pain problem

Tagged: Facial pain associated with cervical disorders

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gerrard87
Participant

July 15, 2019 at 3:51 am

Post count: 15

#30735

Hello Dr. Corenman. I emailed my MRI to another neurosurgeon and he told me that I have multiple herniated discs disease with radicular conflict and that radiologist report is not correct. These opionions are driving me crazy. Tomorrow I’ll be looking to a local opinion of another neurosurgeon with a lot of experience, as far as I know he even make implants with prodisc-c. I’ll see what he is going to advice me. Anyway… I have been to a wedding this weekend even if I was in pain and bad mood, and at night I stayed to talk with some guys outside even if it was a little bit cold. When I got home, my eyes, ears and neck where hurting like hell…so now I am pretty sure that the cold is making my inflamation so bad. Also, when I was driving back home I felt stabbing pain in my arms, no numbness, just stabbing pain that came and go down to my wrist.

One last detail doctor Corenman. I am thinking that my facial pain could be triggered also by some dental work so I need to check this too, but sometimes I am thinking that the pain is so related with neck and shoulder pain, and all started together, so I think that somehow, they are all connected. I have read some cases when some facial pain occured because of cervical herniation touching the root of trigimen nerve in the spine at some level of c5-c6 or c3-c4, also I have read about cervicogenic headache that involves facial pain too. Did you had in your experience any patient that had cervical problem that involved some facial pain? Also…When I had my brain MRI done, I found out that I have a dental cyst that put pressure in one of maxilarry sinus. The radiologist told me that the pain is not from there, but really don;t what to think anymore.

Donald Corenman, MD, DC
Moderator

July 15, 2019 at 10:53 am

Post count: 8660

#30738

Cervical disorders that can cause base of skull (occipital) pain are typically upper facet (C2-4) generated. Facial pain and numbness (rarely) is possible to be generated by upper cervical cord compression but not by lower cord compression and certainly not by lower root compression (foraminal stenosis).

I have seen jaw disorders cause trigeminal nerve symptoms so that dental cyst could be a culprit but I have only little experience with this.

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.

gerrard87
Participant

July 16, 2019 at 4:13 am

Post count: 15

#30740

I’ve just visited another neurosurgeon today, and he is not recommending me surgery right now and he told me that I should try some ozone therapy at the beginning and if this is not working, i should try epidural injections. Surgery should be the last option he said to me. he told me that I need to wear some soft collar in order to make to curve of the cervical spine back as mine is almost straight. I don’t know what is causing the facial pain, but my muscles from back of my neck hurts and when I am stretching them I feel pain in my ear and nose so…somehow the pain from neck muscles are related to pain in the ears and nose. that’s so strange.
also…at night time the facial pain is disappearing.

Donald Corenman, MD, DC
Moderator

July 27, 2019 at 10:01 am

Post count: 8660

#30771

Ozone therapy recommended by a neurosurgeon? Is this some new-age physician as I would not recommend ozone therapy for anyone. Injections can be quite helpful for both diagnosis and treatment.

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.

gerrard87
Participant

August 8, 2019 at 2:39 pm

Post count: 15

#30819

Maybe he just want to make some money…anyway I have not found any response to my pain problems, and depression is getting bigger and bigger each day.

The strange things about cervical issues related with facial pain. I talked with 2 ladies in the last 2 weeks. One of them has a fussed surgery at c4-c5 and right after the surgery she began feeling face pain like trigeminal neuralgia…and the second lady she had a disc replacement surgery at c5-c6 and she began having facial pain too…how is this possible? the second lady told me that the face pain are starting to begin more and more bearable after PT. I am going to visit a pain clinic in the next few weeks.

Donald Corenman, MD, DC
Moderator

August 8, 2019 at 5:01 pm

Post count: 8660

#30823

Facial pain is generally caused by the trigeminal nerve, a cranial nerve that does not enter the spine. There are reports that the nucleus of the nerve (the “brain” origin) can descend into the neck down possible to C2 but that is unproven. I cant tell you why those two individuals who underwent ACDF or ADR surgery developed those symptoms. Possibly during surgery, the endotrachial tube put pressure on the face causing trigeminal nerve compression but that would be the first case I have seen.

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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