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in reply to: Need Help Reading My MRI #6857
Review of the MRI can reveal a solid fusion but the MRI is generally unreliable to ascertain if a solid fusion is present.
He notes mild to moderate degenerative changes at C4-5. This can be a pain generator for neck pain. He reports you have no radicular symptoms. This means you have no arm pain or examination findings of weakness, sensory loss or reflex changes.
Standard X-rays including flexion and extension in your case would be important to determine the presence of degeneration, stability and angulation of the C4-5 level as well as helping to reinforce the understanding of solid fusion at the C5-6 level.
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.Your symptoms sound more like instability than arachnoiditis. Do you have a solid fusion at L3-S1? Have you had a CT scan of the area to demonstrate a solid fusion?
If you had a solid fusion at L5-S1, it would be unlikely that you would have compression of the canal at this level. The titanium instrumentation can generate artifacet that can simulate compressive situations.
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.Don’t read anything into the tech’s behavior. Some techs have bad days and some never have good days.
I am not too concerned about the lack of a standing component for the MRI as previously, I noted these MRIs lack quality imaging.
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: L5/S1 – Just want to run/bike in Fort Collins #6852Your complaints are typical for IDR with foraminal collapse. The back pain is most likely from the loss of shock absorption. The episodes of “going out” are typical from certain impact or vibration activities that overload the bony endplates and cause small fractures (not dangerous but painful).
The leg pain is most likely from the loss of height of the foramen. This foramen is the exit zone for the nerve root. The height of the normal foramen is normally at least 50% from the height of the disc. When the disc rebsorbs, this height is lost. To add insult to injury, bone spurs form in the foramen as a result of bone on bone impact which additionally “clogs” this hole.
The foramen actually changes in volume from flexion to extension (bending forward to backward). Forward bending opens this hole and backwards bending narrows it. The acts of standing and walking cause this hole to narrow- further compressing this nerve. Leg pain can develop immediately and last sometimes for days.
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: Which Surgery is Right? #6851If you had a massive herniation that filled up the spinal canal and caused cauda equina syndrome, this could cause your bowel and bladder symptoms. Cauda equina syndrome is very rare and many people with even huge herniations do not develop it. You have seen a neurosurgeon who was not concerned by your report so I have to assume that you do not have this syndrome.
Bowel and bladder symptoms can be caused by many different disorders. Prostatic hypertrophy, pain, medications, pelvic wall dysfunction (rectocele and cystocele in a female) are some of the other potential functional modifiers.
I await your films.
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: My Condition and Recommendation #6850Your condition can continue to degenerate but there is only a slight chance that a severe flair-up will cause substantail increase your pain. Generally, pain waxes and wanes and your activity level will be in command of the intensity of your symptoms.
If you only needed a one-level fusion, you would not notice much if any restriction of range of motion. A two level fusion causes more need to restrict activities. Due to your mildly degenerative discs above, twisting impact activities might cause symptomatic upper level disc degeneration. Sports like tennis and skiing should be restricted if a two level fusion is necessary.
Driving, standing or sitting generally does not cause significant loads on the back.
See the section on “When to have lover back surgery” on the website to understand timing of 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. -
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