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Thanks Dr Corenman,
I will keep the forum updated as to my progress and outcome.
Thank You
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.Hi Dr,
Just a quick update on the status of my ongoing sciatic pain. I saw 2 neuro surgeons who confirmed scar tissue formation preventing my nerve glide and mechanical compression. I have been given a course of three epidural sine months each apart to see if this helps. The first one has provided some relief so far but I’ve been told there is a very slim chance of breaking up the fibrous tissue with the steroid. Both surgeons recommended a follow up 6 months down the track and briefly spoke about a few options:
1.) chronic pain management ( although thought I was too young for this to hinder my life)
2.) One surgeon said he would have a 50/50 success rate of dissecting the scar tissue away from the nerve to allow it to glide again and pack the area with some sort of anti-adhesion substance.
3.) a fusion to prevent movement (not favourable)
4.) a spinal stimulatorWhat are your thoughts on these options considering I am 27. The medications only help so much because any tension creates pain with or without medication.
Thank you for your input!!
The steroid injection will not break up scar tissue. This injection is designed to reduce inflammation which is the trigger for symptomatic nerve pain.
Your options for treatment you list are exactly correct.
Chronic pain management is the use of medications, physical therapy, activity modification (and avoidance), injections and manual therapy (chiropractic and massage) to help manage the pain.
The surgical neurolysis of the nerve root (removing the adhesions and freeing the nerve) has about a 50/50 chance of having you satisfied with surgery. This is because it is impossible to know if the adhesions are causing pain or are there “to go along for the ride”, meaning these adhesions are an innocent bystander and the chronic neuropathy is the cause of your pain.
A fusion of this segment can be helpful if your symptoms also include lower back pain along with the leg pain. There can be an argument made that motion of this segment causes some nerve root stretch and fusion can stop some of this motion as well as reduce any lower back pain that occurs. There are many factors that go into this decision.
A spinal cord stimulator is the last choice for this disorder but can be helpful in about 60-70% of patients. Look up Melzack and Wall who developed the “gate theory of pain” to understand how these stimulators work.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
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