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Arthritis (Expert Forum)
Eds/spinal stenosis again after fusions
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
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Eds/spinal stenosis again after fusions
by sandysprings, Jun 20, 2004 12:00AM
I have HEDS which has made all my joints loose especially the vertebrae in my back. I am fused from S1-L3 and C3-T1.
I am having major foot problems and am looking at possible fusion of left foot (also had left knee replacement) Doc did a nerve conduction study to rule out other reasons for pain and found I have bi-lateral moderate to severe central spinal stenosis at S1 again. I also have severe stenosis rt foranima on L2 for which I have been getting nerve root injections to prevent surgery.
Q. Are nerve conduction studies as accurate as MRI's. I am suffering a great deal of pain and am back on narcotics and crutches again to be able to walk. Also having cervical spine pain radiating down left arm into thumb and index finger.
Q.Is there a treatment for restenosis of S1 besides surgery again ? EDS makes all PT very difficult and painful. If there is arthritis in my neck, would it cause shoulder and hand pain if there is no nerve involvement. I don't know whether to see foot ortho, back surgeon or neurosurgeon or pain doc.
Q. What would new lumbar surgery involve considering I have rods and screws from S1 to L3?
I am 65 and otherwise in reasonable health. I cannoot climb stairs or walk more than a block on level ground without pain and have difficulty sleeping since I can't find a position where some joint doesn't ache.
Judy/Sandysprings
I am having major foot problems and am looking at possible fusion of left foot (also had left knee replacement) Doc did a nerve conduction study to rule out other reasons for pain and found I have bi-lateral moderate to severe central spinal stenosis at S1 again. I also have severe stenosis rt foranima on L2 for which I have been getting nerve root injections to prevent surgery.
Q. Are nerve conduction studies as accurate as MRI's. I am suffering a great deal of pain and am back on narcotics and crutches again to be able to walk. Also having cervical spine pain radiating down left arm into thumb and index finger.
Q.Is there a treatment for restenosis of S1 besides surgery again ? EDS makes all PT very difficult and painful. If there is arthritis in my neck, would it cause shoulder and hand pain if there is no nerve involvement. I don't know whether to see foot ortho, back surgeon or neurosurgeon or pain doc.
Q. What would new lumbar surgery involve considering I have rods and screws from S1 to L3?
I am 65 and otherwise in reasonable health. I cannoot climb stairs or walk more than a block on level ground without pain and have difficulty sleeping since I can't find a position where some joint doesn't ache.
Judy/Sandysprings
Doctor's Answer
by Kevin Pho, MD, Jun 21, 2004 12:00AM
, Jun 21, 2004 12:00AM
To answer your questions:
1) It is not so much as accuracy, but they test for different things. Electromyography (EMG) measures the electrical discharges made by the muscles. Nerve conduction studies (measuring nerve conduction velocity) determine how well individual nerves can transmit electrical signals. The MRI would look for any structural abnormalities that can cause nerve dysfunction.
2) Other options for restenosis would include lumbar epidural injections, as well as soft-tissue injections. A neurosurgeon would be the appropriate referral to obtain.
3) I cannot make any specific surgical comments without being personally involved in your case. The neurosurgery evaluation would be an appropriate next step.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
1) It is not so much as accuracy, but they test for different things. Electromyography (EMG) measures the electrical discharges made by the muscles. Nerve conduction studies (measuring nerve conduction velocity) determine how well individual nerves can transmit electrical signals. The MRI would look for any structural abnormalities that can cause nerve dysfunction.
2) Other options for restenosis would include lumbar epidural injections, as well as soft-tissue injections. A neurosurgeon would be the appropriate referral to obtain.
3) I cannot make any specific surgical comments without being personally involved in your case. The neurosurgery evaluation would be an appropriate next step.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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