Patient Preparation

This is not a passive event. Unless it is just around the corner, to just wait for your surgery to take place is a mistake. A fit and more conditioned patient recovers faster and has fewer complications. Any regular preoperative cardiovascular exercise like using a stationary bike or elliptical (raising the heart rate, even modestly) will help with recovery.

Even though surgery is designed to reduce the pain you’re in, try to reduce the amount of pain medication taken before surgery. It will make pain control easier postoperatively.

Prepare for the postoperative period. Have some easy to make meals handy. Take up cords or carpets that can cause a trip and fall. An elevated toilet seat or a shower-tub seat can be helpful although the occupational therapist you will see in the hospital after the operation will assist with procurement of those items.

Stop smoking!!! Smoking reduces the chance of healing significantly and if a fusion is involved with surgery, this will reduce the chances of success by 25%!!

Stop taking natural supplements 10 days prior to surgery. Many supplements can interfere with blood clotting and make surgery more dangerous. This includes Ginko Biloba, Ginsing, St John’s Wort and others.

Stop taking aspirin products and NSAIDs (non-steroidal anti-inflammatories) like motrin or aleve 10 days prior to surgery. These can impair blood clotting.

If you are on a blood thinner like Coumadin- you must alert the surgeon. Surgery cannot normally be performed on a patient who is taking Coumadin without great risks.

Make sure your family doctor knows about your impending surgery. He or she will be very helpful in the post-operative period for simple incision checks up to control of blood pressure or diagnosis of potential problems.

If you have had a recommendation for blood donation prior to surgery, this can normally be done at a local, neighborhood hospital that has blood donation facilities and then shipped to our Medical Center. It normally takes a week per unit and many patients are recommended to donate two units. Blood donation is normally requested for lumbar fusion surgery and deformity surgery.

A common question is what supplements can I take to heal faster? The answer if you are of normal health is no. What impairs healing are disease processes like diabetes, malnutrition, alcoholism and smoking. Diabetes under good medical control, cessation of drinking significant amounts of alcohol and stopping smoking are the answers. It might be helpful to take a protein supplement like “boost” or “ensure/ enrich” during the first week or so after surgery if you don’t have a good appetite.

Of course- in general because of our deficient diets, most individuals should be taking 1500 mg. of calcium per day in a “sugar” or chelated form. Some over the counter calcium tablets are made of calcium oxilate which is a mineral form from oyster shells and is harder to absorb. The sugar attached to calcium (calcium lactate, gluconate or succinate) makes it easier to absorb. 400 IU of Vitamin D should also be taken unless you are out in the sun on a daily basis. Magnesium should also be taken with calcium at a rate of one-half of the calcium. (If you take 1500mg of calcium, you should be taking 750mg of magnesium). Many suppliments have all three nutrients in one or two tablets.

As far as food intake – stop 8 hours prior to surgery. Try not to drink anything, but if you must, only sips of water are acceptable up until 2 hours prior to check-in. This means plain coffee or water. Sugar or especially cream in the coffee makes it a food so this can’t be consumed for 8 hours prior to surgery. If you need to take pills, the ones to take and the ones to avoid will be discussed with you during the anesthesia preoperative meeting. Pills need to be taken only with a small sip of water and at least 2 hours prior to surgery.

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.

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Patient Preparation

About the Author: Donald Corenman, MD, DC