flexion & extension x-ray

Tagged: flexion & extension x-ray

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appleannie
Participant

August 3, 2017 at 6:22 pm

Post count: 129

#25857

Hi Dr. Corenman,
Sorry to be a pain in the butt asking you all these questions about my cervical spine,but I’m concerned about my neck and you’ve been a big help.I been reading thru all the Doctor’s Reports that I have concerning my cervical spine and came upon the Report stating that I tore my Ligaments away from my vertebraes at C4-5 and had a compression Fracture of both my C5 and C6 vertebraes back in 1988. Dr.Corenman I have a question and would like your opinion.

1) Dr.Corenman you viewed my X-RAYS can you tell from my recent X-RAYS did I actually tore my ligaments away from my vertebraes at C4-5 and had a compression Fracture of C5 and C6 vertebrae? (Yes or No)why I’m asking is that the spine Doctor who took care of me back in 1988 stated in his Report that I had a compression Fracture at both C5 and C6 level and tore ligaments away from my vertebraes at C4-5 and the ER Doctor who took care of me first in the ER told me that I had tore my Ligaments away from my vertebraes at C4-5 level and had a compression Fracture just of my C5 level. I just want to know if I did have torn ligaments at C4-5 level and compression Fractures at both C5 and C6 level or just the C5 level? That’s why I would like your opinion Dr.Corenman !!

2) How’s my C1,C2,C3 looks to you ? I hope in good shape

Thank You again for answering my questions I’ve been posting for me I really appreciate it!! You’re a great Doctor

Donald Corenman, MD, DC
Moderator

August 5, 2017 at 2:49 pm

Post count: 8660

#25916

I see no obvious evidence for compression fractures of C5 and C6 but mild compressions are possible. Again, the ligaments are damaged at C4-5 but you lose the major focus which is the facets being incompetent at C4-5. C2-3 and C3-4 look OK. I can’t tell about C1-2 based upon these images.

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.

appleannie
Participant

August 5, 2017 at 7:06 pm

Post count: 129

#25921

Hi Dr.Corenman,
How bad is the Ligament damaged at C4-5 ? Mild or Moderate Please let me know your opinion because I was told it was Moderate

Dr.Corenman is the Facets being Incompetent at C4-5, could be from my old injury I had back in 1988 or from the Degeneration I have ?

Do you think I just tore my Ligaments away from my vertebraes at C4-5 in 1988, because I was told I also had a compression fractures of C5 and C6 to in 1988 also. I was asking if you could see the old fractures I had back in 1988 in my X-RAYS.

Thank You !!

appleannie
Participant

August 6, 2017 at 10:55 am

Post count: 129

#25926

Hello Dr.Corenman,
Is my cervical spine in bad shape ? What level is the worse ?? Probably my C4-5 level because of the Facets and the Instability? Am I correct

Dr.Corenman I would like your opinion !! How bad is the Ligament Damaged that I have at C4-5 ? Mild or Moderate because I was wondering if there was Chiropractor treatment for this or can’t have Chiropractor adjustments because of the Moderate Instability I have at C4-5 level.

Dr.Corenman Thank You again for answering my questions for me I really appreciate it. Dr. Corenman you’ve been a big help !! Have a great day

appleannie
Participant

August 18, 2017 at 10:24 am

Post count: 129

#26014

Hello Dr.Corenman,
You have viewed my X-RAYS of Cervical spine on your Forum,and I have two important questions to ask you.

First I was wondering if neck is strong enough if I was in a car accident. Dr. Corenman in your own opinion could my Cervical spine be able to with stand the impact if I was hit from behind or on the side of the car,Dr. Corenman especially at my C4-5 level where I have Moderate Instability at.

How bad are my Facet Joints at my C4-5 level ? Moderate or severe

No you just told me they were Quite Degenerative. I was just wondering if you meant they were Moderate Degenerative or severe Degenerative at the C4-5 level that’s all.

Dr. Corenman in your own opinion from reviewing my X-RAYS has my Cervical Anterolisthesis at C4-5 level turned into Retrolisthesis yet. Hopefully it has not yet and hopefully it doesn’t.

Thank You !! Have a good day

Donald Corenman, MD, DC
Moderator

August 24, 2017 at 9:18 am

Post count: 8660

#26184

The global level of C4-5 is moderately unstable. Again, this is disc, ligament and facet degenerative change that cause this translation. This makes this C4-5 level less stable in a case of trauma. Can I identify exactly what forces will cause injury? No. This is due to the variable nature of trauma forces. You can get hit by a semi truck and have little damage to your neck depending upon how your car absorbs the impact but have a simple slip and fall which causes the exact worst vector blow and injure the spinal cord.

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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