7 months Posst ACDF c4-c7 Pain continues

Tagged: Cervical ribs, Thoracic Outlet Syndrome needing surgery

Viewing 4 posts - 1 through 4 (of 4 total)

Author

Posts
bethalbrec
Participant

July 15, 2017 at 7:34 am

Post count: 5

#25538

Hi. Well as the subject states I remain in pain since surgery. The Arms and shoulders burn, I have shooting pain down one of the two arms. Occasional finger ringing/numbness, and the most excruciating neck pain bilaterally down the side of my neck. My arms are heavy, and I can’t lift them to brush my hair, shop etc. Driving can also be a problem, and i have a weak grip in both hands. I was DX 4 months out of surgery with RSRM and my surgeon and pain doccor both thin that is the cause of my pain. My Neurologisst does not. I have since sought a second opinion of a neurosurgeon who has been working to peel the opinion away with me on this diilitating pain, that has me bedridden by 3:00 most days. This new neurosurgeon as been amazing, Ordering all sorts of X-rays and tests including a Scoleosis series and a new ENG (the surgeon who did my ACDF never did this). Turns out I have C5 C 6 nerve damage and two cervical ribs (one long left, and one short right). He now thinks I may be dealing with TOS – thoracic outlet syndrome. I also tested positive for Adsons, and he ordered a TOS MRI, which I am waiting the results of. My questions to you are: 1. If this is TOS, is it possible that my ACDF and Corpectomy created Trauma and caused the TOS to get worse? 2. With a 3 level fusion would they still be able remove the cervical Ribs/cause of the TOS without causing more issues. 3. Why wouldn’t my surgeon have seen these ribs on all the X-rays/marks he did before he had me gothough a 3 level fusion?

My new doctor is amazing, and not looking to do surgery on me, just help me. He said depending on my MRI he will be sending me to a Thoracic surgeon at UCLA. Nice to have someone who really cares. My other surgeon just basically tells me I am fine, I have fused, and the pain is MS. Would love your thoughts.

Donald Corenman, MD, DC
Moderator

July 15, 2017 at 8:46 am

Post count: 8660

#25539

I was thinking of thoracic outlet syndrome after your first four sentences however, since your surgery made the symptoms worse, I would think there might be some connection with the ACDF surgery too. I assume you had a CT scan and new MRI looking for fusion status and continued nerve compression and that these tests were negative.

Thoracic outlet syndrome has certain symptoms that would lead to this diagnosis. See https://neckandback.com/conditions/thoracic-outlet-syndrome/.

Having cervical ribs increases the likelihood of thoracic outlet syndrome. Only when compression is bad will you see EMG findings but it sounds like you have a significant case.

I’m glad you found a good surgeon as this individual was exactly who you needed.

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.

bethalbrec
Participant

July 22, 2017 at 6:41 am

Post count: 5

#25615

Hi. Thanks for your quick response. The Mra showed I had arterial compression and two different neurosurgeons confirmed the TOS diagnosis. Here is my question. One referred me to a vascular surgeon who doesn’t seem to specialize in TOS but works at USC. The other referred me to a cardio-thoracic physician team that specializes in Thoracic outlet syndrome and works with sanford on training their fellows. Vascular vs thoracic. How do I choose?

Ps. I saw the thoracic yesterday. Confirmed my case as open and shut bilateral tos requiring a minimally invasive cervical and possibly first rib resection.

Donald Corenman, MD, DC
Moderator

July 22, 2017 at 11:01 am

Post count: 8660

#25616

Experience is what you need. Training programs however are a mixed bag. Even though the experience is there, you don’t necessarily want to be under surgery by a chief resident and not the attending surgeon. If this experienced surgeon will state he will be the primary surgeon and the assistant will be the chef resident, you should do OK.

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 4 posts - 1 through 4 (of 4 total)

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