[pluto31]

#4966

I have a ruptured L4-L5 12mm severe stenosis straight into the spinal nerves with a part also in the right nerve root. I heard of a laser procedure that goes through the small hole in the sacrum, goes up the spinal canal, Laser disintegrate, irrigate and suction out. No success. Numb right leg, Post-op MRI concludes “no significant changes from Pre-op Mri” Siatic pain conditions identical to before operation. Have you heard of this procedure? Is it ususlly successful and I was one of the few who did not have success?

[Donald Corenman, MD, DC]

#4967

The procedure using a small scope through the sacrum to remove herniation material in the lumbar spine makes little sense to me. Normally, the lumbar nerve is trapped by the herniation and needs to be untangled. Adhesions form which need to be lysed. The hole through the annulus needs to be explored to make sure that any loose nuclear material is removed to prevent further herniations. None of these problems can be addressed by this procedure as the angle of approach is wrong and the room necessary to keep the nerve safe is limited.

Using laser around nerve roots always makes me nervous. A laser is nothing more than a device to remove tissue using the heat generated by the focused light. Using heat around nerve roots needs to be tightly controlled. This is the reason surgeons use something called a bipolar cautery. This device is nothing more than a forceps (tweezers) that can run an electric current between the tips. Only the material between the tips is heated and nothing else. A laser beam can coagulate anything in its path and in my opinion, has little use in the spine.

It sounds like you need a spine surgeon to perform a microdiscectomy. Please get another opinion.

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.

[pluto31]

#5111

Thank you for your response Dr Corenman, As you suggested I had a neuro surgeon remove the rupture with excellent results. The damage caused by the Accurascope procedure remains. What steps can be taken to obtain a second opinion on this matter. Any advice is appreciated.

[Donald Corenman, MD, DC]

#5112

I cannot comment on any damage that had potentially occurred by the accurascope. I an happy that your results from surgery were successful.

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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