[Scott]

#5525

Hi doctor. It was written down as spondylolysis. It was on the discharge papers from surgery #1 so it was present before the surgery if in fact that is what he meant to write. I’m not sure what kind the x-ray was.

[Donald Corenman, MD, DC]

#5526

The information written down could be either one if a mistake in nomenclature was made. If the spondylolysis was present prior to the first fusion surgery, how was the decision made to fuse L5-S1 made? If the comment “hypermobility” was made, this typically is noted with X-rays of the patient bending forward and backwards (flexion-extension X-rays).

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]

#5532

I had an x ray like that very early on. I’m not exactly sure how he decided to fuse but I’ve been told from the Surgon and the pain management doctor that my films don’t look that bad at all so it’s a bit of a mystery why I have such debilitating pain. The conditions that we’ve discussed was seen during the surgery.

[Donald Corenman, MD, DC]

#5533

I am confused by the decision making for your care. Is it true that the spondylolysis at L4-5 was not seen on the initial workup but found during the fusion surgery of L5-S1? You report a CT scan in the past. This should have demonstrated the pars fractures of L4 that causes the spondylolysis.

If spondylolysis is present, this can cause significant pain. If the disc at L4-5 is very degenerative, this can also cause pain. Have you had a diagnostic workup with pars blocks, possible epidurals and discograms?

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]

#5538

Hi doc. It was not detected before surgery so I’m assuming that the staff spelled my diagnosis wrong and that I didn’t have fractures. I do know that he commented on my degeneration frequently. I have had epidurals and a disco-gram.

[Donald Corenman, MD, DC]

#5540

So you had spondylosis which is degeneration of that L4-5 segment. This can be a pain generator but the height and the integrity of the disc can make a difference in outcome. Pain most of the time is generated by tears in structures like the back wall of the disc or bone injury but can also occur from inflammed nerves. If the nerve itself is injured (called neuropathic pain syndrome- see website), pain can be generated by the nerve and no surgery can help that condition (other than spinal cord or nerve stimulators).

A work-up can reveal some of this information. This work-up would include discograms, facet blocks and nerve root blocks. If you are a candidate for surgery, the success rate should be close to 90% but that other 10% most likely is neruopathic pain syndrome that cannot be helped by surgery.

You need a consult with a well qualified spine surgeon to give you a good 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.

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