An email question about Chronic Back Pain

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

Author

Posts
Donald Corenman
Keymaster

June 28, 2011 at 5:46 am

Post count: 52

#4669

5 years ago I had an accident at work, where I had a horrendously nasty fall. I slipped on a pool of water on a polished floor, I started to fall backwards, I somehow managed to pull myself forward but ended up twisting my left ankle and crashing onto my knees sending me sliding head first into a metal stand. I ended up with a badly twisted left ankle,severe bruising to both knees, over balanced on to my right hip, continued to sliding hitting my back and right shoulder on the metal framework, finally coming to rest with my head and neck burried against the metal stand. The water on a polished floor was equivalent to falling on ice. My GP refered me 9 months after the accident during this time I was taking strong painkillers.The consultant asked where most of my pain was,I told him it was my ankle and right hip, but I also had a great deal of pain in several areas of my back. The consultant decided to concentrate only on my ankle and pelvis. I also had an MRI scan of my right hip at around the same time, apparently there were no signs of a Laberal tear. Four years later and still suffering debilitating chronic back pain,from the neck, down to my coccyx, my GP arranged a full spinal MRI,his request was lost in the British health system files, but I eventualy had my scan 5 years after my accident. I was told that I have a few bulges in my spine, the quality of the images were poor, made worse by the fact I moved and blurred some of the images. I thought it would be a good idea to have a second MRI scan done privately, this I arranged to have done in Norway, as it was considerable cheaper, again the results are inconclusive, having watched several of your lectures on the internet I was very impressed with your info vidios. If you feel that you could help me and study both my scans, plus a spinal mouse report from my osteopath, showing several areas of concern, the areas that were highlighted in the report corresponded exactly where my pain is. A general outline of my pain started off mainly from my hip, it is now radiating from my Lumbar spine,to my right buttock, and down my leg. I walk with a perminant limp. I have pain in my Thoracic spine mainly from inside my chest, also my neck is extreamly painful with limited movement, I am also unable to lift my left arm fully, I feel sure that in the begining I may have fractured a vertebrae,do you feel that after five years you would still be able to spot any fractures or scaring within my scans.Ive always felt I have a trapped nerve somewhere as it makes me shout out in pain. Five years on, its at a point now that I can not do periods of anymore than 15 minutes standing without suffering horrendous pain, if I miss step for any reason my back can be audiblely heard by others to make a loud crack, which sends me crashing to the floor where my legs just give way under me, getting in and out of my car ( volvo XC90 auto ) I often have to physically lift my legs in and over the door sill and thats the same for any car.I am still on a constant stream of painkillers I would dearly love to know whats wrong with my spine and eventually be able to lead a normal healthy life like I used to prior to my accident. Could you please help me to find out whats wrong with my spine. if you are able to help I will send copies of my scans, x-rays, and spinal mouse report to you by post..

Donald Corenman, MD, DC
Moderator

June 28, 2011 at 5:47 am

Post count: 8660

#4670

By your symptoms of right back, buttocks and leg pain that becomes worse with prolonged standing and an “instability pain” in your back (a popping noise with debilitating pain), you could have several specific problems. More likely, you have lateral recess or foraminal stenosis (see web site for description). You may even have facet dysfunction or a degenerative spondylolysthesis. Standing x-rays including flexion and extension x-rays and an MRI may help diagnose the pathology.

Thoracic pain can sometime be difficult to diagnose but again, x-rays and an MRI can be quite helpful.

Inability to raise your right arm could be from a rotator cuff tear (do web search for this), an injury of the C5 nerve (originates from the C4-5 level in the neck) or from arthritis of the shoulder joint. A good examination can reveal the origin of this problem along with x-rays and of course an MRI.

Most fractures leave a bone deformity that can be seen on x-ray or occasionally a CT scan.

I can’t promise anything but I would be happy to look at your images for you.

If you wouldn’t mind- I would like to have your permission to make your letter anonymous so that I can put it in the forum as the forum is designed for patient education and every little piece makes a good teaching point.

Thank you

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.

Donald Corenman
Keymaster

June 28, 2011 at 5:47 am

Post count: 52

#4671

Dear Dr Corenman

Thank you so much for your reply, I would like to send you both copies of my MRI scans that are on CD. Unfortunately they are both different operating systems, but both are Windows based.
The first CD containing my MRI scan was done in the United Kingdom, they use a system called Centricity Dicom Viewer.

The second CD containing my MRI scan, plus a series of X-rays of my neck, was carried out in Norway, I think the MRI equipment they used was a Mitsubishi scanner, they use a Sectra Viewer to access the images, quite hard to operate on my PC as it is in Norwegian language.

Do you want the Disks in their original format, or would you prefer ISO mounted Disks that you can copy and paste, or I can send you both.
All I can say reading directly from the CD is painfully slow, images take for ever and a day to change from one to the next.

The Spinal Mouse Report is paper based, and prevents no problems reading it.

Yes by all means you are more than welcome to use any of the images or information you consider beneficial to the educational forum.

I did notice in your reply that you mentioned it was my right arm that I could not raise, I actually took the impact on the right side of my neck and shoulder, but it is in my left arm that I am unable to raise fully, it goes to approximately to 90 degrees, I am also unable to undo or do up my bra.

There seems to be conflicting reports between the Spinal Mouse report, this was done whist standing in three different positions, whereas the MRI scans were done horizontally, could this be the reason as to why there was nothing conclusive in the MRI scans ?

There are a number of images that I have saved to memory on my PC, which seem to me to be abnormal. I was personally shocked at what I saw within the images, that have been omitted from respective reports, I do hope you can spot what they have missed.

Many thanks

Donald Corenman, MD, DC
Moderator

June 28, 2011 at 5:48 am

Post count: 8660

#4672

If you would convert both images to ISO and send both formats, that might yield the best viewing results.

Sorry about mixing right and left regarding your shoulder.

The x-ray images taken when standing in three different positions is encouraging. Make sure those images are included.

Call my office at (970) 476-1100 (USA) and talk to either of my nurses- Diana or Sarah for mailing directions.

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.

kiki
Member

July 20, 2011 at 6:25 am

Post count: 2

#4708

Hi Dr Corenman

As requested I telephoned your office regarding the address to send my MRI scans to you. Oops Im so sorry I got the time difference wrong I phoned in the middle of the night, somewhere about 3 a.m.needless to say switchboard was not impressed.

I posted the MRI scans to the address given in Vail, approximately 2weeks ago, although I have a tracking number, I have no idea if you have actually received them yet.

Hopefully they have arrived safely, so that you may study them, and hopefully give me some idea of what is causing my debilating pain.

Kind regards

kiki
Member

September 21, 2011 at 8:28 am

Post count: 2

#4911

Hi Dr Corenman, I sent Sarah an email on the 19th September 2011 for your attention, as I have not had a reply I have resent the same message today.

I have also enclosed a Zip file of my hip X-ray, that was taken about 8 months after my fall, to me it looks pretty crook, but I think your expert opinion is called for.

I look forward to hearing from you soon.

Kind regards
Author

Posts

Viewing 6 posts - 1 through 6 (of 6 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