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  • AvatarDonald Corenman, MD, DC
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    Post count: 7481

    The disc herniation you describe initially (first two months) was improving without surgery like 70% of disc herniations will. There is a 10% rate of recurrent herniation however. This includes patients who have had and HAVE NOT HAD surgery. It is a possibility that you have extruded another fragment. None the less, you could have stretched the nerve somewhat over the existing herniation and re-aggravated the nerve.

    As long as there is no motor weakness or bowel/bladder involvement, then you could continue conservative treatment. You do however mention bladder involvement. It is very unusual that the herniation is so large that it would compress the entire canal which is what it would take to cause cauda equina syndrome (see web site) and bladder involvement. I see this condition about once per year and see at least 400 patients with disc herniations.

    If you do have cauda equina syndrome, you should have numbness around your rear and back of the thighs and significant pain around the “saddle region”. This condition is an emergency and you would need to see a specialist “yesterday”.

    In my opinion, you should see a reasonable specialist for a surgical opinion. This would develop a relationship with that physician and the information would be helpful. You have to remember that a spine surgeon is there to help you understand what your options are to make a surgical decision and not to force you into surgery.

    Let me know how you do.

    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.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    An extruded disc at L5-S1 with motor weakness would normally need a microdiscectomy in my practice. In most cases without motor weakness, surgery can be avoided but with motor weakness, I feel that the best chance for motor strength recovery is with surgery.

    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.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    Your father has had three prior spine surgeries. You do not mention which ones but apparently they were all discetomies and no fusions were involved. It sounds like he might have instability or stenosis associated with collapse. Please have him send his images to my office by Fedex (hopefully he has current X-rays and an MRI). My office number is 970 476-1100.

    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.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    By the report of your symptoms, you could have any of the disorders listed on the web site under “conditions”. To “speed up recovery”, an appropriate diagnosis is necessary. What diagnosis have you been given and how was it formulated?

    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.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481
    in reply to: L5-S1 #4622

    If there is no motor weakness (calf muscles- try tip toe walking- if OK- most likely no weakness) and the pain is only a week old, there is a very good chance that physical therapy, medications and epidural injections will relieve your symptoms.

    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.
    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7481

    You do not give enough information to allow me to comment. Did the CT reveal a solid fusion? Is the pain in your back or in your buttocks and leg? You state you can ride a bike but cannot run. This may indicate a stenosis picture but the information is insufficient for comment.

    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 - 7,393 through 7,398 (of 7,480 total)