-
AuthorPosts
-
Hi Dr. C,
I had an L5S1 TLIF with Peek cage, posterior instrumentation and BMP in early 2018. At 5 months I had a CT scan showing a solid fusion. Over the last 6 months I have noticed some crunching/popping in my lumbar spine with occasional dull ache. The popping isn’t painful but becoming more noticeable, especially in the morning upon waking. It’s especially notice when doing lateral pelvic tilts (lifting one hip vertically then lowering, then lifting the other side). Aside from adjacent segment degeneration, and possible herniation of the L4L5, I’m curious what your impression would be? The popping doesn’t feel like a tendon or ligament moving over a bone, but pretty close.
I’ve been reading more studies looking at long term rates of subsidence with the Peek cages and wondered if you think this might be what’s going on? Can subsidence occur with a previously established solid fusion?
Thanks for your help!
A solid fusion at L5 S1 would preclude having any subsidence of the cage. Popping and cracking noises are typically facet generated pain and noise. I would initially assume adjacent segment disease (L4-5) as you’re 5 years out of surgery but it’s a possibility that L5 S1 could be generating some noise. however, that would indicate that you didn’t have a solid fusion. There are very rare circumstances that the sacroiliac joint can create these noises but that would be unusual. I would 1st start off with standard x-rays including flexion extension for diagnosis.
Donald Corenman MD DC
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. -
AuthorPosts
- You must be logged in to reply to this topic.