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  • Donald Corenman
    Keymaster
    Post count: 52

    I had spinal fusion l5-s1 last October. I went to this doctor as he did it minimaly invasive. Somethings are better but went and had CT mylegram 3 weeks ago and still hurts when a I walk. Gave me a SI shot as he thought it could be sacroiliitis, the pain went away for a few days and now is back. I know I am older , but used to run around 25 miles a week and now can only ride the bike as it does not hurt when I do that. Any thoughts or ideas?

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    You don’t mention why surgery was performed, at what level, what your preoperative symptoms were or your current symptoms are now. You don’t mention if the new CT Myelogram demonstrated solid fusion or pseudoarthrosis (lack of fusion), any nerve compression or arachnoiditis. Please be more specific so I can determine what could be causing your pain.

    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.
    Donald Corenman
    Keymaster
    Post count: 52

    Dr. Donald Corenman,

    Thanks very much for your response. I will fill you in quickly as I can with the information.

    Had a lamenectomy back in 1979,

    My left calf or gastroc never really came back. Much smaller then the right.
    My back has been great until 2009.

    July 2009 back bothered me went to chiropractor for around 2 months did not get much better but could walk with not much problem.

    September. 2009 did fall down sprained my ankle.

    Oct. 2009 bent over and could not straighten up went to chiropractor for a couple more months did not get much better.

    Jan. 2010 Had an MRI and CT scan. Had bulge at L3-L4 and had a crack in vertebra where I had my surgery back in 1979 which was L5. They said I should fix both but I would be on my back for close to 12 weeks as they were going to fuse L5 to S1.

    March 2010 Received a different opinion said to do Cortisone shot at L3-L4 seemed to take a lot of the pain away but still hurt very bad when I would walk.

    September 2010 Had a nerve block shot at L3-L4 to get rid of pain when walking and pain did not go away. Same month went for a nerve block shot at L5- S1 went for a walk and felt great, better than I had in about a two years.

    October 2010 Fused L5- S1 minimally invasive. Started swimming 4 weeks later after the first x-ray said things looked good.

    Jan. 2011 another x-ray and all looked good but told him is still hurt when walking.

    April 2011 Is when we did the CT mylegram. Said everything looked good, no blocked nerves and good fusion. That is when I got the Sacro Iliac Joint injection for sacroiliitis and they did a MRI on my hip to see if that could be the problem.

    As of today they have not told me about the hip as of yet. I have waited for a response for 3 weeks so I feel like they have given up on me.

    Things that have improved since the surgery. I can at least walk normal for a while and I can go up the stairs with out pulling myself up on the hand rail. But when I try to walk a few hundred yards it hurts very bad at times always on the right side, and would not think of trying to run. Still hurts to sleep on my right side also, but feels much better after riding the bike.

    So I think my best options today would be to try to get the 2 imaging companies to send you a copy, so you can look at them. Then I should make an appointment with you at the same time, to see what you think.

    Once again thanks for your response and hope this helps and I will wait for your advice before I do anything.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8378

    Answer-

    I still will have to interpret your answers but I think I have a better understanding of what is going on. You had a laminectomy in 1979 and note your “left gastroc never really came back”. You note the muscle atrophied which means you had a large herniated disc at L5-S1 that injured the left S1 nerve and even with the microdisectomy surgery, the nerve never recovered. You had no back pain after surgery until 2009.

    In July 2009, you developed back pain and you were treated by a chiropractor. You had a re-aggrevation of your back pain in Oct. of 2009.

    In Jan. of 2010, you had an MRI and a CT scan because of the back pain. You had a “bulge” in the L3-4 disc (“bulge” could mean torn disc, herniated disc or spur formation) and a “crack” in the vertebra at L5-S1. The “crack” could mean a pars fracture or an endplate fracture- I cannot tell from your description. You finally had a nerve block at L5-S1 which diagnosed the pain generator as the L5-S1 level.

    October 2010- you had a fusion of L5-S1 but you don’t mention which type of fusion (check neckandback.com for the type you might have had). You then started swimming 4 weeks after “things looked good”. Does that mean four weeks after surgery or four weeks after the surgeon thinks you have had a solid fusion?

    You mention a sacroiliac injection after the fusion but don’t mention what the results were. Did you get relief for the first three hours?

    You then mention a hip MRI. It sound like you have buttocks or hip pain now. Did you have the same symptoms prior to the surgery?

    You then mention right sided pain with walking but you fell no pain on a bike. Is this the hip pain you mentioned? This could be consistent with foraminal stenosis. Again, check the web site (neckandback.com) for this diagnosis and let me know if that might fit with your symptoms.

    I would be happy to look at your images. Please contact my office at (970) 476-1100 and ask for one of my nurses.

    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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