Back pain and Lumber area

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gmschumacher
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May 14, 2012 at 11:46 pm

Post count: 3

#6205

Message:
Dear Doctor, I am a 44 year old, male,weight 90kg, 5’9″. Have been getting lower back pain some times on the right and at times on the left, just above the buttock. Had a history of stones two years ago. The pain at times is sever and am forced to take a pain killer. The pain then dispersers after a few hours (it comes from time to time, at times after a month). Saw an Orthopedic Doctor who wanted me to do an xray,which revels nothing. Then he recommended an MRI Scan of the Lumbar Spine. Comment on report: L5/S1 level-Annular tear is noted in the L5/S1 disc with minimal posterior bulging. No evidence of nerve root compression. I used to be physically active, visit the gym often, now whenever I start exercising within 10 days pain returns and am forced to stop exercising. I do not use weights,mostly treadmill,rowing and stretching. I do a desk job (Admin/HR) by profession. Currently I do not have a back pain,except in the upper back area between the shoulder blades, when I want to sneeze and try to take a deep breath-I get a huge pain and am unable to properly sneeze. On waking up in the mornings back feels stiff,at times turning in bed also causes pain. Would appreciate if you could advise on what could be the problem. and recommended exercises to strengthen lower back. Thank you for your time. Kind regards, Glen .

Donald Corenman, MD, DC
Moderator

May 15, 2012 at 9:13 am

Post count: 8660

#6211

I am confused by your description of your pain. Do you have intermittent lower back pain and intermittent thoracic pain? How often does the pain occur? To what intensity? Where is the pain and does it radiate? How has this pain affected your job or home life? Give me a history of your disorder.

Many questions to answer.

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.

gmschumacher
Member

May 16, 2012 at 2:02 am

Post count: 3

#6217

Dear Doctor, yes the pain is intermittent and has been for the past three years (used to occur once in three weeks). At that time the pain is to occur in the lower back area only,at times on the left and at times on the right. I was later diagnosed with stones in the bladder area, which I passed. The back pain as advised by the doctor at that time could have been due to this reason. However a few months later the pain was back. The pain is at times severe, find it difficult to bend or walk, I take a brufen(400mg),a couple of hours later the pain is gone and does not occur for a couple of weeks.

I used to exercise quite a lot,concentrating on the lower back area, mainly to balance the ab exercise. These were done using light weights or just body weight. I still do,mostly on the treadmill now and some stretching, when the pain returns I stop for a couple of days.

During the past month I have been getting the pain once in 10 days or so. The reason I saw an orthopedic doctor,who got me on a bed, bent my knees,stretched my legs, got me to point my toes towards my chin whilst laying face up and legs fully stretched, etc. and checked if there was any pain in the back, to which there was not at that time. Finally did an Xray which did not show anything, I was then asked to do an MRI. These past two weeks, I find a pain in the upper back region,between the shoulder blades when I want to sneeze,the moment try to take a deep breath I get the pain and cannot sneeze properly, I now have a slight cough as well.

My job involves sitting for long periods at the computer, when I get up i have some discomfort in the lower back region. The pain does not radiate. Getting up in the mornings, I find the whole back stiff, turning in bed causes some pain in the buttock area when the back pain is present. On days after exercise I find my back is fitter and no pain. I used to sleep on the floor, using a thick quilt, as I had read a flat surface is good for the back, however when the pain really got bad I started sleeping on a bed and this has reduced the pain.

Hope I have been able to answer all questions.
Thank you for your time.
rgds/glen

Donald Corenman, MD, DC
Moderator

May 16, 2012 at 6:06 am

Post count: 8660

#6219

By the sounds of your lower back symptoms, a good rehabilitation program should help you. Ask your physician if she or she can refer you to a well known therapist.

In regard to your thoracic pain, this is new and sounds like it could be a rib-vertebra articulation. If that is the case, chiropractic manipulation might help.

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.

gmschumacher
Member

May 16, 2012 at 9:31 am

Post count: 3

#6220

Dear Doctor,Thank you for your valuable advise.

Darryk
Member

May 16, 2012 at 11:21 am

Post count: 1

#6221

I was told today that I have to have L5/S1 Laminectomy TILF procedure and i was wondering do they take the hardware out after the bones fuse, or do they leave it in?
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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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