MRI results tspine

Tagged: Brown Sequard syndrome

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Missie
Participant

August 10, 2019 at 3:49 am

Post count: 12

#30832

Operation: Pedicure spurring extra pleural extra cavity approach and exceed of left sided disc prolapse.

Failed ten years ago. This is scan 8 years later.

Chronic discovertebral changes at t7-8 level with destruction of the endplate contours predominantly anteriorly and the related intervertebral disc with significant sclerosis and relativley minor marrow odema in the rest of the veterbral bodies. A central disc herniation/soft tissue thickening/bone fragments are seen indenting the theca with flattening of the cord anteriorly at this level. There is also no evidence altered signal from the cord at this level. There is also no evidence of a syrinx above and below this level. Facet joint degeneration change is also seen at this level and the level above.There is no evidence of foraminal encroachment on the exiting nerve roots although some soft tissue thicking is seen around the exiting left sided nerve root at t7-8 level. However in addition the headof the left sided rib at the t7-8level is not clearly seen while the right appears normal. some soft tissue thickening/bone fagments is also noted here outside the left sided neural foramen probly related to the left costo transverse joint at this level which is also involved. there could be a chronic osteoarticular destruction here related to the costovertebral /cost0 transverse joints and allied with the t7-8 discovertebral changes, the appearences could be those of a chronic progressive neuropathic state in this level of the spine. a ct is recommended. There is an old superior endplate fracture involving the T2/3 levels. No other significant abnormality is seen in the cervical or lumbar spine. The rest of the cord appears normal.

t6 browns sequard syndrome incomplete
I’m now on no meds as they don’t help.
At all. I’ve already got my diagnosis from many years ago now. I’ve got help with neurophysio now after many years and I very happy. It’s helping with spasticity pain a lot. From a spinal surgeons point of view. I would like some opinion about severe side stitch pain that I’ve lived with since the operation. You can see the results of the MRI that shows what the surgeon did when deflated the lung. I have trigger point injections coming and wonder if you recommend any particular area of help. I wonder if this side stitch is from the disc herniation/stenosis or result of the operation. No one has ever explained it to me. Thank you. I Was left undiagnosed by The neurosurgeon who did the operation. I was undiagnosed with this for two years before the operation. A spinal surgeon is who diagnosed me. This why I asking your opinion. As I’m aware spinal surgeons think both orthopaedic/neuro.

Kind regards.

Donald Corenman, MD, DC
Moderator

August 10, 2019 at 11:06 am

Post count: 8660

#30833

You had a prior thoracic disc herniation at T7-8 with a thoracic decompression. It appears the surgeon who did the decompression did not do a fusion with the decompression. Your MRI notes; “A central disc herniation/soft tissue thickening/bone fragments are seen indenting the theca with flattening of the cord anteriorly at this level. There is also no evidence altered signal from the cord at this level”.

You developed a spinal cord injury called a “Brown Sequard syndrome”. See https://neckandback.com/conditions/spinal-cord-injuries-neck/.

The chronic “stitch” you have is probably from a radiculopathy (nerve injury) from the approach that was required. Taking out the rib head is common to get to the canal and the nerve root is right at that point. Manipulation of the nerve or scar formation can cause that “stitch” symptom.

Generally, treatment is nerve steroid injections to calm the root and if no good relief, then a spinal cord or peripheral nerve stimulator can be attempted. See https://neckandback.com/treatments/spinal-cord-peripheral-nerve-stimulation/

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.

Missie
Participant

August 11, 2019 at 2:39 am

Post count: 12

#30844

Dr Coleman, thank you so very very much.

Now I understand the fear has been removed from my memory.

I learnt to think logically about pain.
So instead of thinking ‘ pins and needles’. I think ‘ ok nerves settle down, there’s no pins and needles around here’. Removes the unconscious emotional idea I’m being harmed. I distract with any thoughts that are happy

It’s been a big challenge without much understanding and having no medication. Yet now you have helped me. I feel this is already much less so. I look forward to reading from the website. Thank you millions. My clear mind without medication is wonderful. Even more so now. ?

Donald Corenman, MD, DC
Moderator

August 11, 2019 at 10:42 am

Post count: 8660

#30848

Keep in touch with the forum to follow your treatment pathway.

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.

Missie
Participant

August 11, 2019 at 2:05 pm

Post count: 12

#30854

Thank you Dr Coleman I sure will ?
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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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