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  • Scott
    Member
    Post count: 12

    I have had 3 back surgeries in about three years. I am only 34 years old and my Dr. drove a screw into my L4-L5 disc while fusing the L5-S1 disc.Can that be the cause of my pain now in your professional opinion? I’ve been told that there is nothing that can be done and the screw is right where it should be. It doesn’t seem right to me. I’ve heard great things about you from friends and I hope you can help me. Thank you.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8376

    Please reveal what prior surgeries you have had. Apparently, one was a fusion of L5-S1 with pedicle screws. Let me know where your pain is located. Do you have continued back pain or leg pain or both?

    You note that one screw inadvertantly went into the disc space at L4-L5. This typically will not cause back or leg pain but can increase the chance of degenerative changes of the L4-L5 disc. I am not sure that removing the screw from the disc space if it is not irritating a nerve will help you.

    I have just written a section under “conditions” called “Failed Spine Surgery Syndrome” that will be implanted on the website this week. Please look for it as this section will explain why some patients do not do as well from surgery.

    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.
    Scott
    Member
    Post count: 12

    Hi doc. Thanks for your reply. I had a fusion at L5-S1 and was healing well and after a number of months, the dr. said I was ready to go back to work. I was worried because I’m a logger in Oregon so I told him over and over just what my job entails. He told me that it would take a car wreck to damage the fusion so I went back to work.
    About three days later the pain was back and the spacer between my vertabrates had slid out of place. We waited it out but it wouldn’t fuse from the movement apparently. So he went through my belly and fused it again. The pain didn’t go away and that is when the screw went into the L4-L5 disc. I went to see a pain management dr. and she felt it was the hardware from the first surgery through my back so she injected steroids at each screw and it worked. I felt great for about a week but my surgeon said he didn’t think the hardware was the problem but he removed it anyway. The whole time he said I needed a fusion at L4-L5. When the hardware removal failed to work he had changed what he had been thinking and said he couldn’t do anything more for me.
    When I woke up from my first surgery he told me that the disc was bad and the L4-L5 disc was also bad but he still didn’t want to fuse it. Maybe I can send you my most recent x-ray, MRI and CAT scans if you think you may be able to do something. I need to find some relief to get back to work and be a good dad to my kids again. Hope to hear more. Thank you!!!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8376

    It was obvious from the results of heavy lifting that your fusion was not solid at the time you went back to work. The movement of the spacer in your disc space should not occur as it should be incased in solid bone. Did the spacer migrate into the canal? Was there any leg pain associated with the spacer migration?

    You underwent a re-operation from the front of the spine to try and get a solid fusion. Was the displaced spacer removed at that time? Apparently, the surgeon placed anterior hardware as you note that is when the “screw went into the disc space” unless he replaced the screws in the back of the spine at the same time. You had an instrumentation injection block and then had the screws in the back removed without improvement.

    Questions. Do you have a solid fusion at the L5-S1 level or is it a pseudoarthrosis? Are your symptoms more in the lower back or more in the buttocks/leg and by what percentage? How do you know that the disc at L4-5 needs a fusion?

    I would be happy to review your films. Please contact Diana or Sarah at (970) 476-1100 and tell them your story.

    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.
    Scott
    Member
    Post count: 12

    I have a solid fusion at L5-S1. The pain seems slightly higher than at my fusion and it is horrible. Roughly 95% of the pain is in my lumbar area and only minor leg and foot numbness. I have degenerative disc disease at L4-L5 and L5-S1. As stated in my post operative discharge papers, I was noted to have spondylolysis with hypermobility at L4-L5. I have not received all of my most recent films yet but when I do, I will send them to your office.
    I find it amazing that you take the time to do this for all these people. I’ve never met a doctor who would chat outside of the office and do it without pay!!! You are a great person truly trying to help people. Thanks again.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8376

    I am concerned about the report of spondylolysis at L4-5. Do you mean spondylosis? This is confusing but spondylolysis is a fracture of the back of the vertebra (see website for description) and spondylosis is simply degenerative disease.

    If you do have spondylolysis, was it present prior to the L5-S1 fusion or is it new? You note hypermobility. Was this proven on flexion-extension x-rays?

    If you do have spondylolisthesis with instability (see website), you may need a fusion of that level or possibly a pars repair if the disc is still intact (again- see website for pars repair). You did note previously that the disc at L4-5 was degenerative and that would preclude the repair of the pars.

    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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