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  • Jo Geer
    Member
    Post count: 3

    Dear Doctor Corenman,
    I was given your name by someone who thinks you are amazing.

    I am 50 years of age and have had no quality of life for 5 1/2 years. I have had microdiscectomy and it got infected, so more surgery for that. Since the discectomy did not help I had a fusion of S1,L4,L5 in 2006. Had to have hardware removed because bone was growing out of the cage(?) and irritating nerve. My dr. decided that I had permanent nerve damage and sent me to a neurosurgeon. They put in a neurostimulator only to cause terrible pain from the time I came home in my T spine area where they achored it. I have had a Facet block, rhizotomy, and medial branch in the area and no relief. My neurosurgeon wants to try an unconventional way of fusion to see if that is the problem and if it is, he will go back and do the fusion permanently. If it doesn’t help, he wants to implant a pain pump. I would be happy for advice or to make an appointment, if needed. I have been on Neurontin, norco, and diazapam for all this time. I am now very overweight, depressed, and very limited in life. I am by no means an athlete anymore. My day consist of showering and trying to do light housework. I can not walk any distance, use my upper body much, or sit for any period of time.
    Thank you for reading this. I am ready to have some kind of life back.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    I am so sorry to hear of your dilemma. This is called failed spine surgery syndrome and has many causes. Yours started with an infection after a microdiscetomy. Normally with antibiotics, these infections can be cured. Some patients will go on to autofuse the segment and the problem is solved. If there is continued motion of the segment after the cure of the infection, there are rare occasions that the segment has to be fused surgically. That sounds like the next step you took.

    Unfortunately, you then had bone “growing out of the cage” which sounds like you had BMP (bone morphogenic protein) used in the cage. If not sequestered, this BMP can cause hetertopic ossification (bone growing out from where it should not grow). This can cause nerve irritation but normally surgery can alleviate this situation.

    You somehow then ended up with chronic neuropathy (see website for description) and then had a spinal cord stimulator implanted. This then caused” terrible pain” which I assume was different pain than from before the implantation. I assume you then had the stimulator removed.

    Your surgeon wants to perform another fusion. On what? I am not certain that further fusion surgery is your answer. Fusion stops the motion of unstable or painful segments and realigns segments that compress nerves. If you have significant back pain from a degenerative segment or a segment that is compressing a nerve, then fusion might be helpful. Also, if you have a nonunion (pseudoarthrosis), fusion may be helpful.

    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.
    Jo Geer
    Member
    Post count: 3

    Thank you so much for such a quick and understanding reply.

    The stimulator is still in. It is giving me some relief in the left leg and foot where the pain was so severe. However, the T9-10-11 is where they want to fuse. This pain began as soon as the surgery to implant the stimulator occured. I had never had any pain in that area and it is exactly where my incision was made for the stim. My neurosurgeon said that a fusion in that area was a 50/50 chance it would help. He did a myelogram, xrays, and ct and could not see for sure what the problem was. Of course, I can no longer have an MRI because of the stim. He said that in his report I responded to the facet injection while under anesthesia. However, I felt no relief from it afterward.

    I do not know what to do. If I knew taking the stimulator would help the T spine area I would have it removed. But, since it is helping with the leg and foot pain, I am confused. My neurosurgeion said that he didn’t think it would help the upper back if he took it out. But, I am on more pain meds than ever because of the T spine pain and have a MUCH more limited life. It is really bad. And, the main reason for getting the stim was to help get off of some of the medicine.

    I have an appointment with my original spine doctor on this Thursday, so he can look at everything and give me his opinion. As you know, there are not many doctors that do the neurostimulator, so I am having a hard time getting another opinion.

    If you thought that you could help me in any way, I would love to set up an appointment.

    Thank you again for doing this forum. Most physicians would not take the time to read or give input on anyone that was not their patient.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    I am not certain why the neurosurgeon stated that you responded to the facet injection if you were unaware of the results. The pain from surgical implantation is unusual and I am not sure what your surgeon is treating by fusing those segments. Get hold of the CT post myelogram report by the radiologist and read it. Certainly have your original spine surgeon comment of the proposed surgery.

    You can send me the CT post-myelogram images if you choose.

    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.
    Jo Geer
    Member
    Post count: 3

    I am picking up all of my records and imaging on Thursday before going to my original spine surgeon, (my only doctor for my back before he sent me to the neurosurgeon). I have not seen him since my stimulator surgery in Dec. of 2010. So, about 15 months ago.

    I am definitely not rushing into another surgery. I feel like I have not done myself any favors by doing the ones that I have had without another opinion.

    I would appreciate you looking at my records, very much. I will send them asap.

    As I said before, I was given your name by someone who has great faith in you. In fact, you are doing surgery on her tomorrow. We live in a small town.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    I think you are making the right decision. Do not jump into any surgery unless you know why the surgery is being contemplated.

    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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