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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    in reply to: pain after surgery #5192

    To reiterate your history, a microdiscectomy L5-S1 right in 1997 with good relief. 2008 noted development of left lower back pain and leg pain and an MRI noting a left herniation at L5-S1. Conservative care insued for three years with a microdiscectomy on the left on 6-2011.

    After surgery, the back pain improved but the left leg pain has not. An epidural two months ago helped somewhat. The pain is not as severe as prior to surgery but is now constant where before it was intermittant. Pain now occupies both the old pain pattern and a larger distribution area but only in the left leg. Is that correct?

    Is the pain constant but varies with position? Is the pain worse with standing and walking but improves with sitting or the reverse? Does the pain have the same previous quality or is it changed? Is it more of a burning quality now? Do you have any weakness?

    Pain that doesn’t improve after a microdiscectomy could be from many factors. A hidden fragment that was not removed during surgery, a space occupying hematoma that formed after surgery, a recurrent disc herniation (these can occur just getting up the day after surgery), a foraminal collapse or chronic radiculopathy (see website) are just some of the possibilities.

    Have you had an MRI post-operatively with gadolinium? This would be one of the most useful initial tests. Make sure the MRI is performed on at least a 1.5 tesla machine or better yet, a 3.0 tesla machine.

    “Laser spine” surgery in my opinion is a gimmick that would not help. The laser is simply an ablation device that destroys tissue using heat and should have miminal use in the spine. You need a good work-up to determine what the pathology is and no surgery unless there is reason to operate.

    Hope this helps.

    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: my nick c5&c6 #5188

    Unfortunately, my skills do not reach deep into the field of evaluation of metabolic or inflammatory disorders. Your problems do not stem from the cervical spine so any individual that wants to perform an operation on your spine is not looking down the right path.

    I do not know what a “suction disc” is but it might be like a nucleoplasty- a procedure that puts a cannula into a disc to remove some nucleus. These procedures do not work well and in your case- would be inappropriate treatment.

    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: my nick c5&c6 #5186

    I cannot refer you to a neurologist. You must research the doctor by word of mouth, what he or she has written, years of experience and possibly by posts on the internet.

    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

    Your symptoms of bilateral leg pain with standing and walking that improves with sitting does fit with the diagnosis of bilateral foraminal stenosis (see website). Your MRI report is somewhat confusing in that it notes only left foraminal stenosis- however, the radiologist may have missed right foraminal stenosis. The standing X-ray can be revealing in that with a scoliosis, you may have right foraminal collapse that does not show on MRI (which is performed lying down).

    Ask your surgeon if an SNRB can be considered (see previous post) to diagnose and possibly treat the nerve compression. Use a pain diary (see website) to determine if that is your diagnosis by following the instructions both to aggravate the pain prior to injection and to track the pain levels for the first three hours after the injection.

    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: my nick c5&c6 #5182

    Your symptoms are very diffuse. “Numbness” in bilateral hands and knees, weakness in right hand and leg, “numbness” in tongue and dysarthria (difficulty speaking) and “tingling” in different area of body.

    There is no neck disorder that can cause all of these symptoms and your MRI of the neck only notes mild degenerative changes of C5-6. The report of your brain MRI was normal.

    These symptoms can be from a neurological disorder. There are many disorders that can cause these symptoms. A good neurologist should be able to ferret out the origin of these 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.
    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Good Luck

    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 - 8,323 through 8,328 (of 8,659 total)