What's Wrong With Me? MRI results and Mystery Diagnosis

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Freebird74
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March 30, 2014 at 3:23 am

Post count: 3

#10644

Hi Everyone.

I’m hoping to receive some guidance as to what I should do, who I should see and perhaps “Maybe” even receive some possible suggestions as to what is going on with me..

I’m 39 and tall (which I guess isn’t a plus when it comes to the spine) and in 06-07 I started noticing pain in just my neck. ( I never see a doc unless I’m in a fetal position and dying)… I let it go for about a year and finally went to my primary. Ordered a CT of cervical which I believe showed slight lordosis? He said it’s normal and I left and went on with life..

Here we are 7yrs later. Around sept-oct. of 2013, I noticed pain radiating down both of my upper arms and felt claustrophobic driving with a jacket and seat belt, as I began to notice that taking off the jacket while seated was hard. Just pain in my upper arms with slight weakness… I began to think I was getting ‘Sick’. I felt run down.. I had a crazy schedule and was ALWAYS driving… Than I started noticing pain that is now showing up in my bottom.. Sacral? Great I think…Now I have to drive on my sides… What next….

I also always had lower back pain, but thought, “Hey.. doesn’t everyone” and didn’t want to go to the doc because I knew he’s say, “Oh it’s nothing”…

October I was great. I walked for miles (Exercise)..Played a little volley ball… hiked trails, ran around with my 3yr old… did home projects, etc, etc. I started noticing first the arms… than in the beginning of Nov. I would wake in the middle of the night with what I thought was SEVERE hip pain (Burning kinda), so I would roll onto the other… Would wake with same pain… I thought it was my HIP, but it’s the top of both Iliacs?

THAN… I noticed when I would step and put both feet on ground they would hurt and tingle… Like neuroapthy… Again… I knew something was off, but hoped it would go away :-(

BOOM… Late Nov I get a sick. I chalked it up to my DD bringing me home everything from school. (I never get sick) and it was pretty bad I would say.. Not a sick I had felt since a kid… had a fever for a day..stayed in bed and just felt weak and drained with complete body aches.. I guess this lasted a few days and I remember thinking I needed to finish my DD’s Christmas project….

So while I was “OK” to get up and do things, I was still dragging with me the remnants of just being sick.. I was tired and felt weak. However, I went to spray paint this project which required me to squat.. I would say I did this for about 40min and said to myself, “OK… I need to get back in bed”.. I remember standing back up and thinking, “Oh god”. My legs hurt soooooooooo bad and it felt like I just did a full workout on my death bed..

I chalked this up to still being sick and went back home to bed…

Well…. It went away, but I never regained that “Normal” feeling in my legs. That pain of “You have the flu” was there, but I was not sick.

I thought it would just go away with time, but it never did.

I keep telling my doctor that something is WRONG! I can’t stand longer than 5min. My lower back hurts..my legs are frozen…my feet ach and my dam arms are sore along with cold fingers and sore thumb tip.

Blood was fine (He thinks it’s LD).. yada, yada, yada… I went to an endo after I left him and he said, “It sounds like neuropopathy, but of what..well…that’s difficult”… Wonderful

So I skipped all the docs and went right to the neurologist.

I explained all the above and I was extremely hysterical I remember and I just kept saying, “But I was FINE…and now I can barely do anything”! “What is wrong with me”!

He ordered an MRI of my brain, with and without contrast.. Cervical W/O and Lumbar W/O.

When I get back to his office, he seems more focused on a diagnosis of LD and really says nothing about my MRI’s… He shows me them, but chalks it up to nothing… So I get the reports myself and well, while I’m not a doctor, it certainly doesn’t look like nothing to me.. In fact, it reads like something in my spine could in fact be causing all of my symptoms… But hey…I’m trying to trust the doctor…

My brain-

white matter hyperintensities on FLAIR images, which are non specific findings
mild fluid in right mastoid. status post left matoidectomy

C-Spine-
Alignments- straitening the cervical lordosis with reversal centered at C4-5
Disc height- mildly diminished at C5-6
Osteophytes- minimal marginal osteophytes ventrally at C4-5 and C5-6

Impression –

1. Disc pathology at c4-5 through c6-7 as described (left and right are moderately stenotic)

2. mild cord deformity at c4-5, c5-6 and c6-7

3- Foraminal stenosis appears to be significant on the left at c4-5 and on the right at c5-6

4- disc pathology has progressed with the prior study referenced. The reversal of the cervical lordosis seen currently was not evident previously.

