Cjdegood

Thank you Doctor
I think my problem is that i am not confident when talking with him. I do not think its any fault of his, I just tend to feel intimidated by the whole thing. I don’t know what to make of any of the reports, so I am completely relying on him to do what is best. At this point, the problems i am experiencing has disrupted my life for the past year. It has been quite the journey to say the least. I Hate surgery, because it seems like i have done nothing but recover these past months, and never really got complete relief. I really want a One and Done kinda thing, although there may not be such a thing. I still have not even addressed the left arm pain and numbness/slight tingling in the index finger and thumb. I am worried there will be something else to deal with. So i just take the Robaxin prescribed and the ibuprofen. which I understand i have to stop taking by next Wednesday due to the scheduled surgery date. I am not sure if i should cancel and get another Dr. to look at this, or build up enough confidence to ask the important questions involved with correcting the problem. I so appreciate your time as i know it is valuable. As of right now i am scheduled for this 360 fusion June 23rd. And i am pretty sure i will need to cancel our vacation for July 10th.. which involved a 2 hour flight. I had to cancel last years as well due to this. I just want to make the right decision. I will talk with my husband tonight and see if he would like to talk to the doctor before going through with the planned procedure. I understand that I have one the best spine orthopedic in Houston area… but Houston is quite large :) Thank you again and have a wonderful blessed weekend.

Good morning Dr. Corenman
well I had an MRI completed last month after in office Xrays revealed something the Dr. saw. I met with the Dr yesterday and we really did not over the results, he just said i re herniated and needed a fusion. Then had me take more xrays in the office. Once he looked at those he said fusion would be the way to go as the space is collapsed? Here is what i can see on the written report:
Transitional anatomy is seen at the lumbrosacral junction with L5 sacralized on the left and either sacralized versus partially sacralized on the right. The caudal most disc space will be labeled L4L5, similar to the convention used on prior MRI from 09/19/2019. Confirmation of spinal numbering/anatomy would be advised prior to any planned intervention.

Postsurgical changes are seen to the left of midline at L4-L5 presumably from prior disc resection
Correlate with the specifics of the patient’s surgical history.

Lumbar alignment is preserved There is no significant listhesE. Thoracolumbar levocurvature is
seen without scoliosis by criteria.
No acute fracture, compression deformity, or frank aggressive osseous; lesion Small intraosseous
hemangiomas are noted.

The corms medullaris terminates normally at L1-L2.
T2 hyperintensites are seen in the lower kidneys suggestive of renal cysts.

There is disc desiccation with moderate disc height loss L5-S1 including discogenic endplate
changes. The remaining intervertebral disc heights and signals are preserved.
Evaluation of the individual lumbar Levels demonstrates: Ll -L2:Unremarkable.

L2-13: Unremarkable.

L3-L4: Mild left greater than right faucet arthrosis. Trace facet effusion on the left possible.
Otherwise, unremarkable.

L4-L5: Granulation tissue is seen in the left lateral recess, though evaluation with post-contrast
MRI may be helpful for further assessment.
A posterior central disc extrusion is present spanning 12 mm in craniocaudal extent tracking below
the level of the disc space measuring up to 10.5 mm in AP dimension and over 14mm transvers.
‘This narrows the thecal sac to 9 MM and encroaches on the subarticular zones likely contacting the
bilateral descending L5 nerve roots (series 7, images 27-29). Mild left greater than right facet
arthrosis with a left-sided facet effusion and 4-5 mm synovial cyst also projecting into the left
subarticular recess contacting the descending left L5 nerve root, new since 09 /19 /2019.
Mild right and moderate to severe left neural foraminal stenosis “with a foraminal disc bulge near
the exiting right L4 nerve root and a left foraminal disc protrusion up to 4 mm contacting the
exiting left L4 nerve root.

