MRI results

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Donald Corenman, MD, DC
Moderator

February 14, 2015 at 9:30 pm

Post count: 8660

#12224

I look forward to meeting 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.

staceface
Member

February 16, 2015 at 7:55 am

Post count: 2

#12244

I see a PM doctor for chronic migraines and after having other symptoms she referred me for an MRI for my lumbar and am being treated with epidural injections.
While in her office I explained I was also experiencing numbness in my my thumb and pain between my shoulder blades. I get shooting pain when raising my arms over my head. Pulling shirts on has become painful. She has given me steroid injections and botox injections in my neck and shoulders prior to having the MRI.
I am hoping you can give your opinion of the MRI results. The PM doctor would like to do epidural injections, but stated I will likely need to be referred to a surgeon, but because I am 42, she would prefer to wait on surgery.
MRI results as follows:
Findings:
There is no significant cerebellar tonsillar ectopia.
The atlantodental distance is within normal limits.
There is mild reversal of the normal cervical curvature.
Mild 2 mm of retrolesthesis is identified at C5-C7 and 1-2 mm retrolethesis at C5-C6.
The cervical chord demonstrates normal signal intesity and caliber.
There is mild chronic height loss of the C5 vertebral body likely due to chronic degeneratie changes. There is no acute compression fracture deformity of the cervical vetebral bodies.
Disc desication is identified throughout the cervical spine. There is mild anterior osteophyte formation from C4 through C6.
There is no devinite cervical cord signal abnormality.
On the axiel images,
At C2-3, there is no spinal canal or neural foraminal stenosis
At C3-4. there is a ver smaill 12mm focal central disc protrusion mildly indenting the anterior thecal sac.
At C4-5, theree is a small diffuse disc osteophyte complex with an asymmetric 2mm left foraminal component and mild bilateral uncovertebral joint hypertrophy, left greater that right.
There is minimal left sided neural formainal stenosis.
At C5-C6 there is mild bilateral uncovetebral joint hypertrophy and a smaill 1-2mm diffuse disc osteophyte complex, with these findings resulting in minimal left sided neural foraminal stenosis or spinal canal stenosis.
At C6-C7 there is a smaill 3-4mm broad based left foraminal disc osteophyte complex and moderalte left uncovertebral joint hypertrophy with these findings resulting in severe left sided neuralo formainal stenosis, abutting the exiting left C7 never root. There is mild right sided uncovertebral jointy hypertorphy wiht minimal right sided neural formainal stenosis.
At C7-T1 there is no spinal canal or neural foraminal stenosis.
There is trace mucosal thickening in the paranasal sinuses.
Small lymph nodes are identified and scattered in the neck, nonspecific but most commonly reactive in etiology.
IMPRESSION:
Mild reveral of the the cervical curvature and multilevel degenerative changes in the cervical spine as described above.

At C6-C7 there is a small 3-4 mm broad based left formainal disc osteophyte complex and moderate left uncovertebral joiny hypertrophy with these finding resulting in severe left sided neural foraminal stenosis, abutting the exiting left C7 nerve root. There is mild right-sided uncovertebral joint hypertrophy with minimal right sided neural formainal stenosis. There is no spinal canal stenosis.

Phew….I know this was an extremely long post and I appreciate any time you are able to give to respond. I am wondering if the lymph nodes scattered in the neck are normal or something I should be worried about? I have read a lot of post and have not come seen than mentioned on other people’s MRI’s.

Donald Corenman, MD, DC
Moderator

February 16, 2015 at 11:36 pm

Post count: 8660

#12251

Your current symptoms could match your MRI findings but you do not specify if your symptoms are unilateral (left arm only) or bilateral (both arms). You do have evidence of left C7 nerve compression (“these findings resulting in severe left sided neural foramina stenosis, abutting the exiting left C7 never root”).

See the section “symptoms of cervical nerve injuries” to find what symptoms the C7 nerve compression can cause.

Lymph nodes found in the neck might or might not be common. The radiologist should comment on the size, number and significance of these nodes. If there is question, a visit to an ENT doctor or a general surgeon who specializes in these finding would be the next step.

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.

staceface
Member

February 17, 2015 at 12:56 am

Post count: 2

#12254

Thank you so much for your quick reply. I do have unilateral issues, but predominantly left sided. Interesting new development but not sure if it is related. Woke up this am with the base of my neck, about the size of a grapefruit numb as well as the tip of my right ear.
I have an appointment with a GP this afternoon who will hopefully get the referrals going to the necessary specialists.
In your opinion would surgery with fusion be a reasonable option. My PM Doctor briefly went over what she believed a surgeon would do.

Donald Corenman, MD, DC
Moderator

February 17, 2015 at 3:18 am

Post count: 8660

#12259

The need for surgery depends upon your symptoms, physical examination and response to conservative care. See the section ‘when to have neck surgery” to understand the details of the need for surgery. you might be a candidate for a fusion (ACDF) or an artificial disc (ADR). See website.

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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