Arachnoiditis

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Angel
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May 18, 2013 at 10:18 am

Post count: 2

#8701

My 41 year old son diagnosed with arachnoiditis from being given eight epidural injections of depo-medrol in one day. After waking up he was in excruciating pain and has progressively gotten worse each day since January 2013. Very few doctors know about arachnoiditis. No pain medications help this condition. What hopeful suggestions can you give.
His medical doctor never heard of arachnoiditis. She gave him pain medications like, gabapentin, elavil, for depression, morphine, however, my son every day gets progressively worse with painful paralysis and burning in his bladder, jolting and burning pains in his body and feels very hopeless, as he was very happy doing personal training. He feels his whole life is over.

I told him to keep praying and that God would bring healing to him and not give up.

Can you please give us any insight as to what to do? Thank you.

Donald Corenman, MD, DC
Moderator

May 19, 2013 at 2:58 am

Post count: 8660

#8704

I am unclear why eight injections of an epidural steroid were performed. What was the reasoning?

Arachnoiditis can occur from intradural injections (epidural means above the dura and intradural means inside the dura). If the injection inadvertently was placed inside the dura, arachnoiditis can occur.

The reason why these injections were necessary begs the question as to why he needed them in the first place. What was his diagnosis that necessitated these epidurals?

Arachnoiditis cannot be cured but can be treated using medications and stimulation (spinal or peripheral nerve stimulation).

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.

Angel
Member

May 19, 2013 at 8:46 am

Post count: 2

#8708

It was all about money. He gave my son extra injections, 4 facet, and 4 epidurals. The doctor wanted to get paid by the insurance with the 4 epidurals. My son’s case is truly a tragedy. He thinks a spine stimulator is not that successful according to many people. He lives in constant pain. He is too ill to help is sister with a lawsuit at this time. I always tell him God will bring help. Thank you. Kathy (a very concerned mom)

Donald Corenman, MD, DC
Moderator

May 19, 2013 at 11:35 pm

Post count: 8660

#8715

Even if you think these injections were financially motivated, there still has to be some indications as to why this doctor completed these injections. What was the suspected diagnosis that this doctor used to indicate these injections?

Spinal cord stimulators in the right hands can be very helpful. Unfortunately, there are many individuals that are adequate but not expert in these devices. If you find someone who has great experience and is meticulous, the results can be much better.

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.

webbal
Member

November 13, 2013 at 9:56 pm

Post count: 1

#9786

Hello Dr. Corenman

I am 26yrs old and I’ve recently been diagnosed with Arachnoiditis. After experiencing sudden numbness from the waist down, I was taken to A&E. The MRI scans showed evidence of the disease and was able to see the individual nerves bunched together at the L4/L5 point. I have had a previous discetomy at the L4/L5, at the age of 23yrs on May 2010.

I’m trying to find out how serious my condition is likely to be; how probable it is to be progressive and what life changes should I make or think about ( i.e. would it be sensible for me to have kids; would I still be able to look after them after giving birth, would I be able to pick them up?). Those in the same position as me, what sort of lifestyle do they have? (Are they living an active lifestyle or bound to certain restraints?). Has anyone with this disease been able to go through labour without serious complications and has it had any impact on their condition, lifestyle? How frequently do the nerves flare up and how long do the symptoms last for? I understand that the condition varies from person to person, but someone in a similar situation as me; relevant information would be very useful in order to make very important life decisions.

Reports and analysis taken by radiologists and by the Neurosurgeon (August 2013)

Previous L4/5 discetomy May 2010. Little postsurgical change. No evidence of any significant recurrent disc or scar tissue causing nerve root compression.

L5/S1, minor central disc protrusion which is indenting the thecal sac with caudal extrusion where it appears to be abutting the traversing left S1 nerve root in the lateral recess. No significant change in the previous images of 2010. No new compressive disc lesions. The neural foramina are patent throughout.

Normal cord, conus and cauda equine.

Conclusion: No recurrence of the L4/5 previously large compressive disc. There is a unchanged central mild L5/S1 disc protrusion which indents the thecal sac and abuts the traversing left S1 nerve root in the lateral recess.

On an MRI scan which was perfomed by us there was no recurrence of the disc but a small bunching of the nerves suggestive of an arachnoiditis. Small dose of Dexamethasone for 3 days followed by Diclofenac. Has evidence of arachnoiditis on the MRI scan which can flare up time to time.
I would be grateful for your time and effort to help me understand my condition well and be able to accept whatever the outcome maybe. I know there are many others who are suffering to a great extent and have immense courage to be able to face the world and carry on battling with this hidden disease, not only does my heart goes out to them but gives me hope that I may also be as brave as them.

Yours faithfully webbal

Donald Corenman, MD, DC
Moderator

November 14, 2013 at 2:36 am

Post count: 8660

#9792

Arachnoiditis can occur after spine surgery as it can after a number of events. See the section on arachnoiditis on the web site.

Normally, arachnoiditis symptoms occur with a slow onset and are chronic. It is unusual for flair-ups and remissions although I have seen that on rare occasion.

I assume your arachnoiditis is located at L4-5 where your prior surgery was. Numbness from the waist down does not fit the symptoms expected for this disorder unless in the unlikely event that the root clumping is located high up in the lumbar spine.

Numbness at the waist level would start with the L1 and L2 nerve roots. Again, assuming this arachnoiditis is at the L4-5 level, the L1 and L2 roots would not be involved. I would have a neurologist work with you to determine the real diagnosis is.

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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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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