Cervical myelopathy/ myelomalacia

Tagged: Cervical myelopathy/ myelomalacia

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Hummerh139
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December 2, 2018 at 7:12 pm

Post count: 5

#29839

I was rear ended 44 months ago in car accident….I worsen rapdily even with chiropactor care which I seeked 3 days after accident bc symptoms that I went to ER for and were told sprain neck worsen and worsen rapidly…. Went to ER for horrible neck and lower back pains radiate into arms and legs and tingling/ numbness in hands & feet…11 days after my accident I was barely ambulatory and in an MRI booth having a cervical and lumbar mris….mris of my neck finding were c3c4 grade 1 retrolisthesis c5c6 herniated disc indenting spinal cord and my spinal canal AP diameter was 7mm c6c7 herniated disc no cord compression and spinal canal AP diameter of 8.5mm & lumbar l5s1 grade 1 retrolisthesis & herniated disc abutting left exit nerve root….a month after mris have an EMG/ NCV and this showed radiculopathy at c6, c7, l5, s1 bilaterally both sides both levels….have a shot in lower back did absolutely nothing and board cerfitied physical medicine and rehab doctor said no reason to do anymore shot…rifht after MRI I was referred to spine surgeon but couldn’t see then til 3 months after my accident….when got to spine surgeon PA appointment I was wheelchair bound decrease full body sensation more decreases bully button down then above shoulder weakness and hand weakness…dropping this out of know where…dealing with what I didnt know what it was autonomic dysreflexia bladder issues bowel issues and horrible pains full body burning stinging throbbing sharp achy heaviness tingling numbness full body…so bad back pains like my back was gonna come threw my streum and stomach…blood pressure avg 130’s top number ( read t6 and above level spinal cord damage normal blood pressure is 90-110 top number ) ears always red face and ears always warm….chronic cough breathing problems chronic bronchits eyes swelling up under my eyes and red dry patches around my eyes….spine surgeon said I was myelopathic and damage I was already showing was permanent and surgery was to stop it from worsen but was schedule for surgery 6 months away….was denied for help sooner at a unversity neurosurgery dept…2 months after first visit with spine surgeon PA I seen surgeon and he said it was bad all damage was caused by accident and the way I was was the way I was gonna be and it wont get any worse bc it was caused by trauma not degenerated changes and said we can continue to wait 4 more months…i turned to doctor chiropractor who I first treated with to ask why isnt surgeon helping me and asked did he know another spine surgeon that would help me and he said let me get back to u….the university neurosurgery that said no 2 months all of a sudden said they would see me after my wide doctor called them…I didnt wanna go bc I knew it was gonna be push u out door oh I seen u dont know whats causing r damage….was i completely right…asking me why didnt surgeon do new mris ( myonly mris and ct scan were taken 4-5 months before ) nd I said why arent you…made me know my wife doctor called him to see me & I said and made him know that he said NO to my case 2 months before so why u seeing me know 2 months ago u couldnt and wouldnt help me…told me wasnt enough compression at c5c6 level to be causing my condition…that at c5c6 surgery wouldnt be of any benefit and I said of course not irreserviable permanent damage has occured…he then told me i showed unusual delayed progressive cervical myelopathy & paraparaesis after my accident and I said how is it unusual damage to spinal cord and went untreated and compression was severe enough to progress rapidly and now its 6 months after accident 3 months of it ive been wheelchair bound and basically said ok and left room….disnt listen to anything I told him about symptoms what I experience deal with…I called spine surgeon who was doing my surgery ( I knew surgery prolonging delaying it when I already progressed to paralysis wasnt gonna fix or help ) to see if there was cancellation and I was told I wasnt on surgery schedule anymore bc chiropractor called surgert and spoke to him directly and asked we need to get me in sooner like now bc he cant wait 6 months if surgery is gonna help at all now and surgeon said cant help me sooner so chiropractor said well I need to get him to another surgeon who can help him now is that ok and surgeon said yes and took me off surgery list…ihad no idea he called the spine surgeon who was doing surgery….I said I didnt give u ok to talk to chiropractor or him to call u and why didnt u call me and speak to me and office manager said we wouldnt of call u and told u but then says if it was worsening why didnt you tell the doctor and I said r u kidding me I was wheelchair crying and surgeon said we could wait…so office manager says e can put you back on surgery list and I said for now no wont be now or Jan like it was scheduled for thats already taken it will be 6 months from ur original date and I said r u fucking kidding me wait a year for surgery ur PA and surgeon said it was needed yesterday…I tried another unversity neurosurgery and got same results as the first unversity neurosurgeon I seen not enough compression at c5c6 to be causing my condition and we wouldnt do surgery bc it wont fix anything now…I did all new mris and xrays of whole spine and mris was a nightmare bc my legs spasms so bad I never stay still the whole time I was in mris doing my whole spine nor could I stay still bc of the horrible pains plus autonomic dysreflexia issues….of course doctor said dont show anything and downplayed the only mris and ct scan I took like damage was normal ok and also did a ssep test and supposely was normal even though with my own eyes when did test to lower body/ legs they didnt move at all and when did test to upper body/ arms they moved bc I still can move arms yes there is weakness but can still use even thought weakness & horrible pains…have so many different diagnoses cervical thoracic ( only showed compression fracture on 3 difderent levels in lower spine. .. Fall numerous time when ambulatory and transferrring into wheelchair…after telling me it was my neck hen my middle back then neck again I was told in my head then I was diagnoses cervical myelopathy and paraplegia…after this I stop going to doctors except PCP and urologist and gastrointrologist for bladder and bowel issues and diagnoses neurogenic bladder with incontnience and bowel dysfunction…about a year later my new PCP doctor wanted. Local neurologist to treat my symptoms and told doctor this and all I got was why r u hear and told sorry i cant change your damages…he did a rest to my feet and big toe and toes went upwards and did a new emg/ ncv test to lower body only and test to see if I had blot clots….no blood clots and was told by doctor new week he had no idea what was causing my paralysis and said no surgery nor PT will help with paralysis and weakness it was permanent and I asked why didnt u do eng/ncv to upper body and u doing test to my feet and saying I definitely had spinal cord damage in my neck long tract to my face he said go back to PCP he will tell u what i said…he said in my head basically but billed my health insurance with 6 different diagnoses…complete paraplegia, quadriplegia c5-c7 incomplete, disc disorder thoracic with myelopathy, disc disorder cervical with myelopathy, anterior cord syndrome and central cord syndrome and when I found this out I called office and ask and all I got was oh that’s what he told it was and i said 6 different diagnoses but has no idea…so havent been to any specialist have tried but get turned down….waiting to hear from a board certified physiatrist ( who only specialize in spinal cord injury) office to make appointment bc I was told by spinal cord injury hospital who i need to see so they can diagnose you 100% correctly and help treat bladder bowels AD pains breathing and all else related to spinal cord injury from accident…they also said WOW this is horrible care….sounds like from all symptoms and what I told them cervical myelopathy that was progressively to myelomalacia and surgery wont change anything and now I need care for all related issues from spinal cord damage…please any help would be great…this is a nightmare…

