Had prior back surgery .. New MRI 3 days ago

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melmill
Participant

April 29, 2019 at 8:16 am

Post count: 2

#30406

So I had a laminectomy in 2014, Sat I had a new MRI as back is getting worse. Primary called and will be referring me to Specialist ( I Live in MI) Both arms go entirely numb regardless what side I sleep on and last few months my right thigh has a horrible burning, deep aching throbbing to it. Always feels as tho its slightly on fire. Here are my MRI findings. Really concerned since my 1st back surgery was not good, within 5 weeks I had to have 2 emergency surgeries, 1 a hematoma then 1 week later another I was told “spurs” in my nerves or something. I already had major issues with my knees, and last TKR was a horrible deep bone infection, so tomorrow I am supposed to go in and finally get stage 2 (permanent TKR) scheduled. Really hooping this will not cause a hold up.

My MRI Report>
Impression
Mild reversal of the normal cervical lordosis.
At C3-C4, disc osteophyte complex impresses on the ventral aspect of the sac.
On today’s exam CSF space remains about the cord although diminished
ventrally. Slight flattening the ventral aspect of the cord. Uncovertebral
degenerative change of the right with moderate to severe right neural foraminal
stenosis more prominent than previous study.
At C4-C5, facet degenerative changes on the left new since prior study.
Moderate left neural foraminal stenosis. No disc herniation or central canal
stenosis.
At C2-C3, mild facet degenerative change of the right similar to previous
exam. No disc herniation or stenosis.
Mild cerebellar ectopia.

FINDINGS:
Vertebrae: Mild reversal of the normal cervical lordosis. Otherwise the
alignment is anatomic.The vertebral body heights are maintained. No compression
fracture.
Marrow: No suspicious marrow replacing lesions.
C2-C3: No disc herniation identified. No stenosis. Mild facet degenerative
change on the right similar to previous exam.
C3-C4: Posterior disc osteophyte complex impresses upon the ventral aspect of
the sac. A CSF space remains about the cord with a normal CSF space dorsal and
lateral to the cord in a diminished CSF space ventral to the cord. Slight
flattening the ventral aspect of the cord. Uncovertebral degenerative change on
the right with moderate to severe right neural foraminal stenosis more
prominent than previous exam.
C4-C5: No disc herniation identified. No central canal stenosis. There is
facet degenerative change on the left, new since prior study. Moderate left
neural foraminal stenosis.
C5-C6: Minimal annular bulging. CSF space remains about the cord. The exiting
roots are demonstrated.
C6-C7: No disc herniation identified. No stenosis.
C7-T1: No disc herniation identified. No stenosis.
Spinal cord: No intrinsic cord lesion. Midline sagittal images demonstrates
mild cerebellar ectopia with the cerebellar tonsils 4-5 mm below the level of
the foramen magnum with a normal rounded inferior margin.
Vasculature: Expected flow voids in the vertebral arteries.
Soft tissues: No prevertebral soft tissue swelling.

Than You

Donald Corenman, MD, DC
Moderator

April 30, 2019 at 7:57 pm

Post count: 8660

#30411

You have had some pretty bad experiences with surgery in the past.

Your complaints of “Both arms go entirely numb regardless what side I sleep on and last few months my right thigh has a horrible burning, deep aching throbbing” may originate from difference sources such as a lumbar disorder for the thigh, numbness in the arms from nerve entrapment such as carpel tunnel or cubital tunnel syndrome or from the cervical spine itself.You might even have Chiari malformation causing arm numbness (“mild cerebellar ectopia with the cerebellar tonsils 4-5 mm below the level of the foramen magnum”).

There is too little information regarding your symptoms to determine cause and effect, Please see https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-neck-shoulder-and-arm-pain/ and https://neckandback.com/conditions/chiari-malformation-type-arnold-chiari-syndrome/

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.

melmill
Participant

May 29, 2019 at 9:19 am

Post count: 2

#30488

Hello,

Thanks for reply. Actually yes you are correct I was diagnosed 3 years ago with Chiari, but was told no decompression surgery needed. I just got back my Spine MRI.. and this is that report.. I am hoping to see a specialist within next month or so. It just seems like I feel as though I am almost ready for a w/c. Even my feet hurt like they really feel as though they are broken when I walk. I kno sounds like a lot of made up symptoms, and believe it or not I am only taking Tylenol 3. NO other pain meds.

TECHNIQUE:
Imaging protocol: Multiplanar magnetic resonance images of the lumbar spine
without and with intravenous contrast.

COMPARISON:
MRI LUMBAR SPINE W WO CONTRAST 3/19/2015 11:38 AM

FINDINGS:
Vertebrae: There is a mild extra convex curvature of the lumbar spine. There
is grade 1 right lateral listhesis of L4 on L5. There is minimal grade 1
retrolisthesis of L3 on L4.

L1-L2: At L1-2, there is minimal facet arthropathy.

L2-L3: At L2-3, there is a tiny left paracentral annular tear and minimal
focal bulge or protrusion resulting in borderline narrowing of the left lateral
recess and foramen without neural encroachment. There is early facet DJD.

L3-L4: At L3-4, there is early disc desiccation and annular bulging and early
facet DJD but no limiting stenosis or neural encroachment.

L4-L5: At L4-5, there has been progressive disc space height loss, which is
near is not complete. There is suggestion of disc vacuum phenomenon and there
is a broad to left lateralizing disc osteophyte complex which results in mild
left foraminal stenosis but no neural encroachment. L4 laminectomy postsurgical
changes are noted. No postoperative complication or abnormal enhancement is
evident. Further evaluation is limited due to the lack of fat saturation on the
postcontrast enhanced images.

L5-S1: At L5-S1, there is a tiny central annular tear without focal herniation
or limiting stenosis. There is early facet DJD right greater than left.

Spinal cord: The conus terminates at upper L2.
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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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