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  • Tlif2015
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    Post count: 5

    Thanks again for your opinion and always prompt reply. I assume that since the EMG showed chronic nerve damage and nothing active that the damage is already done and any residual pain is here to stay.

    If you agree with my neurosurgeon that surgical intervention at this point would not provide any measurable relief to my radicular pain then I will probably proceed with the nervous scs trial.

    Thank you,

    RC

    Tlif2015
    Participant
    Post count: 5

    Dr. Corenman,

    I met with an interventionist specialist regarding a stimulator trial. I suggested a CT scan as you mentioned from your previous reply. He Didn’t believe it was necessary at this point but agreed after our second visit when I advised I would not proceed with the trial until the scan was complete.

    I received the results today via fax and the radiologist stated the following: there is some posterior bony fusion at l4-5 and l5s1. At both levels there is some bony bridging in the vertebral body to the facets on the left, osseous bony proliferation significantly greater on left.

    The TLIF was a left sided approach which is the area of the bmp seroma at both levels on the left side extending to the facets.

    Is this what you referred to as hetertopic ossification? I have a follow up next week and would like your opinion if this is abnormal and should I proceed with the trial assuming this is a normal result after lumbar fusion.

    Thank you again for your help.

    RC.

    Tlif2015
    Participant
    Post count: 5

    Dr Corenman,

    It has been a few months since your last reply. I had a number of appointments with the neurosurgeon since our last chat. After an initial assessment he ordered a new mri. Mri showed slight improvement in the seroma at both levels. He had the radiologist compared the last 4 scans for a comprehensive report. He feels that although the seromas are still present they are no longer putting pressure on the l4/5 5/s1 nerve roots. He ordered an emg with nerve conduction report. Report showed chronic radiculopathy at both levels. Follow up with neurosurgeon explained there is no active nerve problems and suggested consult for spinal cord stimulator trial as he feels that after 3 years there is nothing that can be done. 4 back surgeries and numerous steroid epidurals have taken their toll on my patience well being.

    Do you believe I would be a good candidate for this as the referring dr states it would require another laminectomy for permanent place of the paddles if the nervo stim trial is successful. The referring pain management dr believes further surgical procedures may be more risk than reward as most of his patients who have the implant are back in his office with very little long term improvement. Would it be beneficial to obtain another surgical opinion? Not my first choice obviously. Thank you I appreciate this forum for an unbiased opinion.

    Tlif2015
    Participant
    Post count: 5

    Thank you for the prompt reply Dr Corenman. The aspiration you discussed, would this be done percutaneously or would I have to be opened up again? If done percutaneously I assume the seromas would not be visible under X-ray/ft scan guidance is there any danger of further damage? I would greatly appreciate you sharing the rechnique that you would use.

    Thank you again for replying so quickly. I feel I am better prepared for my appointment next week.

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