[Donald Corenman, MD, DC]

#31295

I would disagree with this approach. Local injection of steroid around the root has not hindered any of my patient’s fusion progress and I have found this injection to be valuable for significant root inflammation. You however have to understand that every surgeon has his or her comfort zone and you cannot expect a change of procedure because of another’s different opinion.

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.

[pec5002]

#31366

Hi Dr, in a prior post in this thread when I asked if the BMP irritation can go away on it’s own without a cortisone show you responded with:
“The inflammation can subside on it’s own but that is not an absolute. If this is a result of BMP, I would want to be somewhat aggressive in reducing the inflammation.”

Two questions I have for you is:
1)If i get some shots (you mentioned at least 2 to coat the nerve) would that be a fix or just some short term relief
2) If it is a fix if there a window to get these, if I wait too long will I no longer be able to get the same benefit from them?
3)lastly when you say it isn’t an absolute -what did you mean?

[Donald Corenman, MD, DC]

#31367

I have not had many inflammatory BMPomas in my practice so this is just anecdotal information. I have found that about 50% improve with 1-3 steroid nerve blocks. The others needed a repeat debridement surgery either initially or in a delayed fashion.

Is there a window? I don’t know as of yet but I would speculate that the sooner the treatment is utilized, the better response can be expected.

An “absolute” means that you cannot expect the condition to resolve on it’s own.

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.

[pec5002]

#31379

Spoke with doctor- they want to get a CT scan and updated MRI, they think now that it may be that I’m not fussing or a screen is loose etc. Also they said I may just have nerve damage , all fun.

[pec5002]

#31387

Screw is loose * also they didn’t remove the scar tissue that was there before the surgery either from my previous microdisectomy – is this normal ? Also what do you think about the not fussing and the screw thing- if I’m not, can a full fusion still happen? Next week will be 3 months.

[Donald Corenman, MD, DC]

#31419

Fusion will occur with or without the nerve inflammation. Screws can come loose but that would be unusual in the early post-operative period. Taking out the prior scar from a microdiscectomy can be difficult and rarely, threatening to the nerve root if so much abundant scar is present. Rarely that would be like “pouring glue into the canal” and the surgeon did not want to “be heroic” and free up the nerve root.

Fusion normally occurs at the 5 month time period with BMP use so don’t be in too much of a hurry at 3 months.

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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