Constant spasm

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Ren24
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November 5, 2015 at 10:16 pm

Post count: 21

#20660

Hello I don’t know what do do with this neck issue. In June of 2014 I had and extrusion of C5-6, a discectomy with acdf and plating In June 2015 I had the hardware removed after a successful fusion in an attempt to relieve some of the choking and oressure feeling in my throat at the area of the surgery. Now this did seem to help my issues but now I have this constant sensitive neck. If I do any bending over such as to wash dishes at sink. Even a mild leaning neck over it causes this awful aching spasm to back of neck and even makes this headache from back of neck and head start which is severe. Also turning head one way or other and holding it there for any period of time will set these off. The spasms will also cause pain that goes into my shoulders and upper arms on both sides I can’t even shop at the grocery store in peace as the turning my head back and forth causes this pain and spasm with headache and sometimes just makes me plain sick with nausea. Any clue what this is from. I know I have levels above and below the repaired one which are not good with some protrusion or bulging This leads me to the next part of my issue. Lower back. I have facet arthropathy T L4-5 and L5-S1 and a herniation at L 4-5 extending into foramen on both sides. I have pain her which is worse on right lumbar and doesn’t travel like sciatic. Which I had s long time ago Doesn’t Tavel in a line like that sciatic nerve but the whole right side is just sore and I do also ha e pain in right hip and low front and outer right thigh as well as low left thig but worse in right I also have awful awful pain and stiffness which is so bad I can barely move it when I have been sitting for any longer than 20 minutes on it in my sacrum and especially coccyx and tailbone area. I know I have some SI joint degeneration worse in right with a sour on right. I actually had a ct guided injection to right si which they had some trouble getting the needle into cuz it was right where a spur was when they tried sticking it in. Anyway. I have t even Ben able to go back to work due to the severity and areas of my symptoms. I also ha e weakness in both legs where I find it difficult to get up from a kneeling or squatting position or to even climb over s gate at my mothers farm. I am only 43 Ha e always been very active and don’t feel I am that old that I should be having this much difficulty So you can see my problem. Can’t bend. Twist. Lift or sit any amount of time and I have all this terrible pain all these different places which also comes with stiffness I can barely get up out of a car and get straightened up and walk after I have sat for any period of time in a vehicle I do have fibromyalgia but I have had that for a lot of years now all this has worsened terribly since I blew that cervical disc. All I can do is move as much as my body will allow me and stay medicated with pain or antispasmodic. Medications to stay comfortable. I say a rheumatologist who felt I have osteoarthritis and I tested negative for RA and ankylosing spondylitis markers. Is this just all coincidental DDD things happening to me or is there something else going on. My quality of life has decreased to where all I can do to stay comfortable is medicate and lay on one side or the other as I can lay or sit on low back. I force myself to keep up with house work such as laundry and dishes and try to walk a mile or so a day. But I have so much pain it’s ridiculous. I worked hard my whole life since a young age on family farms on top of a revisit job. Ha e two teenag kids and went back for my nursing degree and ha e been an RN for 12 years. Off work for almost a year now. Please guide me to what I may have happening and which docs to seek out. I do ha e appts with a neurosurgeon in Pittsburgh and an physiatrist in greensburg Pa in an attempt to find some kind of help. The tailbone issue is tuff. The neuro who took out my cervical hardware kinda pushed me off to an ortho. Saying it’s below lumbar we don’t deal with it and ortho pushed me off on neuro saying it has to do win spine go to neurosurgeon. Neurologist just pushes more pills at me which is an going as I want ‘fixed’. Want my active life back. Please help me!!!

Donald Corenman, MD, DC
Moderator

November 7, 2015 at 11:42 am

Post count: 8660

#20675

The symptoms “If I do any bending over” (this) “causes this awful aching spasm to back of neck and even makes this headache” could be from facet origin. The comment; “I know I have levels above and below the repaired one which are not good with some protrusion or bulging” could confirm this. You need a good interventionist (an injectionist) who can anesthetize the proper structures to come up with a diagnosis and plan. See facet blocks and pain diary to understand these concepts.

You note; “I have facet arthropathy T L4-5 (I assume L4-5) and L5-S1 and a herniation at L 4-5 extending into foramen on both sides”.You then state; “I do also have pain in right hip and low front and outer right thigh” which could be an L4 radiculopathy based upon the comments above. See the section symptoms-of-lumbar-nerve-injuries to understand what symptoms the L4 nerve can generate.

Your statement; “I do have fibromyalgia” could indicate a chronic pain syndrome which could make treatment less effective (but still indicated).

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.

Ren24
Participant

November 7, 2015 at 7:34 pm

Post count: 21

#20685

Yes. I’m sorry. I’d did mean lumbar I missed that T. I forgot to mention flexion and extension X-rays showed antero and retrolisthesis at the two levels above the C5-6 repair with the retro being hemodynamically unstable minimally several of the X-rays and scans ha e said I have arthritis in my neck as well as lumbar I am assuming the lumbar 4-5 disc needs a surgical repair? If so could u tell me what I need is called so I may research it more ? Thank tou. An issue I want to mention more was after my hardware removal I was diagnosed with esoohageal dysmotility with spasm and a hiatal hernia difficulty swallowing worse than ever hiccoughs when I swallow meat or bread and chest pain all happen because of these. It has been 5 months since my hardware removal and a year in July since my original rupture and repair. Is this something common you have run into with this kind of surgery in this area. I also had epiglottis at age 5 and requires s trache for approx 5 days after that so that brings my total intubations up to 3 with both surgeries and the trache. Is this unusual? Can I look for it to heal? Seems to ha d worsened over the last several months. Thanks

Donald Corenman, MD, DC
Moderator

November 27, 2015 at 8:52 am

Post count: 8660

#20854

Arthritis of the neck is a bad term as generally it means nothing bur “wear and tear”. Specifically if you have both anterio and retrolisthesis of the cervical levels above and below the prior fusion, you might have instability and pain derived from that disorder (see website).

Based upon your description of “esophageal dysmotility with spasm and a hiatal hernia”, you probably have another thread open and I have discussed this with a prior answer.

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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