disk bulge at c5-c6 level

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shivani
Member

January 18, 2012 at 6:27 pm

Post count: 2

#5398

Hi,
I’m 42 yrs. old female.I’m suffering with numbness and pain in my right side of arm and wrist since last 11 yrs. after an car accident.

My last MRI of cervical spine was done in dec.2007 which diagnosed:
MR imaging of cervical spine reveals early spondylotic changes in the form of osteophytes and partial disc desiccation at multiple levels associated with:
* Broad based posterior disk bulge with posterocentral disk protrusion at C5-C6 level intending the thecal sac and encroaching upon the bilateral exiting C6 foramen.

after this i took physiotherapy treatment with traction, heating,massage and neck exercises. the numbness in my arm and wrist decreased but pain started in neck,shoulder,upper back, arm and wrist.it is increasing day by day.

My current 2012 MRI Report is:

Cervical lordosis is reduced. The size, shape, alignment,height and signal intencity patterns of the vertebrae appear normal,except mild to moderate degenerative changes with marginal anterior and posterior osteophyte formation. Lipid rest/hemangiomain D1 vertebra. There is no significant pre/para vertebralor any epidural collection.

Disk bulge at C5-C6 level,along with mild biliteral facet joint arthropathy,resulting in indentation of anterior thecal sac and mild narrowing of biliteral neural canals. No significant nerve root compression.

Inter-vertebral disks show early degenerative changes.

The visualized cord is normal in signal intencity pattern and integrity.

There is no compression at the CV junction.

CFS shows normal signal.

There is no primary stenosis.

OPINION: MRI findings are suggestive of…..mild to moderate degenerative changes with …disk bulge at c5-c6 level,along with mild biliteral facet joint arthropathy,resulting in indentation of anterior thecal sac and mild narriwing of biliteral neural canals. No significant nerve root compression.

PLEASE DOCTOR, Give me suggestion to cure my problem. thanx

Donald Corenman, MD, DC
Moderator

January 18, 2012 at 11:41 pm

Post count: 8660

#5401

You note numbness and pain in your right arm and wrist for that last 11 years since a motor vehicle accident. After PT, the numbness abated but you developed neck pain radiating into your shoulder and arm. I assume it is the right side like the previous pain you experienced.

Your MRI is 4 years old. It noted at the time multiple levels of some degenerative change with the focal point at C5-6 associated with a disc bulge and bilateral neural foraminal narrowing. The narrowing is noted to be “mild” by the radiologist but terms like “mild” and “moderate” are subjective and may not be consistant radiologist to radiologist.

First, you need a good history and physical examination by a spine specialist. I like to teach that a diagnosis made by history and physical examination can reveal a diagnosis with 90% accuracy.

You most likely will need a new MRI as the last one is 4 years old and significant changes can occur in that period of time. Neck pain can be caused by the disc or the facet. Arm pain can be caused by nerve compression in the neck, shoulder, elbow or the wrist.

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.

shivani
Member

January 19, 2012 at 12:52 am

Post count: 2

#5406

Yes! I had a new MRI on 14th jan 2012, which reports:

Cervical lordosis is reduced. The size, shape, alignment,height and signal intencity patterns of the vertebrae appear normal,except mild to moderate degenerative changes with marginal anterior and posterior osteophyte formation. Lipid rest/hemangioma D1 vertebra. There is no significant pre/para vertebral or any epidural collection.

Disk bulge at C5-C6 level,along with mild biliteral facet joint arthropathy,resulting in indentation of anterior thecal sac and mild narrowing of biliteral neural canals. No significant nerve root compression.

Inter-vertebral disks show early degenerative changes.

The visualized cord is normal in signal intencity pattern and integrity.

There is no compression at the CV junction.

CFS shows normal signal.

There is no primary stenosis.

OPINION: MRI findings are suggestive of…..mild to moderate degenerative changes with …disk bulge at c5-c6 level,along with mild biliteral facet joint arthropathy,resulting in indentation of anterior thecal sac and mild narriwing of biliteral neural canals. No significant nerve root compression.
Can you suggest me about lipid rest/hemangioma in D1 vertebrae?

Donald Corenman, MD, DC
Moderator

January 19, 2012 at 2:13 pm

Post count: 8660

#5415

“Lipid rest/ hemangioma” is a common finding in vertebral bodies. I see it about every 2-3 MRIs. When MRI was first developed and we saw these findings, we use to think that everyone had “tumors” and many or these were biopsied. As time went on, we understood that these were normal variants and learned not to pay attention to them.

Your arm pain could be caused by the C5-6 level. You might be a good candidate for a SNRB at this level to diagnose and possibly treat the pain you experience (see website for selective nerve root block and pain diary).

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.

Shobha
Participant

February 15, 2016 at 2:15 am

Post count: 2

#21353

I have spondilysis since 10 years, i recently had a MRI report. The findings are loss of lirdosis, posterior peridiscal osteophytes at c5-6 c6-7 indenting thecal sac. Early disc bulge at l4-5 indenting thecal sac.

Shobha
Participant

February 15, 2016 at 2:19 am

Post count: 2

#21354

Helo sir i am Shobha 41 yrs old.
I have this spondilysis priblem since 10 yrs due to accident on 2wheeler.
Please suggest me some exercise for this problem
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Donald Corenman, MD, DC

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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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