[Donald Corenman, MD, DC]

#33782

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

[ol99]

#33783

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]

#33784

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

Dr. Corenman

[ol99]

#33785

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]

#33786

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

[Donald Corenman, MD, DC]

#33788

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

Dr. Corenman

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