My son c4 c5 compression injury

Tagged: Central cord syndrome

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terryottow
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October 31, 2014 at 7:31 am

Post count: 6

#11635

The update..
My Son now has had a second opinion yesterday who has been very quick to identify this as Central Cord Syndrome. He is having my son have xrays with the most movement forward of the head that my son can manage to determine if the injury is unstable therefore requiring surgery in 2-3 weeks time after my sons School exams.
After not moving his head forward as much as possible, the tingling for the most part has disappeared now, however the moment he puts his head forward he feels the electrical sensation in his upper thighs and perhaps a little in his lower back.
This surgeon has said that if the instability has not improved at the 12 week mark it probably will never get better then now, would you agree with this?
Would you have concerns in operating with a fusion at this stage, are the bones strong enough to handle the screws etc? and is there a greater risk then leaving this until longer?

He is desperate to get on the hockey field and enjoy his loved sport and again gain back his place in the New Zealand U18 Team, however I wish to make sure that we are doing what is best for him.

The surgeon suggests that if he operates in the next month he would be fine to play sport again with in 3 months what is your take on this?

Thank you again for you comments to date,we very much appreciate the help… thank you!

Regards, Terry and Family from New Zealand

Donald Corenman, MD, DC
Moderator

October 31, 2014 at 7:42 pm

Post count: 8660

#11636

Central cord syndrome is an injury to the spinal cord due to a “pinching” of the cord due to narrowing of the spinal canal. See central cord syndrome under spinal fractures and injuries/spinal cord injury on the website.

This injury can occur only if your son has significant narrowing of the spinal canal or has instability. Canal narrowing is easily seen on the MRI and instability is seen on the flexion/extension X-rays we previously discussed. The injury is also seen by looking at the spinal cord on the T2 and STIR images of the MRI and looking for signal change (the normally “black” cord will have some “white” signal in it).

If there is instability or severe narrowing present compressing the cord and 12 weeks has gone by, the instability will not improve and surgery should be contemplated. He has healed his fractures by this point and his bone should be strong enough to undergo surgery.

I would also generally agree that he should be able to participate in field hockey after three months post surgery. It really depends upon what surgery is necessary and what the results of surgery are.

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.

terryottow
Participant

November 4, 2014 at 3:49 pm

Post count: 6

#11653

Good morning I guess..?

Instability has been accepted and some white signal noise is clearly seen on the MRI results.

We have seen the original surgeon today who has said that he would not want to operate until next year as he is adamant that surgery at this point would be a greater risk as the bones he feels needs more time to heal. Also thinks that a minimum period of 8 weeks in a full neck brace is required post the operation meaning not much chance of my son going to Europe with his school trip in April.
We are stressed and torn whether to wait with the original surgeon or go with the second opinion surgeon.
In your opinion how much more would the bones be healed in the 8 week timeframe for example 16 weeks post injury or 24 weeks post injury, is the risk that much greater?

Are there other alternatives we should consider?

Thank you again for your advice and help.

Regards Terry and Family

Donald Corenman, MD, DC
Moderator

November 5, 2014 at 12:11 pm

Post count: 8660

#11657

I would disagree with the original surgeon who believes that the bones “need to heal more” prior to surgery. There are many times that a patient goes immediately to surgery regardless of the injury to stabilize the spine and prevent further injury. The bones should have healed well enough to stabilize the spine at this point.

According to your information, your son has instability and a cord injury. In my opinion, this needs to be fixed by stabilizing the spine (ACDF) and waiting for any further healing time is pointless.

There are no alternatives based upon what you have conveyed to me. Get this fixed and allow your son to get on with his life.

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.

terryottow
Participant

January 28, 2016 at 8:27 pm

Post count: 6

#21228

Hi Dr Corenman, is has been some time since I first inquired about some information options for my sons spinal injury.
I am very happy to say he has made a complete and full recovery without surgery and in fact is now playing field hockey once again, to level that has seen him selected for the NZ national U19 team called the “Junior Black Sticks”.
I wanted to say thank you for your balanced advice and information which made it easier for us to discuss this with the NZ surgeons.

Thank you again and wish you all the best!

If you are ever in NZ please make contact as I would be very happy to buy you a beer or wine to say thanks !

Kind Regards Terry

Donald Corenman, MD, DC
Moderator

January 29, 2016 at 10:14 am

Post count: 8660

#21231

Thank you so much for your offer. I am curious in that he had instability and a cord injury. He did not undergo surgery and is currently playing a contact sport. What does his neck look like now with flexion/extension X-rays?

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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