Straightening of Cervical Spine

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Omerinam
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July 8, 2012 at 8:26 pm

Post count: 9

#6494

Hi, I have been suffering from straightening of cervical spine for 7 months now. My main problem is the neck tension/stifness and daily headaches I get and it’s been 7months of these headaches/ neck spasm. I got MRI of spine and brain done and also MRV done. all results came out normal except for cervical spine MRI saying “straightening of cervical spine”. I am 30 years old (male) and was a regular at the gym. I am not sure what caused by muscle spasm but it could be due to the following reasons:
a) workout at the gym combined with boot camp classes
b) sleeping position – i used to sleep on my chest with head sidewards and used to watch tv in the same position
c) I had been on Accutane (isotretinoin) for 4 months – I am not sure if this caused by neck spasm/straightening but I read online that isotretinoin has side effects but I couldn’t really find if it causes muscle spasm.

Currently I am taking Cipralex 5 mg, Prothiaden (dosulepin hydrochloride) 50 mg and Gabapentin 200 mg at night.

I have also been on Lyrica 75 mg one tablet at night and it helps with my headache at night but i get a headache again in the afternoon the next day which usually last till the evening. I have been to every possible doctor – GP, Neurologist, Physiotherapist but my neck spasm is not going away.

Is straightening of cervical spine curable? it’s been 7 months and constantly thinking of why this isn’t resolving. I had been a perfectly healthy active man before this took place.

Please advise what I should do.

Thanks,
Omer

Donald Corenman, MD, DC
Moderator

July 9, 2012 at 9:05 am

Post count: 8660

#6496

“Straightening of the cervical spine” is not a diagnosis. This may not even be a disorder as many patients hold their neck “straight” on X-ray without any symptoms. Neck pain originates from discs and facets. If the MRI notes no evidence of disc degeneration, then the problem most likely will be in the facets.

Facet disorders typically do not show up well on MRI as the injury is “smaller” than the resolution of the MRI scanner. Headaches quite commonly are generated by the C2-3 and C3-4 facets. You might try a chiropractor initially for treatment. If that is not successful, see a pain injection specialist for diagnosis and possible treatment of this disorder.

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.

Omerinam
Member

July 9, 2012 at 3:40 pm

Post count: 9

#6498

Dear Dr. Corenman,

Thank you for your prompt reply.

I got MRI done in November 2011 and again in February 2012. The report was as follows:

– Straightening of cervical spine identified
– Normal alignment of cervical vertebral bodies
– Mild right lateral disc bulge at C4/C5 level is identified without any radicular compression
– Normal vertebral body heights
– Intervertebral disc appear normal
– Normal contour and signal from the spinal cord
– No evidence of thecal sac indentation or spinal cord compression
– Pre and paravertebral soft tissues appear normal
– Normal craniovertebral junection

IMPRESSION:
– Straightening of cervical spine along with mild right lateral disc bulge at C4/C5 level as described above.

I have been going for physiotheraphy for 2 months now and it’s only made a slight difference. I wouldnt call it pain, but my neck is stiff and feels streched when I move my neck all the way to the right/left and up/down. Plus I have a constant very mild headache pretty much through out the day.

I am still not sure how this happened. Like I said, it’s been 7 months of this. Is it going to get better? Do I need to have a surgery done to fix this or will it automatically go away one day? Should I get some more tests done? My neurologist has done all blood test (Vitamin D, C-Reactive Protein, ESR, VDRL/RPR, CBC, Glucose fasting, Cholestrol, Hemoglobin etc) and they all came out normal.

I am constantly worried thinking that i’ll have to deal with this for the rest of my life.

Omer

Donald Corenman, MD, DC
Moderator

July 9, 2012 at 8:38 pm

Post count: 8660

#6499

You do have one degenerative disc based upon the radiologist’s MRI report. Again, neck pain is generated from discs or facets. If you do not want to try chiropractic treatment, then the next step is a diagnostic injection. Based upon your physical examination, a good interventionalist can pick the levels and the structures that need to be injected.

Look at the section on “pain diary” to understand what the results of an injection should reveal and what you are responsible for reporting.

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.

Omerinam
Member

July 9, 2012 at 9:22 pm

Post count: 9

#6500

Dr. Corenman,

Is this injection procedure done at your clinic/hospital? If so, what is the total cost of this procedure? Also, what does the injection do to the neck and what are the significant risks and side effects associated with such a procedure?

Omer

Omerinam
Member

July 11, 2012 at 4:42 pm

Post count: 9

#6514

Dear Dr. Corenman,

I could not find the section on “pain diary”. Could you please guide me as to where it is located on your website.

Also, if you could please respond to my previous query on the cost, side effects etc associated with the procedure you had mentioned.

Many thanks,
Omer
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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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