LUMBAR-
Disc bulging at L1-L2, L4-L5 and L5-S1

As it stands, I feel like no one is taking me serious and I’m scared. I know this is long and do apologize, but I’m pulling straws and I’m spent. The only way to describe how I feel is that of someone dying a slow painful death.. and all I want to do is go walking and play with my daughter…

So what I think I have going on is one doctor thinking it’s viral and another thinking it’s fibro and me thinking you’re ALL WRONG….

The only relief I get is by climbing into a hot tub waking my family every 10min because the pain is KILLING me.

Can anyone help with where or who I should see next for a second opinion?

I’m so grateful for whatever anyone could offer.

Kindest-
Jenn

Donald Corenman, MD, DC
Moderator

April 2, 2014 at 7:56 pm

Post count: 8660

#10659

Your symptoms could be from any number of disorders. You could have metabolic problems (hypothyroidism, hypocortisolism among many others). You could have an infectious disorder (lyme disease among others). You could have a supplement deficiency (vitamin B1, B6, B12, celiac sprue-malabsorption syndrome). Fibromyalgia can fit with many of your symptoms.

You might have a spondyloarthropathy (an inflammatory spine disorder that can cause many of your symptoms).

The spine can also give you these symptoms but your feeling of being “sick” or run down does not fit well with a spine disorder (unless depression is also a part of your spine disorder which it is commonly associated).

You might consider an endocrinologist consultation to see if there are some disorders that have not been researched as of yet.

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.

Freebird74
Member

April 3, 2014 at 12:26 pm

Post count: 3

#10664

Thank you so much for your response Dr. Corenman! GREAT points…So greatly appreciated! The doctors are a bit stumped and the only doctor I haven’t seen was an ortho.. Both neuro and primary have done testing (CBC) and ANA and all was good. My neuro believes it’s Lyme, even though it’s not in accordance with CDC positive, I still show positive… The ‘Run down’ feelings have went away. I also saw a rhumatologist. He ruled out fibro…I’m low in Vit. D and he’s checking my B-12.

I guess the number one question that neither really can answer ‘Fully’, is if my MRI of my Cervical and lumbar which showed what I wrote, is significant enough to cause the severe leg pain which is preventing me from doing all the long walking I use to. He’s scanning my sacral spine, as the pain DID initially start with the very, very bottom when I’m sitting? But my primary (while he said the cervical would cause the arm weakness), didn’t seem to think that the stenotic and bulging disks were ‘That’ bad, when I think he could perhaps be wrong?

With findings such as mine, would this cause 24/7 pain in my upper legs? I just can’t get the leg pain to go away and I miss walking and running. If so, should I see an ortho?

Thank you so much again! 10 heads are better than one ;-)

Jennifer

Donald Corenman, MD, DC
Moderator

April 4, 2014 at 8:37 pm

Post count: 8660

#10671

The radiological report is incomplete as to description of the compression and I generally do not trust an understanding of the disorder through someone else’s eyes.

You can test the question of the origin of the symptoms by an epidural injection. If you have significant leg symptoms (or can cause increased symptoms by any maneuver like walking or prolonged sitting), then an injection in the spinal area that gives good temporary relief of this leg pain is an indication that the injected area is a cause of these symptoms (see pain diary).

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.

Freebird74
Member

April 5, 2014 at 3:00 am

Post count: 3

#10675

Thank you so much again! I really do wish you were in NJ. This is what I had thought all along (Inject the area… if it gets well, there’s the origin.. if not, move along), but as I mentioned, I have yet to see an orthopedic or neurosurgeon or pain management doctor of any kind and I really think that is what my next step needs to be, to have this all evaluated.. My primary is of no help. Sad really. If I may ask just one last question, might I ask you who (specialty wise), I should go to with my films that would test your theory and help me? Is it an orthopedic doctor, pain management doctor or neurosurgeon? I have had friends who deal a lot with orthopedic doctors and it all seems to be joint related? E.g. Hip surgery, foot, hands, etc, etc. Never the spinal area. So again. May I ask which doctor I should start looking into next for this pain? Maybe a database?

Can’t thank you enough!

Kindest-
Jennifer

Donald Corenman, MD, DC
Moderator

April 6, 2014 at 4:43 am

Post count: 8660

#10679

Don’t be too hard on your primary care physician. These individuals have to know about the science of just about every speciality and cannot possibly master this knowledge without going to school for thirty years.

Your question of what specialist to see really depends upon the personality of the individual specialist. Some Spine Surgeons are great diagnosticians and some are not. The same can be said of Physical Medicine Doctors and Neurosurgeons. Will they take the time to gain a good history and physical examination? Will they try to get to the bottom of your particular disorder?

Find someone in your neighborhood and you might need to see more than one doctor to gain insight as to your disorder(s).

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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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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