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in reply to: Weight gain and arthritis #7519
I would like to think that I “know a lot about a little”. The field of medicine is huge and this is why I rely on many other specialists to help the diagnosis and treatments.
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: Dura Deficeincy #7511The dura is typically never deficient. The dura can be scarred to the walls of the canal from prior infection, surgery or immune disorders making the dura “look” deficient.
You had a fusion of your spine 15 years ago but do not mention why. I assume you had a fusion for scoliosis with 11 vertebra and 10 discs fused (two vertebra typically share one disc). X-rays noted broken rods in the fusion region. I assume you had no symptoms prior to the auto accident you describe. You note “MRI and CT showed normal” but I also assume that there was an undiagnosed pseudoarthrosis (lack of fusion) as the normal reason rods break is a pseudoarthrosis.
A surgeon typically would “not repair the spot where the rods were broken” unless there was a lack of fusion. If the surgeon was repairing the pseudoarthrosis, I am unclear why he or she performed a decompression of the canal at the same time as the fusion repair unless there was also a narrowing of the spinal canal (stenosis).
You appear to have developed arachnoiditis from the initial surgery “Failed to mention the Spinal MRI also showed an empty thecal sac with adhesive arachnoiditis in the Lumbar region” This may well be why the second surgeon could not find the dura as it was adhered to the walls of the canal. This also may be why you had lower extremity symptoms prior to the second surgery.
Your Multiple Sclerosis was not caused by either of the two prior surgeries. MS is an autoimmune phenomenon where your immune system attacks the myelin of the nerves.
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: Weight gain and arthritis #7510I cannot tell you why your mother is gaining weight as the causes are multifactorial. Medications can change the metabolism in some patients. Lack of cardiovascular exercise is a common reason to gain weight. Possibly, an endocrinologist can give an explanation.
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: MRI for lumbar spine #7508A total knee arthroplasty does in no way preclude an MRI of the lumbar spine. Patients with metal in their back from prior spine surgeries can have an MRI.
Just as an understanding of the CT scan, a CT scan can be performed in the case of metal in the spine but will not define the nerve roots. A myelogram would be needed prior to the CT scan to visualize the nerve roots.
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.I just saw a patient yesterday that fits perfectly with this discussion. She had a fusion surgery of L4-5 back in 1965. In those days, fusions were performed for many times, unreliable diagnoses. This fusion became solid (as did 60% in those days). This patient had a normal appearing disc at L4-5 (the fusion level) and degenerative discs at all the other levels in the lumbar spine. The fusion prevented loading of this L4-5 disc and preserved it.
Hopefully, these days a normal disc will not be fused (but there are some exceptions) but a fused level could demonstrate some degenerative changes over time. This is the exception however and not the rule.
If you would like me to review your films, please contact Margaret at 888 888-5310 to schedule delivery.
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: L5 S1 extruded disc #7503The nerve is still inflamed. The surgery removes the compression from the nerve but the nerve has to heal and this takes time. Stretching the nerve to some extent is important but you can stretch the nerve too much and irritate it. This is where the “art” of medicine comes into play.
The nerve does need to be stretched somewhat as adhesions that form during the recovery period will also be stretched, preventing the nerve from being adhered down. Too much stretch will cause increase inflammation and more nerve symptoms.
If the nerve is really “hot” in the post-operative period, I will give my patients oral steroids to reduce the inflammation. For especially symptomatic patients, I occasionally will obtain a new MRI. Hematoma or even rarely, a recurrent herniation can occur and can be dealt with accordingly.
It can take up to six months for a nerve to “calm down”.
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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