Pins and needles Also in the front of the neck also in the trunk

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Donald Corenman, MD, DC
Moderator

February 23, 2022 at 10:21 am

Post count: 8660

#34867

Yes, there are no other issues than the “bunching” of the ligamentum so with your present symptoms, you then conclude that this must be the cause of your symptoms.

What I do is to think what symptoms this bunching could cause. I see the possibility of local upper neck pain due to the traumatic forces that tore this ligament but this is not your complaint. I would not consider that this would cause long tract signs (LTS) as I have seen much more severe compression without LTS symptoms. As I noted before, I like doing surgery to help patients as it is very gratifying but resist surgeries that would not be productive.

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.

meni learn
Participant

February 23, 2022 at 11:04 am

Post count: 236

#34868

“I see the possibility of local upper neck pain ”
THIS is also one of my symptoms i feel for time to time severe neck pain in the back of the upper neck but this pain stop in the back of the neck ,and sometimes with extremes pain (i thinks this also come from upper facet arthritis.
u see the XR flex /ext and normal of my C spine ?(the xr was in standing off course )
u do not say what u thinking a bout the line of the ligament flavum (on MRI January 2022) them not in symmetrical line ?(you do not refer to it ?
and also some questions: about causes of why this happens (ligament buckling ) but i m read and also listen to lectures why this happen,but I m also ask u as spine surgeon gave me the reason >?
and also in the past white my specific injury and MRI from the past if any other treatment will prevention this ?

Meni

Donald Corenman, MD, DC
Moderator

February 23, 2022 at 11:22 am

Post count: 8660

#34869

You told me that your neck pain faded away as the LTS was the primary worry. Torn ligaments will contract and “buckle”. Ligamentum flavum is a vestigial ligament and not too concerning unless it compresses the cord which is does not in your case.

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.

meni learn
Participant

February 23, 2022 at 12:25 pm

Post count: 236

#34870

Ligamentum flavum is a vestigial ligament ? so if the contract what make them to contract
the main reason (I know the answer ) but want to hear from u
i listen to lectures from someone very Expert and he say why this happen and also that can lead to “somethings
call central stenosis “and this is not good things and if its bad enough you can get somethings call myelopathy very series (significant disability in people he say )” (this man he have
more than 30 years of Experience (he is not a surgeon ) but he D.C and BS.C of DR and is lectures on YouTube very deep to the c spine (he also do lectures very orderly on HOW to read c SPINE MRI .
he is very Expert.
so From your Experience this not my Case (when you see THE MRI )
see the xr ,and here my symptoms :
* heavy legs before 5 months started
1.impossible to go fast walking (from middle November 2021 ) like i before 4 months (not have any gait base )
2.falling 2 times just in last 3 mounts after pins and needles more often in the legs
3.pins and needles started before 3 months in legs in the begin after also to hands .
4.bfore 1 months test hyperreflexia in legs .
5.before one week test by neurologist Hoffman positive in R hand , Tromner R positive ,hyperreflexia
in two legs , with mild clonus , hyperreflexia in R hand ,
,sensitive:poor feeling left arm and leg .
brain Test normal,carnival nerves normal .
history :was big trauma in the swimming pool in 2010 this was you can call big trauma(from head to neck in backstroke swimming ) to the cervical spine
chronic neck pain in last 7 years but more worsen over the last years .
from all of this information also with history and SCAN u do not think the cervical causes my last symptoms :from middle of november 2021

Meni

Donald Corenman, MD, DC
Moderator

February 23, 2022 at 2:42 pm

Post count: 8660

#34871

“Expert and he say why this happen and also that can lead to “somethings call central stenosis “and this is not good things and if its bad enough you can get somethings call myelopathy”. Can this lead to central stenosis and myelopathy? No.

I understand that you have symptoms of long tract signs but I don’t believe this is generated by your neck.

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.

meni learn
Participant

February 23, 2022 at 3:09 pm

Post count: 236

#34872

You can refer please to line of posterior ligament flavum line in MRI LAST ONE
On sagittal t 2 and also t 1 ?
I know that losses the high of the disc and degeneration causes to the ligament flavum buckling (and i was have degeneration of c2-5 (u can see the MRI OF 2016 )
SO THIS LEAD to the ligament flavum buckling on the spinal cord (u think this not compress on the spinal cord even not little compress (on the cord by 10-15 % of the cord in the specific slices (area posterior small area)

” I understand that you have symptoms of long tract signs but I don’t believe this is generated by your neck.”
When u take a look properly on the last
3 MRI IN LAST 6 months .
YOU convenience this not causes the symptoms of dysfunction in lower extremity ,also started feel needles in the trunk before 2 weeks
*Also u take a look to first MRI BEFORE 5 YEARS.
All of the information SCAN i will share with u ,also my symptoms and history here published.

Meni
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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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