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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    In general, a second herniation at the same level requires only a repeat microdisectomy, not a fusion. If however, the level is associated with a spondylolisthesis, isthmic or degenerative, there may be an indication for fusion. Nonetheless, if your only symptom is leg pain and not back pain, the surgical plan should lean toward decompression.

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Your history leads me to believe that you might have developed herniated a disc at L4-5 or L5-S1 compressing the nerve root and causing leg pain. A positive EMG report indicates that you probably have motor weakness. Rarely, a positive EMG report may just indicate nerve irritation but most of the time will pick up muscle involvement.

    Walking pain as compared to sitting and bending pain may indicate a disc hernation in the “far lateral” or lateral recess position but may also indicate foraminal stenosis from degenerative disc disease (see website).

    You need a spine surgeon to examine you and an MRI of the lower back will be necessary.

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Be careful with what you assume are symptoms from a thoracic disc hernation. You note that “with an episode” you lose all “strength in arms and legs”. Compression of the cord will not cause arm strength to diminish or even cause radiation of symptoms to the arms. You should not “drop things” from a thoracic disc herniation.

    There may not be any easy answers.

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    The MRI report indicates you had surgery at both the L4-5 level and the L5-S1 level. You have a residual bulge at L4-5 which is not unusual after a microdiscectomy. There is no bulge at the L5-S1 level. There is no recurrent herniation that the radiologist noted.

    You do have significant granulation tissue at the previous surgery sites. Granulation tissue can be “healing tissue formation” but also can indicate the possibility of an infection. There are non-virulent organisms (ones that don’t create too much of a body response) that can cause this. I don’t expect that you would have an infection but some labs might be in order. Ask you surgeon.

    If infection is ruled out, then you are correct that this is residual neuropathic pain and will take some time to hopefully fade away. I have found that epidural steroid injections can help to reduce the inflammation around the nerve root and speed up nerve recovery.

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8656
    in reply to: Spondylytis #7257

    Traction can be effective in cases of severe degenerative disc disease or of facet disease without instability or degenerative scoliosis. In those cases however, traction is contraindicated in my opinion.

    If your father has no pain and only spondylosis, he then needs no therapy which includes no need for traction.

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    There are surgical options for thoracic disc hernations but the surgery is long, extensive and sometimes the surgery can cause new pain by itself. This is why most surgeons do not recommend thoracic surgery for disc herniations.

    Now if the cord is compressed and causing myelopathy (chronic cord injury), surgery is generally recommended as the bad effects from cord injury are greater than the problems generated from the surgery to remove the disc herniation.

    Your history for treatment is spot on. Epidural injections by a skilled injectionist, therapy and medications are important treatment guidelines.

    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.
Viewing 6 posts - 7,387 through 7,392 (of 8,655 total)