Cervical MRIs

Tagged: headaches, Whiplash and neck pain

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Yousavefer
Participant

February 20, 2017 at 1:10 pm

Post count: 3

#24354

Hello,
I have been in two car accidents in the past year. I had a MRI done on December of 2015 and another one done on Jan 2017.
So 13 months apart.
The first MRI states :
Findings:
Impression: at the C5-6 level, there is moderate posterior marginal spurring and disc bulging, which does cause mild effacement to the left ventral aspect of the spinal cord. There is no evidence for spinal stenosis.

At the c4-c5 level, there is mild posterior disc bulging and marginal spurring.

No evidence for dis herniation or spinal stenosis. No signal abnormality demonstrated within the visualized spinal cord.

Findings : Examination at the c2-3 and the C3-4 levels demonstrate no evidence for disc herniation or spinal stenosis.

Examination at the C4-5 level demonstrates mild posterior disc bulging and marginal spurring. There is no evidence for stenosis of the central spinal canal or neural foramina.

Examination at the C5-6 level demonstrates moderate posterior marginal spurring and disc bulging, what does cause a mild effacement to the ventral aspect of the spinal cord. There is no evidence for stenosis of the central spinal canal or the neural foramina.

Examination of the c6-7 and C7-Ti levels demonstrate no evidence for disc herniation or spinal stenosis.

No Abnormality is demonstrated at the craniovertebral junction or within the visualized spinal core

The One that was taken on Jan 2017:

Normal signal intensity within the cervical and upper thoracic cord. No chiari malformations of the syrinx, no intrinsic cord lesion and no intradural mass.

Cervical Spondylosis with moderate disc space narrowing at the C5-6 preservations of the disc space height and the c3-4 and straightening of the cervical lordosis. Degenerative changes are associated with thicken the posterior longitudinal spinal ligament at the C6 and C5.

T2-3 through c6-7: dorsal disc margins unremarkable with mild dorsal bulging at the c6-7 normal facets at each level and no stenosis or impingement.

C5-6: Moderate-sized 4mm broad based left paracentral disc protrusion/osteophyte with thickening possible ossification of the posterior longitudinal spinal ligament, mild to moderate narrowing of the canal and moderate left ventral cord flattening/ Normal facets joints and patent neural foramina.

C3-4 and C2-3 : dorsal margin and facet joints normal. No stenosis or impingement.

No degenerative or erosive changes within the atlantoaxial or cervical-occipital joints.

Normal signal intensity with the vertebral marrow spaces.

Conclusion: Cervical spondylosis and thickening /ossification of the posterior longitudinal spinal ligament with straightening of the lordosis.

No md has gone over this with me nor will they will for weeks after PT.

Doesn’t seem possible to have my neck change that bad within 13 months, as I’m a healthy 32 year old.

Donald Corenman, MD, DC
Moderator

February 20, 2017 at 5:08 pm

Post count: 8660

#24357

The MRI readings by themselves are not very helpful. It really depends upon the symptoms you have the comparison between these symptoms to the MRI (and X-ray) findings. See the section https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-lower-back-and-leg-pain/ to understand how to describe symptoms.

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.

Yousavefer
Participant

February 20, 2017 at 5:16 pm

Post count: 3

#24358

With the first one I had left arm numbnes ( my first three fingers) I was D.X with whiplash and frozen shoulder with impingement. I was sore and stiff for 4 months with headaches but it got better.

With the last accident, the headaches I’m having are horrible, they start at the base then go behind my eyes to the point where my eyes hurt.
Very limited ROM, pain in the neck that goes down to shoulders. Left fingers are numb again as well. Can’t sleep. Haven’t driven a car very much either.

Also my SI joint has inflammation, as I have been having issues with the right hip going down my leg pain.

The first car accident I was hit from behind. By two cars. The last one I tboned a lady who ran a red light.

Donald Corenman, MD, DC
Moderator

February 21, 2017 at 1:16 pm

Post count: 8660

#24374

Your findings of cord and root compression are not too remarkable. The worst level is noted to be C5-6 (C5-6: “Moderate-sized 4mm broad based left paracentral disc protrusion/osteophyte with thickening possible ossification of the posterior longitudinal spinal ligament, mild to moderate narrowing of the canal and moderate left ventral cord flattening/ Normal facets joints and patent neural foramina”. There is no mention of cord compression but some “flattening”. Your symptoms do not appear to be from cord compression which is generally painless.

Headaches can be from injury to the upper facets but this pain generally will not radiate to the eyes. The left fingers being “numb” should not be generated from the cervical spine based upon your imaging studies. Numbness could be generated by peripheral nerve entrapment. See https://neckandback.com/conditions/nerve-entrapment-compression/ to understand how these nerves become entrapped.

Neck pain and loss of range of motion could be disc related and you do have degenerative changes of the discs. You would need to see a neck specialist to have this worked up.

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.

Yousavefer
Participant

February 21, 2017 at 2:50 pm

Post count: 3

#24400

I have an appt in a month or so.
What was concerning to me how the two MRI are so different in 13 months.
Is it possible for such change naturally or is it from the trauma?

Donald Corenman, MD, DC
Moderator

February 21, 2017 at 6:36 pm

Post count: 8660

#24407

The fact you had a trauma and a change in symptoms after the second accident indicates probable new-onset injury. The previous MRI performed so close to the newer accident is generally a documentation of the results of the second accident.

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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