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  • Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    #5592 In reply to: Lumbar Spinal Stenosis |

    Wow- how much time do you have. Books have been written on this subject. I will give you the Readers Digest version. Lumbar spinal stenosis has many variations including central stenosis, lateral recess stenosis and foraminal stenosis. Most people mean central stenosis when they say lumbar spinal stenosis so we will stick with that.

    There are two types of lumbar spinal stenosis- stenosis without slip and stenosis associated with degenerative spondylolisthesis. If there is no slip or instability, a simple decompression surgery like a laminotomy or laminectomy can be performed. There are various versions of the two but the main consideration is to decompress the nerves in the canal.

    If there is a slip involved (degenerative spondylolisthesis), then stability of the segments has to be taken into consideration. Flexion/extension X-ray films can indicate how stable or unstable the segments are. If too unstable (and a stability discussion is beyond this forum), then fusion needs to be considered. There are many fusion types and selecting one over the other depends upon the patient and planned activity level after surgery.

    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
    Post count: 8660
    #5576 In reply to: C5-C6 Nerve Issues |

    Based upon the radiologist noting “severe” foraminal stenosis bilaterally at C5-6 and increased symptoms with head extension, you might be better off with a spine surgeon. Motor weakness needs to be addressed and if from severe foraminal stenosis, a spine surgery consult would make more sense.

    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.
    MarkL
    Member
    Post count: 3
    #5574 In reply to: C5-C6 Nerve Issues |

    Thanks doc. I just found the MRI report from 07. I’ll type it up in case that’s helpful. At C5-6 disc space, a 3.8mm broad-based bridging osteophyte creates minimal spinal stenosis with attenuation in the anterior subarachnoid space. A 2.5mm far right lateral protrusion superimposed on hypertrophic change to the right uncovertebral joint contributes to severe right C6 lateral recess and proximal foraminal stenosis. There is additionally severe compromise to the left C6 foramen due to hypertrophic change to the uncovertebral joint and lateral spondylosis. At the C6-7 disc space, a 2.5 mm diffuse bulging annulus and minimal spondylosis is present. At the C7-T1 disc space, a 1mm far right lateral protrusion is not excluded. The resolution and definition of the lateral recess and proximal foramen is somewhat limited. The signal intensity of the cervical chord is normal. The facet articulations are maintained bilaterally. There is no compression fracture deformity of the cervical vertebrae. There is no evidence of cerebellar tonsillar ectopia. Normal flow is demonstrated from both vertebral arteries.

    I can’t find the EMG report from 08 but I remember that only 1 side was tested. They had found some weakness that they said was consistent with the neck condition, from the bicep to the wrist flexors. Today I feel weakness in those areas in both arms. At the time of the tests, I was having the paresthesias with head bent back. Flexibility has improved with traction and yoga and I don’t notice paresthesias when bending head back (just stiffness). I get some pain in low bicep/forearm area when sitting with bad posture for extended periods today.

    Given this more detailed information, does it sound like I should be seeing a spinal surgeon or neurologist? OR just tough it out? If nerve damage is being done, is time of the essence that I deal with this so as to prevent further damage or bring back any strength that has been lost? Or would that be permanent loss? Thanks so much.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660
    #5573 In reply to: C5-C6 Nerve Issues |

    You had a motor vehicle accident about 16 years ago and recovered after 6 months. About 5 years ago, you developed neck pain and an MRI demonstrated degeneration of the C5-6 disc. You have been able to manage the pain and live a relatively normal life.

    You underwent an EMG which indicated involvement of the C6 nerve (C5-6 level). You have been developing progressive weakness of your biceps to wrists bilaterally.

    Normally, foraminal stenosis (see website) is not normally bilaterally symmetrical. Also, there typically are paresthesias (pins and needles) and pain associated with foraminal stenosis and the symptoms typically become worse with neck extension (bending the head backwards) and improve with the chin on chest maneuver. Does that fit with your current complaints?

    If you have only weakness without any radiating symptoms, you need to see a neurologist again. If you have the above noted symptoms, you need to see a spine surgeon for a consultation.

    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
    Post count: 8660

    Send the latest studies that would include the latest MRI, CT scan, X-rays with flexion and extension views and any clinical consults.

    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
    Post count: 8660

    Your spine MRI suggest the condition of Scheuermann’s disease (see website for complete explanation). This condition predisposes the spine for degenerative changes which can cause local spine pain. One of the potential problems with Scheuermann’s disease is an increased kyphosis of the spine (an abnormal forward curve) in the upper lumbar spine or thoracic spine (the chest). This condition makes walking and standing more difficult.

    A proper physical examination and standing X-rays would reveal this condition.

    If you do have this condition, extension exercises are the order of the day. These exercises induce the muscles of the spine that bend the spine backwards to strengthen. If your problem is degenerative disc disease without increased kyphosis, then core strengthening exercises are important (see video on website from TV 8 to explain these).

    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.
Viewing 6 results - 2,059 through 2,064 (of 2,193 total)