[Donald Corenman, MD, DC]

#23200

I like PEEK as it is translucent on CT scan and is invisible on x-Ray. The titanium cages are just as good for fusion as a spacer but the metal can block the x-ray beam and make standard x-Rays difficult to interpret for fusion. I have had no problems with PEEK cages but I do use BMP.

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.

[10sAlex]

#23262

Dr. Corenman,

So I am really confused now…

I saw the surgeon for a final appointment to sign the papers. The surgeon tells me he would do a Minimally Invasive TLIF and hardware. No PLF at all. So I am wondering is this really enough support for my spine? I am 34 and I saw how small the TLIF spacer is. He also told me I would be off of work for 8 weeks and I do have a moderately active job as a elementary PE teacher and tennis coach. I cannot imagine returning that quickly…

In the meantime I had my final consult with another highly respect surgeon in the area who I was waiting to see. He without a doubt told me a MIS TLIF only would not hold up and I would end up with a revision. He told me he does TLIF’s often but not in patients as active and young as me. He told me he would do a two day surgery. On Monday he would perform an ALIF with a titanium cage and ground up donor bone. HE said the cage is designed to show fusion not block it so that was not an issue. He even showed me several X-rays of others with it. He would also reduce my slip simply because of gravity. The reduction and return of disk space would decompress my nerves. It is clear how much my spondy moves…it reduces to a grade 1 when I am prone like on my CT and MRI but weighted it is a grade 2. Then on Wednesday he would perform a second surgery, a PLF with hardware. He would also be able to visualize the nerves when he is removing the fractured arch which he would use for the bone graft. This setup would give me 3 places to fuse and the larger space of the ALIF spacer would serve me better with my activity levels. It certainly makes sense that this approach would make things solid. He told me 6 months off of work. 3 months in a brace and then 3 months to ease into things. This timeline seems more realistic especially considering the magnitude of the surgery.

Have any advice?

[Donald Corenman, MD, DC]

#23364

I think the second surgeon is not accurate. The minimally invasive TLIF can be successful but not as successful (by about 10% points) as a minimally open TLIF. I would not have an ALIF and then a PLF two days later as this is more surgery than you need and an ALIF is not necessary with a well performed TLIF. It sounds like you have seen only neurosurgeons. Personally, I would find a spine surgeon who meticulously performs a TLIF.

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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