Spine curvature after auto accident?

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leona19652002
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September 16, 2013 at 1:26 am

Post count: 1

#9388

Good Afternoon Dr Corenman,

I have read some of your forums here and I wanted to give you my situation and see what you think. I am a 48 year old female who was involved in a hit and run car accident this past April 2013. As fast as I saw the vehicle coming at me and turned my head the grill was right in my face. I immediately felt the impact and I believe I blacked out because I don’t remember anything else until I felt the car coming to a stop. I know now the car did spin around but I can’t tell you how many times or anything I just know I was a little ways down the road from the intersection and I was facing almost the exact direction the other vehicle was coming from. I do remember at some point standing beside my car and someone grabbed my head and told me not to move and instructed me to sit down and swing my legs around, I don’t remember anything after that until they were loading me into the ambulance. It was later discovered that it was an SUV that hit me. I was having pain in my neck, shoulder and back. At the hospital I experienced pain in my knees as well. They did do xrays and told me nothing was broken and sent me home with pain meds and muscle relaxer. I do have prior medical issues. I was in a car accident in 1993 where I was struck from behind while sitting at a red light. Was diagnosed with whiplash at that time and have had issue with pain in my lumbar spine. In October 2004 I was hospitalized for viral meningitis which was associated with the West Nile virus. From that I dealt with severe pain in my thorax and in April 2005 I had a full MRI of my spine at which time was sent to a neurosurgeon for a bulging disc at the T11-T12 vertebra. Was told at that time that it is inoperable because of the risk factors so I was sent to a pain management specialist. May 2005 I saw the pain management specialist and he diagnosed nerve damage in my spine that is between my shoulder blades as well as he noted a slight tremor in my hands. I was placed on gabapentin (neurotin) 1200 mg and diclofenac 150 mg. January 2006 while sitting at work I felt a snap in my spine between my shoulder blades and when that happened my lower jaw in my face started to shake like it would if you would be freezing. My pain management specialist sent me to a neurologist who sent me back to the neurosurgeon who still associated it with symptoms left from the meningitis in 2004. Neurologist labeled it as benign essential tremors which I take 200 mg of Primodone (Mysoline). Since then I have had problems with my stomach which I take Prevacid, Oxybuten for issues with my bladder, I do take a muscle relaxer to try to help with the pain in my back. I take levothroxin because I no longer have a thryoid. I have to take a sleep aid Zolpidem just to sleep a few hours. I do take pravastatin for my cholesterol and vitamin B12 because of the neurological issues and I take a multi vitamin. After the accident I did have brusing on my left knee, left arm/shoulder and my back (left side). Since my accident this past April I have been in a lot more pain my my back as well as my left shoulder and arm. Have had physical therapy for the accident for my back and shoulder which didn’t help so was sent to an orthopedic and in doing xrays has told me I have scolosis (which I have never heard of up until now), he also said I have stenosis and tendonosis in my shoulder and gave me a cortizone shot in the shoulder. He has changed my anti-inflamitory from Diclofenac to Mobic and put me on pain med and Flexril. My main question is could the accident have cause the scolosis because after everything I’ve been through and all the tests no one has ever said anything to me before about it. I am hearing it the first time now and you would think it would have been brought up before if it was there. So what are your thoughts? Could the accident have caused the curve in my spine?

Donald Corenman, MD, DC
Moderator

September 16, 2013 at 6:55 am

Post count: 8660

#9391

Scoliosis can be caused by genetics (congenital and idiopathic), trauma (fracture of a vertebra), degeneration or pain. Since you did not have scoliosis as a child, we can rule out idiopathic and congenital scoliosis. You report no fracture of any vertebra so we can rule out traumatic scoliosis. You do have pain but antalgic scoliosis (caused by pain) typically will disappear after some time (six months or more).

This leaves us with degenerative scoliosis. This can occur when the discs asymmetrically wear out and the spine collapses along this asymmetry. Will an auto accident cause degenerative scoliosis? Probably not immediately as it takes some time for this disorder to develop.

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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