Please help with mri results

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Esquide
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August 22, 2019 at 7:37 am

Post count: 5

#30945

After a bad car accident I have been experiencing pain in my neck, shoulder, arm (tingling) and back with pain down my leg. Headaches etc.

I had an mri done and received the results but do not have s follow up with my dr for another 2 weeks.

Cervical spine

Mild to moderate multilevel spondylosis. No cord compression. Multiple levels of posterior Ossetia ridging that effaces the ventral thecsl sac including c3-4, c4/5, c5-6 & c6-7. Varying levels of foraminal narrowing.

Lumbar spine

L5-S1 broad based central/left paracentral disc protrusion compressing the descending left s1 nerve root and mildly contracting the resending right S1 nerve root.

Additional mild multilevel spondylosis as above.

Donald Corenman, MD, DC
Moderator

August 22, 2019 at 2:05 pm

Post count: 8660

#30946

You need to cut and paste the whole MRI report here and not just the brief conclusions. Also, your specific symptoms need to be described.
See https://neckandback.com/treatments/best-questions-to-ask-when-interviewing-a-spine-surgeon/

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.

Esquide
Participant

August 22, 2019 at 2:47 pm

Post count: 5

#30948

I only have hard copies of the report (way too much to type!) is there any way to upload an image of them through an iPhone?

Donald Corenman, MD, DC
Moderator

August 22, 2019 at 3:46 pm

Post count: 8660

#30949

Unfortunately, this site cannot download images. In order to help you, I do need as much information as I can get. Your synopsis of the MRI is limited and information would be missing.

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.

Esquide
Participant

August 23, 2019 at 3:05 pm

Post count: 5

#30958

Typing this out myself so please forgive any typing errors

Indication: Neck and left shoulder pain since motor vehicle accident
Technique: multi-sequential, multiplanar MRI imaging of the cervical an lumbosacral spine was performed per standard protocol

Findings:
Cervical Spine MRI

DISC LEVEL EVALUATION:

C1/2 Evaluated only in the sagittal plane Mild retroflexion of the dens No central canal narrowing
C2/C3 Mild facet productive change No central canal or foraminal narrowing
C3/C4 Posterior osseous ridging effacing the ventral thecal sac No central canal or foraminal narrowing
C4/C5Mild bilateral facet productive change No central canal narrowing mild left foraminal narrowing
C5/C6 Moderate posterior osseous ridging effacing the ventral thecal sac Minimal contact of the ventral spinal cord Facet and uncovertebral hypertrophy contributes to mild bilateral foraminal
C6/C7 Moderate posterior osseous ridging effacing ventral thecal sac and minimally contracting the ventral spinal cord There is mild bilateral foraminal narrowing No central canal stenosis
C7/T1 No central canal or foraminal narrowing
T1-T5 Evaluated only in the sagittal plane No central canal stenosis

ALIGNMENT: Straightening of the cervical spine Mild varying levels of disc space narrowing appreciated
CORD No abnormal signal is seen in the spinal cord
MARROW There is no fracture No reactive bone marrow edema is identified
IMAGED BRAIN The cervicomedullary junction is in tact
PERIPHERAL/NECK SOFT TISUES Symmetric appearance of paraspinal musculature

LUMBOSACRAL SPINE MRI

DISC LEVEL EVALUATION

T11/T12 Evaluated only in the sagittal plane No central canal narrowing No foraminal narrowing
T12/L1 Evaluated only in the sagittal plane No central canal narrowing No foraminal narrowing
L1/L2 No central canal or foraminal narrowing Lateral recesses are preserved
L2/L3 Mild facet productive change No central canal or foraminal narrowing Lateral recesses are preserved
L3/L4 No central canal or foraminal narrowing Lateral recesses are preserved
L4/L5 Mild to moderate left and mild right facet productive change No central canal or foraminal narrowing
L5/S1 There is a broad based central/left paracentral disc protrusion that compresses the descending left S1 neve root and mildly contacts the descending right S1 nerve root There is mild bilateral foraminal narrowing No central canal stenosis

Spinal alignment Minimal retrolisthesis of L2 L3 is noted Mild varying levels of disc space narrowing appreciated most severe at L%-S1
Distal cord and CONUS The spinal cord terminates at the L1 level No abnormal signal seen within the conus
SI JOINTS No articular abnormality appreciated
MARROW There is no fracture No reactive bone marrow edema is seen
Paraspinal muscle and soft tissue Symmetric appearance of paraspinal musculature
Intraabdominal/Intrapelvice soft tissue No abnormality

Esquide
Participant

August 23, 2019 at 3:08 pm

Post count: 5

#30959

Specific symptoms include

Pain and “crunching” at the base of the head — it literally hurts to keep my head up
Pain/soreness in left shoulder
Left arm pain — feels like someone punched my arm, and there is tingling in my pinky and ring finger on left hand
Lower back pain that goes down left leg — sometimes stops at knee depending what I do, if standing a lot hurts down at shin level
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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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