neck had it on the wrong board

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carolns
Participant

April 8, 2013 at 2:13 am

Post count: 88

#8362

I have severe arthritis in my neck and was in a car accident about 40 years ago and had whiplash . Of course back then I signed of . For the last year I have been having severe pain in my neck going up my head. Had physio with acupuncture and stretching. They want me to see a surgeon before they will put me in traction. They are scared of it.
I am to the point that if I need surgery I will do it.

There is 5mm anterolisthesis of c2 on c3 unchanged. There is multilevel facet oa, with severe facet oa at c2 -c3. Multilevel degenerative disc disease most severly c4-c-5,c6-c7 with maqrked disc space narrowing & marginal osteophytosis. No fracture is seen. moderate neural foramina narrowing of the right c5-c6,& mild neural foramen narrowing of the left c4-c5 and left c6-c7 and right c4-c5. no significent spinal canal stenosis.
Depending on patient’s condition. patient may require surgical intervention to stabilize the anterolisthesis of c2 on c3
Do you think surgery would help? Thank you carol

Donald Corenman, MD, DC
Moderator

April 14, 2013 at 6:15 pm

Post count: 8660

#8426

Surgery for your neck is predicated on many different conditions. Since you have no significant central canal stenosis, your spinal cord is most likely not in jeopardy. You then have to compare symptoms to the problems in the neck including disc degeneration, facet degeneration (degenerative spondylolisthesis) and nerve root compression. See the section under “When to have neck surgery” to obtain a better understanding of what surgical conditions look like.

Your question on the stability of the 5 mm anterolisthesis of C2-3 (which is a degenerative spondylolisthesis by the way) is a good one. Is this level stable with flexion/extension X-rays or does it move? Also, what activities are you involved with? If you have a sedentary lifestyle, then the risks are significantly lessened. If you are an avid mountain biker or jump horses, your risk increases.

Degenerative spondylolistheses are also typically found above and below significant degenerative discs. These degenerative disc segments increase the load on the levels above and below. The facets wear out and the vertebra slips on the one below.

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.

carolns
Participant

April 14, 2013 at 9:49 pm

Post count: 88

#8435

Thank you so much……I am 72 and have a lot of arthritis…..I walk a lot and can only bend and lift 2 litre of milk etc….have bursitis in my hip…..lots of health problems…118 lbs and eat well….
Do I need a MRI or is a Cat scan good enough for the doctor to see what is going on?
Acupuncture which I never thought would work took 90%of the pain away but only if I had it once a week. The pins and needles started to come back with acupuncture but would stop quickly. Without it the pins and needle go up on the right side of my neck to the top of my head. Have a hard time to get it to stop. When I sit or drive is when it is worse.
Maybe nerve block or something? This started after I went of celebrex for 10 weeks ….This started 13 mts ago….back on celebrex 8 mts or so.
I want to thank you so very much. Carol

Donald Corenman, MD, DC
Moderator

April 15, 2013 at 12:22 am

Post count: 8660

#8438

Since I doubt you are a professional mountain biker or bump skier at this point, it does not appear that you put your neck at too much risk. The questions for C2-3 are two. One is stability and the other is pain. A set of X-rays with flexion/extension views would be helpful to determine stability. An MRI would look at the health of the disc, joints, nerves and spinal cord.

The C2 nerve is right next to the degenerative facets and can be compressed or irritated by these facets. This nerve (also known as the greater occipital nerve) travels over the back of the head and stops right above the eyes. Irritation to this nerve will cause pain and paresthesias (pins and needles) in this distribution. A nerve or facet block might be helpful to diagnose and possibly treat this disorder.

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.

carolns
Participant

April 15, 2013 at 1:21 am

Post count: 88

#8439

Thank you again…..you are amazing…I understand some of what is going on…wish you were my doctor….my appointment in Halifax N.S. is May 6 and I will let you know how I make out…..thanks Carol

carolns
Participant

April 16, 2013 at 8:02 pm

Post count: 88

#8447

I did have one epidermal injection in my neck in the OR a few months ago but it didn’t do anything…made my nose and eye funny for a few days ….is this a nerve or facet joint injection please? Are facet and nerve injections different?
Maybe before I have surgery I should do the 3 I was suppose to do?
thanks so much Carol
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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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