Progressive thoracic spine pain 10 months

Viewing 6 posts - 1 through 6 (of 26 total)

1 2 3 4 5 Next

Author

Posts
Lovelife
Member

February 24, 2012 at 8:05 am

Post count: 16

#5635

Healthy, active female.
Began experiencing mild burning in mid / upper thoracic spine about 10 months ago. Has progressively gotten worse and is worse at night. Area of t5 cannot be palpated/pushed upon, very painful. Radiates at time down spinal column and has into chest as well. Been to therapy, on Meds, etc. And no relief. Burning sensation without touching, and when lying down sometimes feels as if something is pulling or pushing on spine.
Contrast MRI reading is fairly insignificant. Healed compression fractures at t7/8, small hemingioma at t11, some end plate issues at that level from small schmorls nodes. My spine does not hurt here.
My question is concerning the MRI. A few of the images both contrast and pre contrast (t2 fsfe saggital, water:t1 saggital ideal, post contrast t1) show a bright enhancement of the entire vessel length through the vertebral body at t5. I believe they might be the Paravertebral vessels. The enhancement seems very bright and homogenous with contrast. Seems to also show on nerve roots. Is this just a weird imaging issue, a flow artifact or could it mean something? The radiologist did not mention them and my ortho surgeon was rushed and didn’t look. I understand it’s hard to say without viewing the images but I know my spine is very painful and would like some kind of direction on what it could be and what to do.
Has anyone seen this before? I’ve looked and see nothing like it out there on the web.
I do have a hx of atypical meningioma but in the lumbar spine. No recurrence so far and nothing in t-spine
I am more than willing to pay to have someone who’s and expert take another look at my images if deemed necessary.
Thank you for any thoughts.

Donald Corenman, MD, DC
Moderator

February 24, 2012 at 11:24 pm

Post count: 8660

#5649

My first question would be in regards to the compression fracture of T5. How did it happen and what is the angle of kyphosis (the angular deformity from normal)? A bright signal at T5 could be from the bony injury from the fracture (T2 signal intensity takes 6-12 months to lose brightness from a fracture) or could be from a hemangioma of the vertebra body.

If you had no trauma and the vertebra fractured without force, this could be a pathological fracture (a fracture through abnormally weak bone) from the hemangioma or some other source of bone weakness.

I would contact Dr. Jay Kaiser at Marin Magnetic Imaging in Marin, California for an over-read of your MRI if you have concerns.

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.

Lovelife
Member

February 25, 2012 at 12:17 am

Post count: 16

#5651

Thank you Dr. Corenman. I appreciate your response and this website greatly.

The pain is primarily at T5 and this is where the the vessels seem to light up through/on top of the vertebrae on sagittal view. Not sure if it means anything or if this is normal. It’s the only level I see this at, and I’m not a radiologist so because they don’t mention I’m inclined to think it’s normal but want to make sure. I do not generally have back pain problems unless there is an explanation.

The compression fractures are old and were at T7/T8. One radiologist said compression fractures, another said developmental abnormality (had two MRI’s, as the 1st was non-contrast). They look like wedges, with both superior and inferior end plate deformities. No history of trauma. My blood work was all normal. A small hemangioma was only found at T11.

I will look at contacting Dr. Kaiser as you suggest since I trust your judgment.
Thank you very much for your answer.

Donald Corenman, MD, DC
Moderator

February 25, 2012 at 4:44 am

Post count: 8660

#5652

It is starting to sound like you have Scheuermann’s disorder (see website). This would account for the appearance of wedged vertebra and endplate irregularity. This can cause local back pain that increases with load.

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.

Lovelife
Member

February 25, 2012 at 9:55 am

Post count: 16

#5654

Thank you so much for your thoughts Dr. Corenman.
My spinal curvature is pretty much normal, so I am lucky for that. Hard to know w/o seeing the images so I understand.

It’s difficult to say what, if anything is wrong to be causing the pain. Maybe I am just one of those cases where nothing explains it. Maybe it’ll go away on its own.

Could be ligament strain since pushing down on the spinous process is very painful. I would suspect that would show in the MRI though.

I will keep trying to feel better and hope to find something that works.
If it continues or worsens I will get another read on the MRI.

Thanks again, you provide a very valuable and appreciated service.

Donald Corenman, MD, DC
Moderator

February 25, 2012 at 11:20 pm

Post count: 8660

#5655

99% of the time, a diagnosis can be made. Thoracic spine pain can originate from the disc, facets or nerves as well as rarely from surrounding structures. A good work-up should be able to tell what the source of pain is.

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.
Author

Posts

Viewing 6 posts - 1 through 6 (of 26 total)

1 2 3 4 5 Next

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel