeries. I do not know if those posts are still archived because the last time I searched for info was probably in 2004/2005....At that time there seemed to be many more posts from people that were disgruntled and unhappy about their treatment and surgeries. It also seems that about one year after the surgery is when people started to have difficulties, so please do be careful with your activities, no matter how well you feel now. Good luck with your surgery....and I do hope you are getting regular follow-ups...I saw my surgeon at four weeks, eight weeks, three months, six months, nine months, one year, fifteen months, eighteen months, two years, ...and now about every six months...I see him now for my cervical spine...and thoracic spine as well...You can see as I said...I have extensive problems...Jho would never see me as a patient...I would mess up his statistics...:winky:

Gloria,

Another good post. Just wanted to add that my husband MIGHT be facing a Laminectomy (lumbar L4/L5). Any advice you could give me would be appreciated. Not as in surgeons; we do have some great ones. I am just wondering if you could provide any advice. It is not certain yet that he will need this but it seems to me he is heading that way. :eek: Oh, and it just the one level that is bad; herniated and FRAGMENTED disc. You ought to see this thing on his MRI...it is one ugly beast! In a sense, I hope they say fusion instead...but I don't know yet. He is scheduled for one more injection. If that doesn't work, time to consider surgery.

The following is an excerpt from this Website>>europeanmedicaltourist.com/spine-surgery/laminectomy.html

Laminectomy: Definition
Laminectomy is a surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The lamina of the vertebra is removed to widen the spinal canal and create more space for the spinal nerves. A Laminectomy is not recommended in people under 35 and should not be done on multiple adjoining levels, because it can destabilize the spinal column! :eek: (which, would require fusion and/or cages)

Some surgeons believe that the laminectomy procedure, by removing excessive amounts of bone and ligament from the spine, disturbs the biomechanical stability of the spinal column, resulting in pain. Alternative techniques for decompressing spinal nerves with minimal disruption of spinal stability have been developed and include microsurgical lumbar laminoplasty. (this is the procedure that Dr. Jho does)
Laminectomy: History
The first laminectomy was performed in 1887 by Dr. Victor Alexander Haden Horsley, a professor of surgery at the University College London.

A common type of laminectomy is performed to permit the removal or reshaping of a spinal disc as part of a lumbar discectomy. This is a treatment for a herniated disc, bulging or degenerated disc. Laminectomies are also used trim bone growth in the spinal canal, most noteably from the facet joint or to trim calcification of the spinal canal.

Laminectomy: Reasons for the Procedure
One of the most common reasons for laminectomy is a prolapsed or herniated intervertebral disc. If the herniated disc is in the lumbar region, this can cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. It may also be difficult to raise the leg when it is held in a straight position. A herniated disc in the neck region can cause symptoms including pain, numbness and weakness in the arm. A herniated disc may be triggered by, for example, twisting the back while lifting something heavy. The surgeon will attempt to relieve the pressure on nerves and nerve roots by removing the pulpy material that is protruding from the disc.



>>> Another website that may maybe of interest, they do microsurgical lumbar laminoplasty. They do a procedure that is very similar to Dr. Jho’s. Using the same Endoscopic tools from Johnson & Johnson. But they charge $60,000 and do not accept insurance >>>

Website>>laserspineinstitute.com/spinal_orthopedic_procedures/laminotomy

At Laser Spine Institute (LSI) in Tampa, Florida, we use an arthroscopic approach to laminotomies to open up the spinal canal, without the need for general anesthesia, in an outpatient surgical setting. We do not perform laminectomies.A laminotomy is a surgical procedure that is used to relieve pressure off the spinal canal for the exiting nerve root and spinal cord, increasing the amount of space available for the neural tissue and thus releasing the nerve(s).

Dallaskibby,

Just so you know....I did address Kathi's post about the laminectomy off line...I did not do it on this thread....I did not recommend the laminectomy ....do not think I would recommend this place in Florida...JMO of course...

