Another Opinion (though I think I've decided)

Tagged: osteophyte hypertrophy arthropathy 4 discs

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

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JustMo905
Participant

January 17, 2018 at 9:45 pm

Post count: 2

#27337

Hello Doc!

Brief scenario. About 5 weeks ago, I twisted my ankle, dropped a box and grabbed metal shelf to keep from falling.

Fast forward 2 weeks, my left elbow began to stiffen, wrists felt weak within a few days…arms, elbows, wrists and fingers stopped functioning normally. Burning through wrists and thumbs, unable to grasp, hold, NO SLEEPING…. ER doc was more on point that I could have imagined. Ortho, visit was checked for just the elbow. 2nd Ortho was pre-arranged for the ankle only (WC)…(tho he referred me to hand doc)… 3rd visit I ensured I saw the spine doctor. Although I STILL feel like NONE of them heard anything I said, he requested my MRI.

I brought CD home last night and saw what looked like trouble to my eye, but I’m no doctor.

I just received electronic record report from radiology. I’ll past the damages. From everything I’ve been reading, etc… It sounds like I have no choice except surgery. I refuse to be in pain for the next year just hoping and I would hate to have an accident, fall or something and wind up paralyzed. Over the past 2 weeks, the pain has continued to my neck and upper back. Not to mention, I think I’m going craziER because I’ve got pains in my knees intermittently, on on the back of the knee and my NOT twisted ankle had given out on me three times! See the info below from the report. Thanks in advance of you can shed any light. ? I’m trying to stay upbeat. I don’t want to lose ANY movement, etc…

And with 4 areas, which type surgery would b4 recommended? Seems like a lot to have to do!

I didn’t mention.. Aside from that twist Of the ankle and grab to hold on…. I was lifting and moving packages got 2.5 to 3 weeks. Something I’ve NEVER done before and wish I hadn’t!

C3-C4: Mild disc bulge flattens the ventral cord with overall mild spinal canal stenosis. No neural foraminal stenosis.

C4-C5: Disc osteophyte complex indents the ventral cord with overall mild spinal canal stenosis. Bilateral uncovertebral hypertrophy results in mild bilateral neural foraminal stenosis.

C5-C6: Disc osteophyte complex with indents the left ventral cord with overall mild spinal canal stenosis. Bilateral uncovertebral hypertrophy and facet arthropathy results in mild bilateral neural foraminal stenosis pre

C6-C7: Disc osteophyte complex flattens the ventral cord with overall mild spinal canal stenosis. Bilateral uncovertebral hypertrophy and facet arthropathy results in mild bilateral neural foraminal stenosis

Donald Corenman, MD, DC
Moderator

January 19, 2018 at 8:28 am

Post count: 8660

#27349

First, your specific symptoms and the physical examination would go a long way to determine what disorder and what levels need to be addressed and even if surgery is really necessary. I can comment on the structural problems and what might need to be addressed.

The report does not note significant central canal stenosis so I will assume that you don’t have spinal cord compression that needs to be addressed (myelopathy). For the foraminal stenosis (nerve compression the causes arm pain) the report is not impressive (“C5-C6: Disc osteophyte complex with indents the left ventral cord with overall mild spinal canal stenosis. Bilateral uncovertebral hypertrophy and facet arthropathy results in mild bilateral neural foraminal stenosis”, “C6-C7: Disc osteophyte complex flattens the ventral cord with overall mild spinal canal stenosis. Bilateral uncovertebral hypertrophy and facet arthropathy results in mild bilateral neural foraminal stenosis”). All levels have “mild” bilateral neural foraminal stenosis which leads me away from foraminal stenosis (although this is through the eyes of the radiologist which is always a question).

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.

JustMo905
Participant

February 28, 2018 at 12:05 am

Post count: 2

#27735

Fast forward. So whatever nerve is being pinched or disc is pressing, is causing carpal tunnel of both hands, along with other pain in neck, arms, fingers, etc. Considering I had no previous issues and my tests are mostly ‘unremarkable’, does it make sense that my fall and grabbing onto something to steady myself, was some type of whiplash that jolted my neck to bring on these symptoms? They literally began within 3-4 days afterwards. What sort of treatment going forward should I be looking at. So far physical therapy is missy proving where the problem is… Symptoms can be further induced when manipulating that area of the disc.

Donald Corenman, MD, DC
Moderator

February 28, 2018 at 10:27 am

Post count: 8660

#27747

Carpel tunnel of both hands is a wrist problem where the median nerve is compressed in the carpel tunnel.

Neck pain can be caused by “whiplash” forces but normally, pain is noted at the time of accident, not in a delayed onset.

I can’t tell you where you pain originates from based upon the data I have here.

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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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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