C-Spine X-RAY Report !!

Tagged: Injury with preexisting IDR at C5-7 (slip at C4-5)

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

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fastfreddy
Participant

October 31, 2017 at 11:12 am

Post count: 5

#26733

Dear Dr.Corenman,
I’m new to the forum,and injured my Cervical spine from a ATV accident.Doctor now days I have been having a lot of neck pain,and spasms in my neck area.Recently my Doctor sent me for a X-RAY.I thought maybe you could please help me understand what they are saying in my X-RAY report.

This is what the report stated:: Demonstrate severe degenerative disease, Facet Arthropathy, and Uncovertebral Arthropathy C5 through C7 with Osteophytic impingement on the neural Foramina bilaterally at these levels. The disease is mild at C1 through C4.

Can you please let me know what is Facet Arthropathy and Uncovertebral Arthropathy ?

What does Impingement on the neural Foramina bilaterally means ?

Thank you for your help !!

fastfreddy
Participant

October 31, 2017 at 1:39 pm

Post count: 5

#26734

I forgot to mentioned what was my injury was, It was a serious Ligamentous injury of C4-5 level. I Ruptured and tore the ligaments away from my vertebraes at C4-5 level when I was thrown from the 4-wheeler approximately 10 to 15 feet.

Could you please explain my injury !!

Thank you

Donald Corenman, MD, DC
Moderator

November 3, 2017 at 6:22 am

Post count: 8660

#26751

You have typical degenerative disc and facet disease at C5-7. Probably multilevel desc resorption (see https://neckandback.com/conditions/isolated-disc-resorption-cervical-spine-idr/). This is most likely genetically related with trauma that activates pain receptors.

The C4-5 disc and facets are more exposed to breakdown due to the loss of motion of the C5-7 levels. Typically, the C4-5 level then develops a degenerative spondylolisthesis (see https://neckandback.com/conditions/degenerative-spondylolisthesis-cervical/). The accident can certainly worsen or aggravate this condition and occasionally cause the slip to start or increase.

There is no report of C4-5 so the slip may be pure speculation on my part but normally the slip becomes more obvious on flexion/extension X-rays.

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.

fastfreddy
Participant

November 4, 2017 at 10:57 am

Post count: 5

#26758

Dr. Corenman, Thank you for answering my questions so promptly. My primary care Doctor sent me to see a Spine Doctor, and I forgot the CD-ROM with the X-RAYS Images on it on the day of my Doctor’s appointment with the Spine Doctor,so the Spine Doctor gave me a new Flexion & Extension X-RAY. Here’s what he said in the new Report!!

This patient has a Kyphotic curvature at the lower cervical spine.He also has Grade 1 Anterolisthesis of C4 on C5 which is slightly more prominent on Flexion. Moderate Spondylotic changes of the cervical spine most notable at C4-5 C5-6 and C6-7, where there is anterior and posterior Osteophytosis. Stable moderate / Advanced left neural foraminal narrowing at C4-5, and a C5 anterior Superior Endplate deformity.

Could you please Explain what is Grade 1 Anterolisthesis is? I hope I can still ride my 4- Wheeler (ATV) with this grade 1 Anterolisthesis or is this like instability and my cervical spine is becoming unstable at that level hope this is not what is going on because I love riding my 4- Wheeler? Please let me know

What is C5 anterior Superior Endplate deformity ?

Could you please tell me what is actually going on !!

Thank you, You’ve been very helpful

Donald Corenman, MD, DC
Moderator

November 5, 2017 at 10:33 am

Post count: 8660

#26759

The scenario I noted in my last response is exactly what you have described in your last message. The C5-7 levels have broken down to the point that this discs have absorbed away (https://neckandback.com/conditions/cervical-degenerative-kyphosis/ and https://neckandback.com/conditions/isolated-disc-resorption-cervical-spine-idr/.

This in turn leads to slipping of the C4-5 vertebra (“grade I anterolisthesis”-https://neckandback.com/conditions/degenerative-spondylolisthesis-cervical/).

The vertebral body is essentially square shaped. If there is a corner fracture or excessive wear of the corner, you will get a “C5 anterior Superior Endplate deformity”.

The amount of motion that occurs with flexion vs extension will give the physician an understanding of the potential for instability. If your canal diameter is already somewhat narrowed and the instability is significant, you could put your spinal cord at risk.

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.

fastfreddy
Participant

November 5, 2017 at 5:55 pm

Post count: 5

#26767

You’re GOOD Dr.Corenman !! Thank you again
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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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