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in reply to: Direct Pars Repair #7457
You do not fully describe your symptoms. Do you have mainly instability type back pain (sharp pain with certain motions like coughing, sneezing and quick back motions), typical chronic low back pain or more leg pain?
The next question is where the pain generation originates? Your L4-5 disc could also cause pain and you don’t want to fix the pars if the disc above is the pain generator. You might be a candidate for a discogram of L4-S1. See the section on the website for this procedure.
I have to tell you that it is unusual for the L5-S1 facets to be degenerative (via the report) with pars fractures present. Pars fractures typically unload the facets and they should normally be pristine. If the radiologist’s report is accurate, you might also need facet blocks to determine if they are pain generators.
I agree with the interventionist in that if the anesthetic “leaked” onto other structures, you cannot be sure if the pars blocks were positive or if there was a false positive test (pain relieved but the targeted structure is not the pain generator).
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.The change in your disc appearance over time most likely indicates a non-solid fusion. Flexion/extension x-rays do not have to demonstrate gross motion for a non-union to be present but there are subtle signs that can indicate motion without measurable motion being present.
See if you can ask your current doctor for a CT scan of the L5-S1 segment. The scan should be on a 64 slice or 128 slice scanner for the best accuracy.
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 spine c0 c1 through c7 vertabrae rotation #7453I will tell you one more time and you must listen this time. Your fast heart rate is not from your neck. You should not consider any cervical surgery for a fast heart rate. Find a doctor who can give you accurate advice- not your chiropractor. I hope you understand this as you seem to be fixated on the incorrect information. I cannot help you with this.
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.The medication effects of these pain killers is generally gone within 24 hours. The changes the body makes in response to these pain killers can take as long as one week to re-regulate. There is no need to try to detoxify as the body will do that on its own.
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.Please keep in touch.
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: how careful should I be with cervical stenosis #7444There are two separate concerns here. The first is the central canal stenosis at C4-6. You mention no myelopathy symptoms (imbalance, loss of fine motor control, etc- see section on myelopathy on the website). The danger is then a fall onto your head which causes your neck to bend far backwards. The action will substantially narrow the central canal and could pinch the cord causing a central cord syndrome (see website).
The other problem is foraminal stenosis (narrowing of the exiting nerve hole). This condition is most likely causing your arm and hand symptoms. Controlled exercise (gym or non-wheeled exercises) are generally safe. The greater your speed or the more potential for imbalance (biking or motorcycling) the greater the risk.
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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