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Old 02-12-2009, 06:04 PM
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mmglobal mmglobal is offline
Join Date: Sep 2006
Posts: 2,511

Karen and Cindylou,

Note that many diagnostic injections are referred to by some physicians as 'infiltrations'. I assume that refers to the need to infiltrate the specific tissues with the anesthethetic, steriod, contrast, whatever the injectant is. While we would like this to be pure science, much of this is art and luck. False positive results may occur when the injectant flows somewhere unanticipated and generates relief from a location that is other that the target area. False negative results may occur when the injectant does not get to the target tissue because of missed injection, or proper injection with some reason that the injectant doesn't flow as anticipated... scar tissue, stenosis, etc...

Note that mixed results are also possible. By the time most of us get to this type of diagnosis, we have big multi-focal pain problems and periods of relief and bad episodes from each problem is on it's own cycle. It's difficult (or impossible) to unwind it all.

I don't know how tricky SI injections are. I look forward to learning more from Dr. Stark. Cindylou, how close is he to you?

I hate saying this because it is truly my "dumb-assed layperson's opinion", but I believe that I see more problematic cases in people with transitional segments... L6-S1 (lumbarized S1), less so for the L4-S1 (sacralized L5).

One of the more interesting things that Dr. Stark discussed in his presentation was regarding adjacent or transitional segment disorders following treatment of our lumbar spine. When we fuse L4-L5-S1, L3-4 becomes a 'transitional segment' and is subject to higher loading. While I mentioned (above) the concept of treating the spine instead of the dysfunctional SI joints (as part of a missed diagnosis), there is also the issue adjacent segment disease following the reconfiguration of the lumbar spine with fusion, ADR, auto-fusion, collapsed segments, etc... After your lumbar surgery, does the SI joint become a transitional segment BELOW the lumbar spine as it's the next mobile joint in the system?

I wonder if CindyLou might have a double whammy... is the SI a transitional segment in between a dysfunctional hip AND lumber spine???

This is all interesting stuff... I look forward to wathing this discussion unfold as we learn more.

All the best,

1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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