MRI and diagnosis

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eredy
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September 30, 2012 at 9:25 pm

Post count: 7

#7051

im having pain my neck it goes to my arms down to my hands the major pain is on my right side. stabbing pain in my hands a dull ake my arm .also have pain in my right shoulder. the majority of the pain seems to be on my right side but hurting on both sides right being worse i would say 70% on right with my left just major pain down my arm to my hands at 50% pain . this pain is a 7 out of a ten on a scale and consistent pain on my right side

.ive had 3 mris the report i got from one neurosurgeon said i have a herniated disc between the c6 and c7 vertebra that has ruptured. i have went to pain management gotten 3 nerve blocks and a radio wave done didn’t even touch the pain . i went to pt it helped a little but now ive lost 20% movement in my neck when moved to the right and and a little less percentage to my left making me have a stiff neck.also went to chiropractor before that .im on pain and anti inflammatory meds ,i have a mri but u cant post urls is there a way to send some pics to you what im asking is one doctor said it was just in my head but found this report he had done with out telling me . is this enough to get this took care of .this pain is terrible only thing was worse was passing kidney stones .im knew to posting in this type forum trying to go within guide lines . thank you for any help

Donald Corenman, MD, DC
Moderator

September 30, 2012 at 11:20 pm

Post count: 8660

#7053

Your pain into the arms, left greater than right that is a dull ache with sharp pain components is consistent with radiculopathy (nerve root compression). This pain can be associated with a disc herniation at C6-7. Since you have had the pain for some time (three MRIs normally mean at least six months), you could be a candidate for a selective nerve root block (SNRB- see website).

The nerve block would be good for two purposes. One is that temporary relief for 2-3 hours would confirm that the herniation is the cause of your pain (see pain diary on the website). The second is that the steroid included in the injection can reduce pain and inflammation, sometimes for a long period of time.

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.

eredy
Member

October 1, 2012 at 5:27 am

Post count: 7

#7059

is this why its been so hard to get help here these things i describe.

eredy
Member

October 1, 2012 at 5:56 am

Post count: 7

#7060

had a nerve block all three with little help . my last one was in Feb 2012 was a radio wave .these blocks didn’t help . the first block did work for about 2-3 hrs and gradually wore off after that . have had over 8 cortisone shots from 7 2011 to 7 2012, have had injections pin point injection aka shot just under the skin, closest to the disc with out danger of hitting the spine .the first worked about 4 to 6 then wore off the others never worked.your video on how to read a m.r.i.really helps.the disc looks like its moved foreword compressing the spinal cord.could this rupture be on the nerve root rubbing it causing this pain down my arm and making my hands and arms hurt ? i have been told i shouldn’t hurt in my hands like this but read in other places this can happen.

Donald Corenman, MD, DC
Moderator

October 2, 2012 at 11:09 pm

Post count: 8660

#7090

Nerve blocks have two components- diagnostic and therapeutic. Most individuals pay too much attention to the therapeutic results (feeling better days to weeks after the blocks). This is important for long term relief but does nothing for supporting the diagnosis.

The first three hours after the injection are crucial for the diagnosis. This period is when the numbing agent is effective. This agent wears off after three hours and the symptoms typically reappear.

Keeping a pain diary (see website) will lead to diagnosis. If, in your case, the C7 nerve is blocked (injected) and you gain great temporary relief, the diagnosis is confirmed. If the long term relief is not appreciated by you, at least you have a diagnosis and surgical treatment can 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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