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  • gdbeckett
    Participant
    Post count: 1

    Dear Dr. Corenman,

    You performed a lumbar decompression for me in 2012. If I recall correctly, you discussed the advantages and disadvantages of a non-fusion approach, but that decompression alone could have favorable outcomes. My was that until this year when a new synovial cyst formed and is impinging on the central nerve causing the sciatic symptoms you know so well.

    I am looking for some medical references to share with my insurer to confirm the above (again, if recollection serves). The last procedure did well, and my current DPT and back doctor do not believe that fusion is warranted, as there has been minimal changes in the spondylolisthesis since your work in 2012.

    Any thoughts or advice will be greatly appreciated. Happy holidays and best wishes for a great New Year!

    Park City UT

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    If your spondylolisthesis does not demonstrate instability as found on flexion/extension X-rays and has not advanced in slip (let’s say from 3mm slip in 2012 to 5mm slip now), you could consider another decompression of that level. The caveat is that these cysts tend to be adhesive and stick to the nerve roots and dura making a second decompression more difficult. There are plenty of papers in the literature that discuss this but the insurance company should follow the lead of the surgeon and allow leeway for you and the surgeon to make that decision.

    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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