Dallaskibby and Gloria,

Thanks for the information Dallas but I am with Gloria here. I do not necessarily believe in the minimally invasive procedures. And I did question my husband's PM the other day. He DID say after all my questions, that it would probably be disectomy with fusion which I am glad of for STABILITY reasons. I may have misunderstood him in the beginning when he mentioned Laminectomy but this time around he said BOTH. So, he has to meet with the OSS next...that is after his follow up with his PM. And we are sticking with the Indiana Spine Group because Dr. Sasso is one excellent OSS...hubby will be in good hands with him if and when surgery is recommended. Thanks again.

great success with DR. JHO
 

For all readers who read some of these negative posts about dr jho let me tell you this, I am 35 years old and have degenerative disc disease and within the last year i had L4-L5 and T2-T3 surgeries with dr jho T2-T3 being the worse with extensive spinal cord compression. This was a very dangerous surgery that would require precision surgical procedure and I opted to go with Dr. Jho because he had previously done 7, yes 7 of my fathers 11 back surgeries. He is 58 yrs old and was out in the yard digging post holes by hand for a fence he was installing yesterday and my brother whome is 33 yrs old after having L3-L4 done by Dr Jho was playing his usual 3 rounds of golf per week. Now before my surgeries I was looking at a life of misery and losing my job as a sales rep where i am on the road 12 hrs a day and I can tell you all I havent missed a day of work since my second surgery 6 months ago and my first 11 months ago. So what i am trying to say is that Dr Jho has saved all of my families lives and careers and when you have spinal surgery with any surgeon you will have serious risk of complications no matter how RENOWN they are the central nervous system at risk any time a knife slices into it. I am 35 and dr jho is in his 60's and i dont know what i will do if he ever retires being that i have hstenosis and herniations at 13 leves of my spine at the moment i really hope he starts teaching his techniques to others, but i will never trust anyone like i do dr jho.

sincerely - doing great!

Dr. Jho gets 3 cheers from me!
 

Despite some of the repetitive criticism of Dr. Jho (including those who have never seen him) he did a great job for me. I can't recommend him enough IF you have the type of condition that he specializes in correcting.

The front office IS a little weak and slow but they get calls non-stop. Once I established a relationship with them the communications were no longer an issue.

I flew to Pittsburgh thinking that I was going to have a 3 level cervical surgery based on MRI films only. After I met with Dr. Davidovitch, (Jho's assistant until 9/1/08) and went over my actual symptoms, we re-thought the idea. After reviewing the MRIs and symptoms with Jho and Davidovitch we decided to stay conservative and only do one level. The reasoning was that he might be able to open the canal enough on one side to relieve subsequent compression. The downside was that I might have to come back. That fit my philosophy in advancing slowly and hitting the big spots first.

Dr. Jho IS very brief but that's because he doesn't need to ponder what he's doing and he's not paid to hold hands. I know others don't appreciate that approach but I certainly do. I could tell he was someone whom I needn't question.

I was concerned about intubation side affects do to a GERD/LPR issue. I was told to discuss it with the anesthesiologists, which I did, and they added a little more steroid to the mix. I really had minimal intubation issues - I ate the pork chop that was served for dinner as testimony!

In fact, after surgery, the main problem was urinating which is side effect of the anesthesia. I really had to go but I just dribbled.... It resolved itself the next day. Just drink lots of fluids to flush it out of your kidneys - stupid advice if you can't pee but eventually it does work. ( My sister's take on this was "you had spinal surgery and your main complaint is that you dribble...? Must have been good drugs! (Except I NEVER took a Percocet even though they gave me a jar of them. ))

Anyhow, the surgery was a success and I could sleep on my right side for the first time in years. I never had great pain, just nasty paresthesia, and it's going away. I also feel my muscles are waking up as the re-innervation continues. I was up and walking right after I recovered. Each day gets better and there's no bed rest - NONE! (Just no swimming for couple of weeks to keep water from soaking into the incision.)

