Cervical Instability C1 C2

Tagged: cervical instability

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Dragonfly
Participant

July 13, 2016 at 4:19 pm

Post count: 6

#22592

Hi, I’m new here and saw your post regarding prolotherapy? Could you tell me if it had worked for you? I’m reading posts from years back but just joined and are finding so many of you that have such similar struggles. Any information and support would help.
Thank you
Andrea

Donald Corenman, MD, DC
Moderator

July 17, 2016 at 7:30 am

Post count: 8660

#22599

How do you know your ligaments have been overstretched? Ligament injury can go from tears (too much motion) to contractures (too little motion). With this type of mal-motion, joints can degenerate (arthritis) which is somewhat common. Neurological injury can occur which can radiate pain in unusual patterns. Constant pain with activity can create reactive depression (https://neckandback.com/conditions/back-neck-pain-reactive-depression/) and pain magnification syndromes.

Some of your symptoms should not originate from the occiput-C2 levels (“I off and in experience pain in my joints in my fingers numbness in my thumb finer nail my index and middle finger and arm, at times it hurts so bad I can’t make a fist”) unless there is injury to the cord at the upper level (which would be highly unusual).

The symptoms “when the spasms between my shoulder blades start its shattering and brings you to your knees! It pinches and pounds so hard it worsens to even inhale deep” should not originate from the upper neck but these symptoms can generally originate from the lower neck (C4-T1). I assume that you have had a workup that can shed light on the lower neck.

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.

Dragonfly
Participant

July 17, 2016 at 3:10 pm

Post count: 6

#22616

I was diagnosed with ligament laxity in my neck and upper back, it’s something I never new I had as far as being hypermobile and that it made me subseptable to injury. With no other previous injurys or severe health conditions I experienced a car accident over two years ago, and was at a stop while I was hit full force at 50mph.. From there I checked out ok but had pain so I had been in physical therapy for a bulging disc which is the only thing they related the pain to. But after 7months of treatment they suggested I seek other areas of treatment because they could not pin point why I was feeling still so bad. They had done pressure points on me around my neck and back region and it was so painful and created other areas of my body to hurt when pressure was applied. Like if he pressed on a side of my neck I could feel the pain in my eye arm, etc.. Just examples.. They also did traction and massage and I had a tens unit. But after time I saught pain mgmt which I went through trigger point injections and facet injections, and the use of narcotics for pain and muscle relaxers, I began to be one depressed and had terrible time sleeping so I was also placed on Cymbalta and resteril for sleep..But still no recovery, I have had chiropractic and osteo manipulation, the manipulation was amazing and was the only treatment that gave me immediate relief but it would return just minutes after… We saought out a specialist who did testing MRI DMx brain scan ct scan and XRays and said it was due to my ligaments suddenly being over stretched by such force and already having the Hypermobility made it worse.. I from there was told prolotherapy would be a good form of treatment and am now seeing that by a specialist who also said I had laxity. No matter what I do even the simplest of things like brushing my teeth folding laundry writing, I get awful spasms that cause such agony, I also experience heavy head like my heads to heavy for my neck. My spine at times feels like it’s got so much weight and the pain becomes so unbearable it feels like my spine is going to break in half. I crack also bad and frequently in my upper back, during manipulation my neck would crack so loud but if feel immediate relief. They said because my ligaments are over stretched my muscle keeps spasming to keep the spine in place. They said its instability and that’s exactly what it feels like, like constant movement dislocates my joints. Sitting especially increases the pain and heaviness.. My hand has become worse and can’t write for long periods of time it’s very random and inconsistent but my thumb nail is usually numb and I get pain in my hand fingers and arm. During a massage and area around my shoulder blades was pressed and it automatically made my arm and fingers hurt.. It’s been debilitating I could be adjusted and moments later I fall back out of place.. They also said my jaw when in movement shifts to the right, ever sense the accident my jaw hurts and even the muscles in my face seem so tight like I can’t relax them. My teeth began to hurt I thought I had cavities but my dentist said I’m clinching my teeth from the pain I’m constantly in which is causing the teeth pain..Thank you for replying and suggestions would help.Btw I’m only 32, and most Dr’s are confused because I’m in good health and young and they just don’t understand why my body won’t heal. But sense then with the diagnosis ligament over stretched is a permanent thing without treatment.
Thank you
Andrea

Donald Corenman, MD, DC
Moderator

July 17, 2016 at 7:22 pm

Post count: 8660

#22619

Be careful about your diagnosis. There are disorders of the upper cervical spine that are present but undiagnosed by many physicians. I am relatively sure you have not had facet blocks of C1-2 (or occiput-C1 for that matter) as the individuals who do that procedure are hyper-specialized and normally don’t get these referrals. Hyper-mobility of C1-2 is very rare and most other diagnoses (C1-2 osteoarthritis or C2-3 facet degeneration) are much more common. I am not a fan of DMX motion films as these videos over-diagnose disorders that are many times not there. As I said, be very careful of prolotherapy in this area as the consequences of a maldirected injection can be catastrophic.

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.

Travis
Participant

December 1, 2016 at 5:39 pm

Post count: 1

#23504

Frog37 I pretty much have the exact same symptoms as you, a little different though, I have extremely watery eyes and face pain, extreme fatigue, and have been dealing with them for about 7 months now. Have you had any success with any treatments? I know you posted years ago but please respond if you see this, I need to find something that works, I feel like I’m dying.

Dragonfly
Participant

December 3, 2016 at 3:14 pm

Post count: 6

#23508

Hi Travis,
I had posted a similar question to that post that was so similar to mine as well, I was hoping and praying to hear back even though it was over 2years that post was created. But I saw your response and I cAnt tell you how sorry I am, I know exactly what your enduring, it’s so scary and there’s not much relief in site. I’ve learned having this for over 2years there is a lot of diagnosis failures and treatment, I just got my diagnosis two years into it, I’m 33 and besides this have not have any disabling pain, always been active. Long story short I have ligament damage which is causing my muscles to compensate and stabilize my spine from a car accident. Forever they were treating the muscle spasms but not understanding the cause of it, so I honestly spasm over literally anything. I sweat a lot my heart races I have jaw pain headaches you name it. This injury does not show up on regular MRI or XRay, I was fortunate to finally find a Dr who new exactly what it was and I had a DMX done which is an X-ray but with your body actually in movement which showed why my pain was so severe. And it is deteriorating over the length of time it’s been injured. I had physical therapy, chiropractic care, osteopathic manipulation, pain mgmt, injections for trigger point or and facet injections. But found that a treatment called prolotherapy is one of the few to work for this injury, because ligaments don’t heal on their own and are what stabilize you and help your body to move, it’s like a rubber band being overstretched and once it is it can’t go back to its normal size to hold things in place. If that makes sense. Prolotherapy helps to inflame the areas to help shrink the ligaments back but it is a long process and is a very traumatic injury to have. I’d love to talk with you more if you need too, I know how hard this is and few understand.
Andrea
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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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