back pain since 2months

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August 30, 2011 at 5:32 pm

Post count: 4

#4824

HELLO DOCTOR ,I M FACING SEVER BACK PROBLEMS FROM ALMOST 30-35DAYS N THE PAIN GOES DONE TO MY LEGS,ESPECIALLY MY LEFT LEG,I VISITED DOCTORS WHO HAVE TOLD ME TO REST AND GIVEN SUM PAIN KILLERS ,I GOT MY MRI DONE THE STUDY REVELS THE FOLLOWING:
1)BROAD BASED POSTERIOR DISC BULGE WITH POSTEROCENTRAL DISC EXTRUSION IS SEEN AT L4-L5 level causing severe lumbar canal stenosis with indentation upon the bilateral budding L5 nerve roots.
2)The T11-T12 INTERVERTEBRAL DISC IS REDUCED IN HEIGHT AND EXHIBITS DIFFUSE POSTERIOR BULGE WITH LEFT POSTERO LATERAL DISC HERNIATION WITHOUT ANY NERVE ROOT COMPRESSION.
3)MILD POSTERIOR DISC BULGE IS SENN AT L1-L2 LEVEL WITHOU ANY NERVE ROOT COMPARESSION.
4)MILD OLD WEDGING OF T11&T12 VERTEBRAL BODIES IS SEEN…

PLEASE EXPLAIN ME EACH POINTS ABOVE…AND SLOUTION FOR THE SAME…

DOCTOR I m 28yrs old FROM LAST 2MONTHS MY CAREER IS ON FULL STOP,,,MY Back PAIN IS LESS AS DOCTOR TOLD ME THE INTENSITY OF THE PAIN IS LESS N NERVES R FUNCTIONING FINE but pain is coming n goin,,HE SHOWED ME THT L4-L5 DISC IS BECOME FULL BLACK N PRESSIN THE NERVE,,HE HAS GIVEN ME PAIN KILLER MEDICINES,,how can I make my spine more strong,,,I WANT YOUR HELP AND ADVICE HOW I CN BE FIT N FINE,,WHT PRECAUTIONS SHOULD I TAKE,,HOW CAN I FIGHT WITH THIS PROBLEM N GET INTO MY NORMAL ROUTINE,,NOW M TAKIN MEDICINES SUCH AS PAIN KILLER N HIGH ON CALCIUM MEDICINE..LAST 3-4 DAYS EVEN MY NECK N SHOULDERS R ALSO PAININ WHICH WAS NOT THER BEFORE…WHAT MEASURES SHOULD I TAKE AS I HVE GR8 SUPPORT FROM MY FAMILY,SO PLEASE LET ME KNOW I WIL BE VERY THANK FULL TO YOU..DOCTOR I ASLO WANT TO KNOW HOW TO AVOID THE BULGING OF OTHER DISC….AWAITING FOR YOUR REPLY…THANK YOU…………

Donald Corenman, MD, DC
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September 1, 2011 at 1:38 am

Post count: 8660

#4827

Thank you for your information. You describe your MRI well but do not describe your symptoms with enough detail. “Severe back problems” and pain in both legs needs to be further explored. First, do you have any motor weakness in your legs or bowel/bladder changes? Is the pain worse in your lower back or in your legs? What is the ratio? Is it 50/50, 60/40, 70/30 or the reverse (legs more painful than lower back) 30/70 etc. What makes the pain worse? Is the pain worse with walking and standing or increased with sitting, bending or????

The herniation in your lower back according to the report is significant. “Severe lumbar canal stenosis” generally means a very large herniation causing significant compression. Generally, these very large herniations can be associated with motor weakness or cauda equina syndrome (see website). If either of these are present, in my opinion, decompression surgery needs to be performed.

If the pain is significant and you cannot ambulate, again, surgery would be recommended to gain the fastest recovery.

The T11-L1 degeneration/deformity is probably old Scheuermann’s disease and has been present for quite a while. Most likely, this is not causing the current symptoms.

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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September 30, 2011 at 9:28 pm

Post count: 4

#4957

Hello doctor,Thanks for your previous reply..
SYMTOMS ARE AS FOLLOWS:LOWER BACK PAIN IS MORE THAN LEGS (RATIO LOWER BACK TO LEG IS 85:15),FEEL SENSATION IS PERFECTLY FINE IN MY LEGS,NO BLADDER CHANGE,NO MOTOR WEAKNESS (KINDLY ONCE AGAIN CLARIFY THE MEANING OF MOTOR WEAKNESS),AS I M THIS DAYS ABLE TO MOVE N WALK QUITE A GOOD DISTANCE..ITS JUST THAT THE PAIN COMES N GOES IN WEEKS TIME ..
PAIN USUALY HAPPENS WHILE SITTING AND THIS DAYS TOSUM EXTENT WHILE SLEEPIN ON MY BACK,
dOCTOR I WAS ALSO FEELIN PAIN IN MY UPPER BACK JUST BEHIND THE CHEST ON LEFT SIDE USUALY.
I RECENTLY AGAIN WAS ADVICED TO DO X RAY FOR LUMBAR SACRAL SPINE AP & LAT
AND ALSO DORSO LUMBAR SPINE AT& LAT ON 29TH SEPT.AS I HAD GONE TO NEW DOCTOR AS ALL OF THE SUDDEN THE PAIN HAD INCREASED.
REPORTS SAYS:ALL NORMAL EXCEPT PARTIAL COLLAPSE OF D12 VERTEBRAE.
SO KINDLY LET ME KNOW IS MY BACK SHOWIN IMPROVEMENT AS NOTHING RELATED TO L4-L5 DISC WAS MENTIONED.
ALSO LET ME KNOW WHT MEASURES SHOULD I TAKE WHICH WIL HELP ME TO RECOVER QUICK,
DOCTOR MY WEIGHT IS 100KGS N I M AWARE THT I HAVE TO REDUCE THE SAME.
ALSO WANTED TO KNOW WHEATER YOGA N WALKS WILL BE HELPFULL.
DOCTOR YOU HAD EARLY MENTIONED ABOUT SUM OLD SCHEURMANNS DISEASE WHT IS THAT EXACTLY AND HOW DOES IT OCCUR AND WHAT IS THE TREATMENT FOR THE SAME AS NONE OF MY REPORTS HAD MENTIONED THIS WORD ANY WHER.