I AM SO GLAD I NEVER HAD A FUSION or a laminectomy! I'll do this procedure over and over if I have to. Eventually I might have to have a fusion or an ADR but I'm sure I bought myself years of relief before I ever have to do radical surgery. Since I'm an active old guy that means a lot to me.

Also, Allegheny General Hospital treats Jho's patients with TLC. He and Dr. Jannetta are like rock stars there. Jho's patients get private rooms as part of the contract he negotiated with AGH when they wooed him away from PITT. That's a nice perk that he didn't have to do. It's more than just statistics...

I do agree that it's too bad that more docs don't know the technique. As younger deans come in to the med schools I think we'll see a jump in scope procedures and a slide in knife procedures. These young docs grew up with scopes so they're comfortable with what they're doing. Let's hope it spreads quickly.

My post began this thread and described my positive experience in a 2-level cervical microforaminotomy with Dr Jho. This is literally the first time I've logged on to this site since October 2007, and I'm now 5-1/2 years post-op and feel that I'm doing even better. The fact that I so infrequently visit sites like this is a reflection of how little I ever think of myself now as a cervical patient. I feel compelled to add a post to this thread because of all the Dr Jho bashing that has ensued since then. It is not my intention to minimize anybody else's direct experience with Dr Jho. But I do find some of the negative posts from those without that experience both questionable and potentially unhelpful. I understand that no doctor is perfect and every doctor will have some percentage of cases with a negative outcome. But I am convinced beyond a doubt that the negative posters in this thread have skewed the facts resulting in a misrepresentation of an excellent neurosurgeon offering a pivotal minimally invasive spinal procedure.

Some folks mentioned that they couldn't get answers from Dr Jho and my experience couldn't have been more different. In all my discussions with Dr Jho, I always felt that he was giving me all the time in the world to ask whatever questions I had in mind and he patiently gave me complete, detailed answers. I have somewhat of a medical background, and in my pre-op consultation I felt reassured and confident that I was in the best of hands.

I think all the various surgical procedures have their place. For some conditions, an ACDF or laminectomy is the best approach. But based on my experience, for herniations like I suffered, it makes no sense to use such invasive procedures that drastically change your anatomy and entail a much more extended/involved recovery. When it's a more mature procedure, artificial cervical disc replacement is the only invasive option that I would consider for this condition.

Wishing everyone a successful, pain-free outcome whatever you decide!

Interesting thread
 

I may print this and take it to my NS appt coming up.

Dr. Jho is Awesome!
 

I had cervical stenosis surgery with Dr. Jho in May of 2008, and my experience was tremendous. He cleaned bone spurs/ disc material out of two of my cervical levels on the left side --- C5/6 and C6/7 (or C4/5) --- and my left side of my neck now functions completely normally. Before, it would not turn to the left too easily and had incredible stiffness in that direction. I NEVER have had pain on that side since the surgery, or tingling (which I had before the surgery --- even going into the left arm/ hand!). Since I am bilateral at C5/6, I may need to go back to Jho for the right side at some point (which was never as bad as the left). If the stiffness and / or pain on that side increases, I WOULD NOT HESITATE TO GO BACK TO JHO! I am 34, and would not want a fusion or even ADR if I can preserve motion so well, and eliminate pain, with the Jho procedure. All the local NJ/NY/ Philly docs had wanted to do the fusion or ADR at either 2 or 3 levels! I am so glad I flew in to Pittsburgh for this procedure,which compared to all of my other orthopedic surgeries (2 left knee surgeries, torn ACL), was a piece of cake. Sorry, but anyone complaining about side effects from this minimally invasive procedure on 2 neck levels (one side) really needs to re-think things! yes, there may be those rare cases BUT everyone I had surgey with that day was singing Jho's praises, including myself!!!!

