Neck issues with dizziness

Tagged: TMJ and cranial nerve

Viewing 6 posts - 1 through 6 (of 11 total)

1 2 Next

Author

Posts
EricNeck
Participant

April 17, 2019 at 6:49 pm

Post count: 8

#30374

Hi Dr. Corenman,

I have issues with what I think has to do with my neck and was hoping you would be able to answer some questions and point me to the right direction of where I should take this.

Brief History
– 33 year old male, athletically fit.
– Long standing (longer than 15 years) issues of neck dysfunction meaning neck muscle pain, fatigue, tightness and headaches.
– Long history (longer than 15 years) of TMJD issues requiring splint wearing for sleep
– Previous X-rays show “cervical kyphosis likely due to musculature” as per radiologist report
– Has been practicing the martial art of brazilian jiu-jitsu (BJJ) off and on for 2.5 years. Think of BJJ as wrestling with a lot more chokes and submissions.

History of Symptoms/complaints

– After a hard sparring session in BJJ in Feb, 2018 a day or so later I felt some moderate pain in the left, upper anterior part of my throat (possibly the hyoid bone area).
– With this, I had off/on sensations of “dizziness” (by dizziness, I mean minor sensations of disorientation or kind of “floating like” feeling) for a few months.
– There was no vomiting, no vertigo, no significant scalp, neck or facial pain. No horner’s syndrome or other stroke like symptoms.
– I did feel more “tension” and tightness into my left neck into my face. I also had tingling sensations go up from the left side of the front of my neck into the lower face.
– The throat pain went away over about 8 weeks, the “dizziness” went on for a few months but subsided months later.
– I never got an xray for it or imaging done. I do work with an neurologist and asked him for his opinion. He didn’t think I had a dissection of one of the cervical arteries but said I could take baby ASA for a few months if I was worried. He said if symptoms persisted, I could do an MRI. I never went to do the MRI.
– The neck tension into my face persisted even when I took a few months off of BJJ. This tension is new from the chronic issues I’ve had in the past.

———–

Fast forward to today
– I have had periods of not training BJJ for 1-2 months due to other injuries.
– My chronic neck and TMJD issues persist. I’ve consistently had the left sided neck tension even when not training BJJ. I’ve been having this difficult to pinpoint altered sensation somewhere around the left side of my mouth perhaps originating from my TMJ? I also still get the tingling sensations up the left side of my anterior neck. Also, I cannot open/close my mouth without a loud double click of my TMJ.
– I have started training BJJ again 2-3x a week but most recently after training, I’ve started experiencing the dizziness symptoms again. No vertigo but just a “floating” sensation.”
– I’ve also had sensations of intermittent “wet” and tingling sensations in my left wrist and shoulder. This happens maybe a few times a day.

——————–
Plan going forward

I think this has persisted long enough that I should get at least a cervical MRI done. I will pay for this out of my own pocket and if there’s something abnormal, I will ask my GP to refer me to a neurologist or neurosurgeon. In your opinion, is there any difference between a 1.5T or a 3T MRI for my situation? I have the option of going to either MRI centre.

I’ll also be getting an examination by a dentist who specializes in oral medicine and oral pathology and TMJD issues.

Comments?

I know it’s hard for you to speculate what I could have without seeing me in person and doing more diagnostic tests but based on the above symptoms, what do you think this could be? I think any sort of dissection would be highly unlikely as it’s technically been 14 months. Do you think this could be something as simple as a TMJD issue that got worse with BJJ? Or is it more likely that I have some sort of disk herniation especially with my cervical kypphosis.

Thank you for reading this and I hope to get your opinion so I know how to direct my care.

EricNeck
Participant

April 17, 2019 at 8:09 pm

Post count: 8

#30377

Edit: I also forgot to mention that over the past 2 months or so, I’ve started feeling a “lump” in my throat on most days. There’s no palpable mass or throat pain or difficulty swallowing.

Donald Corenman, MD, DC
Moderator

April 21, 2019 at 12:32 pm

Post count: 8660

#30387

You have symptoms more referable to cranial nerve involvement than cervical spine problems but the cervical spine needs to be ruled out by an MRI. For the neck, the strength of the magnet (“is there any difference between a 1.5T or a 3T MRI for my situation”) is not as important but if you can get a 3T, that would be better. It is really the technician that makes a big difference.

Your symptoms “I cannot open/close my mouth without a loud double click of my TMJ….There was no vomiting, no vertigo, no significant scalp, neck or facial pain. No horner’s syndrome or other stroke like symptoms” indicate the TMJ is malfunctioning. This joint disorder can cause some of your symptoms but not all. I do think a neurologist (not a neurosurgeon) would be a good first stop but maybe an ENT specialist who specializes in TMJ syndrome whole be a good stop too.

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.

EricNeck
Participant

April 21, 2019 at 1:16 pm

Post count: 8

#30389

Thank you for taking your time to reply.

Another symptom I forgot to mention was every few weeks or so, I would get twitching under my left eyeblid that would sustain for a few days. Not sure if that’s related to the overall sympmtoms.

I’ll get the cervical MRI first and go from there.

Thanks again for your time and opinion.

EricNeck
Participant

May 4, 2019 at 4:05 pm

Post count: 8

#30418

Hi Dr. Corenman,

I got the MRI at 1.5T. The radiologist report won’t come for a few days so I have a few questions in the meanwhile knowing that I may not get a complete answer because you don’t have access to the full images:

1. How is the overall quality of the images based on the images below? Are they high quality and diagnostically sufficient?

2. I have attached an T2 weighted axial view at the level of C6. The technologist said she saw something here and I have marked it at the 7.9mm mark right around the area of the left vertebral artery. What is this white object that is sticking out that’s not on the right side? Could it be related to my symptoms?

3. How does the overall sagittal view look?

Thanks again.

images:

EricNeck
Participant

May 4, 2019 at 4:37 pm

Post count: 8

#30421

Edit: The axial image is actually at C5.
Author

Posts

Viewing 6 posts - 1 through 6 (of 11 total)

1 2 Next

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel