c5-6 disc herniation

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Donald Corenman, MD, DC
Moderator

April 22, 2011 at 12:06 pm

Post count: 8660

#4491

The thoracic pain could be from degenerative disc disease. Type 2 changes refer to the bone changes noted on MRI that occur after significant disc disease and vertebral endplate damage. Since the injury occurred while serving our country, you might be able to get a VA doc to help you. Different VAs have vastly different skilled spine physicians so you will have to do your research to find the best one.

Chiropractic manipulation can be quite helpful for your mid-thoracic pain. Get a consultation to see if the Chiropractor agrees if you can be helped.

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.

rpowell01
Member

April 22, 2011 at 6:50 pm

Post count: 6

#4492

I guess I didn’t mention that I was service connected for my cervical and thoralumbar. Yes I go see the VA for these. The problem I have with the VA is that these symptoms have been going on since January 2010. I had a MRI in May of 2010 on my Cervical and Lumbar. How in the world did they miss my herniation at C5-C6 causing left foraminal stenosis? I had all the symptoms during the MRI, I even told the tech all my symptoms. I had to suffer for 10 months Doc before I had to have a private MRI show the herniation and a Orthopedic Doctor to fix it. Seriously do you think I really give a crap about the VA at this point? The VA provides treatment to us veterans like they would provide service to a third world country. Sorry I am upset in this reply but I have had nothing except aggravation with the VA since January of 2010. So you see this is why I refuse to go see them any longer.

They are untrusted in my opinion and yes I am filing a huge complaint against the MRI radiologist for that MRI report! If I had the symptoms then the herniation was there.

Today is the 2nd day in a row I feel really good after the ESI. How will this last? I don’t know but it sure feels good to be without that type of pain.

Thanks Dr. Corenman this will be my last post and I do appreciate your information.

yrsilly
Member

October 15, 2012 at 10:30 am

Post count: 1

#7166

OMGoodness rpowell01, I swear you have been living in my body for the past several years. What you have written describes me to a “T”.

For starters, 27 years ago I was shot completely through the head and was left with headaches and pain above the clavicle region. In addition, I would experience “ice pick” headaches for days and at times, weeks on end. About 10 years I began having severe fasciculations and muscle spasms in my body. The spasms were so severe that you could see the muscles ( many different individuals including multiple doctors) witnessed this happening. Every test known to man was run through blood work and MRIs of the brain. Finally I was told it was Benign Muscle Fasciculation?Spasm Syndrome and that basically nothing could be done for it.

3 years ago I developed left shoulder pain and went to an orthopedist. He ordered X-rays then after viewing them sent me immediately for and MRI of the Cervical Spine. which stated the following: c3/c4 4 mm posterior protrusion centrally, c4/c5, anterior disc protrusion, c5/c6 4 mm left disc protrusion posteriorly with moderate left neural formanal narroing, narrowing of the spinal canal centrally. c6/c7 4 mm left disc porturstion, severe left neural formainal stenosis and impingement of the left exiting roots, There is rotation of the left thecal sac and cord. I was immediately placed in an Aspen collar for at least 12 hours a day, traction twice a day and severely limited on what I could do with my arms.

Within the year I began having constant pain in my chest, as if someone was tearing out my pecs, and yes, like you, specific areas of pain which later I was told were trigger points in my body. Soon my arms joined in the debacle and I was sent off to have EMGs and NCSs on both arms since my pain was bilateral. Reports came back with median and ulner nerve damage in both arms. I am highly allergic to most medications and one by one we went through the list of pain management medications and slowly eliminated them. I have been in and out of ER with chest pain that mimics a heart attack yet all tests show that my heart is fine even though it feels on a daily basis that a spear is piercing my chest wall.

Woke up one morning last winter to find the area on the right side of my chest were TOS would be located swollen to at least triple its size and I was unable to move my arm from shoulder to elbow. Elbow to hand was fine. The pain was horrific and but all I could use was Advil and ice. all other methods had previously been ruled out. Mind you, I was still working a full work day in the Aspen brace. Slowly over the past 6 months the occasional pain in my arms, from arm pit to finger tips, has grown in intensity from burning nerve pain, to feeling like someone is stabbing me with a knife. 2 months ago my right bicep swelled up as large as a grapefruit and the arm turned a pale bluish white. Back to the ortho, immediately sent in for MRI which indicated fluid and swelling in the cubital tunnel. Back to the ortho who physically tested for TOS and he discovered he could not find a pulse in my left arm, the normal one. Now off to a Vascular Surgeon who stated in his report,” I am not sure of what she has, but something is definitely abnormal.”

Next stop is a Rheumatolgist who diagnosed me with aggressive and controlled Fibromyalia above and beyond the physical findings of the surgeon and orthopedist. Now back to the Neuron-surgeon who put me through the pin prick to the fingers test to having me fail on the right hand; never flinched when he was poking the fingers, but on the left hand, the side with the impingement, I could feel pain, but less than before.

Technically my pain should NOT be bi-lateral but it is, and is proven by observation, physical tests, diagnostic imaging and just about anything you can think of. I have had to leave my job because I could no longer perform my duties. My regular MD just shakes his head and tells me he has never in 30 years of practicing medicine, seen anything like this, but here I am. After the latest series of testing by the Rheu to see if there is another issue, I will return to the Neurosurgeon for another MRI and probably the scheduling of surgery. Do not give up, do not be dismissed and believe in yourself. 10 years ago I was told it was anxiety and look where I am today. In a neck brace and arm braces and sorry, I have never seen a shrink instruct a patient to wear those!

rpowell01
Member

January 21, 2015 at 7:47 pm

Post count: 6

#12043

Well after a lot of testing it has come down to a few things. I have DDD and DJD and its the DJD (Osteoarthritis) that is causing 99% of my issues. Since I wrote my posts I’ve had a few EMGs two on my upper arms and one on my legs. The one on my arms showed no radiculopathy but the doctor stated it doesn’t mean I don’t have a pinched nerve. Then I had an EMG in 2013 that showed bilateral radiculopathy at L5-S1.

Long story short, the VA will not touch me because they say I am too young (46) but I see others around me who are younger having surgery with DDD. The VA Neurologist and Pain Management told me that I will have to live the rest of my life in pain.

So, I’ve taken up their offer on placing me on Oxycodone and 3600mg per day of Gabapentin. They help but somedays they don’t help at all. I am a 100% DAV with the VA and I was approved for SSDI because of all these issues.

Here is what is so, so , so weird, my lumbar back doesn’t hurt that much but my legs, feet and toes are in pain a lot. But, my mid back at T8-T10 are in a lot of pain, 24/7.

Can the T-Spine issues and the radiculopathy in my legs be related since the spinal cord is separated at the end of the T-Spine? A Neuro-Radiologist in Maryland conducted a physical on me, read over all my records and he explained that issues in the neck can cause issues in the legs so I am now wondering about this.

XRays on my lumbar shows DJD that is progressing even today.

Donald Corenman, MD, DC
Moderator

January 21, 2015 at 10:20 pm

Post count: 8660

#12044

Compression of the spinal cord does not often cause leg pain. Cord compression typically causes numbness and paresthesias (pins and needles) in the legs but not pain.

Leg pain can be caused by various factors in the lumbar spine such as foraminal compression, lateral recess and central stenosis and disc herniation. See the website for descriptions of those disorders and the symptoms they generate.

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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