Neck issues - 54 years

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cowboybill
Participant

July 15, 2018 at 9:51 am

Post count: 4

#28770

Hi, I will try to make this short and to the point. In 1962, when I was 8, I went off a high dive with closed fists. The water came up and forcibly slammed my head back and to the right. I noticed whenever I moved sharply to the right, the original pain would come back. I stopped moving and it became a part of me not to move my head. 54 years later (I am 63 now), my neck hurts. I have had all the shots, even nerve blocks (these left an intense pain). I have been diagnosed with: broken Dens tip, Type 2 Dens (they say it healed), accordianed by neck vertebrae on the right side which broke pieces off of each C1-C7 and now have extreme severe arthritis over all of it. On April 21, 2018, I had severe trap/neck muscle charley-horsing. IcyHot/Bengay took care of it after 2 days. On April 23rd, I had severe left/right temple pain – like an ice cream freeze on steroids. For some reason, I put my right palm to my right temple and pushed (to find out where it hurt the worse – more IcyHot). Nothing happened. I then put my left palm to my left temple and pushed. I immediately heard a loud grating sound followed by an intense pain (nerve I believe). All scans show the Type 2 Dens break but I don’t believe that the Cats or Xrays can get close enough. I did feel a bit better after the “move”. I think I moved the dens back into place. Since no one can see it with any type of scan, they don’t believe me. The nerve blocks (4) up my neck, left me with intense neck, head, and back pain. I believe, with all my symptoms, that my Dens is just lying on top of C2 but NOT attached. Due to the C1-C7 issues, I have every single nerve being affected and I have different pain all the time. What Can I do. One surgeon told me he couldn’t help me. Was 1962 too early and 2018 too late? This is just getting more intense. I feel some type of pain; numbness forehead, temple L/R, tingling top/back of head, traps/neck muscles cramping, under arm/tricep pain and occasional shots down my left chest. Thanks for listening. Leo p.s. there is a bunch more I could put in here.

Donald Corenman, MD, DC
Moderator

July 15, 2018 at 10:36 pm

Post count: 8660

#28775

Your notation of “C1-C7 and now have extreme severe arthritis over all of it” I will assume is facet arthritis. Is there significant disc degeneration in addition?

Your notation “I then put my left palm to my left temple and pushed. I immediately heard a loud grating sound followed by an intense pain” was irregular degenerative facet surfaces pushing together causing both grinding noises and pain.

“All scans show the Type 2 Dens break but I don’t believe that the Cats or Xrays can get close enough”. You did say that this break was healed. How did you know? The typical scan to reveal healing is a CT scan.

Facet pain can cause severe neck pain radiating up the head or into the shoulders. To diagnose facet pain, facet blocks are used. See https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/, https://neckandback.com/treatments/diagnostic-therapeutic-neck/ and https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/

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.

cowboybill
Participant

July 16, 2018 at 6:28 am

Post count: 4

#28776

Much Thanks for your reply. Yes, I have 4 blown disks pushing into the soft cushion around the cord but not quite there yet. I had a CT scan and from that they are saying it looks like it healed. Right now I have limited L/R, fwd/rev, and no tilt L/R. When I pushing on my temple and something moved, I had full range of motion, all of it including tilt without limitations. It took less than a week for everything to go back, for example, muscle memory in my neck pulled it back out. Since the test nerve block did not work at all but increased pain, I am getting re-evaluated on Weds. Not sure what they will come up with.

Donald Corenman, MD, DC
Moderator

July 17, 2018 at 10:40 am

Post count: 8660

#28781

By your information, it sounds like your need facet blocks with a pain diary to diagnose your possible facet pain generators. See https://neckandback.com/treatments/diagnostic-vs-therapeutic-injections/, https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/ and https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/.

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.

cowboybill
Participant

July 19, 2018 at 9:39 am

Post count: 4

#28795

Hi,
A follow up. I just received an Occipital nerve shot on both sides of skull. It relaxed my neck muscles/tendons
taking away the compression/squishing on those nerves. All of my head pain has gone. I had nerve blocks but found out they were at 4,5,6,7 and now I will get them at 2,3,4. This should work. Unfortunately, the nurse agrees with me that my Dens is not attached to C2, but they can’t see it with a Cat or Xray so they can’t prove it for INS purposes for C1/2 fusion. If the C2,3,4 block works then ablation will be next probably on C2,3,4 and maybe the ON nerves also.
Much thanks for your insights. I appreciate it highly.

Donald Corenman, MD, DC
Moderator

July 19, 2018 at 5:22 pm

Post count: 8660

#28797

If the CT demonstrates that there is no lucency (or break) at C1-2, then most likely, this fracture is healed. Hopefully, the CT is of high quality so the sagittal and coronal reconstructions are of good quality.

Yes, it does seem like your upper facets are your pain generators. Good luck on the ablations!

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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Neck issues – 54 years