Cervical spine injury C4 C5 C7-T3

Viewing 6 posts - 1 through 6 (of 8 total)

1 2 Next

Author

Posts
NeedHelp
Member

April 29, 2013 at 12:51 pm

Post count: 5

#8532

Greetings,
I am new to this forum but have been observing it a lot ever since my spinal cord injury that just took place about a month ago. I sustained two gun shots 1 to my Arm and 1 to my back, while getting shot the force or maybe the shock since it was a close distance shooting led me to fall face first on the pavement thus fracturing the cervical part of the spinal cord (Neck). The CT scan of the neck showed a comminuted fracture of the posterior right C4 facet, in addition there are hairline fractures of the right lamina C5 and Comminuted fractures of the spinous processes of C7 to T3. I was given a Aspen Collar and told to keep it on for 6 weeks, i have now had it on for 4, at the start of my injury i had a lot of burning sensation and pain in my hand and several muscle cramps that would make my hand so stiff and it only goes away when i wiggle my fingers then it feels as if a little rush of blood or something runs through the hand making it less tense until it happens again very shortly, this pain seems unbearable at some points. The pain had reduced a little bit as the weeks went by but i could still feel it even while i was on percocets (pain killers) i cant use my hand as i could before this being my right hand (my dominant hand)and me being a top prospect in the country for basketball has me feeling very distraught and sad, i just wonder if my hand will ever go back to being normal and functioning fully as it once did? I am supposed to go for a MRI test sometime this week for the right bracheal plexus to show what was damaged inside. Im also wondering why this pain is so strong in my hand and why it hasnt really gone away even after a month, keep in mind i also had a clot in the auxillery vein however the ultrasound showed that the blood was flowing so they okay’d it. Im 19 years old and just extremely worried as a normal human would, what can i do to reduce the pain? I also wonder will my neck be able to turn side to side as i once did or will the turning be reduced slightly? Also my shoulder doesn’t seem to rotate fully as much as my left shoulder does but im assuming that also stems from the injury to the spine or maybe the discomfort of the aspen collar on my shoulders or neck muscles. Your help is greatly appreciated, and any input is very beneficial.

Thanks for reading.

NeedHelp
Member

April 30, 2013 at 11:57 am

Post count: 5

#8545

Some 1 please help…

Donald Corenman, MD, DC
Moderator

May 1, 2013 at 6:27 pm

Post count: 8660

#8559

A gunshot wound can cause multiple injuries to the spine and surrounding nerves. The entrance and exit wounds are important to note as this defines the damage tract of the bullet. If you have right hand symptoms and the bullet passed near the spine causing fractures and exited near the shoulder, both the cervical nerve root and the brachial plexus could have been injured.

After four weeks, an EMG/NCV test by a neurologist can shed light on the damaged nerves. This test however will not necessarily lead to better recovery but at least can lead to a better prognosis. You need to undergo intensive therapy on the hand for the working nerve roots to compensate for any damage. Some of the damaged nerves can recover (see “nerve injury and recovery” on the website for a better understanding).

In regards to cervical range of motion, you should not be testing your neck for this motion now. You have fractures of a facet and lamina as well as spinous processes. These fractures take time to heal. You would not try walking on a broken leg until the bone had healed. The same goes for neck fractures. Give these fractures at least eight weeks to heal before you start range of motion.

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.

NeedHelp
Member

May 2, 2013 at 8:56 am

Post count: 5

#8565

Dr. Corenman post=4286 wrote: A gunshot wound can cause multiple injuries to the spine and surrounding nerves. The entrance and exit wounds are important to note as this defines the damage tract of the bullet. If you have right hand symptoms and the bullet passed near the spine causing fractures and exited near the shoulder, both the cervical nerve root and the brachial plexus could have been injured.

After four weeks, an EMG/NCV test by a neurologist can shed light on the damaged nerves. This test however will not necessarily lead to better recovery but at least can lead to a better prognosis. You need to undergo intensive therapy on the hand for the working nerve roots to compensate for any damage. Some of the damaged nerves can recover (see “nerve injury and recovery” on the website for a better understanding).

In regards to cervical range of motion, you should not be testing your neck for this motion now. You have fractures of a facet and lamina as well as spinous processes. These fractures take time to heal. You would not try walking on a broken leg until the bone had healed. The same goes for neck fractures. Give these fractures at least eight weeks to heal before you start range of motion.

Dr. Corenman

The entrance wound was through the bicep exiting out the arm pit, and the second entrance was in the back close by the spine but it did not touch the spine or any spinal columns. The fracture in my neck happened from falling face first on the cement ground after the impact of the bullet thus making me land on my neck in a awkward way causing the nerve damage. As for the damages you said i shouldnt try moving my neck until 8 weeks but im only supposed to keep the aspen collar on for 6 does that mean i should still keep it on for the extra 2 weeks to be on the safe side? Thanks alot for your help it is deeply appreciated and although the truth may hurt sometimes it brings closure and a little rest mentally. As for the spasms and cramps in the hand do you know what i can do to ease this pain?

Donald Corenman, MD, DC
Moderator

May 2, 2013 at 8:06 pm

Post count: 8660

#8566

Cervical fractures can take between six and twelve weeks for healing. The time variability depends upon the structure damaged, the comminution (fragmentation) and the stability of the structure injured. Without knowing the specific extent of the injury, I can only guess about how long it would take to heal. Your trauma surgeon will know that information.

Regarding the pain in the hand, this could be from injury to the nerve root or more likely, the brachial plexus. It will take time to heal. There are medications like Gabapentin (Neurontin) that can help with the symptoms while the nerve is healing. Again, ask your trauma surgeon if you are a candidate for this medication.

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.

NeedHelp
Member

July 29, 2013 at 7:40 pm

Post count: 5

#9107

Hello Doctor Corenman,

Its been 2 months and 3 weeks since i have last posted and your insight and opinions on my injury are still deeply appreciated. I have released my aspen collar for a while now and have regained almost full function and range of motion in the neck still a little soreness in the central part of my neck whenever i turn my neck fully to the right not so much on the left. I was wondering if this would be a life long type of sore/stiffness or as time proceeds and more movement is made it should vanish? Also my gunshot wound to the brachial plexus has still been the major problem as my hand has regained some function as to moving my fingers, wrist and arm as it is gaining more strength but i have developed contractures in my palms which have my fingers curled for the most part unless i lay the back of my hand(knuckles facing the ground) on a stable surface i get some support and manage to make it as straight as i can even though its not as straight as my left hand is. How can i get my fingers to extend fully and manage to close my fist fully, im almost there but it seems i just dont have enough power to clench the fist i stop some where almost or at the middle of my palm. Also i feel like my joints have stiffen up as my fingers are still a little swollen and stiff, how can i get full function of my hand back? Lastly, my muscles around the biceps shrunk completely but now that times progressed i can flex it and the lump has been formed i would love to make it bigger but i cant grip anything enough to work out or develop it again. The tightness of the bicep i believe has also developed an elbow contracture as i have started physiotherapy it seems to be getting better but i still cant extend my arm fully from the elbow it just feels like i cant stretch out that arm or the bicep gets really tight and burns. Please look this over and get back to me, once again deeply appreciated for your expertise and hope to hear from you soon. Thank you!
Author

Posts

Viewing 6 posts - 1 through 6 (of 8 total)

1 2 Next

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