Mri Results ....... Confused would love your opinion.

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tanita78
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July 1, 2014 at 1:03 am

Post count: 3

#11123

Multilevel degenerative changes predominate at C5-6 with
central and right paramedian posterior nucleus pulposus protrusion
measuring 4 x 8 x 9 mm, slightly encroaching on the anterior aspect of
the right side of the cervical cord. No focal nerve root encroachment is
evident. Less severe degenerative change at C3-4, C4-5, and C6-7 does
not result in significant neural foraminal narrowing or canal stenosis.
No other nucleus pulposus protrusion/extrusion is seen. Soft tissue
structures surrounding the cervical spine appear unremarkable. The
cervical spine cord has normal signal characteristics and morphology.
Visualized portions of the brainstem, posterior fossa contents, and skull
base appear unremarkable.

IMPRESSION:
1. Mild to moderate severity degenerative disc disease and spondylosis,
most severe C5-6 as described above.
2. Central and right paramedian C5-6 nucleus pulposus protrusion with
resultant slight cord encroachment and canal stenosis.

tanita78
Member

July 1, 2014 at 1:28 am

Post count: 3

#11124

Mild reversal of the cervical lordosis was also stated in my previous x-ray.

Symptoms include :
Pain and swelling
arm and outside 3 fingers numbness and tingling in left side
Severe migraines
occasional clumsy hands and dropping things
neck locking or catching and unable to move without slow movements and rotation to ” unlock”
and last but weirdest …. I get a crackling water rushing sensation/ sound in the back of my neck that i can hear and my husband has even heard. I almost feels like fluid letting loose and rushing down my neck ???

Donald Corenman, MD, DC
Moderator

July 2, 2014 at 1:59 am

Post count: 8660

#11137

You have multilevel degenerative changes in your cervical spine with a disc herniation at C5-6. This herniation is central and right sided but according to the radiologist, does not cause nerve compression. It does cause some cord compression which could lead to myelopathy (see website). Your complaint of “occasional clumsy hands and dropping things” could be related to myelopathy.

The most common complaint you have; “neck locking or catching and unable to move without slow movements and rotation to ” unlock” and “I get a crackling water rushing sensation/ sound in the back of my neck” are facet related. When the facets become arthritic (the smooth surfaces become pitted and irregular), these sliding joint surfaces can become “caught’ on each other. The gristle and “sand paper” sounds you hear are these surfaces attempting to slide on each other.

Interestingly, you have arm symptoms on the left side but your herniation is on your right side. You might have an entrapment syndrome on your left (cubital tunnel syndrome-see website) which might explain the left symptoms.

The weird symptom of “cracking/water rushing” in your neck is probably the feeling of the facet finally popping over a large divot in the surface of the joint and the relief from this immobility.

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.

tanita78
Member

July 2, 2014 at 2:30 am

Post count: 3

#11138

Thank you for the reply ! Im kind of concerned if any further treatment should be done at this point. I currently have very good insurance that I will only have for 11 more months because I will be relocating and losing my current insurance. Does anything sound of concern to you at this point that I should take care of before losing insurance. I dont want to jump into anything even through I do have a lot of pain and discomfort but if I would benefit from any surgeries or treatment I would like to do it now. Thanks again !

Donald Corenman, MD, DC
Moderator

July 2, 2014 at 2:46 am

Post count: 8660

#11139

Further treatment depends upon your current symptoms and your potential need to have them reduced. If you can tolerate your current complaints without too much sacrifice, you do not need treatment. See the section “When to have neck surgery” to understand this concept.

This I say with a grain of salt as I have not reviewed your images and I do not like to make judgments without seeing the MRI for myself. A radiologist might fully describe what he or she sees but the descriptors he or she uses are interpretable.His descriptor “slightly encroaching on the anterior aspect of the right side of the cervical cord” might be correct but I like to see the images myself.

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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Mri Results ……. Confused would love your opinion.