Would like your opinion on c5,6, and 7 bulging disc pain

Tagged: right sided neck pain

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Fiesta2001
Participant

June 21, 2018 at 8:34 am

Post count: 4

#28557

Hello Dr. Corenman,
My name’s Mike and I’ve been dealing with right sided neck pain for quite some time and it’s a real burden in my everyday life. It has caused me to not be active anymore and hurts pretty much all time, especially standing for periods and walking or running. It hurts to turn my head either direction and also feel pain in my shoulder and shoulder blade. I’m very weak in my arms and legs and get frequent headaches.
C5-6 has a bulging disc with 4mm right paracentral disc protrusion indentation on ventral thecal sac. C6-7 is bulging with ann osteophyte and mild foraminal narrowing on the left. Does this need a surgical intervention or just PT? Is this possibly my pain source that could be all my problems? Thanks alot for your time if you can answer my question! :)

Donald Corenman, MD, DC
Moderator

June 22, 2018 at 4:43 pm

Post count: 8660

#28567

Please copy and paste the full radiological report here. Also, see the symptoms section hyperlink to understand how to better convey your symptoms. https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-neck-shoulder-and-arm-pain/.

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.

Fiesta2001
Participant

June 22, 2018 at 6:39 pm

Post count: 4

#28572

History: Cervical disc disorder. M50.90 Headache. R51
Technique: Sagittal T1, Sagittal T2, and axial T2 weighted images through the cervical spine were performed without contrast.
Comparison: NA
Findings: Straightening of the cervical lordosis is noted. No Spondylolisthesis or compression fracture identified.
C2-3: Unremarkable
C3-4: Unremarkable
C4-5: Unremarkable
C5-6: Bulging disc is seen with 4mm right paracentral disc protrusion indenting the ventral thecal sac. The central canal and neural foramina remain patent.
C6-7: Bulging disc and osteophyte are seen toward the left with mild foraminal narrowing on the left.
Impression:
1. Dehydrated, bulging disc and right paracentral disc protrusion at C5-6 without stenosis. No cord compression.
2. Mild disc bulge and osteophyte toward left at C6-7 with mild foraminal stenosis on the left.

My pain is usually worse in the mornings and and sort of physical activities cause me extreme fatigue fairly quickly. Pain is a stabbing sort of pain no burning or tingling. I’ve tried some PT in the past and one series of Facet Joint injections and that caused extreme pain and I never did that again. Walking around for any periods of time cause me to feel as if i’m carrying someone around on my shoulders and i have to take frequent breaks to sit or lean on something. I’m getting a thoracic MRI soon as well because on top of all of that, I also have thoracic scoliosis and lumbar scoliosis. Thanks for your reply!

Fiesta2001
Participant

June 22, 2018 at 7:01 pm

Post count: 4

#28573

I will post the findings of the Thoracic MRI when i do it. I have had MRI of the C spine basically yearly since 2014 and they have seem to have been progressively worse than the others each time.

Donald Corenman, MD, DC
Moderator

June 23, 2018 at 10:27 am

Post count: 8660

#28597

Your complaints of “right sided neck pain for quite some time and it’s a real burden in my everyday life”. does fit with your MRI findings of “C5-6: Bulging disc is seen with 4mm right paracentral disc protrusion indenting the ventral thecal sac. The central canal and neural foramina remain patent. C6-7: Bulging disc and osteophyte are seen toward the left with mild foraminal narrowing on the left”.

Right sided neck pain can be caused by a degenerative disc, a degenerative facet and a mild-moderately compressed nerve root all of which you might have. If you have symptoms that impair your daily life, the next steps are diagnostic and therapeutic injections. I would start with facet blocks as you can get relief without surgery using ablations (if the diagnosis confirms the painful facet. If not, then a selective nerve root block would be useful.

See https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and
https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/

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.

Fiesta2001
Participant

June 23, 2018 at 10:50 am

Post count: 4

#28599

Thanks alot I will look into that. Also I’m 29 years old with all of these issues. Will I need to go-to a pain management place for these ?
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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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