Chris:winky::winky:

my experience
 

I had a two level cervical foraminectomy 6 years ago. I am still happy with the outcome. Granted, he does not have a warm and fuzzy personality, but he did answer my questions. After the surgery, I stayed at a local hotel for two days. I did have a slight amount of blood on the bandage one day post op. I called and they got me right in. It turned out not to be a problem. Six weeks post op, I got an rx for another mri and flex x-rays. Dr. Jho called me personally to discuss the results. I already had the written report in my hand. The results of the Mri indicated that decompression was accomplished and the flex xrays showed that my spine was stable. The recovery time was not bad at all. I was off all rx pain meds within two weeks and back to pretty much all activities within four weeks. Before the surgery, I was unable to go to the movies because I was unable to sit for any period of time before spasms began. I was beginning to loose coordination and strenght in my fingers and got that lovely tingling. Those symptoms were relieved immedietly. My husband is having lots of pain and shooting pain down his arm due to bone spurs. He is starting PT. If he does not respond to the conservative treatments, I would definitely drive him the 6 hours to see Dr. Jho

Another Dr. Jho failure
 

January 2008 I underwent the Jho procedure. the hospital experience was fair, and while I was in the hospital, Jho and Jeff, his assistant came to see me post op then release me. It was the last time I saw either of them. I had an order to call if I had burning, numbness etc. I packed my overnight bag and left. Within a week of being home, I had a stabbing pain in my arm that was new to me; constant numbness and severe axillary pain. I called the office and reported these symptoms to Jeff, he had no answer for me except to say we needed to wait for the 6 week MRI. Another week passed so I called again and spoke with Jeff. I reiterated my symptoms . Again, Jeff had no answers except to offer me a refill of medication. I asked him why I would be told to call the office if the office didn't want to hear my problems, or real plan to do anything? I sufferred along with the pain, and numbness. three weeks later I returned to work, unprepared to sit at a desk let alone exercise or have any other activity. I called Jeff one last time--never spoke to the doctor--just to make sure I was being fair to the practice. again, story--Jho's office can't do anyhting until the MRI in March.I returned to work in worse pain than before surgery. I struggled along. In March, I receivedthe order for the MRI. I have it done and a week later I call the offce for the results. the receptionist (a very kind lady) takes my name and tells me jeff will call me. another week goes by and I call again since my call has not been returned. No one calls me back. In early May 2008 Darryl, dr. jho's new assistant calls me and tells me he wants me to come in for an exam. I just want to know what my MRI says. darryl tells me that Dr. Jho has been so busy --on vacation--traveling lecturering etc. he'll return in late May.
My C5-C6 decompression collapsed according to the MRI JHO ordered but never read. Nerve impingment is as severe as it was prior to surgery.

I am seeing one of the top ten neurosurgeons in the U.S. at this time and he is less than impressed with the work and practices of Dr. Jho. The institute and the staff are too busy to care for patients. The procedures are not for people who have serious long standing issues that require major surgeries. Although I was recommended to this practice, I do not recommend the Jho Institute to any one. Patients do not need warm fuzzies from their doctors, but they do need and deserve follow up and courtesy.

QUOTE=GJZH;248002]Dallaskibby,

I have not posted anything that is not true...Others have posted their stories about Jho to this thread and to other forums...I think if Jho were as good as the few people that post to a few threads say he is we would see more stories about him on the Internet...I have done a search and just do not find that many people singing his praises...There are as many good stories as bad...

The fact that you were back to work in 12 days and playing sports in 4 weeks tells me that you did not have extensive problems before the surgery.

I think you can tell by my signature that my spinal problems are extensive. I would never waste my time by contacting Jho. I sought only the best surgeons at the best hospitals in the world. I started at Johns Hopkins and then went into NYC. I admit my laminectomy failed...We knew it might at the onset...I wanted to try something that was not as extensive as a fusion at first...The problems with my spine start at the top and go to the SI joints...I doubt that Jho would ever entertain the thought of helping me...or could...He does not have the expertise or the time. He is in and out of the operating room with most patients in hours. My lumbar fusion was 16 hours and took two days...It took the skill of a highly trained OSS....Someone who had done many multi-level fusions..Most spinal surgeons have not done more than a three level or will not do more than a three level fusion....There are not many of surgeons in the US that can do a multi-level fusion and do it with success....I am not pain free, but my spine is stable and my pain is better that it was before my surgery.

