ligamentum buckling or hypertrophy in cervical spine

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meni learn
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April 5, 2023 at 3:59 pm

Post count: 236

#35573

I know how important ligamentum for the stability the column vertebrae
so to do laminectomy just because (you have some pressure from the ligamentum in (small area )
maybe i need to contined with PT and low impact excerise (what i m doing in last 7 years ) (but neurological symptoms lower extremity was not exicst before the end of 2021 )
so the neurological symptoms comes with the evidence of ligamentum buckling .
my symptoms was mild (impossible to walk fast ,and but before half year i walking (somtimes 3 km in day but with some heavy legs )
in last 4 monts the walking less (also hard to standing long time )
but it also down the canal from 13-14 mm to 9-11 (and this process happened with 2-3 years )
so their is processes of this ligamentum (effected by degeneration disc (because in MRI 2016 (6 years after the trauma their was not evidence of ligament buckling .
so the buckling causes by degeneration disc , and facet arthritis (multi-level c2-5 ) and causes mechanical stress on the LF buckling from the back.
this is the causes of ligamentum buckling.
the trauma was mostly causes a tears on the rings of the cervical disc c2-3 c3-4 and also c4-5
c5-6 disc less and c6-7 disc the more less affected *because of the collision of the head with the wall of the pool (s most power goes on the first discs.
this so very sense.
arthritis developed because the disc tear and degeneration disc
in 2016 arthritis are was not very devlpe
and ligamentum hypertropy result of degeneration and loss also high of the disc (because the tears on the rings of the anuelr

Meni

Donald Corenman, MD, DC
Moderator

April 6, 2023 at 2:56 pm

Post count: 8660

#35574

Meni, You need to stop obsessing with your ligamentum assumptions. The only symptom that could be coming from your ligamentum is local neck pain, and that’s a minimal possibility. Please stop trying to relate all your symptoms to something that is not causing them. Full Stop!

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

April 6, 2023 at 8:50 pm

Post count: 236

#35575

I m not fixed on 100 % that my symptoms (heavy legs ,decrease in fast walking ,tingling in lower extremity numbness in lower extermity (mild numbness) .comes (because the buckling of LF C3-4 but this is an option .
other option it is neurological disease like MS (but MRI brain 3T don’t show lesions (in 90% of MS their lesions see on MRI (also tested 3 neurologists M.d dont think i have neurological disease.
their is also some other options (but them are not common.
MJOA score it is 15-16 points (so it is not an indication for surgery also if the ligament causes symptoms it is mild myelopathy.

Meni

meni learn
Participant

April 8, 2023 at 4:44 am

Post count: 236

#35576

“The only symptom that could be coming from your ligamentum is local neck pain”
(the pain i suffer in last 5 years (more severe in last 3 years it is from facet arthritis that developed by the disc degeneration(facet c upper neck c2-c4 mostly ) see
in 2016 MRI the facet are not have arthritis (maybe very little )
but MRI 16 show ddd in the upper neck (affected by tear on the rings in trauma )
so the disc degeneration cause the the arthritis in upper facet .
see the link https://youtu.be/Rj8nrHcGexU
the buckling of LF doesn’t happen because the trauma (its effected by mechanical stress comes from years with degeneration of disc, (and this caused by the trauma )(c5-7 disc their is not any problem also no pain.
buckling of LF doesn’t exist before 2021 (there is a little evidence of buckling on MRI 8.20 )

Meni

meni learn
Participant

April 9, 2023 at 1:14 pm

Post count: 236

#35578

last 2 months (it also hard to walking more than 1 to 1.5 km with out need to sit .
(before 4 months and also before 8 months I can be walking 5000 -7000 steps in day (also without any sexual problem -them started before 2 months ) (not severe sexual problem but I have decreased in sexual dysfunction)
with this symptoms I have tingling in lower and upper extremity (them are more significant than a a year.
but I have also tingling in back of my head and face .
MRI BRAIN (3T flair sagittal 1 mm coronal and axial 2 mm slices 1 mm 2022 (not found nothing radiologic report not pathological
MRI 2023 3T include flair sagittal coronal and axial slices 1 mm (before 2 weeks) radiologic report not pathological .
MRI of the c spine (steel seen the LF C3-4 BUCKLING ) (but the position of the head affected of hot much the lf buckling )
so the symptoms of walking are worse ( the distance decrease also decrease long-standing.
MJOA
upper extremity (normal hand coordination(5)
lower extremity ( mild imbalance when standing or walking (6)
UPPER E SENSORY (MILD LOSS HAND Sensation (the numbness of the hand are not significant (but them are more often numbness and tingling compared before 4 months .(2)
urinary normal (3)
BUT decreased in sexual problems (in last 2 months )(not severe sexual problems but decreased in this function. (sexual problems where not exist before 3 months )
so 16 points on MGOA

Meni

meni learn
Participant

April 9, 2023 at 1:37 pm

Post count: 236

#35579

in MRI of c spine (2.22) the position of the head are little (very little extension the canal (in for slices of 1 mm axial on the center and left side (canal diameter are 10 mm (their is no CSF in this 4 slices and also it is can cold mild compression (on the cord )
the MRI of c 23 was with the head more neutral (little flex) and in this image *their is also buckling of LF (and in 1 slices very significant ( also canal 9 mm also in more flex (when the ligament buckling less )so it is could to say (the buckling are little more (because the position more flex compared to 22 and it is see canal (pinching )
the radiologic report of c s (not found nothing not lesions on cord )
the LF c3-4 buckling can causes (tingling in the face and also in the back of the head ?(between the eyes also ?
what is your opinion?
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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