Donald Corenman MD DC | Spine Surgeon Colorado

Participant

October 15, 2022 at 9:51 am

Post count: 10

#35332

Hello —
Update: I had facet joint injections on 8/12 and had some short term relief. Instead of moving forward with the next steps, I decided to try the epidural cortisone injection on 9/23. The doctor said I may feel pain across the chest and down the arms as he does the injection, which I did feel. After a few days, I started having bad pain in my neck (shock-like and intense aching) and sharp pains in my arms, hands and fingers as well as parentheses.

I had an upcoming appointment with my neurologist that performed a nerve conduction test on my legs and an EMG since my neurosurgeon only did my arms and hands. The test revealed a possible pinched nerve in my left leg. He also ordered another MRI and MRA of my C-spine and an MRI of my L-spine and wrote me a referral to see a neuromuscular doctor to evaluate me for small fiber neuropathy or other neuromuscular diseases. My feet have hurt me for 30 years (since I had CFS). The difference is the numbness and shooting pains.

I am not able to get a follow-up appointment with him until mid December. I made an appointment with a neuromuscular doctor which is in Dec. as well. I have a follow-up with the neurosurgeon coming up.

After talking to my pain management doctor, he suggested I ask the neurosurgeon about trying a spinal cord stimulator.

The results from the current MRI of my C-spine and L-spine is below. I haven’t had the MRA yet.

HISTORY: 55 years Female 55 year old female. Neck pain with bilateral upper extremity radiculopathy for a year. No recent trauma. History of cervical spine surgery October 2021.
TECHNIQUE: Using a 3.0 Tesla magnet, multiplanar T1 and T2 weighted images were acquired.
COMPARISON: MRI 3/12/2022, CT 7/11/2022
FINDINGS: Stable anterior fusion with plate and screws at C5-6. There is no evidence of acute compression fracture or subluxation.
Bone marrow signal shows no evidence of bone marrow edema.
Disc spaces are maintained.Spinal Cord: Normal caliber, contour and signal intensity.
C1-2: Preserved with no atlantoaxial subluxation or significant separation.
C2-3: No disc bulge. No herniation. No facet and/or uncovertebral arthropathy. No central canal stenosis. No foraminal stenosis.C3-4: No disc bulge. No herniation. No facet and/or uncovertebral arthropathy. No central canal stenosis. No foraminal stenosis.
C4-5: No disc bulge. Stable small central herniation. No facet and/or uncovertebral arthropathy. No central canal stenosis. No foraminal stenosis.
C5-6: Stable moderate bony ridging. Stable mild degenerative buckling of ligamentum flavum. No disc bulge. No herniation. No facet and/or uncovertebral arthropathy. Stable moderate central canal stenosis. Stable moderate bilateral foraminal stenosis.
C6-7: Stable mild disc bulge. No herniation. No facet and/or uncovertebral arthropathy. No central canal stenosis. No foraminal stenosis.
C7-T1: No disc bulge. New small herniation. No facet and/or uncovertebral arthropathy. No central canal stenosis. No foraminal stenosis.Paravertebral/Prevertebral soft tissues: Unremarkable.
IMPRESSION: Stable anterior C5-6 fusion. Stable C5-6 annular bulging, degenerative buckling of ligamentum flavum, moderate central and bilateral foraminal stenosis. Stable small C4-5 central disc herniation, mild C6-7 annular bulging, and new small C7-T1 disc herniation.

HISTORY: 55 year old female with left side lower back pain. Pain radiates down the left leg and into bot feet. Symptoms began years ago. No trauma. No prior lumbar spine surgery.
TECHNIQUE: Sagittal T1, T2 and inversion recovery, coronal T2, and axial T1 and T2 images are obtained through the lumbar spine without intravenous contrast in a 3.0 Tesla scanner.
COMPARISON: MR lumbar spine 7/23/2020.
FINDINGS: Conus medullaris ends at L1 and appears unremarkable.The kidneys show no evidence of hydronephrosis. Included portion gallbladder shows no evidence of calculi .normal size common bile duct. Small umbilical hernia containing only fat.
At L1-2, annular bulge. Neural foramina and thecal canal are adequate.
At L2-3, neural foramina and thecal canal are adequate.
At L3-4, left lateral disc herniation narrowing left L3 foramen without foraminal nerve root compression image 6 series 3. Tarlov cyst at L3 foramen on the right side image 11 series 4. Mild bilateral facet degeneration. Thecal canal is adequate.
At L4-5, annular bulge. Neural foramina and thecal canal are adequate. Small Tarlov cyst on the left side.
At L5-S1, neural foramina and thecal canal are adequate.Visualized portion of the sacroiliac joints appear unremarkable. Tarlov cyst at L5 on the right side measuring 8.2 mm at S1 on the left side measuring 15 x 13.5 mm and S2 on the left side measuring 8.5 mm and on the right side measuring 9.3 mm. Tarlov cyst scalloping the posterior margin of the S1 and S2 vertebral bodies.No pedicle edema or spondylolysis detected.
IMPRESSION: Left paracentral and lateral disc herniation at L3-4 level narrowing the left L3 foramen. Tarlov cysts in the right L3 foramen. Additional Tarlov cysts in the right L5 and left and right S1 and S2 foramina. These are usually asymptomatic. Occasionally they can be a source of nerve root compression. Findings unchanged since previous examination 7/23/2020.

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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