MRI SCANS OF CERVICAL SPONDYLOSIS

Tagged: Neck pain and shoulder pain

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Anshumanbt
Participant

February 22, 2018 at 7:16 am

Post count: 4

#27672

Hello Doctor

I am 31 year male. I had an injury while working out at gym.
I would like your opinion regarding the MRI finding below. What should be my treatment approach.

Impression-MRI findings show straightenlng of cervical spine curvature with multilevel
early degenerative dlsc disease, significant at:
C5-C6: Broad-based posterior dlsc bulge noted causing partial effacement of anterior
thecal sac and mild narrowing of bilateral neural foramlna (left» rlght» with slight
lmpingement of the left exltlng C6 nerve root.

It would be of great help if you can give your opinion.

Regards
Anshuman

Anshumanbt
Participant

February 22, 2018 at 8:47 am

Post count: 4

#27674

Hello Doctor

This is the full scan report
M.R.I. OF THE CERVICAL SPINE
MRI was performed on a 3 TESLA whole body MRI Scanner. Sagittal Tl & TSE T2 weighted scans of the cervical spine were studied and these were correlated with axial scans from foramen Magnum to C7-D1 disc level.
FINDINGS:
Straightening of cervical spine curvature is noted.
Vertebral bodies appear normal in height and alignment. Marrow signals appear normal.
Small anterior osteophytes are seen in C4,C5 and C6 vertebrae.
C2-C3: Partial disc desiccation is seen. No significant disc herniation/foraminal narrowing seen.
C3-C4: Partial disc desiccation is seen. No significant disc herniation/foraminal narrowing seen.
C4-C5 : Partial disc desiccation is seen. Broad-based posterior central disc bulge is seen causing mild effacement of anterior thecal sac. No significant foramina! narrowing/nerve root impingement is seen.
C5-C6: Partial disc desiccation is seen. Broad-based posterior disc bulge is noted causing partial effacement of anterior thecal sac and mild narrowing of bilateral neural foramina(left>right) with slight impingement of the left exiting C6 nerve root.
C6-C7: Partial disc desiccation is seen. No significant disc herniation/foraminal narrowing seen.
C7-T1 : normal disc signal and height with patent canal and foramina.
Spinal cord appear normal in signal intensity.
Pre and paravertebral soft tissue appear normal in size and signals.

Please provide your opinion.
Rdgards
Anshuman

Donald Corenman, MD, DC
Moderator

February 22, 2018 at 10:12 am

Post count: 8660

#27675

The MRI only tells a small portion of the story. Your symptoms have to be the foundation of diagnosis. See this thread to understand how to describe symptoms: https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-neck-shoulder-and-arm-pain/

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.

Anshumanbt
Participant

February 26, 2018 at 9:55 am

Post count: 4

#27708

Hello Doctor Corenman,

Thank you for guiding me to the right link. I will try to describe the matter as per the link.

I have pain starting from neck and goes to right shoulder. The pain in neck is kind of dull achy and feels like a pulling sensation. Now about the right shoulder it hurts only when I do some kind of pushing activity such as pushups or benchpress exercises (though I am not currently working out since last 2 months I used to get the pain that time). If I dont do any push activity then there is no pain in shoulder. The pain in shoulder is quite sharp and feels like my movement is restricted. Also I hear popping sound when I shrug my right shoulder towards my neck. I also get daily headaches as I am into desk job because of which Spine surgeon has suggested pain killers. Earlier I used to get a sharp pain in neck when I used to rotate my neck but now that pain happens quite rarely.

The Neck pain is not sharp though 80% pain is in neck. While the shoulder pain is 20% I would say as it starts while doing pressing activity. Now in terms of VAS I would rate the neck pain as 4 and shoulder as 6 due to the fact that the shoulder has a more shooting pain when I do the activities I mentioned earlier.

I do not feel any weakness in any activity though I do not go to gym now as the doctor has advised to avoid any stress or jerking movements.

I am not sure why the cervical issue started. I had suffered a gym injury while racking the weights after squatting 330 pounds. When I was about rack the weights my right hand slipped a little backside. Though I was able to rack the weights my hand was pulled behind a little. For a month I did not feel any significant pain and I was able to workout. But since last 2 months I have started getting pain in neck and shoulder as described above. Though the Spine surgeon or GP are not sure as to why the cervical issue started. Is this because of the gym injury or my daily desk job.

My GP had given some pain medications earlier and physiotherapy such as traction/TENS/Deep tissue massage/heat therapy. However after consulting the spine surgeon he advised me to stop physio and gave medications- Maxgalin, Felicita-OD, RETENSE 100mg and Ultracet. He also advised me to continue heat therapy and the medication. The treatment with my spine surgeon has been going since last one month and I dont feel any such improvement. He saw my MRI and said nothing serious. He just says to continue medication. I am tired of consuming so many pain killers for my headache.

Due to the headache issue it becomes difficult to work at office for 8 hours. Also I feel very depressed as I am not able to work out at gym.

So my question is what course of action should I take further to recover my neck and right shoulder. Also will I be able to continue bodybuilding or gym activities if not heavy then maybe moderately. Should I continue the medications as I dont feel any improvement as such. Also what kind of complications can I expect in future though the spine surgeon said its not that serious but he never gave any definitive reply regarding my questions whether or not I will be able to work out or not.

Please it will be of great help if you can provide your opinion.

Many thanks,
Anshuman

Donald Corenman, MD, DC
Moderator

February 26, 2018 at 3:13 pm

Post count: 8660

#27714

Now we can proceed to the potential disorders list. You have multiple levels of degenerative disc disease or CNS (crappy neck syndrome). This can by itself can explain your neck pain (“The Neck pain is not sharp though 80% pain is in neck”). There is no significant nerve root compression according to the radiologist.

Your shoulder pain could be from a shoulder disorder such as rotator cuff impingement syndrome as it only occurs under shoulder loading and not neck loading (“shoulder has a more shooting pain when I do the activities I mentioned earlier”). See https://neckandback.com/conditions/rotator-cuff-syndrome-shoulder-impingement-syndrome/.

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.

Anshumanbt
Participant

February 26, 2018 at 8:16 pm

Post count: 4

#27726

Thank you Doctor for your opinion.

Can you please give some idea regarding the treatment approach for this shoulder and cervical issue.

Because then I can decide if I should continue with my current spine surgeon or take treatment under other doctor.

Regards
Anshuman
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Donald Corenman, MD, DC

Average rating:

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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