I am glad that you had a good outcome with Dr. Jho...I do not know how far out from surgery you are...but I think you should read some of the testimonials at Healthboards...There seemed to be more people there that posted about failed surgeries. I do not know if those posts are still archived because the last time I searched for info was probably in 2004/2005....At that time there seemed to be many more posts from people that were disgruntled and unhappy about their treatment and surgeries. It also seems that about one year after the surgery is when people started to have difficulties, so please do be careful with your activities, no matter how well you feel now. Good luck with your surgery....and I do hope you are getting regular follow-ups...I saw my surgeon at four weeks, eight weeks, three months, six months, nine months, one year, fifteen months, eighteen months, two years, ...and now about every six months...I see him now for my cervical spine...and thoracic spine as well...You can see as I said...I have extensive problems...Jho would never see me as a patient...I would mess up his statistics...:winky:[/QUOTE]

I am reposting my January 2007 surgery story (below) as a warning to patients thinking about Dr. Jho! In addition, never let give an MRI primary weight, when determining what is causing back pain. The story below, explains why. Lastly, I had always been extremely skeptical of chiropractic, but before any major surgery try to get the opinion of chiropractors that treat professional athletes. That is what I did and today, I am about 85% recovered. If a chiropractor is treating those with wealth, you know they have to be among the best! My Dr. Jho story below, I wrote this in January 2008....

---------------------------------------------------------------
In January 2007, I had L5-S1 , for foraminotomy related to lumbar spondylolisthesis.
I bought into the Dr. Jho story! Simple endoscopic procedure and 80-90% have immediate and significant pain relief.
After surgery, my pain was much worse and I developed foot drop instantly and lost my achilles reflex. Dr. Jho's surgical team came out after surgery and told my family member that they had to "manipulate the nerve" to complete surgery, and it took longer than expected as a result. The next morning they told me the same thing... but at that time, I thought little of it. The pain was the worse thing about the experience, and it lasted at a high level for about 7 weeks.
I went back to my home, out of state, because Dr. Jho was certain that after a course of Medrol Dosepak, I would fine. In initial phone conversations, he could not believe I was in that much pain. His statements were of extreme disbelief (almost like, you must be crazy). The percocet Dr, Jho prescribed, would not touch the pain. My wife called for me on a Sunday, and had Dr. Jho paged. He was extremely rude and critical for paging him on a Sunday. He had little to say that was helpful. He insinuated that I must be crazy and he has never had a patient with this degree of pain after any of his surgeries.
I went to a local pain doc and was put on a fentanyl patch. There was little improvement in pain. After a few days, the fentanyl patch was increased to 50mcg. At that dose I has some pain relief, but no where near complete relief.
I called Dr. Jho (although he always would try to pass off phone calls to his PA, who was nice, but not helpful with my issues), and he suggested we drive back. I told him that I would like to, but my pain was so extreme, I could not handle the drive. Again, he talked down to me, suggesting I could my level of pain was not possible. I mentioned the "nerve manipulation", and he shot back "I never manipulated your nerve!". I told him that his surgical team told me and my family member (seperately) that he did manipulate the nerve. He said, "I don't care what they said, I did not manipulate your nerve."
I went to my local primary care doc, a neurologist, and a couple of orthopedic surgeons. After several weeks, the pain was so bad, that I contemplated another surgery (fusion), with a local orthopedic surgeon. I resisted, since one particular surgeon told me 2 surgeries on the same area within 12 weeks was too risky. And the 2nd surgery was extremely invasive...
so I declined the surgery.
I was torn about what to do. I was in alot of pain (lost 15 pounds), and could not sit or stand for very long.
At around 9 weeks, I started to a little better. I proceeded with a nerve block (which I had tried a few times prior to surgery), and that also had helped. Since I did not want to go on disability, I went back to a moderate work schedule after 10 weeks.
I had a about a 50% improvement (vs. my post surgery low point) in early summer) so I went through physical therapy for about 12 weeks. I thought this would keep the progress moving. It did not work.
Hesistantly, in the fall, I went to a chiropractor (I had tried this once before, unsuccessfully), and he immediately spotted a significant leg length discrepency. Over the next 4 months, I procreeded with 1-2 chiro visits per week. Today, I am at about 75% and I believe the chiropractor (and a diagnoses only he made) are the reason for my success. I hope to get this up to about 90% on a consistent basis.
Although I know a few people have had some good experiences with Dr. Jho, mine was quite the opposite. I would encourage everyone, to think closely about any procedure that they think will help their back, based upon Dr. Jho's work on my back!!!!!

