Ancient back injury not diagnosed properly.

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April 4, 2013 at 5:00 am

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#8343

Dr. Corenman, I was in ahead-on collision in 1971 (no seat belt or airbags back then.) On impact I tried to hold onto the steering wheel but inertia flung me towards the passenger side and ad I gripped tightly with my right hand my body whipped backwards and my buttocks crushed the glove box on my 57 Chev. My lower back impacted the curved dashboard so hard that the dash (metal was bent inward and where it molded into to the side of the vehicle the metal tore loose. My upper back/head hit the windshield cracking it. I ended up sitting in the passenger seat facing towards the driver’s window. My back was on fire and spasms were so bad I couldn’t lay myself down. I have less painful spasms today.

The emergency room found nothing wrong with me and I was released…several people had to place me in the car. The police had to carry me from the car to my home where I laid for three days and my stomach swelled. I have no memory of this…but my wife found a doctor to admit me and he diagnosed a broken 5th lumbar vertebrae. two broken ribs (right side), and a damaged 6th intercostal nerve. I wore a “corset” for some time and after “recovery” continued to have spasms in my lower back, upper back, and when I lifted my right arm to shave I had terrible sharp pains in my ribs (from front to back).

A second doctor performed a “milligram” and found a herniated disc. A chiropractor showed me an x-ray clearly displaying fully formed “6th lumbar vertebra”. (I have a long torso). Twenty years ago a young orthopedic surgeon showed me little white specs on back x-ray declaring I had arthritis and should stops skiing, riding my mountain bike, and roller blading. I changed doctors and today, at age 65 I still bike ride 15 miles a day and roller blade twenty miles once a week in the summer.

Back then I turned down surgery for the disc but ask for surgery on the 6th intercostal nerve. The surgeon passed saying he would not know where to cut. I’ve lived with the pain. At its worst I was in the floor and couldn’t move because of muscle spasm and sharp pain. Over the years the pain has subsided tremendously but today I still have that chronic dull pain in my lower back which s more bothersome if I am inactive. When I sit for hours my mid back “fatigues and it’s hard to sit with good posture. I slouch to be comfortable and relieve the aches.

I don’t feel pain going down my leg..it’s a dull ach in my lower back right at my hips. I feel if I could stretch that area I’d get relief! I do get relief hanging from my inversion boots but nothing relieves the muscle fatigue I get in my middle spine. I recall sending a MRI to a specialist in CA who did minimally invasive arthroscopic surgery and when he phoned he was surprised my mid/upper back wasn’t causing as much pain as my lower!

I stretch/move from side to side (in my chair) to crack my back and that gives some relief but the fatigued/aching feeling doesn’t leave.

My layman’s opinion is that in addition to the injuries diagnosed, I hyperextended by vertebra and the total damage was not diagnosed or treated. Except for having some arthritis at every joint I’ve broken in my life (no debilitating pain from arthritis and no meds for arthritis). Today the pain is not as bad as years ago but I am older so want to correct any injury I can so it’s not an issue as I age. I plan to build a “reverse hyper” machine that lets me exercise my back/hips/hamstrings by swinging my legs. the movement stretches and strengthens. I lift weights but don’t do any training that compresses my spine. For example I do “belt squats” where the weight is supported by my hips…not my spinal column.

Based on the nature of my accident and the symptoms over the years, do you believe there is anything medical I should consider for treatment at this late date? Also, would you recommend any type of corset/brace to hold my back and provide support so I don’t “fatigue” from sitting? I though a corset type back support might be beneficial while working out.

Oh, on rainy/chilly days I also get muscle spasms moving around in bed.

Thank you.

Donald Corenman, MD, DC
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April 14, 2013 at 9:01 am

Post count: 8660

#8422

You symptoms could be generated by disc pathology, facet pathology, unhealed fracture (pars or facet fracture) or by chronic radiculopathic pain (rare). You need a good workup by a spine surgeon to determine what can be treated with conservative management or by surgical intervention.

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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