t spine mri results, what does this mean in plain wording, please.

Tagged: Myelopathy, Thoracic cord compression

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metoyou
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August 10, 2016 at 1:14 pm

Post count: 4

#22754

Technique: Sagittal T1, T2, STIR, axial gradient-echo T2 * were obtained.

Findings:
The alignment, marrow signal intensity of the cervical spine is normal. The
signal intensity and morphology of the cervical spinal cord is within normal
limits. There is no evidence of marrow edema on STIR. Subtle compression
deformities/Schmorl’s nodules arising from the superior endplate of T4 and
superior endplate of T5 are new since prior exam of 2004. There is no
associated abnormal bone marrow signal and therefore are more delayed likely
chronic. There is a T1/T2 hyperintense focus in T11 vertebral body, likely
representing a focal.

At T9-10 level, there is a left central disc protrusion resulting in
effacement of the ventral sac and mass effect/deformity on the left anterior
aspect of the spinal cord.

Impression:
1. Interval progression of disc protrusion at T9-10 level, resulting in mass
effect/deformity on the left ventral aspect of the spinal cord.
2. Subtle compression deformities/Schmorl’s nodules arising from the superior
endplate of T4 and T5, new since prior exam of 2/19/2004, however without
abnormal bone marrow signal, therefore likely interval chronic.

Donald Corenman, MD, DC
Moderator

August 10, 2016 at 1:52 pm

Post count: 8660

#22755

The MRI image is only half the information needed. I would also need to know your history and symptoms to help understand the relevance of the findings.

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.

metoyou
Participant

August 10, 2016 at 2:27 pm

Post count: 4

#22763

Hello Dr. Corenman

where to begin, both my legs went completely numb for a few days, while they were numb I tried to walk and it felt like there was a very strong rubber band from my heels to my back that was preventing me from straightening my legs, am not sure how to explain this feeling but once feeling came back to my legs I was in extreme pain with onset of severe rls. I cant walk straight, i hit walls and door frames, I have tiped over a lot, I have no balance and any activity i do makes the pain worse. I have bad swelling between the shoulder blades and below the shoulder blades. It hard to breath like 40lbs is on my back and chest. If i cough or sneeze I hurt in my back and ribs, a deep breath hurts in my mid back spine area. My skin hurts to touch. And it feels like am always doing crunches, my upper abs always tight and burn. I have to go to the bathroom often and in a hurry or i will have a accident.
I have been seeing my pain dr of 12 years, at 1st my leg pain was dx as rt hip bursitis, with piriformis syndrome affecting the sciatica. I’ve had the steroid injection into both hips and trigger point injections from my lower back to my calfs. The injections did not help, hey even mad the rls worse for weeks after.
I have numbness, burning and odd muscle spasms and twitching in my legs, everywhere.
I have a previous dx of fibro, and have had a lumbar mri which showed…
Mild bulge is slightly asymmetric to the left at L4-L5, and to the right
L5-S1. There are mild facet hypertrophy at L4-L5 and L5-S1. No focal disc
protrusion, canal or foraminal stenosis is seen.
Am not sure what of info you need, please advise if more is needed. Again thank you.

Donald Corenman, MD, DC
Moderator

August 10, 2016 at 10:48 pm

Post count: 8660

#22766

It sounds like you have myelopathy, dysfunction of the spinal cord causing balance issues and bowel/bladder issues. See the section on myelopathy here https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/ but ignore arm symptoms as there would be no arm involvement in your case.

You need to see a spine surgeon for a complete examination and evaluation. If you have long tract signs (see website) and the dysfunction you describe, you would probably need to have the cord decompressed surgically.

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.

metoyou
Participant

September 6, 2016 at 2:07 pm

Post count: 4

#22912

I saw a neuro and during the exam we found out I have clonus, he is sending me for mri of my brain and c spine, along with lower emg and ssep tests.
Any thoughts?
Thank you again, just nervous about all this.

Donald Corenman, MD, DC
Moderator

September 6, 2016 at 9:22 pm

Post count: 8660

#22916

Clonus (continued contraction/relaxation or oscillation of the foot when forced into dorsiflexion-forced toward the face) is a long tract sign associated with cord and brain injury. If there is hyperreflexia and or Hoffman’s sign in the upper extremities, then the cervical cord or brain is suspect. If there are no long tract signs in the upper extremities, it is unlikely that there is cord compression above the thoracic spine.

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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