Nerve damage fears

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Margo
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January 20, 2012 at 11:17 pm

Post count: 12

#5426

Yes right the numbness that I felt was in the last two fingers of my left hand and the left side of my palm of that hand and did go away when I had first written to you, but it came back this afternoon for a little while and now it is gone away again. This is the second doctor I have tried and because of the language barrier or maybe because that’s how doctors are here they do not tell me anything they just prescribe more anti inflammatory tablets and give me more therapy on with that machine.

I don’t know if I can get any information out of them. But an MRI seems too serious and I’m afraid that even if they do not find any damage from the MRI they will still just say “see nothing is wrong with you” and I have no idea what to do about this come and go numbness. Before I do an MRI could I not do a CT scan instead? It looks like I have to find out on my own and then tell the doctor they are not telling me anything nor suggesting the right course of action I feel and I am not aware of what I need to do either.

Donald Corenman, MD, DC
Moderator

January 20, 2012 at 11:30 pm

Post count: 8660

#5427

It would be unfortunate that an MRI would replace a proper physical examination but that seems to be the answer in your position. An MRI is a benign test (uses magnetism) relative to a CT scan (radiation) and I would always prefer an MRI as the first test. Do not worry about what the MRI will or will not show. If there is some significant pathology, you need to know about it. If there is not, then you can relax about the symptoms (and have someone look for a peripheral neuropathy like I discussed in the last post).

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.

Margo
Member

January 21, 2012 at 12:14 am

Post count: 12

#5430

Yes your right. Thank you so much you helped me to understand what is happening here. I wish I could go through the physical examination first but since they will not do that I will then go ahead with the MRI it’s my only option.

Margo
Member

January 21, 2012 at 1:09 pm

Post count: 12

#5431

Hi Dr Corenman,

I got the MRI today and the doctor said that in disc 5 and 6 of the neck there is bone growing into the spine or protruding into the spine. He said the MRI confirms that, but he said the said the symptoms I am complaining about do not correlate to this problem. He said the symptoms of this is upper arm pain and I definitely do not have that so he said my body has adapted to this. He said in that case I will not need an operation or medication for it. But the problem of this numbness and weakness in the last two fingers of my left hand and palm still remains. He said if it is not debilitating I can leave it. But I am worried because I have never had this before and it seems to be occurring too often. So he said he will do nerve test where they put needle type things in my hands. Do you know what that test is? Do have any idea what this numbness weakness is? I seem to get it when i am lying down and picking up something over my head. For example I was laying down yesterday and lifted up my little computer to see something and held it there in position for a few minutes when that numbness came back.

Margo
Member

January 21, 2012 at 1:12 pm

Post count: 12

#5432

In fact this numbness seems to come when I ever i lift something even only slightly heavy for any period of time and just hold it there.

Donald Corenman, MD, DC
Moderator

January 22, 2012 at 3:22 am

Post count: 8660

#5438

There is a condition called thoracic outlet syndrome that can compress the nerves in the shoulder that descend into the hand. I have not written about that condition yet so you will have to do some literature search on the internet.

I assume the spur at C5-6 is not pressing onto the cord and causes no significant compression of the nerve root (see cervical radiculopathy on website). There are also conditions like cubital tunnel and carpel tunnel syndrome that can cause nerve compression in the arms.

The test the doctor is talking about is an EMG/NCV- an electrical nerve test to look for compression of the nerves in the arm. It will not generally diagnose thoracic outlet syndrome.

Good Luck!

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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