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in reply to: Please help! I'm in a great deal of pain. #7431
You have degenerative disc disease and consequent lower back pain. You need to start with a thorough rehabilitation program associated with Pilates core strengthening and ergonomic education. The judicious use of epidural steroid injections should be included as well as medications such as NSAIDs.
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 #7430Yes, this rotation is not uncommon and is associated with idiopathic scoliosis. Rotation by itself is almost never an indication for surgery and you would be very unhappy with any surgery to correct 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.in reply to: cervical spine c0 c1 through c7 vertabrae rotation #7426You can have surgery to derotate and fuse the vertebra and your heart rate will still be unchanged. You are fixated on what your chiropractor told you and this information was grossly incorrect. I don’t know any other way to convey this to you but you are obsessed with your neck as the cause of your increased heart rate and this is simply wrong. Please see a cardiologist!
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 Instability C1 C2 #7425Boy- there is a lot to cover here. I’ll try to be as brief as I can.
You have a fear of spinal surgery that may be warranted after you have listened to various patients troubles but as in anything, spine surgery included, you must weigh the fear against the actual reality.
You have an instability of C1-2. The “head” of C2 has been sheared off (the dens) and your neck is unstable (os odontoidium). C1 now moves too much and has put the cord in jeopardy. However, you have a fear of a stroke with surgery to correct this instability.
Yes, the fusion surgery you mention is uncommon. I personally have performed only about 25 of these C1-2 fusions compared to the thousands of other fusions I have performed. The reason is that this condition is very uncommon. Stroke is possible (the vertebral artery is close by) but I have never seen that problem and even with discussions with all of my colleagues, I have never heard of that complication
You mention you don’t want your “quality of life” to suffer for fear of a stroke but I have to point out that by your report, you have already developed a spinal cord injury from your instability; “had an accident that rendered me unable to walk straight due to poor balance, dizziness…”.
BMP (bone morphogenic protein) is not the terrible evil that you think it is. I use it for many fusions and it is a very useful tool to allow fusion to occur. The posterior C1-2 or C1-3 surgery that you have had proposed is a perfect example of where this protein would be most useful. You have read one study that purports increased risk but there is a new study that refutes this and I personally have seen no increased risk.
Your understanding of fusion is incorrect. Most times, a solid fusion will eliminate pain and not cause it.
Prolotherapy is not the panacea that you purport. First, the indications have to be appropriate. Prolotherapy injects a toxic substance that is designed to injure local tissue leading to scar formation response. Many reported indications in my opinion are not appropriate. You generally do not want to destroy normal ligaments, tendons or muscles to “treat them”. Injecting these toxic substances into the upper neck is strictly contraindicated. What happens if this substance accidentally infiltrates into the spinal canal? Injury to the cord would be irreversible. Even infiltration around the greater occipital nerve would leave your head numb and possibly painful.
Stability of the C1-2 level cannot be gained by prolotherapy. This is NOT a ligament problem but a fracture of a bone that did not and will not heal. If you truly have what you reported here, you need a fusion of this level. If you re-injure the cord in this area, paralysis or death can be the result. I highly encourage you to face your fears of surgery and visit a spine surgeon soon.
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 am confused. Lower back pain is typically generated by the discs and facets, not the nerve roots. Your surgeon decompressed the nerve but did not stabilize the vertebral segments (fusion) due to your “smoking”. The surgeon then repeated the X-rays and noted “she could see a further slippage on the L5 which is why my leg pain has probably come back”.
“Further slippage” to me means continued instability of this motion segment. This very likely could be the source of your back pain. In addition, return of your leg pain more likely than not means that this continued slip has caused further foraminal stenosis which could be the source of your leg pain.
It might be valuable to get another set of eyes to look at your images and perform a thorough evaluation. Find an experienced spine surgeon who will take the time with you.
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: L-5 S-1 Disc Replacement #7421A disc replacement in the lumbar spine is no small matter. These replacements have two problems. One is longevity. We really do not know how long a well functioning lumbar disc replacement will last. At your age of 18, this disc has to last at least 70 years which is asking a lot from a metal/plastic bearing surface. More likely than not, this disc will eventually wear out and fixing a worn lumbar artificial disc is the reason I do not replace lumbar discs with artificial ones.
The other problem is the function of the artificial disc in the first place. The placement requires an anterior approach to the spine with its own set of potential complications. If the disc malfunctions, the surgical options are limited.
I do not know your disorder but I for one would not be the surgeon you would want to see as I do not look favorably on lumbar artificial discs (cervical artificial discs are another story). See the section on the website regarding lumbar artificial discs.
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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