[sim8899]

#18501

Hey Dr. Corenman, I watched your L5-S1 Fusion video right before my surgery. I had two buldged disc in my spine, my L4-L5, and L5-S1. After many trips to my pain specialist, and many failed epidurals, I had surgery on December 31st, 2013, making me the youngest person in Louisiana to have this surgery at the age of 25. I was shocked as I no longer had sciatic pain anymore, and I was released the next day. After spending a couple months at home to heal, I noticed I started getting small pains. I brought this up to my surgeon when I went to get the stiches removed. He told me it was normal and it will take a few more months. The surgery was a minimal invasive disc fusion, but my disc didn’t fuse. Now it’s been over a year and 4 months, and I’m almost unable to move. The pain gets worse everyday, and sometimes I can’t even get up from a lying down position. My sciatic nerve is being pinched on both sides now, and also the pain shoots up my spine to right under both of my shoulder blades. I have been to three emergency rooms, and the X-Ray shows the rods and screws are fine, but no one has ordered an MRI. They refilled my Robaxin, and Neurotin, but weary about giving pain meds. I was told back surgery can make things worse, and unfortunately it happened to me. Now I no longer have health insurance, and my pain is become brutal. I even see a psychiatrist, because of suicidal thoughts. I have always loved life, but I can’t take the pain anymore, no one can live like this, please help.

[Donald Corenman, MD, DC]

#18969

Half of the surgeries I perform are revision surgeries (repairing failed spine surgeries performed elsewhere).”Minimally Invasive Spine Surgery” is a great marketing tool in name but this surgery type has more failures than any other surgery I am required to revise. For reasons made obvious in the ensuing discussion, “Minimally Invasive Spine Surgery” has many problems. This procedure seems to have been adopted more by neurosurgeons (as compared to spine surgeons) and I can tell you that 80% of the failures I see are “Minimally Invasive Spine Surgery” fusions performed by neurosurgeons.

The idea behind “Minimally Invasive Spine Surgery” is not bad. The typical approach to the spine is a midline incision. This exposes the spine through the area where the muscles join together. Years ago Leon Wiltse (a spine surgeon), developed an approach through two lateral incisions. This made placing pedicle screws much easier (part of the fusion process).

This approach was adopted by the “Minimally Invasive Spine Surgery” developers to mean that there was less dissection of tissues required to perform fusion surgery, therefore “Minimally Invasive”. There were studies that compared this type of surgery to the conventional “open” procedures that my predecessors used. Of course, my predecessors did not appreciate a small incision and minimal dissection so the comparisons were way off the mark and made the “Minimally Invasive Spine Surgery” look better by comparison.

I personally do not like the approach to “Minimally Invasive Spine Surgery” for fusion for a number of reasons. First, the truth is that my minimal incision spine surgery through a central incision is less dissection than their approach. If you measure the two incisions these individuals use vs my one incision, my incisions are at least 25-50% smaller in length. In addition, the incisions they use heal less cosmetically acceptable that a smaller central incision (less width and less scar).

The second disadvantage of the “Minimally Invasive Spine Surgery” is that you do not look at the spine centrally during surgery but only at the periphery (the side). This makes decompression of the spine more problematic.

The third disadvantage is the decreased success rate of “Minimally Invasive Spine Surgery”. Admittedly, I only see failures of surgery in my patient base so I don’t see the successes (as these patients would not find me in the first place). My samples may be skewed. Nonetheless, 80% of the failures I see are minimally invasive surgeries. My fusion rate is 99% (but I also use BMP for many procedures).

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.

[nakurac]

#18979

Sim8899,

That’s terrible. How do you know that you did not fuse? Did you have the lumbar CAT-scan or is the doctor just guessing?

[sim8899]

#18981

Cat scan, showed a failure in fusion. I was then given a back support thing called an Orthoflex, which plugs into the wall and supposed to help the fusion much quicker. That was also a bust. Only thing I’m doing at the moment is taking Potassium pills for the nerves, BC arthritis powder for inflammation, and maximum 4g of Tylenol a day for pain. I know it’s not good for the liver, but I’m running out of options.

[Author]

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