[Abbeygirl]

#10451

Hi Doctor I am writing to you again it has been 14 months post spinal fusion L5/S1 and just been sent for another CT SCAN by my nerosurgion to see if the bone has fused at that level the last time i seen her she said it had started to fuse but it was not a solid fusion doctor I have still got no releif from this surgery my symtoms are lower back pain numbness in my thigh my toes big toes are numb but not all the time also I get a lot pain in both calfs and I sometimes get sharp stabbing pain in the bottom of my foot Doctor I was wondering if I type my CT SCAN results that you would be kind enough to explain them to me I will type the results now

EXAM:CT LUMBAR SPINE

CLINICAL INFORMATION

Follow up following previous L5/S1 fusion

COMPARISON IMAGING:
CT lumbar spine 25/10/2013 at spectrum Imaging.

FINDINGS

The previous fusion at L5/S1 with rods and screws and an associated interbody spacer device are noted.The position of the screws remains satisfactory.

Once again, mild scoliosis convex to the left centred at L3 is noted and Schmorl’s nodes at the inferior endplate of L1 and superior endplate of L2

The vertebral body heights are preserved.

The degree of mild diffuse disc bulge and bilateral facet joint arthrosis/hypertrophy at L3/4 is unchanged.There is secondary persistent mild stenosis of the right neural exit foramen.The exiting right L3 nerveroot does not appear impinged

Moderate narrowing of the L5/S1 neural exit foraminae is also again noted. The central canal remains adequate.

CONCLUSION

The spinal hardware remains adequately positioned.

Thank you for referring this patient

Thanks again Doctor for your time and the great service you provide

[Donald Corenman, MD, DC]

#10452

The radiologist did not comment at all on the state of fusion at L5-S1. This is unusual as the CT scan is generally performed to determine the state of the fusion. You need to have another radiologist review these images and comment (or you can send the images to me- call the 888 number for details).

Continued lower back pain could be from the lack of fusion, the degenerative changes above the fusion or from chronic radiculopathy (see website).

The origin of the numbness and leg pain are hard to diagnose from the CT scan. This pain could be from continued nerve compression at the fusion site but a solid fusion should have reduced pain even in the face of continued compression-“Moderate narrowing of the L5/S1 neural exit foramina is also again noted”.

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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