A path to Fitness after spine surgery

Tagged: Post surgery wellness

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Coco
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May 4, 2017 at 1:26 am

Post count: 3

#24723

Dr Corenman I very much appreciate your site and forum for how helpful it is for so many ppl. Thank you in advance for that. I’ll try and keep it short and to the point.

I have a very sedentary lifestyle as I haven’t been released back to work now approaching 4 + years since my injuries onset. I am home 24/7 and have not much of a life, having lost a huge sense of purpose and an identity as a result of the process.. That said becoming more unmotivated and depressed as I approach 40 forced to recreate a new life, a new path starting over from scratch to find any purpose at all has been its own challenge.One I’m not complaining about, though seemingly so. I know how lucky I am and I’m grateful every day for my blessings and what I’m still able to do.. I think I’m just going thru a more recent rough stretch because my focus these 4+ years was solely dedicated on 1 surgery after another, 1 recovery after another, complications and ongoing recoverys to date yes but things have slowed down enough I’m left to process the lul I can’t even envision ever changing. and that sucks.. bc that’s not who I am or wish to be.. I think if my energy and motivation took form I might feel better inside and out, I might regain some confidence and allow myself to contemplate a life in some form. I could use some advice on what I should push myself to do and what I shouldn’t. Things to look forward too but with realistic expectations.. Hard for me. I’m an all or nothing type as a whole.

Anyway for the big surgeries:
1) I had an L4/5 ALIF 2.5 yrs ago and overall I’m really impressed with how well my back feels now in comparison to what it was pre surgery.. it’s not what it was pre injury but I can’t complain bc overall it went much better than I expected.. I get stiff allot and can’t be in any position for more than an hour without changing positions but all things considered I’d call the back surgery a success! I fully fused at my L4/5 1 year post op and now at 2.5 year mark just continue to improve..
2) My neck surgery has been a different story. I had a 1 level fusion c5/6 prior to this injury seems like 12 years ago.. it was a great success and only after the injury 4 years ago did my neck become a big problem. I had to have an ACDF from this injury and had to disrupt my c5/6 plate that was fused to the bone again going on a decade ago.. anyway, this ACDF hardware removal at c5/6 required we fuse levels c4- thru c7 with one plate. My neck surgery was 16 months ago and sadly it hadn’t recovered or fused like expected.. I’m using a bone stimulator and have done so for 3 months and have shown some improvements in bone growth.. it’s so frustrating but atleast some growth is better than it having remained unchanged. I’m hopeful at next follow up in 6-8 weeks we may have a more promising path to a fusion. I’ve had too much PT to be helpful at this point and clearly should wait until I’m further along in cervically fusing I’m sure.
My questions:
1) However, what are things I can safely do now that might help aid in my recovery and strengthening if anything? What things are definite No’s. ?
2) what things can I slowly incorporate or look forward too from an overall more active way of life in the near or distant future?
(I joined a gym but cancelled once I learned of the failed/ delayed fusion.. ) I’m just afraid being in my 30’s and living like my 90 year old grandma who’s in better shape than me isn’t going to improve if I sit and continue to be as sedentary as I’ve been fearful of not recovering as I further into a depression. Is there anything I can comfortably or confidently do without fear of hurting myself worse?

Donald Corenman, MD, DC
Moderator

May 5, 2017 at 4:25 am

Post count: 8660

#24726

You don’t describe your injury. It is helpful to know the forces involved with the accident and why you needed the levels above and below C5-6 involved in fusion. At 1 1/2 years post surgery, does the surgeon expect that you will go on to fuse these two levels as the odds are not great that fusion will be completed this far out? What tools are being used (CT, X-ray, MRI) to determine fusion? What are your current symptoms in your neck?

What has your surgeon suggested as activities at this point?

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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