surgery 5 years ago
 

I had surgery with Dr. Jho 5 years ago. I had an anterior microforaminotomy---he reamed out my neck at 2 levels---stenosis.

HIs front office leaves much to be desired, but I found him to be professional and engaging.

I recovered very well from the surgery. Within a couple of hours of the surgery I was up and walking. My throat was sore, but otherwise I was great.

I went home by car (5hrs) the next day and I drove part of the way, with my wife driving the balance.

I babied myself more than I needed to, but I was back playing sports within a month.

I was and till am very pleased with every element of Dr. Jho's services.

I realize that every professional has clients or patients who are not pleased with the services rendered. I'm sure that the negative experiences mentioned on this board are true. I can only relate my experience. It's not a warranty for others that they will have the same experience. It is simply information for those considering what course of action they should take to resolve their problem.

I recall reading a series of posts by a doctor (opthomologist) who encountered one negative setback afther the other, despite being a doctor and despite doing all of the traditional things to resolve the problem. I think that the bottom line is that the body is a work in progress and there are no guarantees for any medical procedure.

good luck to all.

Dave Edwards

I posted earlier in this thread about my great experience with Dr. Jho back in 2004. I want to reiterate, like Dave, that my neck is still fine and I am still extremely happy with my decision to have Dr. Jho perform my procedure.

I too recall the threads by the opthamologist (Eyeguy) who had a number of procedures with few positive results.

Everyone needs to think through their decisions for themselves. Spinal surgery is never an easy choice in my view, but my experience with Jho's surgical skills has been nothing but positive.

No!
 

The "repetitive criticism" about Jho, that is mentioned in previous post does not originate in vacuum! I would say wholeheartedly that I DO NOT TRUST this person. Never in my life had I encountered a physician that has so little compassion, kindness, patience, or interest in his patients. On the other hand, he certainly has more then just excessive mounts of ego, marketing skills and rudeness. Note: there is an exception, and it is if you are a “celebrity” wrestler. In such a case Jho will take a photograph of you and him., and even smile… The large number of negative remarks one can find in various web sites and forums come from many other that share the same personal experiences and impressions I had. I read a post that blamed it on his ethnic origin. Nonsense, any normal person that lived in our country for so long has some minimal people skills regardless where they came from. The wait time is his office was usually more then 2 hours, and no one would ever explain or appologize for this. The courtesy of the staff competes Jho's attitude. Jho did not examine me seriously (and his PA that helped him was realy inexperienced and with very little medical and clinical skills). In most cases Jho will basically only look at you MRI and will usually offer to operate (if you want it) - even in cases when most other surgeons would advise conservative managment. There is NO post surgical care, and Jho practically dumped me and instructed to follow with my primary physician. You do the math. Overall, the results I had were way below my original (naive) expectations.
He is yet to publish a serious peer reviewed article showing the value of his “technique”. Until then, his surgeries might help you or not, depends on your specific clinical problem, as well as your luck. I suggest you meet with at least one other neurosurgeon or spine surgeon before you make any decision.