Anomaly with Atlas/Axis vertebrae

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sunzzofman
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March 28, 2012 at 11:21 pm

Post count: 2

#5871

Hi there,sorry to bother you but id love to speak with someone like yourself.Iv had extreme dizziness for around 3 years,had loads of tests done like bloods,brain mri,vestibular assesement,hearing and eye checks,adrenal gland test,urine test,EEG,24 hour ecg,all fine.I decided to get my neck checked as i couldnt put up with this anymore and was hoping it would at least rule out the neck.I went to a chiropractor and had a side x ray and a front x ray with my mouth open.they came back shocked saying my side x ray was normal,but my front x ray showed a considerable anomaly.They said it looks like iv been dropped directly on my head as a child.they tried manipulation for a while but said they carnt fix it,they didnt even charge me at all,it was all free,guessing they felt sorry for me or something lol.chiro sent a report to a gp and he sent me to a neurosurgeon,he requested 2 side x rays,even though we said side x rays at the chiro were clear.Neurosurgeon did a Flexion xray and a Extention x ray of my cervical spine,first he said its completely normaly.then he checked it again and said theres a small abnormality but its fine,wont cause any symptoms and its just the way i was born,and to go back to the gp,they didnt even checked a open mouth xray :(. Do the flexion and extension xrays show you everything you need to know? and could a open mouth x ray show a problem thats not detectable from the side? my chiro was really anooyed and is sending his xrays to the surgeon now.im not sure the exact name of what the injury is,he showed me useing one of them plastic spines,and he moved the ondontoid into the corner instead of at the centre back :S Would it be better for me to see a orthopedics instead of a neurosurgeon?

heres the chiropractic report.

“This young man has recently consulted ourselves regarding his ongoing
dizziness/vertigo. Onset occurred some 2 ^ 2 years ago after turning his head quickly. I
believe MRI scans of his cranial area were clear. However plain x-rays of his cervical spine
have revealed a considerable anomaly with his Atlas/ axis vertebrae on the left side.
This is confirmed on the MRI scan which just brings this area into view and I suspect has
not been flagged up before. This would certainly affect his balance and is identified as a
contraindiction to anv routine manipulation. This may be a congenital anomaly or
traumatic in origin from a very early age which now remains unstable.”

Donald Corenman, MD, DC
Moderator

March 29, 2012 at 2:10 am

Post count: 8660

#5874

The open mouth odontoid (OMO) X-ray view does indeed demonstrate structures that are not easily discernible on the lateral views. These structures are the C1-2 articulations or facets. Arthritis of these joints is typically missed without the OMO view. The MRI can pick up on this disorder but the images have to go up high enough to catch these structures and many times they are not captured on the images.

If there is suspicion of a disorder or deformity of the occiput to C2 area, the CT scan is a very good study. Ask your physician if they think that will help with the diagnosis. I am not sure however that dizziness can be caused by arthritis of the C1-2 joints.

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.

sunzzofman
Member

March 29, 2012 at 2:56 am

Post count: 2

#5878

Dr. Corenman post=1566 wrote: The open mouth odontoid (OMO) X-ray view does indeed demonstrate structures that are not easily discernible on the lateral views. These structures are the C1-2 articulations or facets. Arthritis of these joints is typically missed without the OMO view. The MRI can pick up on this disorder but the images have to go up high enough to catch these structures and many times they are not captured on the images.

If there is suspicion of a disorder or deformity of the occiput to C2 area, the CT scan is a very good study. Ask your physician if they think that will help with the diagnosis. I am not sure however that dizziness can be caused by arthritis of the C1-2 joints.

Dr. Corenman

My chiro hasent ever mentioned arthritis so hopefully its not that,also im 21.i do have other symptoms like fatigue,extreme weakness,bad nausea,very off balance and lightheaded,feeling faint,and last month or 2 now when i had a dizzy spell my hands go numb,like a electric shock shooting down my fingers.i do have my brain mri scans on cd,chiro said he could see the problem,dunno what im looking for but how does this image look? imageshack.us/photo/my-images/823/neckmri.jpg/
if i was reffered to you for example with this chiro report would you had just done 2 side xrays and then if it was fine just send me back to gp or? also want to say thank you so much for replying to me it means alot :) p.s that link shows the image on it,nothing to download etc :)

Donald Corenman, MD, DC
Moderator

March 29, 2012 at 11:04 am

Post count: 8660

#5889

I cannot comment of partial images. I need the actual DVD or CD to peruse. Your symptoms could be from many sources. You should consider a good and seasoned neurologist as your next consultant.

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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