KINDLY REPLY.

THANKS :)

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Member

September 30, 2011 at 9:30 pm

Post count: 4

#4958

doctor the pain these days is more on right side it keeps moving from centre to left -right but no pain in the right leg when the pain is on the right side and when the pain is on the left side its mild pain in left leg when i get up from my bed,this pain in left leg is from quite long time before this back problem was detected and it use to happen only when in the morning i use to get up from the bed n use to go away in few seconds its jus these days i happens whn pain is on the left side of my back…PAIN IS MORE ONLY WHILE SITTING.DOCTOR I WOULD LIKE TO AVOID OPERATION SO WHAT MEASURES SHOULD I TAKE AS I HAVE GOT FEEDBACK THAT SPINE OPERATIONS ARE DANGEROUS AND CAN HAVE ADVERSE EFFECT IN LATER STAGE OF LIFE AND ARE NOT SUCCESFUL MANYTIMES.

Donald Corenman, MD, DC
Moderator

September 30, 2011 at 11:16 pm

Post count: 8660

#4959

Most of your pain is lower back in origin. You have very little leg pain and no weakness or bowel/bladder involvement. It sounds like that if your lower back pain improves, your overall picture will improve.

X-rays being reported as “normal” in the lumbar spine are obviously incorrect as you have a previously reported large herniation of the L4-5 disc. The x-ray probably has subtle signs of changes (narrowing of the L4-5 disc) and X-rays will not identify a herniation.

Sitting pain that improves with standing is the most common identifying symptom factor in most disc herniations. However, most pain generated from a lumbar herniation is extremity or leg pain as the nerve root compression is the most painful problem. Your problem with majority lower back pain from a disc herniation is not typical. None the less, epidural injections along with a good physical therapy program is the initial treatment recommendation. If you fail that program, a surgical discussion would be called for.

The fact that most pain is lower back and not leg pain makes a surgical decision somewhat more difficult. Most patients with majority lower back pain that have failed conservative measures should be worked up to look for a fusion possibility. However, according to your report, you have a massive disc herniation filling the spinal canal. Based upon your complaints and the large disc herniation, a simple microdiscectomy has a greater than 50% chance of relieving a reasonable portion of your back pain. If you do fail a simple decompression, a fusion discussion can still be on the table.

You do not need to look for a surgical discussion if you have no inclination for surgery as it sound like you have pain but no neurological compromise.

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.

help
Member

September 18, 2013 at 1:19 am

Post count: 4

#9415

Hello Doctor,

This conversation is in regards to my back problem which had aroused 2 years back.
Doctor on 16th of Sept 2013,i was feeling back pain and it was this time in thoraic region so i was advised to do MRI report which i did again after 2 years,Request you to read my previous conversation which has the details of my previous MRI along with this time MRI.

I was suggested to do Lumbo Sacral Spine with screening of whole spine and observations are as follows:
1)Mild Loss of Lumbar Lordosis.(Request you to explain the cause and measurements to improve).

2)L4-L5 disc is dessicated slightly reduced in height and exhibits diffuse posterior disc bulge ,abutting the thecal sac and bilateral traversing L5 nerve roots.Encroachment of bilateral neural foramina is noted without significant nerve root compression.

3)T11-T12 disc is mildly dessicated ,reduced in height and exhibits mild diffuse posterior bulge without significant thecal sac or nerve root compression.

4)L1-L2 mildly dessicated ,reduced in height and exhibits diffuse posterior bulge with extrusion of the disc material migrating right paracentrally and superior upto the lower 1/3rd of the L1 vertebral body and indenting the thecal sac.(Please Explain as last time it was not mentioned in detailed manner).

5)Screening of the cervical spine reveals :Loss of Cervical Lordosis.No other significant abnormality is seen.

Screening of dorsal spine does not reveal any significant abnormality.

Symptoms :

Back Pain upper and lower,by god grace i think its much much lesser than which was 2 years back also less leg pain as i had taken a break from my work.

I wanted to ask you what should i do to improve my health.If u can suggest any excerise for the above mentioned problems which can actually improve my health.Can my spine become normal like it never had any problem like before.

Precautions which i should take care during my life cycle so that the problem does not worsen.

Awaiting for your reply.

Thank you!!!
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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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