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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    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: 8660

    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: 8660
    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: 8660

    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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Degenerative changes in the neck can lead to four different problems at the same level; radiculopathy, cord compression, neck pain and instability. Radiculopathy occurs when the nerve exit holes (foramen) narrow and compress the exiting nerves. Symptoms increase with neck extension (bending backwards) and leaning to the side of the narrowing. Symptoms vary depending upon the nerve involved. In your case, the right C5 nerve is affected. This can cause pain and numbness radiating into the shoulder.

    Cord compression causes myelopathy or dysfunction of the cord. Symptoms are not of pain but of patchy numbness, incoordination of hand or leg movement, occasional “electrical strikes” with neck position and possibly bowel and bladder involvement. There is a risk of central cord syndrome (see website) with a fall.

    Degenerative disc changes in the neck can cause neck pain just like arthritis of the knee can cause knee pain. The pain is normally worse with activity or a prolonged stationary positioning (sitting at a computer). Some patients develop increased pain when exposed to vibration forces (driving, running, airplane travel).

    Instability develops when the two vertebra have lost the restraining couplers that normally stabilize the vertebra (discs, ligaments, facets). Sharp pain develops with quick motions and the neurological structures are possibly at risk for injury with falls and impacts.

    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: 8660
    in reply to: c7 Weakness #7251

    The Prodisc can easily be converted to an ACDF and yes, there is plenty of room for a plate and screws. I have revised two Prodiscs to ACDFs (implanted by other surgeons) from patients who had continued pain after this implant. I each case, the revision was easy. The keel is not too deep and can be filled in with autograft which in turn incorporates into the host bone.

    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 8,659 total)