Spondylotic bar

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penzy
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November 6, 2014 at 11:04 pm

Post count: 2

#11681

Hi doctor. Thank you so much for this forum. It is very interesting as you are very knowledgeable and make a lot of interesting links to other reasons for neck and back pain. I hope you can help me with my question :) I have a lot of dizzy spells, nausea, neck (Mid and L side neck pain most prominent), upper and mid thoracic (burning T8-T12), shoulder, and upper arm pain.I have sharp deep teres minor pain and constant pain in my posterior underarm area.I have deep infraspinatous,supraspinatus fossa pain. I had a recent MRI and among the most curious notes was this: A moderate caliber diffuse poster central spondylotic bar is noted which, in conjunction with the kyphosis, has completely E.faced the ventral CFS space and mildly flattened the right greater than left ventral surface of the cord without inherent cords signal abnormalities or significant canal compromise. There is a complete reversal at my T2-6 The C4 ventral rootlets are mildly posterocentral displaces without significant forimaninal compromise. Those are only some of the MRI findings. Not sure if it’s serious or not. My physiatrist has ordered another MRI for my thoracic issues. I do have moderate lumbar lordosis.I have a grip issue in my left arm as well as weakness and intermittent pins and needles. I took a power nap last night and upon awakening I could not move my right arm or hand at all I tried to lift it,I asked my husband to put something in my right hand that was bent under for no apparent reason. I could not grip or hold anything for about 45 minutes. MS has been ruled out. So has fibromyalgia,lupus or rheumatoid arthritis (checked 4 times in 10 months). I am wondering what could be wrong. I do have some arthritis in my neck,facet joints, discs,shoulder, and knees.Surgery is being considered but I want to avoid it if unnecessary. Does this sound normal or like an aging process I am a 41 yo female in normal height and weight range 5’7 -119. I have a regular exercise routine and personal trainer. I can no longer use elliptical due to r and l arm and shoulder deep soreness and pain. I am wonder if I need a bone scan?

Donald Corenman, MD, DC
Moderator

November 7, 2014 at 7:58 pm

Post count: 8660

#11687

Your symptoms are diffuse and probably caused by more than one disorder.

The neck pain and upper thoracic pain are probably caused by cervical degenerative disc disease. I assume that your statement; “There is a complete reversal at my T2-6” really means “C2-6” which would be an indication of significant global degenerative disc disease.

Your right arm weakness after sleeping could be from a nerve compression syndrome like thoracic outlet syndrome or cubital tunnel syndrome. See descriptions of these disorders on the website. Cervical radiculopathy cannot be ruled out with the limited description.

Before you decide that you need surgery, you need a good diagnosis and discussion with your surgeon. The reason for surgery should make sense and the outcome should be discussed. A bone scan appears not to be necessary.

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.

penzy
Member

November 10, 2014 at 6:24 am

Post count: 2

#11710

Wow, thanks so much!Once again I am impressed by your depth of knowledge and linking.Cervical radiculopathy and thoracic outlet syndrome sound serious, but if you say that surgery may not be necessary I’m happy.I will be sure to do research concerning the conditions that you mentioned.I be sure to heed your advice and consult with my surgeon to establish the need for it.

When you say degenerative I associate the term with wear and tear and the aging process in general, but since I have so much pain, numbness and pins and needles it feels neurological. In your estimation might it be a good idea to consult with a neurologist as well? It has not yet been proposed to me by anyone.
Thank you Dr. Corenman. You are very much appreciated!

Donald Corenman, MD, DC
Moderator

November 11, 2014 at 10:28 am

Post count: 8660

#11716

Degenerative does mean “wear and tear” but probably not how you think of it. Genetics plays a great role in degeneration but so does trauma, occupation, advocation and prior surgery. Accidents typically cause increased stress at a previous degenerative but non-symptomatic level.

A good spine surgeon should be able to ferret out the source of your symptoms.

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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