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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    in reply to: c2; Occipital #7207

    Since I left the faculty of the University of Colorado, I have not practiced in Denver. I do not give endorsements on this site but if you call the 888 number, Margaret will be able to give you some potential referrals in Denver.

    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: spondylolisthesis #7206

    A fusion of L5-S1 with a preexisting isthmic spondylolisthesis without screws has a high rate of non-union (no fusion). The surgery itself will create further instability if the fusion does not occur. This is what has happened in your case.

    A 12mm slip is typically called a grade 2 slip.

    Swimming would be a good exercise for you. A stationary bike would also probably be OK.

    The purpose of screws is to hold the two vertebra together to prevent motion while the vertebral bodies heal together (in this case the L5 vertebra to the sacrum). If motion is allowed while healing this many times leads to a pseudoarthrosis. This lack of healing has occurred in your case.

    What you most likely will need to finally fuse these two vertebra together is a TLIF. See the website and also read about BMP, a synthetic protein that induces bone formation.

    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

    If you had foraminal stenosis causing nerve compression, the type of surgery does matter for effectiveness. If the foraminal stenosis is due to a disc hernation, a simple microdiscectomy can be effective. If however, the foraminal stenosis is due to angular collapse of the vertebra, a foraminotomy can be effective. However, to be effective, significant amounts of bone have to be removed to free up the nerve.

    Unfortunately, most of the time, that bone originally grew into the foramen to stabilize the angular collapse. Removal of the bone to free the nerve root also destabilizes the vertebral segment and allows re-collapse and recurrence of the original symptoms after a time.

    If this is the case, a TLIF fusion (see website) may be necessary to stabilize the segments and free the nerve while realigning the vertebral bodies.

    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

    Well- I’m glad to hear you found someone you trust and has experience. Every surgeon’s protocols are different. Some require you to wear a temporary brace called a hip-spica. Others feel that just reduction of activity is enough. Part of the decision process is made during surgery. If the implants have solid purchase and the bone seems strong, there is less need to use bracing and less restrictions are necessary.

    Let the forum know how your progress goes after 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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    in reply to: spondylolisthesis #7201

    I assume that you did not have screws and rods when the fusion was performed. I also assume that you have 12mm of motion of L5 on S1 as you have developed a pseudoarthrosis (lack of solid fusion).

    Your current symptoms fit with the above assumptions. The foramen that the L5 nerve roots exit from are deformed from the instability and the nerves are compressed. Your lower back pain is from the instability and certain motions will increase the slip and therefore, back pain.

    If my assumptions are correct, you will ned a redo fusion surgery at L5-S1. A redo surgery is not uncommon under these circumstances and the success rate is still very high. If my assumptions are wrong; well, back to the drawing board!

    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: c2; Occipital #7200

    One of the causes of suboccipital headaches is inflammation of the facets at C2-3. The “puffy feeling” could be a sensory abnormality of these nerve roots which is not uncommon

    You could consider finding an interventional injectionist (PM&R or anesthesiologist) to perform diagnostic and therapeutic facet blocks on C2-3 (keep a pain diary- see website). This may help to diagnose and possibly relieve the headaches.

    There are other causes of suboccipital headaches including arthritis of occiput-C1, vascular origins and central origins (brain mediated).

    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 - 7,417 through 7,422 (of 8,659 total)