Donald Corenman, MD, DC
Moderator

December 7, 2018 at 9:04 am

Post count: 8660

#29852

Next time, paragraphs would be very helpful as you have included lots of text!

You note on the initial images “c3c4 grade 1 retrolisthesis c5c6 herniated disc indenting spinal cord and my spinal canal AP diameter was 7mm c6c7 herniated disc no cord compression and spinal canal AP diameter of 8.5mm & lumbar l5s1 grade 1 retrolisthesis & herniated disc abutting left exit nerve root”.

You then note; “month after mris have an EMG/ NCV and this showed radiculopathy at c6, c7, l5, s1 bilaterally both sides both levels”.

You then note “was wheelchair bound decrease full body sensation more decreases bully button down then above shoulder weakness and hand weakness”

You then note “spine surgeon said I was myelopathic and damage I was already showing was permanent and surgery was to stop it from worsen but was schedule for surgery 6 months away”

Finally, “I tried another unversity neurosurgery and got same results as the first unversity neurosurgeon I seen not enough compression at c5c6 to be causing my condition and we wouldnt do surgery bc it wont fix anything now”.

Your symptoms of paralysis do not fully fit the initial MRI findings that you note. Myelopathy can cause weakness with severe canal compromise but your report is lacking in that “severe’ notation or of significant cord signal change. Many patients with myelopathy have incoordination of gait but not overt weakness. I am unclear if you have long tract signs (hyperreflexia, clonus, Hoffman’s sign, unstable gait and hand incoordination). Has anyone looked at your thoracic spine with an MRI at this point?

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.

Hummerh139
Participant

December 7, 2018 at 9:21 am

Post count: 5

#29854

Yes nothing wrong with thoracic except compression fractures at t8 t10 t11…have positive clonus babanski Hoffman hypereflxia grip strength weakness and shoulder weakness myelopathic hands make fist and release only can do 7 in 10 seconds…surgeon told me all damage was from accident and was coming from c5-c7…I was wheelchair bound when I got to surgeon PA which was 3 monthd after my accident….
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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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