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Viewing 6 results - 1,915 through 1,920 (of 2,200 total)
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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    There are a number of unanswered questions regarding your biomechanics. A “backwards lean” (extension posturing) could be from any number of conditions. What does your standing lateral X-ray show? What is your lordotic angle measure? What does your sacral angle measure? What is your pelvic tilt angle?

    What do your flexion/extension X-rays demonstrate? What is your global range of motion of the lumbar spine?

    Do you have a lateral scoliogram X-ray? What is your positive or negative sagittal balance? Do you have a thoracic hyperlordosis (Scheueremann’s disorder)?

    Backwards leaning can also be antalgic (holding a posture to reduce pain).

    As you can see, the biomechanics of your condition is still relatively unknown according to your current understanding. You need more workup to determine what is causing the pain and the lean.

    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, MD, DC
    Moderator
    Post count: 8660
    #6950 In reply to: L4-L5 Herniated Disk |

    First- please let me know the level of the herniation. Is it mid back (thoracic spine) or lower back (lumbar spine)?

    Any time you have a known preexisting hernation with worsening symptoms, one of the first questions should be if the symptoms are the same but with greater intensity or are the symptoms different. The reason is due to either recurrent herniation or a hernation at a new level.

    A recurrent hernation at a previously herniated level will typically intensify preexisting symptoms and a hernation at a new level will typically yield different symptoms.

    In either case in my opinion, a new MRI should be considered.

    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.
    Sandy743
    Member
    Post count: 1
    #6944
    Topic: TOTAL NECK FUSION? in forum GENERAL |

    I am a 44 year old male in very good shape other than my spine. Years of sports and abuse on my body has left me with C3-C7 fusion (2003). Within the last 6 months my range of motion has decreased almost to no movement. I had an x-ray and C1 and C2 have almost doubled in size and it looks like C2 had collapsed in the posterior area of my neck. I have intense pain in the back of my neck radiating thru the back of my head. I get constant shocks running up the side of my head and my left ear hurts constantly. If another fusion is done, I know the C1-C2 will wear out and then my entire neck will be fused. IS it possible to shave the spurs down and/or is there an inplant like the ones on your website that may be used to allow some motion if a fusion is required? Can the C3-C7 be divided and an implant be added to allow some mobility? I have a jpeg of the xray, but can’t find a place to attach it? Thanks for your help.

    SpinelessWench
    Member
    Post count: 38

    Given the band of severe bilateral pain approximately 2″ above the gluteal cleft (seriously, I just really like “butt crack” better, but…..), the intense and sudden “bee sting” sensations in the upper buttocks and hips, and the bilateral throbbing in the anterior thighs and lateral calves, could spondylolithesis at L2/3 be a possibility? Or, could hypertrophy of the facets, in and of themselves, be a pain generator? I have several that appear thickened and markedly inconsistent with others. Unfortunately, clarity of the areas below L4 is severely compromised due to titanium artifact, however those around L4 and below seem to jut out to the left (if you look at the sagittal view), then encroach upon the area where you can see the cauda equina. Is it typical for these bony structures/facets to significantly jut out like this? Or, are they supposed to be somewhat aligned with the far right edge/border of the spinal canal?

    My PM anesthesiologist ordered plain films of my lumbar spine today, making sure to include both flexion and extension views. The dynamic stabilization instrumentation, because of that small hydraulic “hinge”, makes flexion much easier than extension…bending backward is almost impossible. Which is more important in assessing instability and spondylolithesis?

    As always, thank you again.

    S.W., NC

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    #6930 In reply to: failed fusion? |

    You have a condition called failed back surgery syndrome (FBSS). After your first two surgeries that I assume were decompressions, you eventually had an anterior lumbar interbody fusion (ALIF). You can read about both of these topics on the website.

    The questions are if you have a solid fusion at L4-5 or L5-S1, if you have residual nerve compression of those level or some form of permanent nerve injury. The answers to those questions can be determined from a new CT scan, a new MRI, X-rays including flexion and extension films and a thorough physical examination.

    If you want to come to the office, I cannot prescribe these studies beforehand. However, I can have all those studies obtained the day you come to the office. Please call my office and talk to one of my nurses for further information.

    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, MD, DC
    Moderator
    Post count: 8660

    I think you are on the right track. Flexion/extension X-rays are important to determine the weight bearing component of your disorder. A CT myelogram is a great test to determine both fusion quality and nerve compression. If you were my patient, that would be a test I would endorse.

    In addition, as I mentioned before, a SNRB of the L2-3 level bilaterally would be considered if there was a solid fusion of L3-S1. A good temporary result would indicate those nerve roots as the pain generator (see pain diary on the website). This does not necessarily mean that the nerves are mechanically compressed but the likelihood of that is very high.

    If the L2-3 level turned out to be the problem, surgery would depend upon the angulation of the deformity. If the endplates of the two vertebra were parallel on standing films but there was instability (spondylolisthesis) present, a simple one level TLIF fusion would be the likely surgery needed. If there was significant angulation (called a kyphosis), adding another level might be necessary to correct the deformity.

    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 results - 1,915 through 1,920 (of 2,200 total)