Viewing 6 posts - 19 through 24 (of 33 total)
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  • Avatarwestie10801
    Participant
    Post count: 79

    Dr Corenman your the best! We all appreciate everything you do for us. Thanks so much again

    Avatarwestie10801
    Participant
    Post count: 79

    Good evening Dr. Corenman,

    I’m sorry for all the questions on proposed C2-C3 posterior fusion surgery. Per my telemedicine consult today, surgeon is stating that C2-C3 requires a fusion due to severe facet degeneration and is contributing to symptoms of base of skull pain, right side occipital headaches, and imbalance. He commented that I have neurological issues with tandem gait i.e. can’t perform heel toe test.

    He is reluctant to perform T1-T2 fusion to correct pseudarthrosis since he feels that both issues need to be addressed while he’s in there. I’ve expressed my concerns on additional reduction with my range of motion and he doesn’t seem concerned, stating “some loss can be expected, but you will have at a minimum 50% to 70% improvement in your pain”. From what I can see online most of our range of motion comes from C0-C1, C1-C2, C2-C3. Is this information correct in reference to ROM? I also had a anterior partial corpectomy with titanium cage at C7/T1 back in November, my question is will this help a T1-T2 pseudarthrosis when totally healed? Thanks again

    Avatarwestie10801
    Participant
    Post count: 79

    Dr. Corenman,

    Two quick questions please:

    I was told by pain management that C3-C4 is definitely contributing to my pain, however surgeon stated that this segment can’t be treated surgically because “bone spur is inside where you were fused”. Can you explain what is meant by this?

    My next question is in reference to my T1-T2 pseudarthrosis. Can this non union improve over time with my anterior partial C7-T1 corpectomy -titanium cage or would a revision procedure with hardware be more appropriate? Thanks always Doctor, hope all is well on your end.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7569

    The C3-4 level I assume has foraminal stenosis. The surgeon stated that this segment can’t be treated surgically because “bone spur is inside where you were fused”. This probably means that there is a spur at the disc level or even the uncovertebral joint has a spur. It is true that the proposed spur cannot be removed from the rear but a foraminotomy can make more room for the nerve. The nerve might be still be “tented” after a foraminotomy but less compressed.

    Pseudos can become solid fusion on occasion but generally, the longer it has been since surgery, the less chance a fusion will occur. A revision surgery might be your best bet.

    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.
    Avatarwestie10801
    Participant
    Post count: 79

    Thank you Dr. Corenman!

    The bone spur is located on uncovertebral joint causing modererate to severe foriminal stenosis after an ACDF, including Laminectomy at this seqment. From previous conversations any posterior fusion procedures ablate medial nerves at this level, so a medial nerve branch block is a waste of time.

    In addition, there’s currently a plate fixation at this level, so my best option is a posterior foramenotomy with the hope of getting some pressure off the nerve. My concern’s are will this be enough and two what’s the possibility that this bone spur will grow back into this space again?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7569

    So you have had an ACDF, a posterior laminectomy and a posterior plated fusion at this C3-4 level? Is the fusion solid? If so, you can have the posterior plate removed and a foraminotomy performed. Again, it won’t fully decompress the root but will make more room which has a reasonable chance for some pain relief. If the fusion is solid, the bone spur should not grow back.

    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.
Viewing 6 posts - 19 through 24 (of 33 total)
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