Viewing 6 posts - 25 through 30 (of 31 total)
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  • Calista
    Participant
    Post count: 18

    Well, surprisingly my CT Myelogram has not been canceled. I will let you know the results and try to persuade the radiologist to review with me. Fortunately one needs to inject contrast, so have the opportunity to ask directly.

    The NCS will be repeated. Previous test results were consistent/correlated with MRI findings. But it is a simple test to redo.

    Thank you again, will let you know when I know the results. Not sure how things will work with COVID-19 restrictions, surgeon offered telehealth for review of issues and results. He already has examined me and viewed MRI – and CT is supposed to resolve concerns over potential artifact that can obscure results. Hopefully I will have less questions and more answers soon.

    Thank you!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Keep in touch!

    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.
    Calista
    Participant
    Post count: 18

    Hi. My CT Myelogram was canceled due to COVID19, with 427 cases, mostly north of where I live. So rescheduled for 3wks later, with 50k reported cases…makes sense? So have CD, uploaded to my surgeon, but have not seen the report yet.

    I have been trying to read it, however my eyes hurt, the resolution on preview is poor, had to use a very old laptop that had a CD drive to upload.

    I may see report Monday, if not have call scheduled with the surgeon on Tuesday. I will add here the radiology report and surgeon’s opinion when available.

    Thx!

    Calista
    Participant
    Post count: 18

    Spoke with surgeon today, I do not have solid fusions at L3-5, and L3/4 hardware is loose and level moves on flexion/extension, plus confirmed bilateral foraminal stenosis, both levels, worse at L3/4 – with residual disc.

    He recommends a posterior full decompression with revision fusion and me taking bone density drugs in addition to using BMP. The logistics of removal of hardware is the concern, versus augmenting what is in place, due to small size of pedicles.

    Need to have in person consult to review particulars. So now just waiting until in person office visit & when elective surgeries can be performed in NJ.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    If you have a painful pseudoarthrosis at L3-5, then you do need a revision surgery. I can’t comment on the required revision techniques at it depends upon what the fusion failure looks like and how it failed. You would need to revise the hardware as a loose screw cavitates (erodes the bone around it). Bone density drugs might 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.
    Calista
    Participant
    Post count: 18

    Hi, it’s Calista again.
    I am 2.5yrs post XLIF, had CT and I did not achieve a solid fusion. The surgeon who viewed the CT said I have hollowing around the screws used for the lateral plate fixation. Have 2 screw plate by Nuvasive. I also had another MRI. Results are
    Results are
    The unfused disc spaces are intact
    Straightening & reversal of the lumbar lordosis
    3mm anterolisthesis of L5 on S1
    L3-4 Large disc bulge Mild right and severe left foraminal stenosis
    L4-5 Moderate disc bulge and severe facet hypertrophy. Mild right and severe left foraminal stenosis. No spinal stenosis
    L5-S1 moderate disc bulge. Mild right & severe left foraminal stenosis. No spinal stenosis.
    (Note surgeon confirmed that the herniations are residual disc, not cages ir scar tissue.)
    Impression
    1) Transitional anatomy
    2) Status post L3-S1 fusion. Severe left foraminal stenosis at L3-L4 L4-L5 L5-S1

    I cannot stand up straight long, need to lean on right leg, Have severe axial & radicular pain, mostly left side. However right side my leg goes pins & needs numb if sitting more than 5 min, plus pain to lateral side of foot. Unsure if due to pathology or overuse.
    Also felt spine pop at likely L4/5, no sound, just internal snap & if f*ing hurts like hell.
    I have bilateral groin pain, much worse on left side. I try not to stay in bed, cannot sit long..
    New symptoms since XLIF – when standing get pins & needles numbness & pain creeping upwards to almost my rib cage, then it takes several hours at a minimum for pain to subside when laying down to sleep, often I cannot sleep at all, will go 36-48hrs before falling asleep, which is completely unhelpful for pain. Also my legs feel very heavy, feel as if someone us pulling me towards the ground. The symptoms are debilitating & scaring me.

    I am at the end of my rope. I am scared of more surgery, but realize I have to get issues addressed. One surgeon recommended open decompression of L3-L5, plus add more BMP to cages and posterior cortical screws. L5/S1 I had posterior hardware removed 18 mos post original fusion, because one screw fractured plus I am very petite & pedicle screws were pressing into skin & formed bursa over all of them. So I realize I have L5/S1 left foraminal stenosis, but the level is fused, unsure about if the level is decompressed again if more screws needed.

    I cannot visualize how the cortical screws will fit with lateral screws. Besides being 5ft tall, I have short pedicles for size, go figure? My brother has same issue, also fused at 3 levels, had ASD + XLIF & it was not a good outcome either.

    I realize revision of XLIF is not common since new, plus using technique as a revision of choice for many. But since the fusion, I have had rashes & increased joint pain throughout body, and prefer to have XLIF hardware removed, since I have a nickel allergy & thought I was getting titanium hardware as I had previously. When web like rashes appeared on arms & legs, plus increased joint pain in hands, I looked up the Nuvasive Hardware & it contains nickel. I understand the jury is out on metal allergies, but if I have an allergy plus autoimmune disease, it seems dumb to have nickel within hardware since revision is required.

    I am going for more consults, but what would you recommend for surgical approach to deal with my clusterF situation?

    Note I do not receive pain mgmt because worried stigma if use of narcotics will label me a bad outcome waiting to happen, when already labeled due to amount of surgeries.

    Your feedback would be greatly appreciated. Thank you!

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