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in reply to: Sports After Cervical Fusion #4755
If surgery is contemplated regarding cervical stenosis and an ACDF is recommended, there is a difference between a two level and three level biomechanically. There is more stress on a three level fusion. Also, the type of graft and precision of placement makes a difference in time to solid incorporation of the grafts. The level of participation in biking and skiing also makes a difference.
Regarding the level of participation, are you a road biker or mountain biker? There is less potential load and motion that needs to be dissipated in road biking than in mountain biking. If you rode well maintained gravel roads as a mountain biker rather than tough rocky or root encrusted single track, there is a difference in loading of the cervical spine. The potential for falls and endos increases with greater risk taking while mountain biking. This is the same for skiing. Steep, rough terrain, bumps and crud snow are more risky than groomed slopes. What is your skiing level and what terrain do you like to ski?
Regarding the grafts used, there are three choices, autograft, allograft and Peek cages with a bone substitute filler. Autograft is bone from your own pelvis. Allograft is bone from a cadaver and Peek cages are plastic inserts with allograft filler. The fastest and most complete incorporation is with autograft but this requires a small hip incision. Allograft can be from multiple sources, a pelvis, fibula or calcaneous bone. Each has difference times to incorporation with the pelvis bone incorporating the fastest.
Typically in my practice, you can ride a stationary bicycle in the upright or recumbent position within three days of surgery. You can be on the road within 8 weeks and on single-track in 9-10 weeks depending upon the appearance of the X-ray. Skiing is allowed typically within 8-12 weeks.
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.By your description, you have pars interarticularis fractures at L3 bilaterally but one has healed. How was the healing diagnosed? Was it by X-ray or by CT scan? Did you have an MRI of the lumbar spine? Pain can be generated by a unilateral pars fracture but can also occur from a degenerative disc caused by the instability of the fracture.
Where is your pain? Do you have back pain or leg pain or both? When does the pain occur- with standing, sitting, lifting or? You need to supply more information.
Your lowest vertebra with the “wings joints” is a transitional vertebra and the “wings” are transverse-alar articulations between the transverse processes of L5 and the ala of the sacrum. These articulations normally stabilize this motion segment and cause no pain.
The possible tumor at the base of your neck is another matter entirely and needs to be followed by a neurosurgeon if it involves the spinal cord and by a spine surgeon if it involves the bone of the vertebra.
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.This is a decision that you alone have to make. If you can tolerate the symptoms and participate in your life activities without any significant restrictions without aggravating symptoms, then you don’t need to consider surgery. If the symptoms “get in your way”, then you need to consider surgery. You have to weigh the benefits of surgery (decompression of the nerve root and hopeful relief of pain) against the risks of surgery. Your age is in the typical range for these problems but does not by itself matter in the equation.
Again, the indications for surgery for a disc herniation are cauda equina syndrome (you do not have this), muscle weakness (you report you do not have this) and pain that is not tolerated. The last indication you will notice is a value judgment by you alone. Do you feel that you want relief and are willing to undergo surgery with the attendant risks?
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: mri ?????????? #4748New onset weakness in your arms and legs needs to be evaluated. This could be from pain inhibition (not emergent) or from a new problem (a new hernation or injury) that requires attention. Get another consult from your surgeons. If there is nothing emergent, you can go through diagnostic injections to discover what the primary source of your pain complaints are (see SNRB on website). If the weakness is from nerve or cord compression, this needs to be addressed.
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.This MRI report was written very poetically. This indicates that the “tracks” are the surgical scar tract that is always visualized after a lumbar spine surgery. The L4-5 disc has some degenerative changes. The L5-S1 disc where the previous surgery occurred obviously has some degenerative changes and the “altitude” changes are the narrowing of the disc space after the herniation.
There apparently is a recurrent herniation at that level that causes some compression of the S1 nerve root in the lateral recess.
Your doctor is correct. Without motor weakness, you have two options: to wait or to have surgery. This is a value judgement that only you can address. Benefits of waiting are that you avoid another surgery and the benefits of surgery are that a direct decompression of the nerve root has a good chance to give you relief of your buttocks pain.
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 Extruded Disc #4744I cannot personally recommend any particular surgeon in Houston. I understand it is not easy to know who is good. Recommendations from prior patients is generally a good sign and possibly something positive from the internet can be helpful.
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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