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  • Thistle
    Post count: 5

    Dr, Corenman,

    I moved this post to the proper forum.

    Lumbar: w/o & with/contrast:
    1. far advanced chronic DDD L1-2 associated with chronic loss of stature of the L1 vertebral body
    2. moderately severe L1-2 canal stenosis with prominent bilateral foraminal narrowing secondary to sponylosis, disc bulging and facet hypertrophy.
    3. status-post fusion L2-S1, decompressive laminectomy L3-4 to L5-S1, and intervertebral body fusion L4-5 with a stable mild anterolisthesis.
    4. moderate levoscolosis

    Lumbar x-ray:
    1. status post paired pedicle screw and rod fusion L2-through S1.
    2. chronic compression fracture of L1 with advanced chronic DDD at L1 subchondral sclerosis and large marginal spurs.
    3. status post intervertebral body fusion L4-5 with grade 1 anterolisthesis and no sign of instability on flexion or extension.
    4. moderate levoscoliosis

    My first surgery in 2001 was for a small herniation in L-4 L5. The surgeon left the spine unstable…..did a hemilamie (spelling)
    My spine shifted like a stack of plates.

    The second was in 2003 for stabilization by fusion, by another surgeon.
    He put what others are saying was wayyyy to much hardware and went into thoracic to “explore”. Thus RFA was unable to be utilized.

    Back pain is horrific in lumbar, right hip, and lower thoracic. Like being stabbed with knives or broken glass. In the hip, there is an extremely sharp, burning pain that stops whatever you’re doing. It seems to be radiate up and down. It is excruciating, and it happens with certain movements of which I am not aware, except for turning over in bed. Sleep is always disrupted when I try to turn. I almost have to stay on one side, especially to fall asleep.

    Thank you,

    Donald Corenman, MD, DC
    Post count: 8459

    You have had a previous fusion at L2-S1 with residual scoliosis remaining. This surgery will increase the pressure at L1-2 and over the years, this level has worn out. This is not an unexpected finding.

    When the level wears out, the disc narrows, bone spurs form and the level angulates forward. The spurs cause central stenosis (see website) which compresses the nerves, especially when you try and stand up straight. This will cause standing and walking pain that can radiate into your hip.

    The differential could also be wear of your hip joint (arthritis). An X-ray of your hip as well as a good physical examination will rule that in or out.

    The test to determine if your L1-2 level is causing the pain is a diagnostic and therapeutic epidural at that level. You would need to keep a pain diagram (see website for ESI and pain diary).

    More likely than not, you will need to have that level surgically decompressed and stabilized (fused).

    Dr. Corenman

    Dr. Corenman

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