Question about MRI finding

Tagged: Cervical myelopathy ?

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Hummerh139
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October 1, 2018 at 5:50 pm

Post count: 5

#29447

Dear Dr.corenman I was rear ended 41 months ago…went to ER bc of horrible neck pains radiate into arms tingling numbness in hands and horrible lower back pains radiate into legs and tingling and numbness in feet….ER said only had strain neck and told to go see primary doctor…here in florida primary doctors don’t take car accident so I had to seek care with chiropractor who takes car accide t injuries…everyday after accident I started to experiwnce hands disnt feel rifht dropping things out of the blue and legs didnt feel right and walking was different…3 days after accident I seek care that care worsen my neurological symptoms….11 days after accident was in MRI booth neck and lower back…at c5-c6 herniated disc indenting spinal cord and said my AP diameter of my spinal canal was 7mm at c6-c7 herniated disc no cord compression but spinal canal AP diameter was 8.5mm and at c3-c4 grade 1 retrololesthesis…at l5-s1 herniated disc abutting left exit nerve root and grade 1 retrolisthesis….was referred to surgeon…couldnt seen surgeon PA for 2 months…did nerve test / emg and it said at c6c7 both side both levels radiculopathy and same with l5-s1….seen surgeon PA said needed a level acdf surgery “TO STOP PROGRESSION OF MY SPINAL CORD FROM BEING DAMAGED EVEN MORE then it was already showing bc at time of this visit I was in a wheelchair and this was 3 month after my accident…was told I had true apinal cord compression..surgery was not to fix damage already happened but to stop it from worsening…surgery was scheduled for 6 months away…seen surgeon 2 months later said oh its bad definitely need surgery but we can wait for more months bc all damage happen During accident and it won’t get worse then it already has…long story short never had surgery tried other neurosurgeon at university hospital and all I got was not enough compression to be causing my paralysis…for 39 months ive been wheelchair bound cant walk stand using my legs deal with horrible spasms spasicity pains heaviness burning and have shoulder weakness and hand weakness…my grip strength I am told for a 42 male should be 100lbs mine is 19lbs both hands…only been to PT for upper body bc I was having issues transferring and for a referral for powerwheelchaor which Medicaid denied…have neurogenic bladder and bowels with leaking and deal with autonomic dysreflexia multi times a day 99% bc of my bladder issues…all doctor after surgeon prolonged and other issues they rushed exam and I have taken video of myself doing Hoffman bakinski clonus and knee reflex hyperreflexia test bc if they did a d my legs spasm they would said cant do test ur legs r spasm uncontrollable which happen when u lift bend touch strength my legs…had 1 doctor tell me I dont have spasicitt and I said then why do my legs sudden jerky movements and tighten all the time…this has been a nightmare….also told I showed unusual progressivr cervical myelopathy and paraparaesis after my accident and I seen this neurosurgeon at a unversity hospital 6 months after my accident and 4 months of being wheelchair bound and I said how is it unusual I was rear ended and continued to worsen even with treatmen….I didnt wake up yesterday and came to u today…I would just be pushed away…told by other university neurosurgeon cervical myelopathy then it wasnt its lower back then middle back which I found out have compression fractures on3 levels in middle back ( I fell nimerous times trying to walk/ stand ambulatory and transffering into wheelchair) asked if I had lawsuits and after asking ordered 4 more mris when I jist did whole spine 2 months b4 test for bladder even thought doctor said I had no issues with bladder but was wearing adult briefs and had rash for months on my butt…both university neurosurgeon just stop talking to me and a nuerologist 2yeara after did bakinaki test right in front of my face a d my big toes and other toes moved upwards and seen I had shoulder weakness and hands weakness and did emg/nerve test of only my lower body…went back to see neurologist gor results and all I got was in confused what’s cauaing ur severe paralysis and weakness and I said so telling me to my face I definitely have spinal cord damage after testing my feet and u looking at me and why didnt u do eng/nerve test for upper body and after I said this he said go back to ur or I set doctor he has tje results and of course he said plantar reflex was normal and it was in my head…was diagnosed by 1 of the university doctors I was a paraplegic but have weakness in shoulders and hands and then I was told by chrisopther reeves and craigs hospital RN nurses hotline bc I have no where to turn and had to learn alot on my own that I am a quadriplegic incomplete spinal cord injury…the neurologist said surgery and PT wouldnt help its been over 2 years wheelchaor bound and university doctor said woupdnt do surgery if it wasnt gonna fix anything and it wont fix anything and this was 8 months after my accident….I cant even get to see doctors i need like pulmonary urologist for am told supra pubic catheter to manage my bladder bc of the AD issues…no doctor will take my insurance or bc its a car accident…please give me some ideas information…i like I said have read watch as much as I can on cervical myelopathy and if not treated in timely matter or if its progressing in front of ur eyes like my primary doctor at time of accident said to my insurance to get me a wheelchair and to help fet my ssi disability and also said I couldnt wait 6 months for surgery I wouldnt be a candidate for surgery to fix or help anything…my myelopathy was progressing now…please help with ideas and some information on what I have said about my catastrophic injuries…please and thank you and god bless

Donald Corenman, MD, DC
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October 4, 2018 at 8:04 am

Post count: 8660

#29451

You sound like you have spinal cord dysfunction but your images are not quite what I would expect for the symptoms you have; “c5-c6 herniated disc indenting spinal cord and said my AP diameter of my spinal canal was 7mm at c6-c7 herniated disc no cord compression but spinal canal AP diameter was 8.5mm and at c3-c4 grade 1 retrololesthesis…at l5-s1 herniated disc abutting left exit nerve root and grade 1 retrolisthesis”.

You need a thorough evaluation from an experienced spine expert. You might need new studies and you certainly will have to bring your prior images and consultations. A meticulous physical examination would be quite helpful to ferret out what is causing your myriad of symptoms. You have a complicated case and there are many possibilities for your current disability.

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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