Neck and back pain resulting from a MVA 2 years ago, multiple XRAY, MRI results

Tagged: back pain resulting from MVA 2 years ago

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Amberglpn
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February 7, 2017 at 3:13 pm

Post count: 2

#24300

Hi Dr. Corenman

I have been experiencing severe neck, cervical and thoracic back pain following a motor vehicle accident 2 years ago. I have flair-up’s on a biweekly-monthly basis to where my cervical spine “locks” up and I have no ROM in my upper back and neck. These flair-up’s last 3-4 days at a time. When I am experiencing them I cannot get out of bed, I cannot lift my head and I have to roll off my bed to get up. I can rate the pain 10/10. I have taken days off work and it interferes with my life, and job. On a regular day basis; non-flair up, I am “sore”, stiff and have days that are better than others, and there are days that I can feel good and experience no pain at all, but those days are few in between. I experience radiating pain down both shoulders and arms, I also experience radiating pain down both my legs. I was seeing a chiropractor following the MVA for quite some time, roughly 6-7 months, I finished with the Tx with them and was moving along with suing the insurance company. Shortly after completing treatment with them- roughly 5-6 months after I started to experience those “flair-up’s” mentioned above and am now seeing another Chiropractor and have recently got a second set of X-rays since the MVA and an MRI of my neck yesterday. I need some help interpreting the results. I have a pending lawsuit with the insurance company for my injuries. The person hit me from behind going 35mph, I was traveling 5mph and pushed me into the car infront of me and I did not see the accident coming, so I was not braced for impact, the person did
$18,000 in damages to my car in which I only had for 3 months, and totaled it. I really need to know If the findings from the X-rays and MRI are contributed from the accident, in which we will fight in court. I need to get down to the root of this issue and see figure what’s really going on with my back, I’m 28 years old, I should not be experiencing this severe back pain as I am. Than you in advance for any help with this issue.

MVA 1/15/15 XRAY AND MRI FINDINGS;

XRAY POST MVA 6/13/15:Cervical Spine
Alignment:Reversal of the cervical lordotic curvature from degenerative change.
C5-6 level:There is mild right uncovertebral hypertrophy with corresponding mild foraminal impingement. There is also mild posterior osteophytic lipping.
Visualized upper thoracic spine: There is mild narrowing of the T1-T2 disk interspace with a slight anterolisthesis
IMPRESSION: Mild degenerative change primarily at the C5-6 level

XRAY post MVA 6/13/15:Lumbosacral spine
THe L5-S1 level: There is moderate narrowing of the disk interspace may be congenitally hypoplastic as there is pseudoarthrosis of the left transverse process with the sacrum with mild partial sacralization. The possibility however of disk degeneration is not excluded.
IMPRESSION:Narrowing at the L5-S1 disk interspace as described, probably congenital.

XRAY 11/9/16: Cervical spine
FINDINGS: NO acute compression fracture, no subluxation, no lytic or blastic lesions. Facet joints demonstrate normal alignment, there is a reversal of the cervical lordosis.

XRAY 11/9/16: LUMBOSACRAL SPINE
FINDINGS: no acute compression, fracture or subluxation noted. The oblique images reveal no evidence of spondylolysis. Mild disk space narrowing at the L5-S1 level with possible partial sacralization of L5.

XRAY 11/9/16 DORSAL THORACIC SPINE;
Findings: There is mild dextroconvex curvature of the thoracic spine with the apex at the T8 level

MRI WITHOUT CONTRAST: ORBIT, FACE, NECK 2/6/17
FINDINGS: There is mild reversal of the normal lordotic curvature of the cervical spine which may be relate to pt. positioning. The sagittal T1 weighted images suggest multilevel cervical spondylosis with posterior disk/osteophyte complexes most pronounced at the C5-6 level where there is a right-sided disk/osteophyte complex contributing to the effacement of the right ventral subarachnoid space without significant cervical cord deformity. There is mild right-sided neural foraminal narrowing. Further eval with an MRI of the cervical spine could be considered as clinically warranted.

***I will be getting another MRI completed in the next 1-2 weeks, pending insurance auth of the cervical, thoracic and lumbar spine. The MRI technician stated that an MRI of the neck is usually completed WITH contrast and I might have to have another MRI of the neck with contrast when I come back for the other MRI’s of the rest of the spine. DO you think it is warranted to have another MRI of the neck with contrast when I go back for the rest? As stated above, the sacrum had some findings on 11/9/16, should I have my Doctor add the Sacrum to the rest of the ordered MRI’s?***
I’m sorry for such a long in depth question, I am just confused as I do not understand the findings and wanted to provide you with all the information. Thank you again! -Amber

Amberglpn
Participant

February 22, 2017 at 11:39 am

Post count: 2

#24419

Any thoughts on my issue?

Donald Corenman, MD, DC
Moderator

February 25, 2017 at 4:44 am

Post count: 8660

#24435

Obviously, you had an injury to your neck from this impact. You might have had asymptomatic degenerative changes prior to your impact (quite common) and the accident focused stress on these areas causing pain.

Your most prominent degenerative level is C5-6 but the T1-2 level has a cervical degenerative spondylolisthesis (“There is mild narrowing of the T1-T2 disk interspace with a slight anterolisthesis”). There is a typical pattern where the C5-6 and C6-7 levels are degenerative and lack range of motion increasing stress on the C7-T1 level causing the cervical degenerative spondylolisthesis. If is unusual for the C7-T1 level to be “normal” and the T1-2 level to have degenerative facets (needed to allow the slip). Your pain generators have not yet been worked up and you might consider a pain physician to perform a thorough work-up.

Your lumbar spine has a sacralized L5 segment and the thin disc typically is associated with this anomaly. It is highly unlikely that this segment is causing pain but there is a condition called Bartolotti’s syndrome that can cause pain. You can look that up here on the website.

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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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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