Degeneration of all spine discs X-ray results

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Ren24
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March 3, 2015 at 11:32 am

Post count: 21

#12334

Hello doctor
I have posted numerous times and I am greatly concerned about my recent rheumatologist/immunologist visit. She ordered me a lot of bloodwork first of all and XRays of my thoracic and lumbar spine and SI joints. Hoping you could answer some questions for me. First of all I had a positive Igg/Igm titer for Lymes disease but a negative Western blot with only one reactive band which was 58KD. I know this isn’t exactly your specialty but do you have any idea what it means as I have several weeks until my next appointment and I’m concerned obviously. Now into an area that you are probably more comfortable with. I am going to tell you what my x-Rays said and I was hoping you could tell me what you see as problem areas and what it means.

Lumbar: vertebral alignment well-maintained mild reductions in all disc spaces and lumbar spine vertebral body height well-maintained some facet arthropathy changes at L5/S1 irregular density seen in medial aspect on right kidney measuring 1.2 cm and diameter impression mild degenerative disc changes at all levels of the lumbar spine and a 1.2 cm renal calculus (which a year ago was 9 mm )

Thoracic: vertebral alignment maintained mild reduction in all disc spaces of the Thoracic spine Vertebral body heights maintained no fracture or subluxation impression mild degenerative disc changes at all levels of thoracic spine

SI joints : bilateral SI joint spaces fairly well maintained. Some sunchondral sclerosis bilaterally especially along the iliac side of the right SI joint Inferiorly. Small osteophyte along the inferior aspect of the right SI joint no erosion evident. Impression: findings suggestive of the generative changes involving bilateral SI joints

I would appreciate anything you know this means or may lead to. I have done a lot of researching. I know it’s the Internet and I’m no expert but from what I have been reading it all leads me to the same thing; Ankylosing spondylitis I didn’t get my bloodwork result for hlab27 but it may not even mean anything. I do not have an elevation I need rate. Crp. Aldolase. How can I have so much pain and. Or have any inflammatory markers? Only a positive Lyme titer. I’ve been told I have fibromyalgia. In the last 6 months since my C5-6 discectomy with allograft and plating all my pain has increased. Approximately 1-2 yr ago I started having heel pain and was told I have plantar fasciitis and needed injections in my feet which I have needed numerous times until I started daily stretching my calf muscles. Now I still have outer ankle and Achilles tendon pain and stiffness. The. I started having neck pain and stiffness and worse headaches than ever. Then was told I have DDD in my cervical spine with bulges at C3-4/4-5. And ruptured the disc at 5-6 last July. Dx with asthma. And since my surgery constant pain and spasm in my neck and shoulders worse in the right radiating down into my right upper arm with some accessory nerve damage? To sensation right upper arm. Developed carpal tunnel. Which was negative last October and now all the sudden positive oh and don’t let me forget about the trigeminal neuralgia in the right side of my face which tegretol helped with but it made me nuts emotionally and I stopped it and now I just let it hurt Found out all the above issues from XRays I am constantly hurting and fatigue quickly also developed tennis el ow and I assure you I don’t play tennis and haven’t worked since a strain of my neck at work in November. I was placed on lyrics and thought it was working. Especially for the tennis elbow but it is slowly creeping back in again. Last weekend I ended up in the ER with severe right neck and shoulder pain. Was given pain shots and decadron IM which worked wonders and I felt almost human within 1-2 days but now it is all coming back. It tough getting up in am. I am so stiff and sore especially in lower back. Don’t sleep well. Seems once I’m walkin and moving I can do things with some moderate pain but after I rest and try to move I can barely do it and if I do too much I’m down for days. It’s hard to even get turned around enuff to wipe between my lower back and right shoulder(not to get too personal) I have started physical therapy. My thoracic spine on the right between shoulder blade and spine is so tender I can barely stand to have it touched and therapist said it is swollen and I have a huge lump or knot approx T7-8 or so. I have been reduced to staying home and doing only whatever my body allows after growing up on a farm. I’ve always been active. A single mother with two t kids. A 12&14 yr old. My own home and a home health RN out myself thru school. I have no idea what’s happening to me and would appreciate anything you can tell me. It just seems one thing after the other is happening to me. Doesn’t this week like some kind of arthritis or connective tissue disorder. Please. I know this was quite long winded but I’m scared and need help. Thank you

Donald Corenman, MD, DC
Moderator

March 4, 2015 at 9:04 pm

Post count: 8660

#12341

I just wrote a new thread on the spondyloarthropathies that you are worried about. Please read this.

You note heel pain along with possible sacroiliac joint involvement. Look especially at the segment on Reiter’s syndrome although this is normally found in males.

Lyme disease can also cause many of your 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.
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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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