[Tlif2015]

#27682

Dr. Corenman,

I met with an interventionist specialist regarding a stimulator trial. I suggested a CT scan as you mentioned from your previous reply. He Didn’t believe it was necessary at this point but agreed after our second visit when I advised I would not proceed with the trial until the scan was complete.

I received the results today via fax and the radiologist stated the following: there is some posterior bony fusion at l4-5 and l5s1. At both levels there is some bony bridging in the vertebral body to the facets on the left, osseous bony proliferation significantly greater on left.

The TLIF was a left sided approach which is the area of the bmp seroma at both levels on the left side extending to the facets.

Is this what you referred to as hetertopic ossification? I have a follow up next week and would like your opinion if this is abnormal and should I proceed with the trial assuming this is a normal result after lumbar fusion.

Thank you again for your help.

RC.

[Donald Corenman, MD, DC]

#27683

You do have heterotopic ossification as there should be no bone from the disc space to the facet as the only connection should be from the pedicle itself. The amount of bone growth and the location of additional bone growth would be the factors in determining if this is indeed causing some nerve compression. There is an area in the posterolateral spine where additional bone growth can be tolerated and obviously multiple areas where additional bone will be compressive to the nerve root.

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.

[Donald Corenman, MD, DC]

#27684

You do have heterotopic ossification as there should be no bone from the disc space to the facet as the only connection should be from the pedicle itself. The amount of bone growth and the location of additional bone growth would be the factors in determining if this is indeed causing some nerve compression. There is an area in the posterolateral spine where additional bone growth can be tolerated and obviously multiple areas where additional bone will be compressive to the nerve root.

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.

[Tlif2015]

#27687

Thanks again for your opinion and always prompt reply. I assume that since the EMG showed chronic nerve damage and nothing active that the damage is already done and any residual pain is here to stay.

If you agree with my neurosurgeon that surgical intervention at this point would not provide any measurable relief to my radicular pain then I will probably proceed with the nervous scs trial.

Thank you,

RC

[Donald Corenman, MD, DC]

#27689

Chronic radiculopathy does not mean there is no expectation of relief from further decompression surgery. It really depends upon the amount of compression still existing and your history and physical examination.

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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