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  • Donald Corenman, MD, DC
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    Post count: 8339

    Left psoas pain I interpret as anterior hip pain. This could be your hip joint as well as a nerve referral pain. Obviously, lower back pain is located in a different spot and is normally generated by the lumbar spine. Hyperlordosis doesn’t occur overnight so your earlier X-rays would be helpful to determine your current lordosis which I suspect is within normal limits.

    It sounds like flexion (bending forward) relieves your pain. Backpacking causes spine flexion to compensate for a heavy load posterior to your spine. Mountain biking and skiing are also flexion activities. You might have a facet disorder> See:
    https://neckandback.com/conditions/lumbar-degenerative-facet-disease/

    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: 8339

    A Seroma is a collection of post-operative fluid that can have a compressive effects. However. if you had “dye” (gadolinium), that should be helpful enough to distinguish fluid collection from recurrent herniation. It could be helpful to get some simple lab tests to make sure this is not infection (but normally the radiologist can distinguish fluid from infection-but not always). If your symptoms are increasing and especially if you have increased weakness, I would recommend some type of action (either an aspiration or an exploration).

    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: 8339

    I do think a consultation with a spine surgeon would be helpful for you. You need a good history and physical examination with whatever imaging needed to elucidate your problem.

    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: 8339
    in reply to: Chronic neck pain #35132

    You note after the C5-6 ACDF; “After surgery, my feet were worse. They were tingling and numbness constantly for several weeks. Now it’s on and off throughout the day but all my pain and symptoms are worse since surgery. Some of the pain is very sharp. I also had zapping down my spine but that has subsided”. All of your symptoms are non-specific so further description could be helpful. I’ll include a hyperlink noting how to give a good history at the bottom. Normally, myelopathy (problems due to compression of the spinal cord) causes incoordination and paresthesias in the feet but not pain.

    The radiologist notes; “appears to be some residual endplate hypertrophy indenting the thecal sac and abutting the cord. This is not as pronounced as the disc protrusion noted previously, is accentuated by the blooming artifact caused by metallic hardware. There is no cord edema or myelomalacia”. This means there is some smaller residual abutment of the cord, but not as bad as before surgery. However, you could have developed a pseudoarthrosis (non-fusion) of the C5-6 level which could leave you with greater neck pain than before. A fine-cut CT scan would be quite helpful to evaluate the fusion, residual compression and will get rid of the “blooming artifact” noted to obscure the image.

    https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/

    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: 8339

    I would agree more with Surgeon B that a microdiscectomy is all that is needed, While he is there, he could probe the foramen and if tight (unlikely), he could additionally perform a foraminotomy.

    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: 8339

    Your comment “I did get some relief with the L5-S1” along with your symptoms “where initially pain was felt in the gluteal region and R hip. I had difficulty with sit to stand. This gradually went away. Now, my foot issues appear to be amplified with prolong sitting” does fit with a radiculopathy. Added to the symptoms, relief with an L5-S1 block points to the HNP right L5-S1 as your pain generator.

    I’m not clear what surgeon B thinks but surgeon A’s advice; “do a laminectomy to see if we can unroof this and give him as nerves more space with a foraminotomy and medial facetectomy on the right side” sounds like a good idea. No fusion should be contemplated especially below a pars defect.

    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 posts - 1 through 6 (of 8,338 total)