IMPRESSION:

1. Transitional anatomy again seen at the lumbosacral junction with the caudal most disc space
labeled L4-L5. Confirmation of spinal numbering anatomy would be advised prior to any planned
intervention
2. Postsurgical changes are seen to the left of midline at L4-L5 presumably from prior disc
resection.
Correlate with the specifics of the patient’s surgical history.
3. L4-L5: Granulation tissue is seen in the left lateral recess , though evaluation with
post-contrast MRI may
be helpful for further assessment
Posterior central disc extusion tracks below the level of the disc space measuring up to 10.5 mm
in AP.
My other question is this. He said he would go through my abdomen and then two small holes in my back? is this considered Anterior? which is fine, but i am curious if my having 3 c-sections and one abdominal hysterectomy is a problem? i hope not as i have heard you heal faster going through the front. I am not sure how i feel about all of this just yet, but i do want to feel better and get back to life. Do you think in your opinion this is the best and/or only way to go to get relief and back to somewhat normal? thank you again for your time. I truly value your input .

Dr. Coreman
Good Friday afternoon!
i am reaching out to you once again for what I hope might be some comforting information. My micro-discetomy was back on November 6 2019, after 2 weeks post op I certainly started to feel great! I was able to get back to nearly normal although restrictions were in place for a few more weeks. I do recall most of the month of December feeling alright, and I did have my grandkids here with us for the holidays (4yr & 2yr old) I performed all of my holiday chores and duties and did not think much about it. Then after the New year around January 3rd, I woke up during the night with terrible low back pain. I have never had anything like that, especially during sleep. So i got up and took my ibuprofen (800mg) I was up for about 4 hours before it let up enough to go back to bed. The next morning i woke up and was okay for the most part, but as the morning progressed i started feeling the pain again and this time it came with a sharp pain mostly on the left side. I just started to deal with it and take my ibuprofen and try to keep normal going. But i was up again the next night and the next. Now when i walk i can feel sharp pains on the left(near the area of my incision site) mostly with every step I take. Actually when I step with my left, I can feel something shifting? I am not sure how to describe it. I also am not able to lift myself and roll over at night, if i do i am thinking that is when i am waking up hurting. I have to grab side of bed and use my upper portion of myself and pull that way even to just get out of bed otherwise i feel like i am pulling something out of place. If I put full weight on my left foot when walking the pain is there in my back. Sitting at night though, i feel tingling (not strong pain) all the way across my lower back. The only relief i have found, is stretching forward (basically bending over) it seems to take what ever the pressure is, off of me. now coming back up is not great, but those few seconds are such a relief. I have alot of popping which i know may not mean anything, some people just pop, but i wanted to note that was new and i can definitely feel it. Its almost like i can feel something rubbing me? inside? always when i am walking, so i definitely walk slower. Maybe a better way to describe it while walking or getting up is like a “catch” and a sharp one. I have been participating in physical therapy as well (aquatic) i dont feel any better, but it doesnt make it feel worse either. The therapist said my left leg is weaker and shorter than my right (dont know what that means) we do a lot exercise in the water and then they put some sticky pads on my back and this machine puts some kind of tingling in them. The doctor gave me a steroid pack today (6 day dose) and 800mg Ibuprofen. We did not do a post op MRI as he said there would be no sense in the expense, if something showed up and i did not want anything invasive? so your thoughts? should i see if the steroids help with any possible inflammation? because maybe that is what it is and i just need to give it more time? I always sleep with pillow under knees as well, since i cannot lay flat anyway, i cant stand that empty space between my bed and my lower back..that causes sharp pain as well but it always has. on another note.. I only feel tingling in my left foot at night when i go to bed and it doesnt last long and not as bad as it was prior to surgery. However that was never a chief complaint! I really was hoping by now i could get back to my regular workouts and jogging.. but i dont want to do anything that would even remotely bring that pain that i had last year back, however i dont think i am willing to live with an alternate pain either. I don’t think i planned on trading one pain for another. I am only 48yrs old. I am about 5’2 and have been maintaining 143lbs since last year. This whole journey started last year when i made the decision to lose weight and get healthy. (lost total 50lbs) I had made that decision after losing my mother a little while back- she was short, overweight and went in the hospital with terrible back pain (could hardly walk) and that is when they discovered that her spine had started crumbling?? not sure exactly and they did kyoplasty. Turns out she had multiple myeloma and it had already consumed 70% of her marrow..that was in the month of Sept (2018) and she died that November.. the chemo was too much for her heart. All i wanted to do was get healthy weight.. and i have hurt ever since.
Thank you for your time Dr. Coreman.