Car accident - cause of scoliosis

Tagged: CSF leak, EDS, Ehlors-Danlos, Scoliosis, Spinal CSF leak

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

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tine312
Member

February 19, 2013 at 5:42 am

Post count: 3

#8023

Hi Dr. Corenman, how are you? I went through the forum & didnt see any results for my exact question. So, I will just ask it. Do you feel it is possible, if I had an “insignificant scoliosis” in 2005 & 2007 (xray reports stated just scoliosis, but doctors that read report & saw films said it was so insignificant, could have been caused by a very serious motor vehicle accident? The curve never moved for 4 yrs, until 2009, the accident occured in 2008, but upon impact from a huge truck hitting me on drivers side & pushing my car across street & hitting passenger side into telephone pole, my body swayed from left to right, not front to back. I hit my shoulder so hard on the door that I ended up w/a torn rotator cuff, of that there is no doubt the car accident caused it. I just cant find any medical documentation that states that a car accident can absolutely cause or “awaken” a dormant curve, to progress into severe scoliosis. I did have a pre-existing herniated disc and back pain, but my pain became much worse and different after the accident. Sometime toward the end of 2009, I started to curve, limp, shoulders became uneven, all the symptoms of scoliosis began to appear. I felt something pop or snap in my spine upon impact. Anyway, by 2010-2011, it became so severe, my breathing became affected because my lungs were starting to become compressed & now when xrays are taken, they ask me if I ever had a problem with my right lung. I told them after both surgeries for my scoliosis, I was told I have restrictive lung disease. They say that the lung is still smaller then my left one & still compressed. Also, my degree of curve was at 70%+. I had the surgeries in Jul 2012, 6 mos ago, first they went in through side & abodomen & took out discs & replaced them with cages. Then, a week later they did the spine, the rods, pins, screws, nuts, bolts, ya know, all kinds of hardware, ha ha! In any event, I am thankful to be straighter, but I still have one leg shorter than the other, I am still curved and reports show I still have scoliosis in the lumbar area, I still have pain, and am just starting PT. My back is completely numb & tingly, with the weirdest feeling, I cant even descirbe. Hypersensitivity, I’ve been told, is what it is, and it isnt improving. Anyway, I just want to get some peace about this issue, because I dont believe I would have ever had this all happen to me had the truck not hit me. So, if you know of any medical documentation or reported cases of a MVA causing or advancing scoliosis, I would really appreciate you letting me know. And, if you feel it is absoultely possible, I would like to hear your opinion and medical reasons as well. Thank you in advance for taking the time to read my information and answer my question. Christine

Donald Corenman, MD, DC
Moderator

February 20, 2013 at 12:36 am

Post count: 8660

#8024

In general, the increase of a scoliosis is not related to trauma with two exceptions. If there was a fracture associated with the trauma, this can increase a scoliosis curve (measured by two angulated endplates-the Cobb method). If there is pain associated with the trauma (disc herniation or such), the curve can increase from antalgia (pain that causes adaptation of the spine to compensate for the curve).

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.

tine312
Member

February 24, 2013 at 5:01 am

Post count: 3

#8071

Dr. Corenman, thanks for your answer. Antalgia seems like the most fitting answer for me. However, if you can direct me to any websites (preferably medical), such as published articles in JAMA, or articles written by doctors explaining the causes of & how antalgia develops would be really helpful. I would also like to find one site, or one doctor, who believes that even w/out antalgia, that a motor vehicle accident can “awaken” a dormant scoliosis curve. I have read way too many stories of other people online who were involved in MVAs and said that their doctors told them it was the accident that caused or furthered their scoliosis without a doubt! I guess I just cant understand how I can end up with a torn rotator cuff because of how hard the truck hit me & caused my body to sway left to right, & I felt something pop or snap in my spine upon impact, but the power of the impact couldnt be enough to make this slight curve start to advance. I will find proof somewhere, eventually, that it is possible, because, as we know, anything is possible. Thanks again, & I await your reply for some resources.

Donald Corenman, MD, DC
Moderator

February 25, 2013 at 10:20 am

Post count: 8660

#8082

A scoliosis can be present but not symptomatic. An accident can cause new symptoms that would not be present from the asymptomatic scoliosis. The scoliosis curve progressing without pain provocation (antalgia) or from fracture has not been noted in the literature or by my personal clinical experience.

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.

nanmglenn
Participant

September 19, 2022 at 4:48 pm

Post count: 1

#35309

Dr. Corenman,

Could you speak to scoliosis made worse or initiated in the case of Ehlors-Danlos and joint hypermobility.

I have EDS and significant back pain. I have a Buffalo hump (kyphosis) since having my neck and upper back whipped forward and to the left (no shoulder belt) in a motor vehicle accident.

I have had Scoliosis mentioned by PT and chiropractic, but when I try to pin anyone down about whether I have it or not, including a spine surgeon, my primary care, and physiatrist I don’t get straight answers.

I feel like my back isn’t straight. I have done different forms of Yoga for years and I can feel the difference in my spine. I also sit in a very weird kind of side folder way that is new to this accident. I also have lumbar and thoracic suspected CSF leaks

Donald Corenman, MD, DC
Moderator

September 19, 2022 at 5:30 pm

Post count: 8660

#35310

A hyperkyphosis (a large back to front spine bend) can be associated with a scoliosis and vise-versa. Ehlers Danlos Syndrome can have scoliosis and hyperkyphosis related to it. Scoliosis is measured by the Cobb method and a curve greater than 10 degrees is defined as a scoliosis. When you have EDS and become involved in an auto accident, you are more susceptible to injury due to your hypermobility from EDS but it would be unusual to have an increase in your kyphosis just from the auto accident unless you had vertebral fractures. It would be unusual to have CSF leaks spontaneously. See these links:

https://neckandback.com/anatomy/normal-spinal-alignment/
https://neckandback.com/conditions/hyperkyphosis-scheuermanns-disease/
https://neckandback.com/conditions/scoliosis-thoracic/

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.
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Donald Corenman, MD, DC

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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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Car accident – cause of scoliosis