Stenosis, Fear, and Facts: Navigating Spine Surgery with Dr. Allan Levi

For anyone who's ever been told their spine is "degenerating" or that they're a millimeter from paralysis, the fear can feel as debilitating as the condition itself. In this episode, Dr. Brent sits down with his own neurosurgeon, Dr. Allan Levi — Chairman of Neurological Surgery at the University of Miami Miller School of Medicine and Chief of Neurosurgery at Jackson Memorial Hospital — for a full-disclosure conversation about lumbar spinal stenosis, one year after Dr. Levi performed the surgery that gave Dr. Brent his leg back. Dr. Levi breaks down what stenosis actually is, why imaging findings so often don't match a patient's symptoms, and why some people walk around with "severe" degenerative changes on MRI and no pain at all. Together they trace the full continuum of care, from physical therapy and diagnostic epidural injections to the decision points around laminectomy versus fusion, and what recovery really looks like at each stage. It's a candid, myth-busting conversation for anyone facing a stenosis diagnosis or supporting a patient through one. IN THIS EPISODE: What lumbar spinal stenosis is and how degenerative versus congenital stenosis differ Why MRI findings alone don't tell the whole story, and how symptoms guide treatment The role of epidural injections as both a diagnostic and therapeutic tool How surgeons decide between a laminectomy and a spinal fusion What recovery timelines and movement restrictions look like after each procedure Why waiting too long for surgery can lead to worse outcomes — and why urgency isn't always warranted How to find the right spine specialist and know when a second opinion is worth seeking RESOURCES MENTIONED: University of Miami Miller School of Medicine, Department of Neurological Surgery Jackson Memorial Hospital DEFINITIONS: Lumbar spinal stenosis — Narrowing of the spinal canal in the lower back, usually from a combination of enlarged facet joints and bulging discs, which can compress the nerve roots. Neurogenic claudication — The pattern of back, buttock, and leg pain triggered by walking or standing and relieved by sitting, caused by nerve compression from stenosis. Spondylolisthesis — A condition where one vertebra slides forward relative to the one below it; often described by patients as a "slip." Laminectomy — A surgical procedure that removes the lamina (back part of the vertebra) to create more space for compressed nerve roots, without fusing the spine. Spinal fusion — A surgical procedure that joins two or more vertebrae together with bone growth and hardware, typically used when the spine is unstable. SOURCES & CITATIONS: Machado GC, Ferreira PH, Yoo RIJ, Harris IA, Pinheiro MB, Koes BW, van Tulder MW, Rzewuska M, Maher CG, Ferreira ML. Surgical options for lumbar spinal stenosis. Cochrane Database of Systematic Reviews. 2016;11:CD012421. doi:10.1002/14651858.CD012421. Machado GC, Ferreira PH, Harris IA, Pinheiro MB, Koes BW, van Tulder M, Rzewuska M, Maher CG, Ferreira ML. Effectiveness of Surgery for Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis. PLoS ONE. 2015;10(3):e0122800. doi:10.1371/journal.pone.0122800. Use the code DRBRENT to save 10% off any Polestar Pilates Teacher Trainings sold on polestarpilates.com. Applies only to Pay in Full.