Viewing 6 posts - 43 through 48 (of 49 total)
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  • westie California
    Participant
    Post count: 138

    Good afternoon Dr. Corenman,

    Just brain storming, as you know last procedure performed extended fusion to T2-T3 due to degenerative spondylolisthesis. My concern is at T3-4 level, the same condition exist and I was wondering if this level can be causing my continued base of neck, shoulder, muscle spasms, etc. pain? If so, should a diagnostic block be performed with pain diary to evaluate if source of pain? Also, if source of pain, can an RFA address, I’m not really looking into having another fusion surgery? thanks a million!!!!

    westie California
    Participant
    Post count: 138

    Good evening Dr. Corenman,

    1. My top focus will be “peripheral nerve stimulator”.

    2. A quick question on my T3-T4 level, has degenerative spondylolisthesis, can this be a reason for my continued base of neck, shoulder, muscle spasms, etc. pain? Just wanted to rule this out before following the path to PNS. Thanks Dr. Corenman

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Are you sure you have developed a degenerative spondylolisthesis at T3-4 as that level should be stable with the rib attachments? I would be very careful in thinking that your current pain is generated from an apparent slip at T3-4 and not chronic pain syndrome or the possible pseudo at T2-3. A nerve stimulator might be quite helpful.

    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
    Participant
    Post count: 138

    Hello Dr. Corenman,

    I was making sure before focusing 100% on a nerve stimulator that there’s nothing else I’m overlooking? Before my last surgery, my thoracic MRI noted a herniation at T3/T4 (see below). Is there anything in this report that can cause base of neck pain, muscle spasms, headaches, etc.? If there is should a diagnostic block be in store to rule out if this is the source of pain? Thank you

    T1/T2 disc space level, postsurgical changes are noted. Posterior stabilization rod is noted with paired transpedicular fixation screws transversing the T1 and T2 vertebral bodies. No evidence of herniated disc or sideline thecal sac deformity . Loss of disc signal is noted with preservation of disc space height.

    T2/3, disc herniation is noted deforming the thecal sac with bilateral paracentral components, Loss of disc signal is noted with partial loss of disc space height.

    T3/4, disc herniation is noted deforming the thecal sac with bilateral paracentral components, Loss of disc signal is noted with partial loss of disc space height.

    T4/5, left paracentral disc herniation is noted deforming the thecal sac. Loss of disc space height and signal is noted with mild disc degeneration.

    T5/6, disc bulge is noted with paracentral orientation deforming the thecal sac. Loss of disc space height and signal is noted compatible with mild disc degeneration.

    T6/7, disc bulge is noted with paracentral orientation deforming the thecal sac. Loss of disc space height and signal is noted compatible with mild disc degeneration.

    T7/8, disc herniation is noted deforming the thecal sac with bilateral paracentral components.Loss of disc space height and signal is noted compatible with mild disc degeneration.

    T8/9, disc herniation is noted deforming the thecal sac with bilateral paracentral components.Loss of disc space height and signal is noted compatible with mild disc degeneration.

    T9/10, right paracentral disc herniation is noted deforming the thecal sac. Loss of disc space height and signal is noted with mild disc degeneration.

    T11/12, disc bulge is noted deforming the thecal sac. Loss of disc space height and signal is noted compatible with mild disc degeneration.

    These extruded disc exert extradural pressure. Ventral dural tube subarachnoid space is impacted upon and deformed. Spinal cord surface is also encroached, without resulting in flattening.

    Central canal integrity is partially compromised. Persistent thoracic multilevel discopathy noted

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You have multilevel thoracic degenerative disc changes so there is not one particular level you can “rest” a fusion on. You should check the standing thoracic kyphosis measurement as you might have Scheuermann’s kyphosis but none-the-less, do no continue to fuse further down the thoracic spine as there is a high chance that this fusion descent will continue.

    See: https://neckandback.com/conditions/hyperkyphosis-scheuermanns-disease/

    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
    Participant
    Post count: 138

    Dr. Corenman,

    Thank you so much! I appreciate all your feedback.

    Have a great summer.

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