need diagnosis

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mariskab
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February 9, 2013 at 12:33 pm

Post count: 4

#7950

I have had a right limb with no feeling, burning sensation, no feeling in the last 2 toes on the right leg, feels like one big bruse that I cant touch. T7/8 herniated disc and a tumor on T3. Had 3 spinal blocks and 6 MRI scans with normal xrays. Been taking Lyrika 75ml twice a day and pain doesnt subside. Been to see 3 surgeons, neurosurgeon, fisio no one can help me figure out what is cousing the nubniss and dead feeling to the right limb. I get shooting pains out the back all the way down both legs. I have pain around the rib cage and awake with a feeling of bricks on my chest and back. cant sit/stand or lie for long periods, some days my leg feels like jellow and cant put any pressure on it.

Donald Corenman, MD, DC
Moderator

February 9, 2013 at 6:33 pm

Post count: 8660

#7951

Right leg numbness, burning and weakness (“leg feels like jello”) normally occurs from nerve or cord involvement. If this is an upper motor neuron injury (central nervous system involvement), there will be certain physical examination findings (long tract signs) present. If this is a peripheral nerve injury (lower motor neuron involvement), then both EMG test findings and physical examination findings (reflex deficit, motor strength loss and sensory loss) will be apparent.

Occasionally, a brain problem will cause these symptoms but there are other signs and symptoms that would accompany this particular disorder.

A trip to a good neurologist might be helpful to you.

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.

mariskab
Member

February 10, 2013 at 4:03 pm

Post count: 4

#7960

Thank you Doc, been for a full examination at a neurologist already and she’s stunned at the numbness. There are no conclusions on MRI that there is a nerve problem. MRI findings 30/11/2011 There is hemagioma on the T3 vertebral body that is of no significace. At T7-8 leverl there is a central dis cerniation that does cause spinal stenosis. Ther is also minimal impression the the spinal cord. No ther disc herniations can be seen and there is no additional spinal stenosis. The spiinal cord and conus medullaris are normal, the cuauda equina has a normal apperance. MRI of the brain findings: Ther is calcification the anterior aspect of the falx cerebri that is of no sinificanes all is normal. MRI findings 03/10/2012 dorsal spine: study was compared to the previous MRI of 30/11/2011. At the T7/8 level there is a central disc protrusion. This caused impression on the anerior tecal sac and slso an impression the anterior aspect of the spinal cord just to the right of the midline. The lateral recessed are normal. there is no neural foraminal rarrowing, the facet foints are normal. The haemangioma in the T3 vertebral body was also previously seen and is of no sinaifiace. The signa intensity of the spinal cord is normal with no mass lessions noted. Fiosio is no help, some days I cant walk at all.

Donald Corenman, MD, DC
Moderator

February 10, 2013 at 11:58 pm

Post count: 8660

#7965

It is unlikely that the small disc hernation at T7-8 is causing your current leg symptoms unless there are physical examination signs (long tract signs) present on physical examination. I would assume that the neurologist would be able to find those on examination and since you do not mention these signs, I also assume that they are not present.

Your MRI of the brain sounds normal.

Have you had an MRI of your lumbar spine? What does the neurologist state when discussing the origin of your weakness? What are the physical examination findings for your lower leg?

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.

mariskab
Member

February 11, 2013 at 2:40 pm

Post count: 4

#7974

Neurologist only diagnosed me with paralysis of the limb, no sign of MS. EEG was done and only mentions that the right side is not responding as good as the left limb. Ive been treated for damage to the nerve but nothing is working or confirming that its a nerve problem.
Could this be a mussle sickness as the mussles on my buttoks and down the right leg is always feeling like its brused. I get shooting pains from down the buttocks all the way to my ancle. I have a burning sensation on the calfe section of the leg, some days the leg swells double the size of my left leg and only swells to my knee. When the leg pains I sometimes have a cold foot and my leg feels like is up against a cold piece of metal. Ive had sonars done to look for deep vain trombosis but there is no sign of clots or narrowing to vains. We are now mannaging my pain with muscle relaxants. When I move in the mornings its stiff over my lower back and rib cage and sometimes ease if I stand with the back bent to the front. I’m frustrated as this is now been going on for longer than a year now. Somedays it feels like I cant sit and other days I cant put any pressure on the leg as it doesnt repond. My pain is constant every day and feels like a deep bone pain that doesnt weaken or strengthen it stays the same. I also have this numb sensation over the right side of my private parts and have no feeling with intercouse on days where the leg pains. I also have a tingeling feeling when it starts paining.

Donald Corenman, MD, DC
Moderator

February 11, 2013 at 8:13 pm

Post count: 8660

#7976

if the nerve is damaged, typically there will be signs on an EMG (not an EEG which is an electrical test for the brain). Shooting pains from the buttocks to the ankle sure sound like sciatica, another reason to have an MRI of the lumbar spine.

True swelling of the leg has to be proved by measurement with a tape measure. If the leg “swells” then diagnosis of a deep vein thrombosis (DVT) has to be considered. You have had that ruled out. Many times, neurological involvement will make the leg “feel swollen” but not actually be swollen. Actually motor nerve involvement will make the leg shrink due to muscle atrophy.

Again, an MRI of your lumbar spine would be the next step.

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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