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 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 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.

Hi,
I live in Dallas, TX too. I am glad that you have a positive experience with Jho. I am planning to have a Posterior endoscopic foraminotomy procedure to remove bone spurs from the cervical spinal canal (OPLL). Your comments about Jho makes me feel better.
Are there any other things to know or prepare for before the surgery?

Hi,
I thought of sharing the information I received from few Neurosurgeons. So far I have contacted 6 of them. Three of them wanted to perform Laminectomy and two of them Laminooplasty for my OPLL from C3-C6. The sixth one is Dr. Jho who will be performing the minimally invasive posterior endoscopic decompression from C3-C6 in mid May.

Regardless of the outcome from the procedure, I just wanted to take chances with Dr. Jho. I have an option of Laminectomy if it does not work and if I survive the Jho's procedure

Well, also I heard from these doctors and some research on the internet that, we all OPLL lucky people have the NPPS gene that plays an important role for the OPLL. So this is the culprit.


You may research on the NPPS gene on the internet - you will find lot of information.

Thought of sharing this and wish me luck for the procedure from Dr. Jho.

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.

How long ago did you have the procedure?

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