New cervical spine issues nearly eight years post cervical laminoplasty

Tagged: cervical laminoplasty 2009

Viewing 5 posts - 1 through 5 (of 5 total)

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Lollipop
Participant

November 30, 2016 at 4:08 pm

Post count: 31

#23502

Hi Dr. Corenman,

I have corresponded with you regarding my lumbar spine in the past. Most recently regarding the arthrodesis of my L4-5 fusion. I am scheduled to have a revision in January.
Today, I am writing to get your “take” on a recent MRI of my cervical spine. I did have a cervical laminoplasty in 2009 due to severe congenital stenosis. It was a C4-C6 laminoplasty which was successful and I have had no further issues until around July of this year. I did have an MRI in May 2010. (1.5 years after my surgery) I will include the results of that here for comparison of my most recent MRI.

MRI done 5/28/2010

1. Status post laminectomy and fusion from C4-C6 on the right since the previous examination.
2. Severe cervical spondylosis as has been previously described. There is left-sided encroachment at C7-T1 due to focal hypertrophic change which is unchanged from the last exam
I had the most recent MRI done as the left side of my neck felt different… like a full/tight feeling with pain occassionally shooting down into my left scapula. The tightness feels better after I tip my head hard to the right. I also have intermittent tingling in my third and fourth fingertips on my left hand. I have had crepitis in my neck forever but sometimes when I turn my neck now, there is a tremendous crack that I feel and hear…again crepitis. The right side of my neck is great, no issues.

MRI November 21, 2016
The results are lengthy so I will just give you the “impression.”
1. Development of a new small right paramedian disc protrusion/herniation of 2 to 3 mm in AP range at T2-3 based on sagital images compared to the previous MRI of 5/28/10. Therefore, further evaluation by MRI of the thoracic spine is suggested.
2. Moderate bilateral neural foraminal stenosis due to spurring from the uncovertebral joints at C4-5 and slight retrolisthesis of C4 on C5 causing mild ventral thecal flattening but no focal disc herniation or central spinal stenosis.
3. A small right paramedian osteophyte disc complex at C5-6 causing mild right ventral thecal indentation but no herniated disc, significant spinal stenosis or significant neural foraminal stenosis.
4. Apparently severe right and moderate left neural foraminal stenosis at C6-7 but evaluation for the right-sided neural foraminal stenosis from C4-5 through C6-7 are limited due to ferromeagnetic artifact from the posterior fixation pedicle screws.

I am wondering what you think about this most recent MRI. I don’t know if this is something I should get evaluated sooner than later. Thank you so much! Lollipop

Lollipop
Participant

December 6, 2016 at 12:58 pm

Post count: 31

#23515

Hi,
I’m following up about my recent post. The only reason I am asking you is that my primary physician ordered my recent cervical MRI and said I would need to discuss it with my surgeon. I would, but he passed away unexpectedly six months after my laminoplasty. I have switched to a neuro spine surgeon who will do the revision of my arthrodesis at L4-L5 in January. I am not sure at all if these results are important or can wait. I know most surgeries are “elective,” as was my laminoplasty… though I was told I could be paralyzed from my neck down with a bad fall or car accident.

Please respond, as I will determine who to follow up with from your opinion. Thank you.

Donald Corenman, MD, DC
Moderator

December 10, 2016 at 1:20 pm

Post count: 8660

#23518

I don’t have previous correspondence as the forum threads are not connected. What are your symptoms to compare with your MRI findings?

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.

Lollipop
Participant

December 10, 2016 at 2:53 pm

Post count: 31

#23520

Hi, I will resend prior post…

I had the most recent MRI done because I was having pain in the left side of my neck and an occasional feeling of something catching, the same area feels tight and swollen internally. The tightness feels better for a little bit after I tip my head hard to the right. I also have intermittent tingling in my third and fourth fingertips on my left hand. I have had crepitis in my neck forever but sometimes when I turn my neck now, there is a tremendous crack that I feel and hear. The right side of my neck is fine.

Here is the previous post…

I have corresponded with you regarding my lumbar spine in the past. Most recently regarding the arthrodesis of my L4-5 fusion. I am scheduled to have a revision in January.
Today, I am writing to get your “take” on a recent MRI of my cervical spine. I did have a cervical laminoplasty in 2009 due to severe congenital stenosis. It was a C4-C6 laminoplasty which was successful and I have had no further issues until around July of this year. I did have an MRI in May 2010. (1.5 years after my surgery) I will include the results of that here for comparison of my most recent MRI.
MRI done 5/28/2010
1. Status post laminectomy and fusion from C4-C6 on the right since the previous examination.
2. Severe cervical spondylosis as has been previously described. There is left-sided encroachment at C7-T1 due to focal hypertrophic change which is unchanged from the last exam

MRI November 21, 2016
The results are lengthy so I will just give you the “impression.”
1. Development of a new small right paramedian disc protrusion/herniation of 2 to 3 mm in AP range at T2-3 based on sagital images compared to the previous MRI of 5/28/10. Therefore, further evaluation by MRI of the thoracic spine is suggested.
2. Moderate bilateral neural foraminal stenosis due to spurring from the uncovertebral joints at C4-5 and slight retrolisthesis of C4 on C5 causing mild ventral thecal flattening but no focal disc herniation or central spinal stenosis.
3. A small right paramedian osteophyte disc complex at C5-6 causing mild right ventral thecal indentation but no herniated disc, significant spinal stenosis or significant neural foraminal stenosis.
4. Apparently severe right and moderate left neural foraminal stenosis at C6-7 but evaluation for the right-sided neural foraminal stenosis from C4-5 through C6-7 are limited due to ferromeagnetic artifact from the posterior fixation pedicle screws.
I am wondering what you think about this most recent MRI. I don’t know if this is something I should get evaluated before I have my revision of the arthrodesis.

Thank you so much! Lollipop

Donald Corenman, MD, DC
Moderator

January 22, 2017 at 10:01 am

Post count: 8660

#24194

The complaint of “sometimes when I turn my neck now, there is a tremendous crack that I feel and hear” is not important if there is no pain associated with this problem. Facets commonly become degenerative and the surfaces become irregular. When one facet moves, the surfaces “grate” on each other causing the crackling noises. The pop generally is from a “release” of the suction that every joint is under and is the same noise as a chiropractic manipulation.

You might not have had a laminoplasty as this radiologist notes “ferromagnetic artifact from the posterior fixation pedicle screws” but these might not be pedicle screws (indicating fusion) but metal struts that keep the laminoplasty open until the back of the lamina heals.

Your symptoms are more directed to mechanical disc failure than to cord or root compression. Your MRI reading doesn’t focus on your degenerative disc or facet disease. Nonetheless, with “severe right and moderate left neural foraminal stenosis at C6-7”, you might also have radiculopathy. See this section; https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/ and look at the C7 nerve root.

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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