Q
: 1
01/06/2010 |
My daughter has Scheuremann's kyhosis with most recent xrays showing an 80 degree curve. I suspect that has increased over the past few months. We are due to be seen again in March. I have exhaustively educated myself on the condition, but have a couple of questions regarding the actual surgery. 1.Is it really more risky than scoliosis surgery and if so, why? 2.While she is in no real pain now, what is the likelhood that this condition will affect her adversely in the future? She is 15.5 y ears old.
Surgery for correction of kyphosis has a higher rate of neurological complications than scoliosis surgery in general. Correction of kyphosis than stretch the spinal cord, which is not well tolerated. However, newer posterior based techniques that shorten the spine rather than lengthen it, seem to have a lower complication rate.
Most surgeons will recommend surgery for a kyphosis that has reached 80° in a young adult (teenager). There is a high likelihood that the curve will continue to progress beyond skeletal maturity. The alteration in spinal mechanics caused by the curve usually causes significant low back pain problems in adulthood.
|
Q
: 2
06/10/2009 |
I've been diagnosed with cervical stenosis. How does one stop it from getting worse? 4,5,6, all compressed)
To some extent, the progression of your cervical stenosis is probably outside your control. We know that certain habits such as smoking lead to accelerated disc degeneration. Some of the changes are genetically preprogrammed. There may be little you can do. The good news is that cervical stenosis changes very slowly and is unlikely to lead to rapid progression of symptoms or neurologic deficits.
|
Q
: 3
06/10/2009 |
I had a fusion of L4 & L5 done in February of this year. It is almost the middle of June and I am still in horrible pain. I did not have any pain before surgery. My leg was dragging because of a slipped disc. My surgeon does not address the pain issues I have. I would like to transfer to another ortho doctor but understand no one will take me on as their patient because someone else did the surgery. Is this true?
Not true at all. Although we all like to see patients before bad outcomes have occurred, many of our patients are from failed previous surgeries. I would be happy to see you for an evaluation but, of course, I cannot guarantee what I can offer you until I have had a chance to examine you and look at all the pertinent imaging studies. You can call for an appointment at 410-448-6400.
|
Q
: 4
02/10/2009 |
Which of the following can help kyphotic posture: stretching lower trapezius, strenghening thoracic erector spine, strengthening rectus abdominis or stretching the lumber multifidus?
Most of the time a true structural kyphosis cannot be corrected by exercise or muscle strengthening. It is simply too difficult to fight gravity continuously forever. However a program of strengthening the erector spinae muscles would probably go the farthest to help strengthen your back and improve posture.
|
Q
: 5
02/05/2009 |
I'm a former football player and just got diagnosed with three bulging discs. I started physical therapy and am thinking about also using a chiropractor. No real back pain, just dull pain in my right gluteus. I know that playing basketball is out of the questions, but what's the usual outcome from these bulges (L4, L5, S1)?
There is no reason for you to give up any activity if you enjoy it. Bulging disks are not dangerous and often only give minor symptoms. Recreational sports are no more likely to lead to injury than other routine activities of daily living. Fitness is important in maintaining the health of your back. Go ahead and do what you want.
|
Q
: 6
12/04/2008 |
I had a T12 compression fracture a few years ago. I would like to know if these bladder problems could be related to that injury. Some days I feel the need to urinate more frequently; some days even a couple of times at night. My urine flow is slow and often even though the urge is strong getting started is difficult.
I would greatly appreciate your opinion.
I think it is unlikely that a T 12 compression fracture is causing your symptoms. Urinary symptoms are only seen when there is significant spinal cord compression which should not occur with a simple burst fracture.
|
Q
: 7
08/27/2008 |
My husband was told a surgery of decompression and fusion for his herniated disc-4th and 5th would help. What does this surgery involve and is it risky to have?
You need to speak to the orthopedic surgeon or neurosurgeon who is recommending surgery in order to have a full discussion regarding the details of the surgery and the risks. Most relatively healthy individuals will tolerate surgery well and have good outcomes. There are several different types of fusion techniques available. All of them work well in appropriately trained surgeons. Each has some risks that are specific to that type of technique.
|
Q
: 8
08/24/2008 |
My husband has a ruptured disc between the 4th and 5th vertebrae. A surgery that was suggested is something with a cylinder put in place of that disc. They can go in through the side and only port holes in the back to do this. Is this anything you have heard of, and is it relatively new?
