Degenerative disc disease size

Tagged: Degeneration and disc high

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meni learn
Participant

September 7, 2021 at 3:40 pm

Post count: 236

#34322

What is degenerative disc(I know I read but what is more degenerative disc and indicate more to replacement ? and what is disc collapse!? Its diffrent and when its indicate for ADR becase this surgery available from more than 15 years(in c3-7) its(I also gave u the image more clear from my first mr and is the best image from see the disc
I can gave u size width and high
And gave u very ceae image with axial and sagital T 2
AND U SEE MORE CLEAR.
THANKS

Meni

Donald Corenman, MD, DC
Moderator

September 7, 2021 at 8:42 pm

Post count: 8660

#34323

The disc is similar to a car tire lying on it’s side full of jello instead of air. The height of the disc depends upon how much jello is in the tire and the disc’s integrity depends upon if the plies of the tire are intact or torn. If the jello is somewhat depleted (the tire “doesn’t have enough air in it”) but the height remains at least 50% of what it was and the facets behind are not worn (as they tend to do with a disc that drops height), then an artificial disc is acceptable. However, if the facet is causing pain, the ADR will not be indicated and facet radio-frequency ablations (RFAs) is the preferred (and less invasive) treatment.

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.

meni learn
Participant

September 8, 2021 at 3:32 am

Post count: 236

#34325

“The disc is similar to a car tire lying on it’s side full of jello instead of air” i read this on the topic d d d your website . also print this topic .
“the facets behind are not worn (as they tend to do with a disc that drops height)” the do it with degeneration but if disc was thin (loss 40% but color good the facet not degeneration (djd in the level
the facet worn with mostly the disc level more (for ex ddd in c5-6 lead for facet mostly in l c5-6 facet it true in most %?
clear point
facet worn over years mostly this not happen in on mount also not year. injury (lead for disc deg.. but not facet deg.. the injury and life with ddd on the front devlope the facet worn (i know that i just clear the pint more (i see the facet measurement space so when in level the close to its other (look by xr my last i see this arthritis in facet (like other joint in body i see 2 mm space or 1.6 mm and its come to 0.5 mm so this facet worn .
u r expert and u know what is deg..disc (what is call disc collapse its change than ddd and what ligament flavum if the line (black line on mri side view ligament close to csf (this indicate disc collapse in most time .(i ear one lecture from one spine surgeon from us youtube “when the disc collapse on the front that ligament f compress on spinal cord “we see this all the time and the radilogic dont comment …..because i do know maybe boring (its not like a tumor …,but its cause is stenosis( i say over time off curse ) “(this lecture i listen in 2016
i say something not relative to disc but over the time yes (“like mechanically in c s every thing resolve a round the disc so .
their is great lecture i also see a bout c s and what cause this (this great lecture i think
https://www.youtube.com/watch?v=sK5BdbUY8LQ&t=1176s (i listen this to more u s the spine and most c s .
thanks

Meni

meni learn
Participant

September 8, 2021 at 6:45 am

Post count: 236

#34326

so if facet in level worn out so xr show (facet distance less how much mm in xr its worn out average
its ok to see dgd in xr (WITH OUT NEED XR FLEXEION AND EXTENTION IF ITS CLOSE TO FACET SPACE ITS FACET D
ON MRI ALSO CAN SEE THE FACET (WHHAT IS GOING OVER WITH TIME TO FACET (CARTILAGE BROKEN ?AND ITS SEE IT IN MRI CHANGE OVER YEARS ALSO (ON MRI I NEED TO LEARN THAT .?THE DISC LOOK VERY GOOD IN MR (MY FIRST WAS THE BEST IMAGE MAYBE I CAN SHARE WITH U CLEAR IMAGE (I USE THE CUT LINE (ITS 3 MM AND SHOW U WHAT DISC LOOK IN UPER NECK SO U CAN UNDERSTAND MORE WHAT CAUSE FACET (BECASE PAIN IN LEVEL BEHIND NECK NOT MUCH LIKE TODAY OR EVEN FROM AFTER INJURY
NOW I NEED MORE INFO ON THE SPINE ALSO MR ALSO XR (WHAT IS ALIGNAMENT and facet disc how to measurement and other function that before i did but u know i not have a lot of to compare and i have “little” to average person. info for who has more years and see more images (i listen to lecture and read and if i learn more i know more .
.MISS LORI FUGATE YOUR OFFICE STEAL WORK WITH U.
thanks

Meni

Donald Corenman, MD, DC
Moderator

September 8, 2021 at 9:06 pm

Post count: 8660

#34327

Unfortunately. facet disease may not show up on MRI due to the thin nature of the cartilage and the fact that cartilage erosion is so microscopic in the neck that the subchondral bone may not develop reactive changes. The only good way I know to determine the presence of facet disease is with facet blocks.

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.

meni learn
Participant

September 9, 2021 at 2:16 am

Post count: 236

#34328

OK i learn little where and i under why its more hard to see that (but what a bout cartilage in facet the see (what color i check )?
.WHAT A BOUT CARTILAGE (WHAT HAPPEN when disc d on the front lead to dgd behind(the cartilage break like the other joint in the body (so xr show facet space in facet joint so space between indicate to djd ?(like the knee.
arthritis developed from ddd over year if the disc d.
i see last xr and see the facet joint (and i understand this arth.. in neck(and its not happen in one year also i see (facet in xr level befure 18 mount so its with life and age happen(but injury effect this more fast .(so xr indicate for pain in facet? (space bone on bone i und very well this .
what is disc collapse is same like deg… and what u call(the neuclos pop see in whith in t 2 side so this also gave u information a bout the disc healthy very .
thanks

Meni
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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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