Forum Replies Created
-
AuthorPosts
-
in reply to: Discectomy even without leg pain? #7708
You are correct in your research. Lower back pain (that centers in the back) is typically generated by disc or facet pain and not by a disc herniation that compresses the nerve root. Now there are some exceptions to that rule.
If the pain is not just central back pain but does refer to one side, especially if it radiates to the SI joint (the area on one side in the pelvis), then the origin is more likely to be nerve pain. This would give a better prognosis if you underwent a simple microdiscectomy.
Even central back pain can be improved about 50% of the time with a microdiscectomy. The reason why that procedure is not highly regarded is that the satisfaction rate is only 50%.
You could consider facet blocks of L4-S1 (see website for description). The facets generally don’t generate as much lower back pain as the disc, but the treatment of facet pain more likely than not does not require surgery. I think it is worth looking into the facets in your situation.
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: Cervical Foraminal Stenosis #7695If you get good temporary relief (as noted under “pain diary”), then a referral to a spine surgeon or a neurosurgeon would be recommended.
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: Cervical Foraminal Stenosis #7693With two preselected images, it is somewhat difficult to accurately tell if you have foraminal stenosis but the axial image does indicate right sided stenosis. If you have symptoms of root compression (see “Conditions”, “Neck”, “Radiculopathy”) and you have failed conservative therapy, then a selective nerve root block could be both diagnostic and therapeutic (see “pain diary”).
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: What approch should I consider? #7691If you need a surgical procedure, a microdiscectomy would most likely be the procedure of choice.
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: What approch should I consider? #7689The MRI report does indicate both lateral recess stenosis and foraminal stenosis are present. These two narrowed regions together could compress both the L5 and the S1 nerves. The radiologist did not use modifier words (mild, moderate or severe) and you report the surgeon was not too impressed with the imaging findings.
Possibly a consultation from another surgeon might be in order to help figure this out.
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: What approch should I consider? #7687To have foot drop (L5 or possibly L4 nerve) and have gastroc/soleus weakness (S1 nerve) with a “small herniation) at L5-S1 does not fit with a mechanical compression of both nerves. I would look to the neurologist to come up with an explanation as this compilation of symptoms with your dictated imaging findings does not make sense for mechanical compression of the nerve root.
In order to consider surgery, you need to have a surgical pathway that makes sense. Either the imaging findings are incorrect or there is another explanation for your current weaknesses.
You need an advocate to search the “small stuff”- a call to the neurologist to explain her findings, a re-review of the imaging to look for undiscovered findings and another thorough physical examination to confirm weakness findings.
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. -
AuthorPosts
