Mri result support

Tagged: Mri neck result help Lyme disease

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Wendyh1
Participant

May 2, 2022 at 10:30 am

Post count: 4

#35033

I have disc herniation flattening the left hemicord at c5 c6. And left paracentral annular fissure. C6 c7 there is disc osteophyte complex and bilateral uncinate hypertrophy indenting on ventral the Al sac. Neural foramens are patent. I am currently on treatment for a tick borne illness that was not detected for 3 years and spinal fluid has one ogliclonal band. I have muscle twitching, changes in circulation and blood pressure and also shortness of breath. Less sensitivity to heat and cold. Left arm muscle feels tight and weakness all over. What should I be exploring next. Are any of the mri results of concern. Thank you in advance.

Donald Corenman, MD, DC
Moderator

May 2, 2022 at 1:44 pm

Post count: 8660

#35034

What are your physical examination findings, especially balance, reflexes, clonus, motor strength and Hoffman’s tests? Can you paste your MRI report here?

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.

Wendyh1
Participant

May 3, 2022 at 9:17 am

Post count: 4

#35035

(EN) G)
MRI-CERVICAL SPINE NON CONTRAST
HISTORY: M79.602 Left arm pain R20.2 Upper and Lower Extremity Pins and
Needles M62.81 Muscle weakness
TECHNIQUE: Sagittal T1, T2 and STIR images were supplemented by axial gradient
echo images through the disc spaces. Study was performed on a 3 Tesla ultra
high field wide bore magnet.
Comparison: MRI cervical spine dated March 22, 2010.
FINDINGS:
There is straightening of cervical lordosis. Cervical vertebral body heights are
maintained. Bone marrow signal is within normal limits. There is mild disc space
narrowing at C6-C7 level.
The spinal cord has a normal signal. Specifically, there is no intramedullary
mass, syrinx or demyelinating lesion.
Cerebellar tonsils are in normal location. Prevertebral soft tissues are
unremarkable.
C2-C3: There is no disc bulge, herniation, thecal sac compression or foraminal
narrowing.
C3-C4: There is small central disc herniation without significant spinal canal
or foraminal stenosis.
C4-C5: There is small central disc herniation without significant spinal canal
or foraminal stenosis.
C5-C6: There is left paracentral disc herniation indenting upon the ventral
thecal sac and flattening the left hemicord. There is mild spinal canal
stenosis. There is left paracentral annular fissure. Neural foramens are patent.
C6-C7: There is disc osteophyte complex and bilateral uncinate hypertrophy
indenting upon the ventral thecal sac. There is mild spinal canal stenosis.
Neural foramens are patent.
C7-T1: There is no disc bulge, herniation, thecal sac compression or foraminal
narrowing.
Overall degenerative spondylosis of cervical spine is mildly progressed compared
to prior MRI dated March 22, 2010.
Paraspinal soft tissues: Not evaluated on this MR examination of the cervical
spine.
Thyroid gland; Not evaluated on this MR examination of the cervical spine.
IMPRESSION:
Straightening of cervical lordosis.
C5-C6: There is left paracentral disc herniation indenting upon the ventral
thecal sac and flattening the left hemicord. There is mild spinal canal
stenosis. There is left paracentral annular fissure. Neural foramens are patent.
C6-C7: There is disc osteophyte complex and bilateral uncinate hypertrophy
indenting upon the ventral thecal sac. There is mild spinal canal stenosis.
Neural foramens are patent.
No demyelinating plaque is identified.

Wendyh1
Participant

May 3, 2022 at 9:57 am

Post count: 4

#35036

And to answer your question regarding balance reflexes and strength it’s reported as good. Though I know it’s not my normal and my daily life is affected. My muscles shake and I am weak. I am 49 and was very active and healthy before the start of the borrelia miyamotoi infection that was just found. It’s hard to tell what symptom is from what. Then tHIS TEST was ordered but not sure what I should be doing if anything regarding the findings. Can any of what’s reported be from infection or more likely from past injury or other.

Donald Corenman, MD, DC
Moderator

May 3, 2022 at 11:48 am

Post count: 8660

#35037

Your cord has some what appears to be some mild compression “The spinal cord has a normal signal. Specifically, there is no intramedullary mass, syrinx or demyelinating lesion…C5-C6: There is left paracentral disc herniation indenting upon the ventral thecal sac and flattening the left hemicord. There is mild spinal canal stenosis”.

This does not appear to be problematic, especially since you have no myelopathic symptoms (“balance reflexes and strength it’s reported as good”).

“The most common clinical manifestations of B. miyamotoi infection are fever, fatigue, headache, chills, myalgia, arthralgia, and nausea”. This type of Lyme disease sounds more like your problem.

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.

Wendyh1
Participant

May 3, 2022 at 12:04 pm

Post count: 4

#35038

Thank you Dr. Corenman for your thoughtful, timely reply. It is well appreciated. I forgot to mention nerve conduct testing that said left deltoid and bicep have increased polyphasic potentials. Left tricep shows the same plus reduced recruitment. Evidence suggestive of cervical motor radiculopathy. Is that basically like saying a pinched nerve and ties in with the mri? My upperleft arm always feels like someone is grabbing it. Again thank you.
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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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