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bigbahookie
Member

March 6, 2013 at 7:51 pm

Post count: 2

#8136
Topic: help with severe arm pain in forum NECK PAIN |

Hi there
I wonder if you could suggest a treatment to release me from the severe arm pain I have been experiencing for the last 6 months. Currently I am prescribed, 8 x co-codamol 30/500, 8 x zydol 50mg, naproxen 250mg x4, amitriptyline 100mg and gabapentin 900mg x 3 times a day.

I am still in severe pain and the most recent GP visit suggested cutting the amitriptyline to 50mg per day, and reducing my co-codamol by 1 tablet per day until I am no longer using co-codamolas he felt I shouldn’t be on co-codamol and zydol at the same time. Instead he has given me a prescription for diazepam 2mg 3 times a day.

I have been seeing an NHS physiotherapist who gives me exercises for my neck- chin tucks. I saw a neurologist who referred me for an MRI and here are the results.

There is multi level degenerative disease present most evident in the mid and lower cervical spine. There is straightening of the normal lordosis but allignment appears maintained. No definite abnormal signal identified within the cervical or upper thoracic cord, although some artifact does make interpretation difficult.

At c4/5there is broad based disc osteophyte which centrally indents the theca and mildly distorts the anterior aspect of the cord.

At C5/6 there is a broad based disc osteophyte which is a little more prominent on the right, indenting the theca and minimally flattening the right lateral aspect of the cord, No foraminal compromise.

At C6/7 there is a broad based disc osteophyte which indents the theca and flattens the anterior aspect of the cord. There is narrowing of the left foramen causing some compromise to the existing C7 nerve root.

Conclusion: Broad based disc osteophyte diseas at several levels a described with foraminal narrowing at C6/7 on the right and some compromise to the existing C7 nerve root.

I have had arm pain for 6 months and now I am feeling pain on top of shoulder, back of shoulder blade and under my arm.
I need to gain some relief from this pain so I can return to work and wonder if you could suggest any treatment which mey help,
Thanks

Donald Corenman, MD, DC
Moderator

March 6, 2013 at 12:24 am

Post count: 8660

#8132 In reply to: archnoiditis |

There are some questions that need to be answered. Pain “throughout the body” is not related to surgery, arachnoiditis or granulation tissue. Pain that is focused in the lower back and leg can be localized to pathological issues. Leg pain that is bilateral is typically more associated with arachnoiditis. Pain in one leg only might be associated with the nerve root, prior surgery or chronic radiculopathy (see website).

Lower back pain that is more intense than leg pain is more likely associated degenerative disc disease. There are different treatments for each one of these disorders.

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.

abhishekarun
Member

March 4, 2013 at 3:00 am

Post count: 5

#8120
Topic: archnoiditis in forum BACK PAIN |

i had a surgery laminectomy at l4-5 level 8 months back. there was relief for 1 and half month but after that severe pain again started.i had some epidural steroids injections, it temporarily reduced pain but i am again having severe pain. my current MRI shows following findings
1. intensely enhancing granulation tissue in epidural space at l4 level
2. archnoiditis as is evidenced by clumped nerve roots at l3/4 4/5 level
3. degenerative disc dessication at multiple level

i want to know whether granulation tissue can be treated or it will heal automatically, how much time it will take to heal

what to do do eleviate the archnoiditis symptoms
do i need surgery again

andy
Participant

March 2, 2013 at 6:22 pm

Post count: 7

#8117 In reply to: chronic neck pain |

Dr, Corenman,

Got the results from the MRI. Need to get the actual report and pictures. The nurse said i have moderate narrowing of nerve passage between c3 and c4. The family Dr. wants me to see a neuro surgeon.

Does this correlate with the extension/flexion slippage on c4 and c5?

Thanks
Andy

Donald Corenman, MD, DC
Moderator

March 2, 2013 at 10:51 am

Post count: 8660

#8115 In reply to: C5,c6 severe spinal chord compression pre-op and post op acdf |

Cord flattening or central cervical stenosis can be concerning depending upon your activity involvement and the severity of the narrowing. The central cervical canal changes in volume with flexion and extension (bending your head forward and back). A forced extension can significantly narrow the canal and “pinch” the cord causing something called central cord syndrome (see website).

If you involve yourself in sports that have a risk of a face plant at speed (snow or water skiing, biking-especially mtn biking, horseback riding and others), you have an increased risk of this injury. If you are more sedentary, the risk is less. Also, as I discussed before, the MRI interpretation is colored by the radiologist’s bias. One radiologist’s “minimal’ might be the next one’s “moderate”. These is less risk if the CSF (cerebral spinal fluid) surrounds the cord vs. “flattens” the cord on one side.

Unfortunately, I cannot give you the risks in terms of percentages. I know how many individuals develop central cord syndrome but do not know the denominator. That is, how many individuals have this disorder but never develop central cord syndrome. Your risk might be 1% or 10% (also depending upon your activity level).

Yes, all these issues can be thought of as “arthritis” but that is a bad term for this disorder. It really is called degenerative disc disease and is quite common in most everyone.

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.

Donald Corenman, MD, DC
Moderator

February 27, 2013 at 3:55 pm

Post count: 8660

#8096 In reply to: chronic neck pain |

Instability is demonstrated on flexion/extension X-rays and will not be demonstrated on an MRI. An MRI will show degenerative changes of the disc and facet. Make sure the surgeon sees both the X-rays and the MRI if you can get an appointment.

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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Viewing 6 results - 1,771 through 1,776 (of 2,199 total)

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Donald Corenman, MD, DC

Average rating:

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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