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Donald Corenman, MD, DC
Moderator

June 20, 2011 at 1:03 am

Post count: 8660

#4649 In reply to: Neck Pain, Numb Fingers and Fibromyalgia |

With fibromyalgia, it is difficult to discern what is causing pain as by the definition of fibromyalgia, you have pain in multiple areas.This does not mean that some of the pain is not caused by your neck or ulnar nerve but makes diagnosis more difficult. Neck pain radiating down the arm with head extension (bending the head backwards) can be a sign of nerve compression in the neck.

Positive sharp waves above the level of the elbow makes cubital tunnel syndrome less likely. Have your doctor give you a copy of the MRI report and the EMG/NCV report and read the conclusion yourself. It should not be too complicated with the information you now have.

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.

Anya
Member

June 19, 2011 at 9:36 pm

Post count: 3

#4648 In reply to: Neck Pain, Numb Fingers and Fibromyalgia |

No, I DO have pretty constant neck pain, mild shoulder/elbow and moderate forearm (wrist) pain. I do not have pain radiating into the hand, but the left portion of it is also numb. I also have weakness in the left hand but no loss of coordination.

Yes, I had one EMG and one NCV. From my understanding, there was minimal slowing of the nerve signals (compared to the control test taken from the same hand on the fingers with normal sensation). There were positive sharp waves in the arm muscles with increasing intensity to the neck muscles (which prompted the MRI).

The first specialist stated that the MRI was normal, but wouldn’t go over it with me. The second specialist (who took the EMG/NCV tests and ordered the MRI) would not comment. (I assume he didn’t want to contradict his colleague.)

My symptoms do not worsen with overhead activity or sleep. I sleep on my back as I must use a CPAP which restricts much of my movement. I also have been sleeping with a brace holding my arm in a slightly bent position and have taken an oral round of Prednisone – with no relief.

There is pain at the ‘funny bone’ in the elbow, it skips part of the forearm then starts again at the inside of the wrist (that’s not new and I’ve always attributed that to carpal tunnel – diagnosed over 15 years ago). The numbness does not start until you get to my hand.

I’ll follow instructions sent to get the images posted.
Thanks.

potomachomesalf
Member

June 17, 2011 at 12:48 pm

Post count: 1

#4636
Topic: tightness in both feet, big toes turning up in forum GENERAL |

Dr. Corenman –

I have been dealing with a myriad of symptoms for 2 years. It is easier to chronologically summarize my journey. Prior to the onset of these symptoms, I have been in excellant health. My question is do you have thoughts on a cause of my current symptoms (see 1/11 entry).

7/2009: acute onset of bilateral foot (level of arch to toes) tingling, burning pain
6/2009: acute onset of bilateral hand/finger(1-4) burning, tingling pain
12/2009: having much difficulty walking & using my hands from pain. No hand/foot weakness. MRI: Chiari Malformation with very small cervical syrinx
2/2010: underwent Posterior fossa decompression for CM, all symptoms completely resolved initially then gradually returning
5/2010: all original symptoms returned
8/2010: developed tingling in posterior upper/lower legs, buttocks, ba20ck, arms
8/2010: Lumbar MRI results “disc degeneration of the L4-5 and L5-S1 with probable L5-S1 annular tear. Mild to mod central canal stenosis at the L4-5 level secondary to facet hypertrophy and ligamentum flavum thickening”
9/2010: developed significant tightness in both feet, L>R. eventually both great toes began turning up (hyperextension of 60+ degrees)
after multiple tests, doctors..still do not know what is cause of symptoms.
11/2010: consulted with neurosurgeon who determined I had severe cervical stenosis (8-9.5 mm). physician states stenosis may be common with Chairi Malformation
12/2010: Underwent ACD with fusion of C4-C7.
1/2011: hand/arm symptoms primarily resolved. feet/leg symptoms continue with worsening (tightness in feet, big toes turning up, decreased sensation to pain & temperature in both feet, burning in posterior and medial section of upper/lower legs, buttocks. (No radiating symptoms)
5/2011: referred for EMG of lower ext to r/o tarsal tunnel syndrome. EMG (knees to toes) shows tibial nerve impairment. referred to podiatrist for injections & PT
6/2011: Podiatrist does not believe it to be TTS. Tinel’s sign negative; in 30 yrs of practice has never seen bilat TTS much less with the same onset of symptoms in each foot; dermatones affected do not match with TTS. referred for repeat Lumbar MRI
6/16/11: Lumbar MRI completed. all physicians who previously reviewed the 8/10 lumbar MRI state cause not originating in Lumbar region. Today I viewed both lumbar MRI’s for comparison & do not see any real change.

