x-ray c5-c6

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steph
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January 11, 2014 at 2:22 am

Post count: 1

#10118

Hi there I am looking for some help and advice.

In 2004 I was in a car crash and I suffered from whiplash. pain persisted and I then when to see a private physio. she told me that there was a problem with my neck twisted discs is what she thought it was and advised me to ask for a MRI from my NHS Dr. I eventually got sent for a x ray of my neck and it showed thinning of my c5-c6 discs.

since then I have been diagnosed with M.E and fibromyalgia. in 2011 I had a bout of extreme neck pain and then lost feeling in my arm it cam back but never to normal.

I have been doing a lot of research and came across some of the videos you have done on you-tube then found this site and was hoping you can advise what I should do.

I have been to see a neuro surgeon and he told me that he was not willing to MRI me as the thinning he saw in the x ray was normal at my age (27).

I have been sent on a pain management course and the psychiatrist asked if I felt I had explored all avenues and I said no this got reported back to my normal Dr, who then asked me to come in for a chat she then seemed confused as to why I said that I felt let down, although told her several times previous that I wanted a MRI to double check. which she said that she could arrange and today I have found out that it has been declined.

I am so confused as to where to go from here as I went from being a very healthy person, running twice a day as well as working full time as a carer to a person stuck in bed six days out of seven who needs help with even the most basic of needs.

Donald Corenman, MD, DC
Moderator

January 11, 2014 at 4:00 pm

Post count: 8660

#10127

I am unclear what M.E. is (“since then I have been diagnosed with M.E and fibromyalgia).

Thinning of a disc at your age is not “normal’ and probably an indication of prior injury and degeneration.

“I had a bout of extreme neck pain and then lost feeling in my arm it came back but never to normal”. This sentence sounds like a disc herniation that compressed a nerve root. That is not an uncommon disorder after a motor vehicle accident.

Unfortunately, the NHS is not designed to accommodate patients if you cannot find a sympathetic doctor. In your case, you had a sympathetic primary doctor but he or she was overruled by a secondary reviewer (MRI).

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.

walker
Member

March 11, 2014 at 3:50 pm

Post count: 1

#10513

Hi Dr .Corenman,

I’m having some trouble creating a new post so i’ll post here (my apologizes).
I’m a 28 yo medical student here in Denver, who is otherwise healthy with no prior medical conditions.

last year i was working out and doing squats when i started having some minor neck pain. A few weeks later i started having some headaches and sensitivity to light. I went to a neurologist who ordered a brain mri and said everything was fine. dx with my first migraine. i continued to workout, play football until one day i couldn’t even stand up. I was having trouble supporting my neck. I was also having paresthesia on my right face, back of scalp with occasional sharp 1 second shooting temple pain. I went to a chiropractor and after an adjustment i noticed my neck pain and face paresthesia became bilateral.

I went to another neurologist who ordered another brain and cspine mri w/ contrast as well as blood work. she ruled out ms, tumor, etc and found a bulging disc at c5/6 which is “moderately” pressing the nerve and c6/7 which is “severely” pressing the right nerve. The c5/6 is also bulging towards the spinal cord. the report also indicates borderline spinal stenosis at c5/c6. The thecal sac/diameter is 9mm. She felt that this is causing all my symptoms.
The neuro recommended some physical therapy. I did about 4 months and noticed that my symptoms have increased after using the traction device.. I am now having paresthesia all over (arms, legs, back, abdomen region, face, scalp). some right muscle atrophy. my shoulders appear uneven. i have pain at the base of skull.

I would like to consider the next step here and get your opinion. I’m also wondering about my symptoms. It doesn’t sound typical. Most c5/6 or 6/7 disc problems seems to cause arm and neck pain. How am i getting facial and body paresthesia. is the spinal stenosis causing these problems?

Thanks for your time

Donald Corenman, MD, DC
Moderator

March 15, 2014 at 2:30 am

Post count: 8660

#10534

As you note and are correct, C5-6 and C6-7 hernations do cause lower neck and arm symptoms. There is a small subset of patients that do have headaches from these lower herniations but that is the exception and not the rule.

Generally, back of the head symptoms (if there are no cerebral origins), are generated by the greater and lesser occipital nerves, C2 and C3. The way to diagnose these disorders is with selective blocks.

Aggravate your symptoms and then have an injection block. See pain diary on the website. This would be an epidural steroid injection or large volume TFESI at C5-6. Then on a different day, have facet blocks at C2-4. You will be able to determine the difference based upon temporary relief of symptoms.

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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