Pain in the Neck

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laurasteele
Member

December 18, 2012 at 10:30 am

Post count: 3

#7622

Hi Dr. Corenman,

I am a 26 year old female. In May of 2011 I awoke to severe neck pain and was unable to get out of bed. I literally had to have assistance to lift my head. I had close to no range of motion. This severe pain and limited ROM lasted approx 1 week but I continued to have pain (probably 6-8/10 pain level) with any range of motion, sudden movements and also had debilitating headaches. I tried PT and chiropractic for months to no avail. In Oct of 2011 I finally got an MRI. It showed a moderate disc herniation of c5-6 with mild bulge at c4-5. I had an ACDF c5-6 on Oct 25, 2011. I continued to have severe pain and debilitating headaches following the surgery. In May 2012 my surgeon finally ordered a CT that revealed my surgery was unsuccessful and I did not fuse. He repeated the surgery in June of 2012 this time using bone morphogenic protein along with a bone growth stimulator(he did not use either in first surgery). Since June I have continued to have pain. My pain is basically the same as it was prior to my FIRST surgery. I had an MRI in the beginning of November showing only a mild bulge at c4-5. I’ve had two rounds of cortisone injections since November. The first was at the level above the fusion (c4-5) and the second was in the facets at that same level. That pain management doctor basically said there was nothing more he could do if they did not help. I didn’t notice a difference even for one minute with either set of injections. My surgeon has also pretty much washed his hands of me at this point. The pain and headaches are terrible. My pain is hardly ever below a 6/10. I work as an Occupational Therapy Assistant and have a very difficult time working a full day and carrying out the duties of my job. The pain has really taken a toll on me over the last year and 7 months physically and mentally. I also have a 3 year old son that I can’t play with like I want to because the pain. I’m just getting extremely frustrated and feel like I’m running out of people to turn to. Like I said before, I’m only 26 years old and feel like I’m 80. I can’t do a lot of the things I once enjoyed and I can’t help but think about what my life will be like just 10 years down the road if I can’t find some relief. I was just wondering if you had any suggestions on where to go from here or if there even is somewhere to go. Thank you so much for any help or suggestions!

Sincerely,

Laura

Donald Corenman, MD, DC
Moderator

December 18, 2012 at 7:55 pm

Post count: 8660

#7623

It looks like you have obtained good care up to this point. I will assume that the second surgery to gain a fusion at C5-6 was successful. Please tell me if that has not been assessed fully yet.

I will also assume that your pain is mainly neck pain and headaches without significant shoulder or arm pain.

Pain can be generated from the facets or the discs. Have your upper facets been included in the diagnostic facet injections? These facets commonly can cause headaches.

Have you had standard X-rays including flexion/extension? These can yield a treasure trove of significant information.

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.

laurasteele
Member

December 31, 2012 at 3:11 am

Post count: 3

#7663

I am to get a CT scan this week to see if I have fused since last surgery. I have had several flex/ext x rays in which the doctor just said everything looked fine but that I did have abnormal motion while performing those movements. No one has mentioned anything with facets above level c4-5 where I last got injection that did not help. My family physician has decided to send me to get a nerve conduction study and he also put me on Cymbalta. I was very against this as I’m just wanting an answer and a “fix” to the pain I’m having but he talked me into it saying that would be what the next doctor (a physiatrist) would want to do. This way he would be ahead of the game. I’ve noticed absolutely no change in pain. I’m just worried that they are just going to give up on me when they talk antidepressants. I honestly feel like there is something that needs to be fixed or addressed that they are missing. Thanks again for any help or information!

Laura

Donald Corenman, MD, DC
Moderator

December 31, 2012 at 11:10 pm

Post count: 8660

#7665

The CT scan will be important to determine what your fusion status is.

Cymbalta takes some time to become effective (at least 1-2 weeks) and is a good medication if it works for you.

The nerve conduction test will probably not reveal any valuable data as you have no motor weakness or symptoms of nerve entrapment (carpel tunnel syndrome, cubital tunnel syndrome).

Continue to gain more information so an appropriate diagnosis can be made.

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.

AlbertDisuza
Member

January 30, 2013 at 3:16 pm

Post count: 26

#7853

It is important to get timely treatment to avoid any further health problems. Along with the treatment given by doctors, ask for any kind of exercises or physiotherapy that will help to make it better for you. Your muscles need to get stronger and for that exercise routine with a special diet is necessary. This will fasten the healing process.

laurasteele
Member

January 30, 2013 at 9:19 pm

Post count: 3

#7856

I completely agree with you. I am an occupational therapy assistant and work in an outpatient therapy clinic. I have actually been performing formal therapy under the supervision of the occupational therapist at our clinic. I’ve been doing that for approx 2 months now. My ortho surgeon has actually recommended me seeing a neurosurgeon for now. I’m still awaiting further info on that but plan to see the neurosurgeon within the next couple of weeks. Over the last three to four days I’ve been having horrible headaches. They are worse than any migraine I’ve ever had. The headaches knock me off my feet. I’ve also noticed my chest becoming very red and blotchy when the pain is at it’s severist. I’m not on any new mess or anything. Also, there seems to be a spot around right posterior neck (maybe around c4-5) that is very sore and stiff. It hurts to turn my head to the right as well as left lateral flexion. This is still not “the pain” but something that has happened over the last few days with the intense headaches. Thanks for any info or help!!!
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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.

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