[Donald Corenman, MD, DC]

#33772

There are some radiologists who are quite good at assessing fusion status and others that are not as good. You could get a copy of your films and send them to a specialist radiologist to over-read the films for a second opinion. If that works for you, call the office to get that contact information.

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.

[westie California]

#33773

I will look for another radiologist. The question’s that I still have is, what will be suggested if one has pseudarthrosis at those levels, would it be revision ACDF’s for those segments? In addition, if a second opinion comes back that there’s a solid fusion, how does that explain “Spondylitic ridging and uncovertebral spurring at C4-5, C5-6 and C6-7, mildly progressive since 5/19/2018” ?

Is it possible to have some kind of instability/movement that’s not being picked up on a CT scan? When one is in a scanner there’s no load or movement. Is another possibility, that although there’s a fusion due to arthritis, bone integrity is lacking? thanks in advance

[Donald Corenman, MD, DC]

#33774

Almost all of the time, a fusion eliminates motion so progressive bone spurs do not occur. I assume if there is an “anemic” fusion present (minimal bone mass), there could be micromotion that can induce spur formation. If there is a pseudoarthrosis, you would expect spur formation. In your case, an ACDF with iliac crest graft would be the revision to consider in the presence of a pseudoarthrosis.

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.

[westie California]

#33776

Thank you so much Dr. Corenman! I appreciate all that you do take care and be safe Doctor.

[Donald Corenman, MD, DC]

#33778

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.

[westie California]

#33914

Good evening Dr. Corenman,

Spoke to my surgeon earlier today in reference to a number of questions I had, however his responses were not what I expected. We spoke in reference to the following:

1)”Spondylitic ridging and uncovertebral spurring at C4-5, C5-6 and C6-7, mildly progressive since 5/19/2018”, and was told “previous surgeon removed some of spurs, however there were some that remained”.
Bone spurs take time to dissolve. I kindly mentioned, that my ACDF’s were performed in 2012 and 2013, how can they not dissolve after 8 to 9 years? Was told in my case give it a little longer, it takes a very long time. This does not sound right to me.

2)Reviewed my Ct Scan again, not overly concerned with nerve root compressions, being mild to moderate they don’t operate on those compressions. I asked about moderate to severe noted on my CT scan at C3-C4 and was told that the radiologist over stated the degree of compression. This was a bit of a surprise.

3)We spoke about Nuclei ligament that was removed during laminectomy and that one surgeon stated to me that some individuals can have issues with removal because its a cable that stabilizes neck and without it one can run into trouble with pain due to instability and muscle fatigue. He didn’t feel that was the case for me because my kyphosis is not severe. I’m lost on this one also, my thought is, if you have an instrumented fusion, how would one develop severe kyphosis after laminectomy?

4)I asked if he can order an over-read of my CT films for a second opinion to ascertain fusion status on C4-5, C5-6 and C6-7, said a CT Scan will be ordered in approximately 5 months, and they will look at cervical and upper thoracic fusion status.

5)He didn’t address nerve channels during last surgery, because in his opinion the level below my previous fusion T2-T3 should be pain generator. I’m scratching my head on this one also, by no means I’m a spine surgeon, however this is strange for a pre surgical plan to be drafted only to be scraped during surgery.

6)Still thinks after 4 months it’s too early to state surgery was not successful.

6)His plan is to order for my next office visit flexion and extension x rays – next week

7)refer me to pain management for workup

Is there any recommendations on my situation? I’m extremely tired, frustrated and confused. Thanks

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