a long trip

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exercise453
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March 25, 2012 at 1:53 am

Post count: 53

#5842

Hello Dr Corenman,

I can see myself traveling 2000 miles to see you for a diagnosis and have direct questions to determine its possibility and practicality
and even what you think about it.

If additional testing is needed are they expedited for someone on the road? How much time do you actually get with Dr Corenman? Do you personally do the history and examination? Can you get a followup visit for the inevitable questions the next day? Can you give an approximate number as to how many cervical surgeries you have performed in the last year? 2 years?

My concern is that after such a journey one might receive the same rush you could surely get in your own town due to the hectic schedule doctors have, especially elite doctors.

This response you wrote verbalizes the fear I have versus the desire to get in a room with you for an hour (or two)

Re: cervical spine and MRI ‘early cord flattening’ 1 month ago #1300
“Your experience regarding the time taken for physical examination is sad but not unusual. It even happens here with pay for service.”

Can u you explain and provide any insight for those entertaining a trip to Vail.

I admire what you are doing…thanks

Donald Corenman, MD, DC
Moderator

March 25, 2012 at 3:11 am

Post count: 8660

#5843

Travel to visit the clinic and see me is quite common. We have services to help with accommodations (“Here to help”- call my nurses for contact information) and information regarding transportation.

The clinic has its own 3.0 Tesla MRI machine and the hospital has a 64 slice CT scanner and another MRI. If diagnostic injections are needs, there are three very well qualified interventionists who can accommodate injections at the last minute.

Between my PA, Eric Strauch and myself, the typical history, physical examination and explanation of the disorder with viewing of the X-rays and MRI or CT takes about one hour. I never rush a patient as I understand that your knowledge of the disorder takes precedence. If you are coming out for potential surgery, we have to know more about your disorder before your trip.

I perform between 350-400 surgical procedures a year and one third of those are cervical.

If you have further questions, please call my nurses Diana and Sarah for further information at (970) 476-1100.

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.

exercise453
Member

April 2, 2012 at 2:13 am

Post count: 53

#5936

Hello again Doc,

I do not understand the loss of motion with single and double ACDF. So much is trumpeted about motion sparing techniques but you suggest that surgical skill, not choice of surgery is most important. Just what are the motion and other long term consequences of a successful fusion and do the levels matter?….vs posterior.

What is the importance of a positive, year old and a repeated (current) emg test showing +1 fib and +1 psw at at c4-5 paraspinal, a painful neck level. (posterior disc-osteophyte complex with mild narrowing of the spinal canal and moderate bi-lateral neurofaraminal stenosis). Only one side is symptomatic. The deltoid is smaller than the other side but the shoulder and rotator cuff have suffered earlier traumas. Muscles are strong. Cord is fine. There is more neck than arm pain 70-30. Also when an ACDF relieves the pressure on the canal will the neck pain reduce or vanish?

The nerve test also was positive at the bicep. Can this be verification of c5 or is c6 positive as well?

I notice that as the legion of “coren ites” grows our medial jargon improves. Your generosity aside, does it not speak to the state of our medical system or the rampant, earned distrust of their own doctors that has 1000’s turning to Dr C.

Thanks

exercise453
Member

April 2, 2012 at 2:28 am

Post count: 53

#5937

Doc
Want to add, the smaller gimpy, protected side deltoid injury history is 6 years old. The neck issue from a jogging fall is 5 years old….strength is excellent, tingling, parasthesia is felt

Donald Corenman, MD, DC
Moderator

April 2, 2012 at 6:12 am

Post count: 8660

#5940

Positive EMG testing at the paraspinal muscle level is generally not significant unless there is concern about Parsonage Turner syndrome (not your problem). The use of EMG in the cervical spine has applications, but not in your situation. If the nerve test was positive at the biceps, this indicates the C6 nerve is involved.

If muscles are strong (and you have tested all pertinent muscles), then root compression is not a great concern. 70/30 neck to arm symptoms means that most of the pain is generated by the disc or facet. Have you had a facet block? Facets generally generate about 30% of the neck pain that patients exhibit. If the block is positive, you might be a candidate for a facet rhizotomy.

If you are looking at surgery, an ACDF is the procedure of choice for neck pain. The surgical levels are generally obvious by X-ray and MRI but if there is some concern for level choice, a discogram by a meticulous injectionist is warranted.

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.

exercise453
Member

April 3, 2012 at 5:10 am

Post count: 53

#5945

Hello again,

I have had c2-8 rhizotomy. The total effect was minimal. I am 63 and athletic. I suffer from a combination of chronic symptoms and levels stemming from a jogging fall and trauma doing an incline bench press five yeas ago. My appearance belies my age, and functionality belies my pain. Further elaboration on the board would unfairly consume your precious time.

You say a positive emg at cervical paraspinals is not terribly significant and positive at the bicep involves c6. So I understand, if the bicep (or another muscle) shows the same +1 fib +1 psw as the paraspinal but has full strength, then the root compression affirmed
by emg is not significant? Muscle strength and function overrule emg at all muscles?

You say 70-30 more neck pain indicates disc or facet…its not facet. I have posterior disc & spurs (along with lateral) encroaching the canal but no cord compression. Does this mean the neck pain comes from the disc and/or spurs pressing nerves within the canal, not the disc material itself?

You have mentioned cervical epidurals several times. If they give effective relief for a couple of months in chronic pain management cases how many of these do you consider safe each year in the hands of a board certified anesthesioligist? Are they equally effective for arm pain and neck pain?

Thanks again doc

PS (those excellent one liners “the bone is probably intact in your head” in anatomy and motion of the cervical spine and “you can’t ask your mother to stand up straight” in a tv interview, did not escape me)
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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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