post microdiscectomy frustrations

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killerkutie
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May 29, 2013 at 9:26 pm

Post count: 9

#8763

In October 2012 I started having sciatic pain and in Dec 2012 I was diagnosed with an 18mm herniation at the L5S1 level.
Symptoms started with burning and pulling behind right thigh, progressed to buttock spasms and eventually had heal pain and what felt like foot drop.( no pain behind knee and none in calf )2 weeks before surgery I noticed I couldn’t stand straight, my body kept shifting to the left side.

I had a microdiscectomy March 21st 2013.

Ive had no relief from sciatica since surgery, but certain symptoms have disappeared such as burning behind thigh, buttock spasms,thigh pain and heal pain. But some newer pains have settled in such as behind the knee pain, some calf tightness and the pain is no longer around my heal but under it now.
I guess my question is, is this normal? my pain is constant,if I don’t take meds. My sitting and standing tolerance as well as pain has definitely improved somewhat but pain increases some week, and diminishes others.

I seen my family dr yesterday ( at 9.5 weeks ) He dosent seem concerned.
I had a follow up with surgeon on week 4 which was a good week and was cleared as a success. Surgeon said pain will eventually go. Im frustrated…
Please advise.
Meds Im currently on is 5m Flexeril x 2 a day. Advil and Tylenol.

killerkutie
Member

June 5, 2013 at 10:00 am

Post count: 9

#8807

Can someone tell me if my post is in the right section?? Or am I just chopped liver lol

Donald Corenman, MD, DC
Moderator

June 5, 2013 at 8:27 pm

Post count: 8660

#8810

A very large herniation (18mm) can create nerve injury that can take time to heal. See the section under “nerve injury and recovery” to understand how nerves heal. Pain relief however should generally be quite good after a microdiscectomy.

Pain that continues to be somewhat disabling after a microdisectomy can originate from a recurrent herniated disc, an intracanal hematoma (a small collection of blood) or even on very rare occasion, incomplete removal of the disc herniation.

In my practice, if the patient does not have great pain relief, I generally order another MRI. If there is no compression of the nerve, I order an epidural steroid injection which takes some of the inflammation out of the nerve root. If there is a hematoma present, I have it aspirated.

If the pain is of root injury origin, I use membrane stabilizers (Neurontin or Lyrica) and physical therapy.

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.

killerkutie
Member

June 7, 2013 at 4:46 am

Post count: 9

#8818

Thanks for the reply dr corenman Its pretty sad when Ive gotten a reply from another surgeon before my own! Im from northern ontario and unfortunately My surgeon and surgery was done in Toronto, its very difficult to get through and speak to someone at the office. I spent yesturday cumpulsionally calling my surgeons office in hopes to speak to the secretary as my body is shifting to the left side again! I left a message. Hopefully I get a call back! As far as the mri my family physician said he wont repeat one till 1 year post op seeing that it would only reveal inflamation and scar tissue lol and theres no one here that can give us shots! It takes 8 months to see a neurosurgeon!!

Donald Corenman, MD, DC
Moderator

June 7, 2013 at 8:44 pm

Post count: 8660

#8819

I know that national health care can be really unresponsive and spine care has some of the most prolonged delays in that system. Maybe you can get hold of a nurse and ask if they would consider giving you an oral steroid for this nerve root inflammation.

Good luck!

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.

killerkutie
Member

June 13, 2013 at 9:42 pm

Post count: 9

#8885

I got a hold of my surgeons secretary. One if my surgeons colleagues is hosting a clinic in a near by northern ontario community tomorrow and Ive managed to get an appointment to see him. Im hoping he will send me for a new MRI so I can get some answers. Thanks again for your response Dr Corenman!
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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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