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in reply to: weakness, atrophy, and dysfunction #35859
It is hard to know what type of damage is present without sacrificing the nerve for microscopic determination (obviously defeating the purpose). I do think that decompression is important even with prolonged compression as motor strength tends to improve from surgery.
“Am I correct in reading that 1 years/12 months is really the you’ve gone too long mark”? Not correct. Denervated muscles fibrous at 18-24 months so there is still time for enervation.
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.in reply to: weakness, atrophy, and dysfunction #35856WIth compressed cervical nerve roots, of course faster decompression is always better. However, cervical roots have a better record of recovery than lumbar roots due to their shorter length. Read the two hyperlinks to understand how recovery occurs.
https://neckandback.com/conditions/how-muscles-recover-from-nerve-injuries-neck/
https://neckandback.com/conditions/peripheral-nerve-anatomy-neck/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.in reply to: Peek cage subsidence in TLIF #35854A solid fusion at L5 S1 would preclude having any subsidence of the cage. Popping and cracking noises are typically facet generated pain and noise. I would initially assume adjacent segment disease (L4-5) as you’re 5 years out of surgery but it’s a possibility that L5 S1 could be generating some noise. however, that would indicate that you didn’t have a solid fusion. There are very rare circumstances that the sacroiliac joint can create these noises but that would be unusual. I would 1st start off with standard x-rays including flexion extension for diagnosis.
Donald Corenman MD DC
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.in reply to: MRI Opinion #35849You do have some significant problems in nerve and maybe even spinal cord compression. Part of the information missing is your physical examination, part is what structures were the target for the injections and part is what side your symptoms are on.
Did you have deep tendon reflex changes (DTR) on exam? Did you have sensory changes in your arms? Did you have any weakness of muscle groups upon examination? Did you have long tract signs (hyperreflexia, clonus, Hoffman’s sign) present?
WHen you note levels for injections, are these medial branch blocks (MBB), facet injections, selective nerve root blocks or epidural injections.
When you developed “Arm pain – I do occasionally have upper arm pain but this is minimal. My arms are quick to fatigue which has prevented PT progression beyond basic arm exercises. I also have tingling in the forearm and into the hand as well as a decrease in grip strength”, what sides?
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.in reply to: Back Injury Diagnosis & XRay vs MRI #35847Based upon your daughter’s symptoms, one of the more common disorders is a stress fracture of the pars interarticularis (see: https://neckandback.com/conditions/spondylolysis-in-children-healing-potential-and-treatment-pars-interarticularis-fractures-in-the-lumbar-spine-in-adolescents/).
Diagnosis requires an MRI using STIR images so yes, an MRI is necessary. These initially do not show up on X-rays.
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.in reply to: Back and legs pain after lumbar fusion L5 S1 #35843Is you leg pain new, increased or unresolved from prior to surgery? What grade was your slip (25%-75% or mm).
If you are 6 months out from a PLIF fusion for an isthmic spondylolisthesis and have continued leg pain, I would be concerned with incomplete decompression or surgical stretch of L5 nerve roots. At 6 months, I would start with a new MRI but wouldn’t hesitate to add a CT scan. If there is no root compression, a nerve test (EMG/NCV) would be helpful.
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. -
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