9/12/14 I just had a lumbar fusion L4 to S1 w/ Cage

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Rox1919
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October 24, 2014 at 3:14 am

Post count: 6

#11579

Hello Again Dr. Corenman,
I went to the ER this past Friday, the did X-Rays on my back and foot. The follow up with my surgeons office was they were going to send me to pain mgmt. I went the this past Tues morning at 8:30am. A Dr. Walks in and say “Hi what can I do for you today” I said I’m here for pain mgmt. he replies I don’t do pain mgmt I am a spine surgeon. So after I kind of insisted he take a look, he agreed. He sent my down the hall for x-Rays of my back(again) he pulled the disk up onto the computer screen. He then says” well I’m not the original surgeon but I will continue anyway. He sends me back to the hospital for a Cat Scan,which shows the screws on the right side were in fact touching the nerve. By 6pm the same day I was in the OR having a revised surgery. They removed 3- metal screws with a rotating hex thing on the top. He removed 1 rod as well. Also the 2 lowest stitches the put on my from the original surgery positioned between the cheeks had not become infected and turned into a Palinode cyst which the had to operate on as well. So in the past 5 weeks or so I have experience the utmost pain I could have ever imagined. I should be home tomorrow, thank you for all your advice!

Donald Corenman, MD, DC
Moderator

October 24, 2014 at 10:36 pm

Post count: 8660

#11584

Well at least you were persistant and finally (hopefully) found the source of your new onset leg pain (screw stenosis). Did the screws that were removed get replaced or did the surgeon leave no hardware on that side?

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.

Rox1919
Member

October 25, 2014 at 2:09 pm

Post count: 6

#11591

Hello,
Persistent yes .. Not like I had much choice. As for the 3 screws and rod that they removed ,that is the only info I have at this time. My husband was in the waiting room alone and when the Dr. Came out of surgery he handed him a cup with the hardware in it. He never thought to ask if he replaced them or left them out. I will ask when I see him on November 3rd. In the meantime I still have right foot and leg problems. My right foot is swollen like a balloon and I have swelling in my right leg up to my knee. On top of that I have no idea what to expect when they remove this bandage. I do have terrible back pain now which was the only good thing I didn’t have from the first surgery. I just want to thank you for all your advise, you were right one from the get go 100% and you have no idea how much you helped me. Thank you again I will let you know the results after my follow up.
Warmest Regards

Donald Corenman, MD, DC
Moderator

October 26, 2014 at 12:17 pm

Post count: 8660

#11592

Nerves that have been compressed take some time to “calm down”-sometimes as much as six months. The medications that are effective for these symptoms are the membrane stabilizers (see website under medications).

If the screws were not replaced, then you will have some motion of the surgical site until the fusion “takes hold” (about three months). I am surprised that the surgeon who took out these screws did not comment about replacement or just removal.

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.

Rox1919
Member

November 7, 2014 at 7:50 pm

Post count: 6

#11686

Hello again,
Well I found out some info. The surgeon did NOT replace any screws and he did remove the rod as well. My right foot and now it has spread up my leg to my knee has edema. Again my surgeon has seen me and said and I quote, I’m not that concerned about it. At this point all I can do is cry. I cry myself to sleep or lack of sleep every night because the pain,throbbing,and the feeling someone hit my big toe with a hammer is so painful you can’t imagine. I contacted my primary she saw me immediately, when she saw my leg she sent me for an ultrasound just to be safe and rule out DVT. Good news with that. The tech who did the ultrasound asked have you ever had your arteries checked. I sain no so the scheduled me an appointment. I went on Tuesday and the Vascular Surgeon asked me a little about my previous surgeries inquiring when and how I came to the point with the swelling. His exam consisted of a few questions then he proceeded to put his first 3 fingers on the top of my foot to feel my pulse. He then said I feel a good pulse your arteries are fine. The tears just started to pour down my face and I put my slipper back on because I haven’t been able to wear any shoes since 9/12/14. And I said I can’t believe what you just did. I come in the check my arteries and that’s what you do? Is this some kind of joke? I can’t believe you are going to get paid for an office visit. I was just here last week in the office getting an ultra sound to rule out DVT and this is what you call checking my arteries. Do I only have one artery in my right foot? And I walked out hysterical crying because no one is taking my problem serious. I know my body and something is wrong.
Regard from
Totally Devestated and Extremely Depressed and let’s not forget in unbelievable Pain

Donald Corenman, MD, DC
Moderator

November 7, 2014 at 8:26 pm

Post count: 8660

#11693

An intact pulse in your foot does indicate that there is reasonable arterial blood flow. A swollen foot and ankle could mean venous obstruction (the blood flow out of the leg) but that is unlikely with a posterior spine surgery. The ultrasound to look for blood clots was important to rule out DVT.

A swollen foot with pain could be an indication of RSD (reflex sympathetic dystrophy) currently called CRPS (complex regional pain syndrome). I do not have a description on my website but you could look that up on the internet. This could also be an injured nerve root (chronic radiculopathy).

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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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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