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#5222 In reply to: pain after surgery |
Cervical cord compression can cause myelopathy which in turn can cause paresthesias in the upper and lower extremities. There should be more symptoms than these paresthesias however. Imbalance, some loss of fine motor control, possible electric shocks down the spine and other symptoms could occur. If the paresthesias increase with neck extension, this could be myelopathy as the spinal canal narrows with extension and cord compression increases.
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.#5221 In reply to: Resorption of Disc |Unfortunately, most “muscular back aches” are really from degeneration of spinal disc, nerve or facet. A disc herniation compressing the nerve root will cause mainly buttocks and leg pain but there are variants that can cause only lower back pain.
My recommendations for non-surgical care of disc herniations are that there is no motor weakness (except the extensor hallicus longus- big toe lifter) present and the pain can be controlled and improves on a timely basis. There is some data that indicates surgery performed after six months has poorer results than if done before the six month period.
That being said, what I tell my patients is that if they go through a good rehab program, epidurals and proper medications and still after 6-8 weeks are dissatisfied with their pain or progress, I would consider surgery. It is really a patient decision regarding whether to do surgery or continue down the course they are on.
Of course, if there is motor weakness, I recommend surgery sooner than later.
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.#5216Topic: MD/DC daul degree advice in forum GENERAL |Dear Dr. Corenman,
I am writing to express my interest in the process of how you obtained your dual Medical/Chiropractic degree. I recently graduated from New York Chiropractic College after completing an 8 month rotation at the Miami VA hospital. After being exposed to the complex cases there I have decided that my next step is to strive for a more in-depth role within the medical community. I am an evidence based doctor who has a strong desire to work as a team member and play a key role in patient centered care and to facilitate this I am interested in beginning a MD program. I am trying to find out if I can get some of my credits from Chiropractic College to transfer. Ideally, I am hoping to transfer the credits from my basic sciences coursework. I wanted to know if you had any advice or input of schools to look into that might be open to accepting someone with clinical experience and extensive knowledge in anatomy, pathology, and differential diagnosis. I also wanted to know if I could pick your brain regarding the process of how you went about starting a MD program and the best way to approach different schools.
Sincerely,
J A, DC#5206 In reply to: Revision Surgery |If you have a fusion from T11-S1, there are two areas that need to be watched- the sacroiliac joints and the T10-11 level. You can mitigate the wear by doing just what you stated- low impact activities. The spine fusion should not affect your hips, knees and ankles.
Swimming, cycling including mountain biking, hiking (without a heavy pack), rowing, reasonable gym workouts, cross-country skiing and snowshoeing are all activities that in general, would not harm your back.
Intermediate activities that could cause increased wear are skiing groomed slopes, hiking with a heavy pack, heavy weight lifting and water skiing.
Acivities to avoid are all impact activities such as running, tennis, volleyball, basketball, soccer as well as others that increase the load on the back.
Normally, both a CT scan on a 64 slice scanner and an MRI on at least a 1.5 tesla machine are necessary for the workup. In-office standing x-rays with flexion and extension view are necessary.
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.#5197Topic: Revision Surgery in forum BACK PAIN |Hx:
1991- Ant/post spinal fusion T11 to L4 age 14 (Idiopathic scoliosis) performed by Dr. Thomas Lowe. Continued active lifestyle until…
2001- injury resulting in Ant/post spinal revision surgery L4 to L5 extension by Thomas LaGrone. Corrected pain.
2010- April. Two children later… Began running and active lifestyle. Felt good with only manageable levels of pain- not enough to stop working out and enjoying life. Came off a plyometrics box about mid-thigh and felt like I was going to pass out. Acute pain.2010-present. Daily and nightly pain- disabling. Attempts to walk, swim, elliptical, cross country ski, climb stairs, bend, twist, sit… everything seems to agitate the back. Waited to go in due to insurance purposes. Added about 40 lbs. due to extremely sedentary lifestyle. Feels like bone on bone- no muscle no nerve pain. Just intense deep pain that is not ever fully alleviated.
Today- Pain worsened to the point I had to go home from work. Ready to get this looked at. Pain is definitely in what I believe to be the L5-S1 region. Very week hips, stretching hamstrings agitates the injury… never recovered from injury in 2010…
Questions: Do you do revision surgeries with this much going on? I have been turned away by several surgeons within Colorado. If you do not, do you have any ideas on where to go for this type of surgery? Can you recommend good articles or journals to research on spinal fusions that extend from sacrum to Thoracic vertebrae that did not maintain the lordodic curve? Would it be wise to seek the same surgeon as my second revision surgery? Thank you for your time!
#5171Topic: my nick c5&c6 in forum NECK PAIN |hi doctor
how are you ?
i am from saudia
A year ago
(((( doctor All the symptoms came after the neck pain step by step))
I feel numbness in both hands and knees on the
Weakness in the right hand and right leg as well as
I feel numbness in the tongue and difficulty to speak, sometimes
I feel tingling in different locations of my body
I am also a small muscle in my hand shaking for 15 seconds more or less
I have (MRI) of the neck and brain Can I send you by e-mailTest result (mri) as follows
1-+++++++++++++++++++++++++++++++++++++++MRI CERVICAL SPINE WITH CONTRAST ENHANCEMENT.
Spin Echo T1 weighted and gradient rephased T2 weighted images were obtained in axial and sagittal plane. T1 weighted images were obtained after contrast enhancement in axial, sagittal and coronal planes.History: Sensory symptoms.
Mild straightening is seen involving the cervical spine.
Mild disc bulge is seen at C5/6 indenting the thecal sac.
There is no evidence of disc degeneration or disc herniation.
There is no spinal stenosis.
The spinal cord shows no abnormal signal.
The paravertebral soft tissues are normal.
The vertebral bodies show no evidence of abnormal signal to indicate bone marrow replacement.
No unusual enhancement is seen after contrast injection.CONCLUSION:
Mild straightening is seen involving the cervical spine.
Minimal disc bulge is seen at C5/6 indenting the thecal sac.2-+++++++++++++++++++++++++++
MRI OF THE BRAIN WITH & WITHOUT CONTRAST ENHANCEMENT:
Clinical History: Sensory symptoms.
Comparison: None.
Technique: T1 and T2 weighted images were obtained before contrast enhancement in axial plane.
Flair images were obtained in coronal view. T1 weighted images were obtained after contrast enhancement in axial, sagittal and coronal planes.Findings:
There is no evidence of abnormal signal in the brain to suggest intracranial mass, bleed, area of infarction or hydrocephalus.
The ventricles are normal size.
Brain stem and cerebellum shows normal signal intensity and morphology.
There is no midline shift.
The sellar floor and bilateral cavernous sinuses are normal.
The vestibulo-cochlear nerve complexes are normal.
Visualized parts of calvarium and skull base appear normal.
No unusual enhancement is seen after contrast injection.IMPRESSION:
There is no evidence of abnormal signal in the brain to suggest intracranial mass, bleed, area of infarction or hydrocephalus.
finly
Thanks doctor for evry thing in advance30 nov.2011
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