Upright MRI

Tagged: Bowhunters, loss of balance

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foxylady
Participant

February 15, 2018 at 9:13 am

Post count: 123

#27566

I cannot comment on brain MRI, unless you had lesions, then it could be MS possibly. But you need Dr Corenman to talk to you about that. I know very little.

Good luck!!

Sherrycox
Participant

February 15, 2018 at 10:55 am

Post count: 11

#27571

Thank you Foxlady, sorry you have been going thru this too. I appreciate the links and thoughts. I hope Dr. Corenman can give me some clairity on this.

Sherrycox
Participant

February 15, 2018 at 11:52 am

Post count: 11

#27576

Sherrycox wrote:

Sherrycox wrote:

DR. Corenman,
I have had 2 mri’s, x-ray, and ct of my cervical spine. They showed sone Compression, bulging and 1 herniated disc from c3-6. Ther is also degeneration involved. I have loss of balance and my left hand goes numb when I turn my head to the left looking over my shoulder, usually takes only 30 seconds for my hand to start tingling. I was thrown forward onto the left side of my head, down and into the bed of a fire truck.
My questions are:
Can these neck problems cause loss of balance?
Would an “upright MRI” show more compression, more clearity, than the normal “position MRI”?

Thanks Dr. Corenman for this site.
I’m 53, female, volunteer fire & ems, working maintance for my local school. In March 2016 I was involved in a low speed fire truck accident while fighting a grass fire. I was ridding on the hose reel on a “brush” truck when we hit a road crossing in front of us, unseen because of high grass. We came to a sudden stop, I was thrown forward and down into the steel flat bed of the truck. I landed on my left side of my head. I had large bruises on the insides of my thighs from the metal ring that holds the hose on the reel, lost a shoe in the process of being thrown. I also had a second degree burn on my left hand after another incident on another fire truck that same day when I wasn’t seated and the driver started forward causing me to lose my balance and put my hand down onto the exhaust muffler on the water pump.. Not a good day for me! I had no neck pain, could have been dulled by the pain meds given for the burn. I slept in a ridged c-collar because it was the only way to get any rest.
Most recent MRI w/o contrast:

Details
Study Result
Impression
Impression: Multilevel degenerative intervertebral osteochondrosis
and facet arthropathy is noted as described. Findings are more
pronounced at the C4-C5, C5-C6 and C6-C7 levels. At the C5-C6 level
there has been some progression of the degenerative process. At the
C6-C7 level the findings have improved compared to the last
examination suggesting that there is some retraction of the disc
extrusion.
Narrative
Presbyterian

Clinical Indication: worsening of neck pain, headaches, and dizziness

MRI CERVICAL SPINE WITHOUT CONTRAST

Comparison study: MRI dated 6/29/2016 and x-rays dated March 26, 2016

Findings: The alignment and segmentation of the cervical spine are
normal. The cervical vertebral bodies show no sign of fracture or
destructive lesion.

The spinal cord shows normal shape and signal intensity on this
noncontrast exam.

The cranio-cervical junction anatomy is unremarkable.

There is multilevel degenerative intravertebral osteochondrosis and
associated facet arthropathy.

C1-C2 level: There is no significant abnormality associated with the
atlantoaxial joint.

C2-3: There is no significant extrusion or protrusion noted.

C3-4: There is a small central disc the protrusion noted resulting in
mild distress compression of the thecal sac. Mild progression of the
degenerative change is noted.

C4-5: There is mild spondylosis. There is a slight hypertrophy of the
uncovertebral processes. A small central disc bulge is noted.
Stability is a central disc protrusion present.

C5-6: There is loss of disc height and desiccation present. There is
hypertrophy and eversion of the uncovertebral processes associated
with anterior and posterior spondylosis. There is a broad-based disc
protrusion present.The spondylitic disc complex results in extrinsic
compression of the anterior aspect of the spinal cord. Findings have
advanced slightly since the last examination. There is mild facet
arthropathy.

C6-7: There is loss of disc height and desiccation present. There is
hypertrophy and eversion of the uncovertebral processes associated
with anterior and posterior spondylosis. Broad-based disc extrusion
is noted. There is extrinsic compression of the spinal cord centrally
and in the subarticular area. Mild facet arthropathy is seen. I
believe findings are less pronounced as there is less compression in
the left lateral aspect of the spinal cord compared to the last
examination

C7-T1: There is no significant extrusion or protrusion noted.

