t6 incomplete spinal cord injury stenosis flattened theca spinal cord anteriorly

Tagged: T6 incomplete spinal cord injury T7/ disc prolapse stenosis flattening of thecs

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Missie
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August 9, 2019 at 1:42 am

Post count: 12

#30828

Hi Dr,
Two years after a horse fall. I was diagnosed t7/8 disc herniation and stenosis. A week after I was admitted for emergency surgery as lost walking bladder and bowel function.
I’d suffered all this time with no help or even am x-ray as no Dr believed me.
Sadly it got worse. Surgery of pedicure spurring extra pleural extra cavity approach and exceed of left sided disc prolapse’. I deteriorated yet no one believed me again 6 months later it was confirmed I had all this time incomplete spinal cord injury browns sequard syndrome t6.
Along with autonomic dysreflexia neurogenic bladder and bowel. Proof too the surgeon had moved no disc no stenosis in surgery. I chose not to take legal action.
Fast forwarrd to now. 11 years post injury. After top doses of meds. I chose to take nothing for pain. I think logically over emotionally. I had minimal help as NHS say I’m too rare and complex. I’ve now found a neuro physio whose helping me. My spasticity is so severe even Baclofen doesn’t touch it. Bit I use this to walk transfer and stand. I think logically about pain and remove emotional attachment. Best way to describe it is that I think like stunt men do. I remove fear. My autonomic dysreflexia is very severe. I can’t feel bladder or bowel and I get hypothermia along with hallucinations and dysplastic and autonomic dysreflexia, my cardiologist has discharged me as he says I have managed to make my bp drop again very quicky after episodes. Spinal injury consultants however say I should use gtn tablets. I’m sticking with my cardiologists opinion.
What I need to understand. Is that since my first MRI. I deteriorated a lot and the theca is now flattening the cord anteriorly. Yet I still have the browns sequard left side hypersensitive and weaker than right side hypo and stronger. What do I do to avoid more disc prolapse/stenosis. I don’t understand.if you have any insight please let me know. Do I avoid bending for example?

I do have trigger point injections and they help great. So I’ll have more. I have had horrendous side stitch since the operation. The injections help.

Here’s my results.
But I’ve deteriorated a lot since.
But have had no further scan. As suggested. Should I do you the NK push for this? Chronic discovertebral changes at t7-8 level with destruction of the endplate contours predominantly anteriorly and the related intervertebral disc with significant sclerosis and relativley minor marrow odema in the rest of the veterbral bodies. A central disc herniation/soft tissue thickening/bone fragments are seen indenting the theca with flattening of the cord anteriorly at this level. There is also no evidence altered signal from the cord at this level. There is also no evidence of a syrinx above and below this level. Facet joint degeneration change is also seen at this level and the level above.There is no evidence of foraminal encroachment on the exiting nerve roots although some soft tissue thicking is seen around the exiting left sided nerve root at t7-8 level. However in addition the headof the left sided rib at the t7-8level is not clearly seen while the right appears normal. some soft tissue thickening/bone fagments is also noted here outside the left sided neural foramen probly related to the left costo transverse joint at this level which is also involved. there could be a chronic osteoarticular destruction here related to the costovertebral /cost0 transverse joints and allied with the t7-8 discovertebral changes, the appearences could be those of a chronic progressive neuropathic state in this level of the spine. a ct is recommended. There is an old superior endplate fracture involving the T2/3 levels. No other significant abnormality is seen in the cervical or lumbar spine. The rest of the cord appears normal.

I don’t understand too about the degeneration process. Any help greatly appreciated to assist me with my new found wonderful physio help. A medical perspective is all I need. By the way, I’ve lost lots of weight since stopping Baclofen. This has helped me so much too.

Kindest regards and thanks
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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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