Minimally invasive surgery with an anterior cage and percutaneous pedicle screws is an accepted method of obtaining a spinal fusion. It is relatively new but has had good early success.
|
Q
: 9
07/31/2008 |
I have been diagnosed with a condition called Cervical Radiculitis. I have had an X-ray and an MRI. What is my next step? I have had this problem for three weeks. I am taking pain medication
regularly. Sometimes the pain in my
neck and arm are very acute. My
doctor is on vacation for another two
weeks.
Cervical radiculitis is a pinched nerve in the neck causing neck and arm pain. It is not dangerous but painful. Many times the symptoms will run their course in 8 to 12 weeks and then resolve. If the pain does not improve, then surgery to decompress the nerve may be needed. Try to stick it out for a while.
|
Q
: 10
05/12/2008 |
How many new cases of HNP are reported each year?
I do not know that there are really good statistics. Since most get better without surgery, there is really no way to know. This is a very common problem. Surgery for herniated disk is one of the most common procedures.
|
Q
: 11
04/15/2008 |
I was recently diagnosed with cervical sponylosis which has resulted in compression to my spinal cord in two places. The doctor in Thailand has recommended surgery to remove two discs and repalce them with plastic ones, thus relieving the compression. It sounds like pretty major surgery to me and I cannot help wondering if the risks outweigh the benefits.
Currently I have little pain just stiffness in my neck. The only symptoms seem to be is a tingling in my fingers and a hot sensation on my back and intermittent muscle spasms on both legs and sometimes the abdomen.
I have been advised my condition is beyond conservative treatment.
Is surgery the only option at this stage or should I ride it out to see if the conditions worsens?
Symptomatic cervical spinal cord compression with progressive neurological symptoms (worsening spasticity, numbness, clumsiness or weakness) is best treated surgically. Sometimes the symptoms can be fairly vague and the patient does not realize they are related to the cervical disease. Mild static symptoms or asymptomatic individuals can be observed closely until there is evidence of progression. However, sometimes symptoms progress rapidly and the best surgical results are obtained when treated early and before severe symptoms occur.
|
Q
: 12
03/03/2008 |
I am a 60-year old active white female with five months of
left leg pain with no back pain at night only. This wakes me up 2-3 hours after falling asleep. Getting up relieves the symptom but after returning to bed the pain continues to awaken me frequently until morning. Sleeping on my back with a pillow under my legs or on my right side has not improved my symptom. Four views of the lumbar spine shows DJD at L2-3 with narrowing at that level. Erect bilateral knees shows DJD and slight narrowing of the joint space. An injection of Depo-Medrol relieved the pain for a couple days. A doppler, sacroiliac joints, AP pelvis and frog lateral were all normal. Could this be a pinched nerve only in the supine position? Would a physical therapy, MRI or EMG be helpful? Naproxen and Celebrex are the medications I have tried.
L2-3 can give pain that occurs primarily when lying flat on your back or with hip extension. Where was the injection, knee or back? An MRI would be helpful.
|
Q
: 13
02/01/2008 |
I am 47 years old and right now and I am not experiencing any back pain but I am wondering if there are any preventive measures I should be taking to keep my back from getting worse. After experiencing great pain in 2001 I had an MRI done and the results showed, Levoscoliosis. Mild spinal stenosis at L3-4 and L4-5 due to facet degeneration.
Since then I can tell that my rib cage is protruding more and my clothes are hanging more lopsided on my shoulders, but I am pain free except when I do any amount of twisting (which I have learned not to do). Is this something that should or could be monitored now to prevent pain down the road?
Despite the fact that you are relatively asymptomatic, you should have your scoliosis checked. Adult curves that progress tend to continue to progress throughout adult life and can become substantial and debilitating. The problem is many people are too old to have anything done about the curve at that point. It is better to deal with it before it becomes a major deformity. In the meantime, good general health measures are the best advice: regular exercise, early osteoporosis screening and treatment, weight control, don't smoke. At the very least you should have a screening X-ray about every 5 years.
|
Q
: 14
01/31/2007 |
Is there a laparoscopic procedure for spinal stenosis at the University of Maryland Medical Center? If so, is this procedure successful? Your information seems to address only invasive surgery.
Since there is no documented success for laparoscopic surgery, we do not offer that option. We do use minimally invasive techniques with an operating microscope.
|
Q
: 15
12/07/2006 |
I am a 60-year-old male. I injured my back on 7/22/06 and have had an MRI, EMG and two steroid injections. Nothing has helped with the lower back ang leg pain, numbness and tingling. I am scheduled for a myelogram 12/12/06. My doctor stated in a letter he issued that he supects that I have developed spinal stenosis. My question is can an accident cause spinal stenosis?
It can contribute to the changes that lead to spinal stenosis.
|
