mri ??????????

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josh
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June 5, 2011 at 8:39 am

Post count: 3

#4612

Aloha from Hawaii,
I had gotten a final report of my MRI ( granted I waited 3-4 months before the Dr. finally ordered one) I have been dealing with pain in my neck, back and shoulder for about 6 months and after looking at my report I am quite worried.
is as follows:
at c3-4 there is a mild to moderate right para central focal disc protrusion. this is associated with hypertrophic spurring. this impress upon the ventrolateral aspect of the thecal sac and compressed the spinal cord in this area. there is mild to moderate narrowing of the right foramen at this level due to uncovertebral spurring and facet arthrosis. c 4,5 level is unremarkable
at C5-6 there is a tiny central disc protrusion and mild disk bulging without cord compression or spinal stenosis. there is mild narrowing of the right foramen at this level
the C6-7 level demonstrates maderate narrowing of the foramen on the right due to uncovertebral spurring. the left is mildly narrowed. there is no focal disc protrusion or extrusion.
the c7-T1 is unremarkable.

The cervical spinal cord appears normal in course, caliber.and signal intensity. there is no cord contusion or myelomalacia noted.

Impression:
muscular spasm with no fracture or subluxation.
Mild to moderate right paracentral disc protrusion at C3-4level with associated hypertrophic spurring. compression of the thecal sac and right ventrolateral aspect of the cervical cord is noted. ( these are under lined and is written neurosurgeon)
Disc bulging with small central disc protrusion at C5-6 ( under lined as well)no cord compression
Several levels of foraminal narrowing, as described above.

First your site gave me a better understanding of what and how is affected but I am still in a big grey area ( thanks for the info on your site)

can you explain this and any severity to this ( if any)
there is one neurosurgeon on the island and the closest I can get to him is in August ( 2 more months of pain)
I would appreciate advice or opinion.

My wife particularly is very worried ( as am I)

HELP!

I have been prescribed muscle relaxer, anti inflammatory, pain pills and PT Would rather fix it than keep going through this, even little movement cause cracking and crunching in my neck.

Donald Corenman, MD, DC
Moderator

June 5, 2011 at 11:21 am

Post count: 8660

#4613

The MRI report gives an idea of the cause of the symptoms, but does not specifically identify what is causing pain. I can let you know what potential symptoms you can have from the MRI report, but without a good history and physical examination, this is conjecture.

Do you have central upper neck pain? This can occur from the C3-4 disc space. Do you have right sided neck and shoulder pain? This can occur from compression of the C4 nerve which is compressed at the foramen. The C4-5 and C5-6 levels do not sound too problematic but you have to remember that we are reading this report through the eyes of a radiologist and personal opinion can flavor the report.

The C6-7 level has foraminal stenosis on the right. This can cause arm pain and paresthesias (pins and needles) into the middle of the hand and weakness of the triceps muscle.

The way I confirm the diagnosis of a patient with this type of MRI is to have a selective nerve root block performed at the suspected level. Good temporary relief would confirm the suspicion of the diagnosis.

Treatment could range from physical therapy and injections through surgery.

Hope this helps.

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.

josh
Member

June 5, 2011 at 1:44 pm

Post count: 3

#4614

Thank You so much, to answer your question about what kind of pain I have, it is exactly what you said abbott my neck and arm also shoulder pain.my concern is that it feels worse every day. I am now starting to have pain going down toward my lower back and even to my legs. I have done everything as stated in my previous message.it feels like it is progressing and that is what I am afraid of. Again much thanks for your reply and last but not least should you think that I might be needng the surgery and your professional opinion what would be the best optionon
or recommendation.

Donald Corenman, MD, DC
Moderator

June 5, 2011 at 8:46 pm

Post count: 8660

#4615

You need a good spine surgeon or neurosurgeon to go over your options with you.

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.

josh
Member

August 3, 2011 at 6:56 am

Post count: 3

#4746

following all this I have seen 2 neurosurgeons
1) after pointing out all abnormalities told me he can’t make a surgical decision.
2) the other recommended a second opinion after he pointed out the same abnormalities.

Now I am having weakness in my arms and legs ( to where my legs would buckle )

THOUGHTS?

Donald Corenman, MD, DC
Moderator

August 4, 2011 at 1:32 am

Post count: 8660

#4748

New onset weakness in your arms and legs needs to be evaluated. This could be from pain inhibition (not emergent) or from a new problem (a new hernation or injury) that requires attention. Get another consult from your surgeons. If there is nothing emergent, you can go through diagnostic injections to discover what the primary source of your pain complaints are (see SNRB on website). If the weakness is from nerve or cord compression, this needs to be addressed.

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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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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