C5-C6 Nerve Issues

Viewing 5 posts - 1 through 5 (of 5 total)

Author

Posts
MarkL
Member

February 14, 2012 at 10:11 am

Post count: 3

#5571

Hi. I was a passenger in a 1995 car accident where a driver drove into the passenger door at 40mph. After 6 months of neck PT, symptoms disappeared for 12 years. Neck pain in 2007 led me to get an MRI which showed some C5-C6 degeneration, spur formation, narrowing, slight bulging. Yoga and home traction relieved the pain and brought more movement to the joints but it’s still generally on the sore side. I’m early 40s, in good shape, live healthy lifestyle (despite working at a computer).

A nerve conduction study was done in 2008 before a rotator cuff repair. The surgeon wanted to be sure the pain was coming from my shoulder and not my neck. Although the neurologist concluded the shoulder was the cause of the shoulder pain, he told me there was bilateral nerve weakness consistent with a C5-C6 injury. Although I barely felt anything at the time, I have been getting progressively weaker from the lower bicep through my forearms and into my wrists since 08. I lift weights to avoid muscle wasting and keep trying to ignore it but I am noticing fine motor skill issues and very early fatigue. Gripping things for a while and even typing can be a challenge after a few minutes. It’s all still livable (though annoying) but at the pace it’s moving, I fear whether I’ll have use of my arms/hands by age 55 or 60.

My Question: Is this type of damage generally permanent? Is time of the essence to get it treated? Should I not be fighting through it but instead be having something done about it? What would typically be done for this? Back in 07 when the MRI was done, they said they don’t like to do surgery for stuff like what they saw because the risks of neck surgery are so great. Thanks for your help!

Donald Corenman, MD, DC
Moderator

February 14, 2012 at 1:16 pm

Post count: 8660

#5573

You had a motor vehicle accident about 16 years ago and recovered after 6 months. About 5 years ago, you developed neck pain and an MRI demonstrated degeneration of the C5-6 disc. You have been able to manage the pain and live a relatively normal life.

You underwent an EMG which indicated involvement of the C6 nerve (C5-6 level). You have been developing progressive weakness of your biceps to wrists bilaterally.

Normally, foraminal stenosis (see website) is not normally bilaterally symmetrical. Also, there typically are paresthesias (pins and needles) and pain associated with foraminal stenosis and the symptoms typically become worse with neck extension (bending the head backwards) and improve with the chin on chest maneuver. Does that fit with your current complaints?

If you have only weakness without any radiating symptoms, you need to see a neurologist again. If you have the above noted symptoms, you need to see a spine surgeon for a consultation.

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.

MarkL
Member

February 14, 2012 at 4:04 pm

Post count: 3

#5574

Thanks doc. I just found the MRI report from 07. I’ll type it up in case that’s helpful. At C5-6 disc space, a 3.8mm broad-based bridging osteophyte creates minimal spinal stenosis with attenuation in the anterior subarachnoid space. A 2.5mm far right lateral protrusion superimposed on hypertrophic change to the right uncovertebral joint contributes to severe right C6 lateral recess and proximal foraminal stenosis. There is additionally severe compromise to the left C6 foramen due to hypertrophic change to the uncovertebral joint and lateral spondylosis. At the C6-7 disc space, a 2.5 mm diffuse bulging annulus and minimal spondylosis is present. At the C7-T1 disc space, a 1mm far right lateral protrusion is not excluded. The resolution and definition of the lateral recess and proximal foramen is somewhat limited. The signal intensity of the cervical chord is normal. The facet articulations are maintained bilaterally. There is no compression fracture deformity of the cervical vertebrae. There is no evidence of cerebellar tonsillar ectopia. Normal flow is demonstrated from both vertebral arteries.

I can’t find the EMG report from 08 but I remember that only 1 side was tested. They had found some weakness that they said was consistent with the neck condition, from the bicep to the wrist flexors. Today I feel weakness in those areas in both arms. At the time of the tests, I was having the paresthesias with head bent back. Flexibility has improved with traction and yoga and I don’t notice paresthesias when bending head back (just stiffness). I get some pain in low bicep/forearm area when sitting with bad posture for extended periods today.

Given this more detailed information, does it sound like I should be seeing a spinal surgeon or neurologist? OR just tough it out? If nerve damage is being done, is time of the essence that I deal with this so as to prevent further damage or bring back any strength that has been lost? Or would that be permanent loss? Thanks so much.

Donald Corenman, MD, DC
Moderator

February 15, 2012 at 10:37 am

Post count: 8660

#5576

Based upon the radiologist noting “severe” foraminal stenosis bilaterally at C5-6 and increased symptoms with head extension, you might be better off with a spine surgeon. Motor weakness needs to be addressed and if from severe foraminal stenosis, a spine surgery consult would make more sense.

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.

MarkL
Member

February 16, 2012 at 2:26 am

Post count: 3

#5578

OK. Thanks for your reply.
Author

Posts

Viewing 5 posts - 1 through 5 (of 5 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