Viewing 6 posts - 7 through 12 (of 14 total)
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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    A “bilateral S1 interlaminar nerve block” generally would not anesthetize the L5 roots which are the ones that are compressed. You are absolutely correct that a transformational approach at L5-S1 (called a TFESI) would be more helpful for diagnosis and treatment.

    OLIF at L5-S1 is really a lateral ALIF (anterior lumbar interbody fusion) which needs backup posterior instrumentation. In my mind, there is nothing wrong with an “OLIF” with a posterior instrumentation but it does require two incisions while the TLIF requires only a posterior incision. The real choice is your understanding of which surgeon you feel has a great track record and has your best interest at heart.

    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.
    ol99
    Participant
    Post count: 14

    OK, got it!

    Before a fusion though, would there be value in getting a CT?

    I’ve only had an MRI, and due to the weird nature of my injury, I was wondering whether a CT for spondylolisthesis would have an effect on the surgeon’s strategy for the surgery.

    I injured myself doing an extension with rotation movement, which may have broken the pannus on the right pars. I’m guessing that’s why I only have compression on the right L5 nerve – I have almost no symptoms on the left L5. There is potentially some kind of rotation movement going alongside the sliding of the vertebrae.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    I don’t think a CT is necessary for your case unless there is something I’m missing.

    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.
    ol99
    Participant
    Post count: 14

    Shouldn’t be missing anything. I was just wondering what would explain why I more L5 compression on the right nerve and not so much on left. Perhaps that’s relatively common with instability?

    ol99
    Participant
    Post count: 14

    And I guess a bone spur would be seen on MRI?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Bone spurs are seen on an MRI. Commonly, foraminal collapse occurs more on one side than the other.

    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.
Viewing 6 posts - 7 through 12 (of 14 total)
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