My issue is with C1-2 and i can't find much information published

Tagged: C1-2 arthritis

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JLG
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February 23, 2017 at 6:17 pm

Post count: 4

#24427

My problem has been diagnosed at c1-2. From what I’ve been told there isn’t much i can do about it. I went to a pain clinic and the dr schedule a rhizotomy for c234. I told my previous orthopedic dr and he cautioned me because I’ve already been diagonosed and having c234 wouldn’t help. He said there is no branch at my level to have the rhizotomy preformed. I’m in so much pain with no guidance. Any help will do.

Donald Corenman, MD, DC
Moderator

February 25, 2017 at 4:26 am

Post count: 8660

#24433

I will assume that you have arthritis of the C1-2 joint causing your pain. Your physician is correct in that rhizotomies will not work at that level. However, if your pain is from the levels below (C2-4) rhizotomies will work in about 70% of patients. If the pain is generated only by the C1-2 level, you have proof of this by imaging (noting destruction of the C1-2 joint) and a successful diagnostic facet block (X2), you could be a candidate for a C1-2 fusion. You would be giving up painful motion for reduced pain and reduced motion of your head.

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.

JLG
Participant

February 28, 2017 at 2:34 pm

Post count: 4

#24446

Hi Dr Corenman,
I truly appreciate your site. My life has truly been shaken up over the past year without anyone to discuss my issues with. After having a successful diagnostic facet block i have almost been shamed away from the medical community. My personal Dr did recommend gabapentin that has provided some level of relieve but the pain is always there at night. During the day it’s much more manageable. Ive have had arthritic problems since 6 years old and I’m now 60. As a child it was primarily in my knees and hips. However still playing sports my elbows as well as my knees would fill up with fluid and need to be drained.
I have had both knees and hips replaced. Now my shoulders also need to be replaced. None of these issues measure up to the problem i’m now having with my neck. 2007 I dove head first into a river. Slightly below the surface was a boulder and I had a flight for life whisk me away to the local hospital. I fractured c5 and dealt with that for about a year before it started feeling better. Nov 2015 the pain in my neck came back after palates class. However it was totally different pain shooting up into my skull. Can’t turn head side to side and at night feels like a meat hook shoved up my skull and I’m hanging on it.I don’t have head aches and can move my head up and down without difficulty. I was told that a fusion would eventually cause the other facet joints to break down. Whats your opionion? Thanks for listening

JLG
Participant

March 2, 2017 at 6:05 pm

Post count: 4

#24449

Hi Dr Corenman,
I’m confused reading some of the messages regarding sympotoms of the cervical spine. I was told my primary problem is c1-2. However my symptoms are at the base of my skull. I can’t turn my head left or right with out sever pain. I have the traditional cracking and popping. Minor numbness in arms and hands from time to time. Blurred vision sometimes and memory. Not sure if i can blame this for lack of short term memory however. I don’t get headaches in the front but chronic pain like a meat hook shoved up my skull. Does this sound typical c1-2 to you or could it be other facets gone wrong?

Donald Corenman, MD, DC
Moderator

March 3, 2017 at 5:01 am

Post count: 8660

#24452

Symptoms at the base of the skull are typical for C1-2 disorders. The C1-2 articulations are responsible for 50% of the rotation of the entire neck so loss of rotation would be expected with arthritis of these joints. Clicking and popping go hand and hand with arthritis as the joint surfaces are irregular and motion causes these uneven joint surfaces to “catch” causing popping.

Memory loss would not be associated with C1-2 arthritis.

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.

JLG
Participant

March 12, 2017 at 5:41 pm

Post count: 4

#24516

I appreciate your opinion, have you heard any success using stem cells injected into c1-2?
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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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