loss of bowel bladder control due to cervical pain

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shrikant_touch
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June 11, 2012 at 6:07 pm

Post count: 6

#6348

Dr Corenman
on 12 may 2012 My father age 69 suffered from shooting neck pain started from rightside of the lower neck area and within seconds spread across both the hands ,legs and shoulders .(he felt like paralysis attack) He was brought to hospital and admitted for next 12 days Since that day he has lost his bowel /bladder control (is on catheter and taking anema for clearing bowel) His MRI report is as below 1. loss of cervical lordosis is noted. 2.mild anterior and posterior osteophytosis is noted at c3 to C6 vertebral bodies. 3.Neural foramina and facet joints are normal. 4. Sagittal daimeter of bony spina canal as follows C2 16mm ,C3 14mm, C4 13mm C5 15mm ,C6 14mm C7 15mm 5.Central prostrusion at C3-C4 and C6-C7 are noted causing thecal sac compression. 6.Central extrusion at C4-C5 are noted causing mild cord compression. 7. the thecal sac shows normal signal characterstics. 8.central linear cord hyper intensity on T2WI is noted at C3 to C6 levels. 9.paraspinal soft tissues are normal.

He is taking rest at home with naturopathy /homeopathy meds /massage and is showing some relief from pain but his bowel /bladder problem not solved yet is
Please tell us whether surgery is required for this.

Donald Corenman, MD, DC
Moderator

June 11, 2012 at 10:53 pm

Post count: 8660

#6352

Your father has symptoms that could be from spinal cord injury. The sharp electrical like pains that radiate down the arms and spine could be L’hermitte’s sign- lightening type pain that occurs from cord compression.

Bowel and bladder failure has a long differential but cord injury is one of them. Can he walk and if so, is his gait normal?

The signs of spinal cord injury are hyperreflexia, Hoffman’s sign, clonus, problems with balance in lower extremities and problems with fine motor control in upper extremities (zipping a zipper, picking up a coin, handwriting changes, putting a key in a lock). A good and thorough physical examination can reveal these signs and help with diagnosis.

The MRI notes a signal change in the cord from C3 to C6. This could be from cervical stenosis and myelopathy (see website) or from a process within the cord itself. A careful radiologist can determine what the source of the signal change is.

If this is injury from cord compression, he will need surgery but further information regarding the signal change needs to be completed before a decision can be made. Get 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.

shrikant_touch
Member

June 12, 2012 at 2:02 pm

Post count: 6

#6359

https://picasaweb.google.com/101358136413953845980

Thank for the reply

Please find above link for the MR Images taken on the day of injury (12/05/2012).

> as on today (12 june 2012) my father can walk normally ,can stand straight ,having no problem in zipping a zipper/inserting key in a key hole or writing (his signatures are also alright).

>on 26.may.2012 USG done for
1. Hepato-Billary Systems
2. Genito-Urinary System
3. Retroperitonem
shows no demonstrable abonormality except excessive bowel gases.

> on 4th June evening catheter was removed to check bladder functioning , atleast three or four times he urinated well on his own but next day morning he was again put on catheter due to retention.

> 7th June 2012,due to fever, he underwent pathological tests for
1. Complete Heamogram
2. Maleria Antigen
3. Urine Examination
4. Widal test
and is daignosed with typhoid ( S pythi “o” and S pythi “H” positive in 1:80 dilution) ) and taking antibiotics for the same .

> Ever since discharge from hospital he is regularly taking naturopathy for clearing bowel ,massaging etc feeling relaxed except bowel/bladder problem.

> in the year 2004 ,he was bedridden for almost 3 months due to severe pain on lumber disks L4 and L5 (I donot have much details).
and recovered without surgery with the help of a Chiropractor cum physiotherepist within 3 days.

>Dr please tell us how long can we wait before undergoing surgery ?
Thanks
Shrikant

Donald Corenman, MD, DC
Moderator

June 12, 2012 at 9:33 pm

Post count: 8660

#6361

The images indicate that your father has severe central stenosis and cord injury. Does he have any of the spinal cord injury signs that I previously indicated (long tract signs like Hoffman’s sign)?

Bowel and bladder dysfunction can originate from the cord but there are physical examination findings that go along with this dysfunction. If the problems stem from the cord injury, he does need surgery. Recovery is an unanswered question as even with cord decompression surgery, there is no guarantee that the cord will fully recover.

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.

shrikant_touch
Member

June 14, 2012 at 12:18 pm

Post count: 6

#6382

Dr Corenman
We got consulted with two spine surgons ,one of them examined my father and suggested meds(oral) for B12 defficiency for 15 days and asked us to wait.

While another surgon suggests immidiate surgery (microscopic posterior decompression)to avoid further damage

my father does not show any tingling sign / sensation triggered by a mechanical stimulus (hoffman’s).

shrikant

Donald Corenman, MD, DC
Moderator

June 14, 2012 at 12:54 pm

Post count: 8660

#6383

B12 deficiency is unlikely. There are blood tests however that can reveal this. I do not have the luxury of examining your father but if he has long tract signs (as I indicated earlier) with the current symptoms you have indicated and the MRI findings that I reviewed, I tend to agree with the surgeon who thinks that decompression of the cord would be helpful.

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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