Issues 7 Years After C6-7 ACDF Surgery

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Queen Mush
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March 18, 2013 at 8:46 pm

Post count: 4

#8214

In February of 2005 I was playing rec volleyball and after several serves felt twinging in my upper back between the shoulder blades and chalked it up to a pulled muscle. The pain/irritation never really got worse so I continued to play. One day as I was getting out of bed to get my son, I felt excruciating pain as if someone has stuck a knife in my back. I got into the shower to see if that would help, which it did not. I went to my doctor who referred me to a pain specialist and I ended up with two cortisone shots in my upper back, both which didn’t do anything. I saw a neurosurgeon and we did physical therapy (neck harness, some exercises). The pain was so intense that I wore a TENS unit to just control the pain I had. Finally, in July of 2005 I had ACDF surgery at the C6-7 level with bone graft (donor) and plate with screws. Unknown to the doctor at the time, when I had risen to get my sone (he was 5 at the time), I had broken a fragment from the herniated disk and it had lodged in my spinal nerves. I’m told it was about the size of a thumbnail. I wore a soft collar for a month and couldn’t drive. I don’t remember doing any physical therapy afterwards. Three fingers on my right hand are numb and tingly like something is rubbing against them all the time. My neurosurgeon at the time informed me that if that didn’t go away after a years’ time, then it was permanent nerve damage. Today, my fingers get really cold and I drop things. As far as the neck pain goes, in the beginning I didn’t notice it much but between my shoulder blades it feels as if someone has their hand against me all the time. I get really achy and burning sensation which varies. Some days it’s really bad and others not too bad, but it’s always there. I know I have lost some range of motion as I can’t look up without it hurting nor down very far or to the left/right. I’ve also been noticing that it’s starting to hurt when I turn in my car to look behind me when driving. I’ve been seeing a licensed medical massage therapist for some time to help with the achiness. The muscles from my neck, to the middle of my back, across my shoulders get very tight and very achy. Some days I get pounding headaches. My temples are also tight and tender. I am curious to know if what I am feeling is permanent nerve damage. Thank you for your assistance in this matter.

Queen Mush
Member

March 18, 2013 at 8:58 pm

Post count: 4

#8215

I should also mention that I’ve been sleeping on a posure pillow since surgery. As far as exercising goes, I can’t do things above my head with my arms for very long because the achiness/tightness between my shoulder blades gets very intense. I saw the neurosurgeon after a year and she released me to full activity. I don’t have any tingling, shooting pain, etc. that goes down either arm. I have noticed that if I put my arms against the wall (to do exercises) that after 30 sec or so I will get a tingling feeling running from the middle of my upper back down both arms. Sleeping is starting to become an issue because I can’t stay comfortable. I sleep on my side most of the time but after a while, my neck starts to hurt. Sleeping on my stomach is a huge no-no and impossible, and after a while, sleeping on my back causes issues. Most mornings I feel like I’ve been hit by a truck until I get in the shower, which helps the achiness some. I am a secretary and after my surgery I had a headset to quit from cradling my neck against my shoulder which I’m told is very bad for someone with my neck issues. Now, I have a headset again. Sometimes it also feels like someone’s hands are ‘pushing’ against my shoulders which also makes them ache and tight. I am continually shifting my weight during the day at work and will get up to ‘stretch’. The massage does help but it doesn’t hold for very long.

Queen Mush
Member

March 20, 2013 at 3:22 am

Post count: 4

#8224

As additional information to this, I obtained a copy of my surgical report and the surgery was a C6-7 anterior cervical diskectomy with iliac crest allograft and Danek venture plating. It was a large herniated disc with significant canal compromise. The disc fragment I had spoken of had ruptured to and through a ligament though it did not specify which one.

Donald Corenman, MD, DC
Moderator

March 25, 2013 at 12:25 am

Post count: 8660

#8246

You might have had permanent nerve injury as the neurosurgeon has indicated but that diagnosis is one of exclusion (you need to rule of anything else that can cause these symptoms before this diagnosis is made).

In my opinion, X-rays and a new MRI are warranted to see what the canal, nerves and fusion look like. You could possibly have a non-union (pseudoarthrosis), a remaining bone spur, a new level of injury (C5-6 or C7-T1) or something else.

Pain and tingling in the arms with overhead work could also be thoracic outlet syndrome (TOS). I an currently writing a section on this but it won’t be on the website for another month. You will have to research this yourself and see if the symptoms of TOS fit your complaints.

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.

Queen Mush
Member

March 25, 2013 at 9:08 am

Post count: 4

#8259

Dr. Corenman – Thank you so much for your reply to my inquiry. I have definitely considered having new x-rays and an MRI performed since it’s been nearly 8 years since my surgery. I will definitely research TOS and the other issues you mentioned. I will check back on your website your article on TOS. Thank you again!
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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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