The visualized posterior fossa discloses no significant signal
alteration.

The paraspinal muscles are symmetric.
Component Results
There is no component information for this result.
General Information
Collected:
05/31/2017 1:10 PM
Resulted:
06/01/2017 8:19 AM

Brain MRI:
Study Result
Impression
IMPRESSION:

1. There is a very large retention cyst/polyp in the right maxillary
sinus, with additional mild scattered polypoid paranasal sinus
disease , as detailed above. Clinical correlation is advised in this
patient with a history of “headaches worsening after accident/MVA”.

If there is strong clinical concern to further evaluate the
paranasal sinuses for disease – a dedicated (outpatient elective) CT
of the Sinuses may be of further benefit.

2. Otherwise – there are NO ACUTE posttraumatic intracranial findings
– the remainder of the examination is unremarkable – there is NO
acute infarction, acute intracranial hemorrhage, intraparenchymal
masses, nor abnormal extra-axial fluid collections.

3. There are other minor chronic findings as detailed above.
Narrative
Clinical indication : H/o MVA, HA worsening started after
accident, Age > 50..chronic headaches worse after auto accident March
2016.

Comparisons: Head CT from 4/5/2016, MRI of the cervical spine report
from 5/31/2017

HMINWKS125

Exam: MRI BRAIN WITHOUT CONTRAST

Findings: The brain parenchyma demonstrates relatively normal
signal intensity.

The major arterial and venous flow voids appear normal.

The ventricles and sulci are normal in size and configuration for
the patient’s age .

The visualized internal auditory canals are unremarkable.

There is a very large retention cyst/polyp in the right maxillary
sinus, with additional scattered mild polypoid mucosal disease in the
maxillary sinuses and the right sphenoid sinus. There is minor
nasoseptal deviation convex right. There is no significant
opacification the mastoid air cells.

The visualized parotid glands are negative.
The visualized TMJs are located bilaterally.

The visualized globes and orbital contents are negative.

The cranio-cervical junction is normal.

There is straightening of the normal cervical lordosis, with mild
degenerative changes of the visualized upper cervical spine. These
findings were better seen on the dedicated MRI of the cervical spine
from 5/31/2017. Clinical correlation is advised.

The images are slightly compromised secondary to patient tilt /
positioning on the MRI scanner .
Component Results
There is no component information for this result.
General Information
Collected:
11/15/2017 8:33 AM
Resulted:
11/15/2017 11:50 AM
I have LOSS OF BALANCE as my main problem. The “drunk”heel to toe with head looking at my feet causes me to fall to both sides. Looking up, like putting eye drops in causes me to fall backwards. Turning my neck totally left looking over my shoulder causes my left hand to go numb. I have stress headaches when I sit in a straight back chair for meetings, and when my neck is put under stress by lifting or when I’m bent over working on something. I’ve had RFA C2-6 left and right, helped headaches for 2 weeks. I have no neck pain, I stopped going to the chiropractor because after last cervical manipulation the loss of balance was worse.

I have seen 3 neurosurgeons who say my Loss of Balance has nothing to do with my neck. Was sent to neurologist that did brain MRI.
Can you please give me your opinion, and suggestions.
Thank you
Sherry

I have had vertigo testing by neurologist, it was negative. I’ve also had RFA C2-C6 by pain specialist, helped headaches for about 2 weeks. I am pretty much ” off balance” all the time, except while sitting.

foxylady
Participant

February 15, 2018 at 1:10 pm

Post count: 123

#27577

https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/

Donald Corenman, MD, DC
Moderator

February 18, 2018 at 11:38 am

Post count: 8660

#27622

I am confused as I have answered this on another thread. As I’ve noted, the cord probably is not related to the dizziness. The left hand numbness is probably related to nerve compression in the neck. The vertebral artery could theoretically cause dizziness. See Bow Hunter’s syndrome on this website. It is a video.

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.

foxylady
Participant

February 18, 2018 at 1:21 pm

Post count: 123

#27628

Hi Dr Corenman, This is another lady’s post, not mine that’s why. I was just advising her on what I knew from what I have learnt, going through similar.
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Donald Corenman, MD, DC

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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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