standard mri vs stand up nd chronic back pain helpp

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mohsinaliasdf
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July 28, 2012 at 8:54 am

Post count: 11

#6605

Hi Dr corenman I have very bad back pain almost every wherevery bad in my lower back and mid and upper neck. My question is if I get a standard MRI done for the back is it going to be less effective in diagnosing difficult problems .because I heard the stand up MRI diagnoses it better and accurately .what do you think about which one I should get.secondly regarding my pain its ao bad i can’t even move from it because of weakness and I get muscle spasms when I stand for longer than 10 minutes. I don’t know of its injury or some other illness because besides back pain I have a lot other going on. most of the pain is in the back near the shoulder blade and I can literally feeltheres like a very tight rope muscle coming from the lower back all the way up and it looks like a very bad either strain or muscle rupture and its been there for 8months . Also in my right lower back there a couple of small sort of ballsthat move around when I touchthem and they give me pain a lot. Now one thing that drives my crazy iwith every single breath i feel my back getting tight by the rips and when pressure builds up I hear a big loud click or pop that in my middle back . So overall how effective is it going to be getting an MRI to get to know whats going on and which one I should go with . Please reply ill wait thank you

Donald Corenman, MD, DC
Moderator

July 28, 2012 at 10:00 pm

Post count: 8660

#6609

The stand-up MRI is distinctly poorer in image quality and information gathering. Yes, the image will demonstrate what effects gravity has on the spine but with poorer image resolution which significantly diminishes the information.

A good supine MRI (standard type) along with standing X-rays (including flexion and extension) will yield better information regarding pathology and the effects of gravity on the spine.

By your description, I am unclear if the pain originates from your lower back or your mid back (thoracic spine). Please see the section under “Conditions”; “How to describe low back pain” for a template to describe 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.

mohsinaliasdf
Member

July 29, 2012 at 1:59 am

Post count: 11

#6616

my pain in in the lower back with the bottom two joints which are i guess the sacroliac joints , in the mid upper back by the shoulder blade and spine and in the neck. this pain is radiating throughout my whole body mostly my right buttock and down the tigh to the legs. the quality is pain is so bad its ruined my life i can barely move from it. the pain constantly changes its form sometimes its sharp , stabbing , sometimes aching and other times when its really bad its almost everything. i cant even look down with my neck to touch the chest when i try this my whole back just feels like im ripping a muscle into two and pulling something very hard it starts to burn and stab. with it i also have very bad fatigue weakness and muscle pain with muscle spasms. in the mid upper back near the shoulder blade there is a very tight muscle that feels like a rope when touched that comes from the lower back joint to the neck . when i try to squeeze my shoulder blades together i hear very loud clicks and pops, besides this when i breath my mid back contracts and the pressure comes right in the middle of the spine and pops. the percentage of back pain is 80 percent with the legs and buttocks with 20 percent. i know i have something very serious going on . because it has disabled me and stiffened me as well. the intensity of pain is 10 all the time never comes down if there were a number to describe more than 10 i would. because of my pain i have been limping when i walk for 6 months now and daily it progresses more and more . the pain first started in the neck with just stiffness i was able to do everything but then later it started to move into to my lower and gradually increased everywhere. im wondering if it had anything to do with my other illness. i also have rheumatic fever and i think rheumatoid arthritis that im being checked for. my doctor put me on a cane to walk because my joints have been damaged and they don’t take anymore pressure. is there any blood test that i can o for my back to see whats really causing it. i haven’t been pain free for 9 months constantly and now im on anti depressants because of it. i even left school work and sports all because of this . ive had no treatment so far only painkillers. thank you

Donald Corenman, MD, DC
Moderator

July 29, 2012 at 2:18 am

Post count: 8660

#6618

Rheumatoid arthritis could cause some of your symptoms. You need a full work-up from a rheumatologist or experienced primary care doc to determine that diagnosis. Pain can also originate from lumbar spine disorders. You need a good work-up from a spine specialist to determine what disorders you have. The hip joint also needs to be checked.

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.

mohsinaliasdf
Member

July 30, 2012 at 8:23 am

Post count: 11

#6622

Okay thanks doctor now I know this may not have anything with your profession but I want to give a little history about everythingover a year ago I was very overweight and so I had went to a homeopath who gave me some herbal drops to lose weight .so i used those meds for barely 4 months and it had to lose 150 pounds . And from ever since then my body turned into a chaos machine and I developed so many problems to the point that I’m disabled nowthe doctors that I see can’t figure me out . And recently I read that homeopathic medicine can cause chaos in the body and eventually kill you ,I’m very concerned on what doctor I should see because I think it was poisounous and that’s why it had me lose soo much . I want to get rid of the bacteria and toxics it caused in my body. What is your suggestion please on what kind of testing I should do and what the main specialist should be for people who get sick from herbal medicines . Thanks allott

Donald Corenman, MD, DC
Moderator

July 30, 2012 at 10:44 pm

Post count: 8660

#6624

Do not worry about Homeopathy causing body disturbances. If this was true Homeopathy, the substances used are so diluted that there is little evidence that the diluted substance even exists in the solution that you were given.

Homeopathy is safe because of the significant dilution. Homeopathy is based upon the assumption that the more dilution of a substance, the “stronger” this remedy is. By this very assumption, the substances are very safe.

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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