Don't know what I have.

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Margo
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September 2, 2012 at 8:41 am

Post count: 12

#6884

Dear Dr. Corenman,

I’m in South Korea and started having all these back troubles and the doctors are having trouble or won’t really tell me what is going on.

After a couple of years, 2 xrays, 1 MRI, I think I’m narrowing it down. I think two doctors have mis diagnosed me and I finally found one who may have it.

I’m 46 I had bad fall off a horse when I was 22 that left with with an pelvis that came apart and locked hip.

In mid 2010 I started feeling numbness in my 3rd and 4th toe of the left foot after I walked for long periods. I mean an hour or more. When I sat down and rested it was OK. Every time I walked I felt it so didn’t really know who to see about this so rather just rested every time I felt it. In 2011 maybe November I saw a back doctor as I started jogging and I felt this sprain in my lower back. How you feel when you sprain your ankle I felt that in my back. The Xrays showed a herniated disc (so they said) between 4 and 5 of the lower back. He put me into physio treatment a hot pack, and a machine with 3 or 4 pads connected to my nerve pathway that went for 15 minutes then traction and some medication. I’d go for two weeks stay away after a month go again. The pain would go after the two weeks but never completely. Later on the physio therapy was less and less effective. Finally I saw another orthopedic doctor today and he said I have spinal stenosis after looking at those xrays. He injected an anti inflamatory in my back at the spine and told me to come back in 4 days but there was no physic treatment. I think that is working.

Apart from all that I have something wrong with my neck i think between 5 and 6. It’s also bulging and caused numbness in both hands. I first noticed that in January and when I asked about it they again put in for physic treatment which was NOT working, so everytimge I told him he seemed mad at me and finally snapped and said “it’s just a herniated disc and because you don’t believe me I’ll put in for an MRI. I did the MRI. This I discovered last January and wrote to you then. You were very helpful. The doctors here not so much and when it wouldn’t go away I kept going back he was mad that I’d go back and just told me to go for an MRI without any explanation what this was. I still don’t know. I hope this attachment works I’ll send you the MRI of my neck there are about 50 different angels of it so I’ll send two or three if I can. I’m really really worried. I have so much wrong with my spine and I’m not even insured if I did need an operation though i had better find a way to do something. My neck is constantly stiff. The good news is since I’ve improved my posture and got myself a comfort neck traction unit at home and use that. I have not felt the numbness in my hands again. But my neck is very very stiff. When I do slow turning or stretching exercises on it. I kind of feel this stiff clickty click feeling which is really scary. I go for massages sometimes and the girls are shocked at all the tightness. The Xrays show my neck is not the normal S shape but rather straight up. Can this be changed with good posture?

Can you give me any warnings of how to slow down whatever is happening to me?
Can you tell me what you think is happening to me?
I’m scared of getting a stroke or something out of this. Please tell me that’s not likely.
Can you tell me what exercises are best for both the neck and lower back?
I’m moving to Turkey to teach English and I’m not sure if there is therapy so easily available there.

Not sure how to attach my MRI here.

Thanks
Margo

Donald Corenman, MD, DC
Moderator

September 2, 2012 at 7:14 pm

Post count: 8660

#6885

First fact to acknowledge is that your neck and lower back are not related (except for genetics). Do not send me selected images as this generally does not work due to the fact all the images joined together are needed to understand the anatomy of the spine.

In regards to your lower back, degenerative disc disease (extremely common and generally benign) can cause most of the symptoms that you describe. The “tired feeling” or “sprained back feeling” is quite common. A good core strengthening program, especially using Pilates can help to strengthen the core muscles which will reenforce the weakened lumbar spine. There are rare patients that cannot tolerate these symptoms and a surgical consultation could be in order.

Now, if you have lumbar stenosis, that is a different story. Narrowing of the central spinal canal or nerve root exit zone (foramen) will compress the cauda equina or nerve root causing “numbness” when standing, walking and running.

Clicking and popping in the neck that is not painful is very common and by itself, nothing to worry about. Stiffness is generally related to degenerative disc and facet disease. If there is no instability or canal/foraminal narrowing, therapy is the beginning treatment necessary. Chiropractic treatment can be very effective.

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.

Margo
Member

September 2, 2012 at 7:50 pm

Post count: 12

#6886

Thank you so much. That’s very helpful and relieves a lot of my initial fears. I seem to have found a doctor finally that knows what he’s talking about so I’ll see what he says on wednesday.
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Donald Corenman, MD, DC

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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.

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