Symptoms and condition after two back surgerys

Viewing 6 posts - 1 through 6 (of 6 total)

Author

Posts
galtanov
Member

September 15, 2014 at 9:17 pm

Post count: 3

#11437

Hello,
My name is George Altanov and I live in Sofia, Bulgaria. I am 33 years old, 5’57” 87 kg. I am writing about my complains from a herniated disc at level L5-S1. Here is a short description of my problems:
I got my first crisis in October, 2011. It was characterized by severe pain in the back. I could only walk bent forward. I was diagnosed with disc disease (Discopathy). I was taking only strong anti-inflammatory and the pain was gone in 10 days. After this I was feeling weak pain at mornings. In March, 2012 I got my second crisis. At first I felt pain in the waist and thigh of the left leg. A few days later the pain in the thigh became unbearable and I could neither stand straight nor sit. On March 15, 2012 I was admitted to hospital where I stayed for five days. I had a scan and a herniated disc at L5-S1 was found. I was treated with medication only. Upon discharge from the hospital, the pain in the back and thigh was gone, but the fingers of my left leg were very numb. The first two months I didn’t have back pain, but the pain in the thigh was appearing and disappearing. After that the pain switched from my foot to my back and was constant. In October 2012 I underwent a classical open surgery for removing the hernia. On the third day after the operation I started feeling pain in the leg and in the back. Two months after the operation I had a MRI which showed that there was hernia again on level L5-S1. Since then the pain had been in the leg for 2-3 months then switching to the back for 1-2 months and then switching to the leg again for couple of months. In October 2013 I underwent second operation on the same level, but this time Endoscopic discectomy. There was no change in the pain except that till July this year the pain had been only in the foot and sometimes in the thigh and there were no burning sensations. Since the end of July the pain started switching from back to leg again, but this time the switch happens in matter of 2-3 days. For example for 3 days I feel strong burning and pain in my left feet and back thigh. Suddenly I stop feeling almost anything in my leg, but after a couple of hours the burning and pain switches to my lower back. After some days it switches back to the leg again. I can have one or two days with significantly less pain and no burning if I am resting at home. When I am at work (sitting beside a computer) this changes can happen in matter of hours.(4-5 changes during a 8 hour workday). I don’t feel any significant weakness in the leg or the back (only a little bit when the pain grows much stronger). I can walk on my fingers and my heels without any pain. In laying position I can stretch my legs to full without any pain also. On other hand wearing any kind of socks or closed shoes gives me very significant pain in the leg to the point that I can’t wear them for more then 1-2 hours. The only way to ease the pain is to be bear footed and wear open sandals. Sometimes even wearing long trousers can give me pain and burning sensations. Laying down also causes me pain depending on the surface I lay down. I have tried taking many kinds of anti-inflammatory drugs, but without any significant pain relief. The only different thing that I have tried is taking proteolytic enzymes (serrapeptase, bromelain and papain). I started them in the end of July this year and took them for 3 weeks, but then I stopped them because I think they give me extra pain. I have done couple of MRIs (before first surgery, two months after it, one before the second surgery and one two months after it, and the most recent on is from begin of September this year). I have been told by doctors, that according to the MRIs the herniation before the first surgery was a small one and in the latest MRI there is almost nothing left of it. According to the latest doctor that I have talked to cause of this pains shouldn’t come from the herniation.

Here are the MRI images:

Before the first surgery :

Two months after the first surgery:

Most recent one(09.2014):

Thank you in advance for any help i can get.

Donald Corenman, MD, DC
Moderator

September 16, 2014 at 8:54 am

Post count: 8660

#11441

Sorry but I cannot look at any files of images due to potential viruses.

You history sounds to be of two compression episodes of the S1 nerve root and then a chronic injury to the root. This is due to the presence of allodynia (painful sensations from gentile touch of the skin).

“Wearing any kind of socks or closed shoes gives me very significant pain in the leg to the point that I can’t wear them for more then 1-2 hours. The only way to ease the pain is to be bear footed and wear open sandals. Sometimes even wearing long trousers can give me pain and burning sensations”.

With chronic radiculopathy (see website for explanation), recovery takes much time and occasionally, symptoms may be permanent. The membrane stabilizers (see medication section) can be helpful for these symptoms.

Finally, there still might be some residual compression of the nerve root present. A careful review of the MRI would be helpful.

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.

galtanov
Member

September 16, 2014 at 9:49 pm

Post count: 3

#11444

Thank you for your quick reply.

I have taken Gabapentin for one year till beginning of this September. I didn’t had any significant pain relief. One week ago my neurologist decided to change Gabapentin with Lyrica. In 10 days i will reach 300mg per day. At the moment this is the only medications that i take.
I have tried Talvosilen (Paracetamol 500mg/ Codeinphosphat-Hemihydrat 30mg) which brings down the symptoms for several hours, but according to my pharmacist Codein is highly addictable and should be avoided.

Also i have read that the nerve can heal itself for 12, maximum 18 months after a surgery. Is this correct, or the healing process can go more than this period ?

Thank you in advance.

Donald Corenman, MD, DC
Moderator

September 17, 2014 at 1:03 am

Post count: 8660

#11445

You are on the correct medication and correct dosage. You are correct in that the nerve can heal in eighteen months. Anything after that generally will not heal. The narcotic medication can occasionally be effective long term but in many cases will not work long term.

A new MRI might be warranted as you could still have some compression of the root. Without compression, you could consider a spinal cord stimulator.

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.

galtanov
Member

September 18, 2014 at 10:17 pm

Post count: 3

#11456

Can the cause of my symptoms be a ARACHNOIDITIS or worst scenario ADHESIVE ARACHNOIDITIS ?

What kind of MRI technique must be used to determine a possibility of ARACHNOIDITIS ?

Thank you in advance.

Donald Corenman, MD, DC
Moderator

September 19, 2014 at 1:17 am

Post count: 8660

#11457

This chronic pain could be arachnoiditis but that would be unusual. Chronic radiculitis or recurrent herniation would be the most common disorders that would cause your condition.

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.
Author

Posts

Viewing 6 posts - 1 through 6 (of 6 total)

You must be logged in to reply to this topic.

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel