Losing My Mind C5/C6

Tagged: myeloradiculopathy

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jmc1982
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September 12, 2017 at 2:29 pm

Post count: 9

#26311

Hello, I am a 34 year old man with a history of being healthy. About 9 months ago I experienced a fall going down a set of steps, striking my head and back. I was temporarily knocked unconscious, when I came to I was experiencing a great amount of pain and nausea. I was transported to the ER where they kept me for a few hours and ruled out any fractures and sent me home. The ambulance report noted I had left sided / left arm weakness.

Since my injury I did about 40 visits to physical therapy, I’ve had a MRI in March and was referred to a spinal surgeon who in turn ordered me to do a Myelogram and an EMG.

My current symptoms are: lower neck pain on the left side. Upper back pain in between my left shoulder blade and spine. The top of my left trapezius will spasm intensely. The outside of my left shoulder will ache and that pain will go down most of my bicep and along the top (thumb side) of my forearm into my wrist. When the pain isn’t there I feel a tingling sensation like the hair is wanting to stand up on my skin in the affected area. About 7 inches below my wrist on my forearm is a patch of skin that is 99% numb. I can scratch it with a stick pen, pull the hair out and I might as well be poking a dead piece of meat. When the overall pain is most intense I’ve had a sensation of warm water running down my arm. I am scared to sneeze, cough, or even strain myself using the restroom because on many occasions I get a crushing intense pain down my left shoulder and arm. My balance has been affected, I don’t get a dizzy feeling its just I am very wobbly sometimes and have to hold onto a wall to walk through my house. Sometimes if the pain catches me by surprise I have a hard time holding my head up as if it weighs 100lbs and the muscle in the back of my neck are just so fatigued. When I get like that there is usually an insane upper back pain and my legs are very shaky and I am barely able to stand. Headaches are pretty common I have a couple of intense ones a week, and a lot of little nagging ones. Some nights I get 4 hours of sleep some nights a little more or a little less just depending on how I feel. I spend 80% of my day or on a recliner with a pillow behind my head. Randomly throughout the day and night I’ll just get very flustered and sweat profusely. When I do get some sleep, I’ll wake up feeling bad and my pillow will be soaking wet.

My job requires me to climb ladders, and bend over alot. I have to be able to regularly lift up to 30lbs and infrequently lift 80lbs. When I’m not doing physical labor I am required to sit for several hours and maintain focus. I am going nuts with depression and worrying about taking care of my family. I have 2 small children I cant even pick up let alone provide for right now.

Sorry for the long rant, I’m just sick of complaining to the wife and needed to vent a little. Thanks

jmc1982
Participant

September 12, 2017 at 3:13 pm

Post count: 9

#26312

I’m no doctor but here are some of the pictures I think are pertinent to my issues.

Donald Corenman, MD, DC
Moderator

September 16, 2017 at 9:41 am

Post count: 8660

#26340

You have symptoms of myeloradiculopathy possibly due to a chondroosseous bar (a combination of disc herniation and bone spur) somewhat compressing the spinal cord and exiting C6 nerve root. The canal narrowing (stenosis) is not severe but cord draping over this spur can sometimes cause myelopathy.

See https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/ and https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/ to understand these two disorders.

Your symptoms of “lower neck pain on the left side. Upper back pain in between my left shoulder blade and spine. The top of my left trapezius will spasm intensely. The outside of my left shoulder will ache and that pain will go down most of my bicep and along the top (thumb side) of my forearm into my wrist” fit with this C6 pinched nerve.

The symptoms of “My balance has been affected, I don’t get a dizzy feeling its just I am very wobbly sometimes and have to hold onto a wall to walk through my house” can fit with myelopathy.

You need a consult with a spine surgeon.

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.

jmc1982
Participant

September 16, 2017 at 9:49 pm

Post count: 9

#26350

Hey doc, thanks for taking the time to give your input. I’m sure your a busy man.

The Myelogram report said: at c5/6 there is small osteophyte complex with superimposed posterior central, left central disc bulge indenting the corresponding ventral thecal cord associated with effacement of the ventral thecal sac and mild to moderate stenosis of the ventral lateral recess. The neural foramina are patent.

I’ve been to a neurosurgeon. He’s the one that ordered these additional tests. I’ve got a follow-up scheduled after the EMG. As far as advocating for my treatment. I don’t want to put the cart in front of the horse, I’m assuming this is something that either now or sometime in the future that might need addressed surgically. After the last couple of months I feel that it would be in my best interest that if that’s the case to go ahead and address it. Everything going on in my life and that of my family seems to revolve around my neck. I missed my daughter’s soccer games. I haven’t gotten to pick her up from school. I don’t go out and socialize with my family. It’s just as important for them as it is me to get this lined out. I’ve never been one to take much for pain, I’ve got 2 young children so I can’t lay around the house medicated heavily. I take 300mg of neurotin 3x a day, 4mg of zanaflex up to 2x a day and Zoloft for depression. When it gets unbearable I’ve made a couple trips to the local ER and get treated like anyone else who claims they are having pain. They give a shot of morphine and send me home. Ive done that a couple of times in the past few months.

I understand that different doctors have different personalities. And this sorta thing involves a little bit of subjectivity. Should I just flat out tell him I’m sick of this and just want it fused? It’s not like it’s going to compromise my range of motion anymore then what it already is. Every time I sneeze I’m just waiting for that crushing arm pain. I just feel like it’s a time bomb.

Again, thanks for the time. Sorry about the rant.

Donald Corenman, MD, DC
Moderator

September 17, 2017 at 7:55 am

Post count: 8660

#26353

I would agree with the radiologist’s reading. I don’t think the EMG reading will be helpful in making surgical decisions but at least it won’t hurt. It would be helpful for you to have a diagnostic selective nerve root block to prove your pain is generated by the C5-6 level. Temporary relief would prove this level is the pain generator and you could more reliably undergo an ACDF surgery (see https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/ and https://neckandback.com/treatments/diagnostic-therapeutic-neck/).

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.

jmc1982
Participant

September 17, 2017 at 10:03 am

Post count: 9

#26357

Thanks Doc, I’ll see what the surgeon says and try to respectfully mention that.
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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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