Will be seeing another neurologist with new Lumbar MRI in a few weeks.

Thank you for any thoughts you have!

Donald Corenman
Keymaster

June 7, 2011 at 10:39 pm

Post count: 52

#4621
Topic: Question from our YouTube Channel: Recovering from disc herniation in forum BACK PAIN |

I have this condition. Disc herniation, left leg pains. Numbness, pins and needles, tight hamstring. Also major lower back pains. Left side of my back is full tensed up.

I’ve been doing a lot of hydrotherapy and core activation exercises. Any more ideas to speed up recovery?

Sally
Member

June 6, 2011 at 10:30 pm

Post count: 1

#4616
Topic: Treatment for L5-S1 Spondylolisthesis in forum BACK PAIN |

Hello Dr. Corenman,

I am a 55 year old female, very athletic. I have been diagnosed with a Grade 1 L5-S1 anterior spondylolisthesis with bilateral chronic pars interarticularis defects at L5. My symptoms are essentially all on my left side with pain in my lower left back and down to my left buttocks. I have no pain in the leg, but then extreme pain and discomfort (tingling/burning) along the outside of my left foot. My MRI shows that I have a stable grade 1 L5-S1 spondylolisthesis of approximately 3mm with evidence of bilateral pars inter articularis defects at L5 (L5 spondylolysis). There is no central or formainal stenosis from L1 through L5. There is a diffuse pseudo disc bulge but no central canal stenosis. There is a mild left side foraminal stenosis with contact with the exiting left nerve root.

I have received differing opinions as to surgical options. I have seen several surgeons who believe I should have a fusion with hardware. I am very concerned about this extensive surgery which could be more problematic because I have severe osteoporosis. I have also received the opinion that I could be helped by a foraminotomy of the left side without hardware. This would obviously be less invasive. I am wondering whether I truly need the more extensive surgery with hardware. I have seen several articles in the literature recently where patients with seemingly similar symptoms and defects to mine have been helped without hardware. Since my symptoms seem consistent with the left side foraminal stenosis, could the foraminotomy be sufficient for relieving the pressure on the nerve? Afterall, I likely lived pain free for years with the small instability and only likely developed the pain from the left side stenosis that developed. I realize you can not make a determination without an exam, but I would value your opinion and thoughts on my surgical options. I have had several series of steroid injections and they did not really help.
Thank you for your time.

josh
Member

June 5, 2011 at 8:39 am

Post count: 3

#4612
Topic: mri ?????????? in forum NECK PAIN |

Aloha from Hawaii,
I had gotten a final report of my MRI ( granted I waited 3-4 months before the Dr. finally ordered one) I have been dealing with pain in my neck, back and shoulder for about 6 months and after looking at my report I am quite worried.
is as follows:
at c3-4 there is a mild to moderate right para central focal disc protrusion. this is associated with hypertrophic spurring. this impress upon the ventrolateral aspect of the thecal sac and compressed the spinal cord in this area. there is mild to moderate narrowing of the right foramen at this level due to uncovertebral spurring and facet arthrosis. c 4,5 level is unremarkable
at C5-6 there is a tiny central disc protrusion and mild disk bulging without cord compression or spinal stenosis. there is mild narrowing of the right foramen at this level
the C6-7 level demonstrates maderate narrowing of the foramen on the right due to uncovertebral spurring. the left is mildly narrowed. there is no focal disc protrusion or extrusion.
the c7-T1 is unremarkable.

The cervical spinal cord appears normal in course, caliber.and signal intensity. there is no cord contusion or myelomalacia noted.

Impression:
muscular spasm with no fracture or subluxation.
Mild to moderate right paracentral disc protrusion at C3-4level with associated hypertrophic spurring. compression of the thecal sac and right ventrolateral aspect of the cervical cord is noted. ( these are under lined and is written neurosurgeon)
Disc bulging with small central disc protrusion at C5-6 ( under lined as well)no cord compression
Several levels of foraminal narrowing, as described above.

First your site gave me a better understanding of what and how is affected but I am still in a big grey area ( thanks for the info on your site)

can you explain this and any severity to this ( if any)
there is one neurosurgeon on the island and the closest I can get to him is in August ( 2 more months of pain)
I would appreciate advice or opinion.

My wife particularly is very worried ( as am I)

HELP!

I have been prescribed muscle relaxer, anti inflammatory, pain pills and PT Would rather fix it than keep going through this, even little movement cause cracking and crunching in my neck.
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Viewing 6 results - 2,173 through 2,178 (of 2,193 total)

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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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