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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    #6836 In reply to: Scared and Confused |

    I cannot understand the disregard displayed to you. No surgeon has 100% success and the patients that are having difficulty post-operatively are much more time intensive to help than the ones that have perfect results. If the results are not perfect, there is generally a reason for this. The work-up for less than perfect results can be difficult but needs to be completed.

    Find a spine surgeon who would accept you for post-operative care. There are reasons for all your symptoms. You just need a work-up to find out why.

    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
    #6831 In reply to: MRI RESULT / BACK PAIN |

    You have a variant of Scheuermann’s disorder. I do not know by your report if you have an increased thoracic kyphosis. This is an increase of the “round back” curve in the mid back. This increased curve is diagnosed by a standing lateral X-ray of the mid back.

    Scheuermann’s causes pain by two and occasionally three factors. FIrst, the increased curve places more stress on the spine due to alignment. The increased curve places more stress on the discs and facets. This strain is resisted by the extensor muscles of the mid back. When the muscles fatigue from this increased stress, they “burn”.

    This “burn” can be reduced by strengthening these muscles. Rowing exercises and extension exercises can help to reduce the pain and increase your sitting time without pain.

    The second pain generation could be from aggregation of degenerative disc disease. Stretching the spine into extension (lying over an exercise ball on your back) periodically during the day at work will help to relieve some of this pain.

    The possible third pain generator is a disc herniation. This can cause nerve compression. If that symptom is present, an epidural injection can help with the 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.
    Jellyhall
    Participant
    Post count: 91
    #6812 In reply to: Risks of ACDF? |

    Thank you Dr Corenman,
    I do have brisk reflexes in my legs and arms, which I believe indicates early myelopathy. I don’t have Hoffman’s, Clonus or Babinski, although one neurosurgeon registrar has said that I had extensor plantar reflex bilaterally. Generally I either have no response at all or very slight flexor when tested.

    I do have strong, involuntary, stiffening spasms in my legs and feet with my right foot especially turning inwards while my toes stick up. I also get this stiffening around my abdomen causing my back to arch up off the bed if I am lying down, or to cause me to slightly bend forward and make a sound as air is expelled from my lungs, if I am standing up. Recently I have occasionally had a jerking of my right leg early in the morning as I move it.

    Other symptoms are very subtle and they come and go. My hand and foot pains are now being quite well controlled by Nortriptyline.

    I am correct in thinking that the address on this site (181 West Meadow Drive, Suite 400, Vail, CO 81657) is the correct address to send my MRI scan disc? What is the best way to label it so you know that it is my scan? Title of this thread? My user name? – Perhaps both of those.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    You have two herniations- one at L4-5 and one at L5-S1. Which one is the far-lateral herniation?

    You feel “weakness” but note no weakness upon muscle testing. You note sciatic type pain but do not note the intensity of pain on a VAS (0-10 visual analog scale).

    If your symptoms are tolerable and you have no demonstrable motor weakness, you could be a candidate for an epidural injection and physical therapy (see website for those descriptions).

    Numbness is not considered the same as pain. The pain or noceceptive nerves will scream at you if disturbed. The sensory nerves will not cause pain but will cause numbness.

    Herniations can get better and about 70% do get better with time, injections and therapy.

    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.
    Rubylee
    Member
    Post count: 7

    Thank you for your answer. The coccyx pain is intense when standing from sitting position. Goes away upon walking. Could this be related to lower backache (weakness) and hip pain left side? Would problems with this area show up on an X-ray of lumbar spine, or is an MRI warranted? I’m disinclined to accept what I’m feeling is normal and requires a few more weeks of healing considering it is unchanged in 4 months. Coccyx pain went completely away for about 3 weeks with injection into area, but is back now. Low backache, hip pain, and pain into left buttock increases with activity, but again has never gone away. Burning pain down left thigh wakes me up at night only. Im wondering if this could be a problem with SI JOINT, and how would this be properly diagnosed? Thank you again.

    Rubylee
    Member
    Post count: 7

    Thank you for considering my question. I previously posted but assumed it would go unanswered. I shortened the info in hopes you could alleviate my fears.

    Chronic low dull backache left side, never lets up. VAS 2-5 increases with activity. Moderate paced walking causes pain to radiate in to left buttock VAS 3-6 resulting in an altered gait or slight limp. Occasionally sharp pains wrap around into left knee VAS2-4. Eventually pain reaches into left hip VAS 2-6 causing a throbbing ache that diminishes with rest. During sleep only sharp pain radiates down into posterior part of thighVAS5-7. Also while sleeping hip pain increases to VAS3-7.
    Tailbone has excruciating VAS 5-8 upon standing only. Pain immediately goes away upon walking. Tailbone soreness VAS 2-3 while driving longer than 15 min and upon sitting on overly soft cushions. This was ultimately relieved by using coccyx pillow. Although going to standing position still causes pain.
    Additionally, chronic neck pain VAS 2-5 accompanied by tightness moves up over skull and behind left eye causing throbbing headache VAS 4-7 that lasts about 10-16 hrs. This sometimes radiates behind left ear and resembles an earache with area just below earlobe sore to touch.
    I have periodic numbness and pins and needles in elbow pinky and ring finger left hand. VAS1-4 more annoying than painful and nerve test could not confirm ulnar nerve damage. It did however confirm early onset carpal tunnel syndrome bilaterally .
    Initially(4months ago) there was extreme hypersensitivity anterior left thigh that caused intense burning pain just lightly running fingers over the area. That has since dissipated.
    New onset symptoms that have started this week are both legs have gone numb from thighs to feet (pins and needles) while sitting on the toilet and passively sitting on a fully supported swing.
    My question is could there be an underlying cause to these symptoms other than SOFT TISSUE DAMAGE from MVA? Or if not what are your thoughts on manipulation under anesthia? My family has a history of over producing scar tissue and adhesions.
    My current doctors feel I should be progressing faster than I am.

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