Coflex Implants still in pain?

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Mango
Member

April 9, 2013 at 12:12 am

Post count: 4

#8375

Hi I am new here but not new to spine issues I have had three surgeries One in 1995 Lam at L5-S1 with great success until four years ago now with DDD four levels. Herniation L4-L5 2009 surgery Micro Disc re herniation six months later. I have seen several Spine Docs lots of suggestions ADR replacement to four level fusion and fusing S-I joint. I had surgery June 2011 with decompression,Two Coflex implants at L4-L5 and L5-S1 now still low back pain Left leg weak and lots of numbness? Currently taking Lyrica and celebrex seems to help me get along.
The last surgeon i visited suggested to remove the implants and to do a fusion at two levels I asked about the other levels above the fusion witch are not great and his reply was ” yes we may have to do those in the future”

Mango

Donald Corenman, MD, DC
Moderator

April 9, 2013 at 1:24 am

Post count: 8660

#8376

You have to coorrelate symptoms with pathology to understand what needs to be addressed. See the section under “How to describe symptoms” to explain what problems you are having.

The coflex device is a good idea but it is not effective for many pathologies. Used in the wrong circumstances, it does not work. Even in the correct circumstances, it can erode into the bone or create a change in center of rotation and create new pain.

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.

Mango
Member

April 10, 2013 at 12:15 am

Post count: 4

#8387

Hello

Thanks for the reply.

Back pain 80% leg pain left side 20% Pain is worse in the morning, Stiff better with movement and Celebrex pain level 7 Some times I am crooked to the left with extreme pain shooting, stabbing in the lower back with increased leg and foot numbness.hot shower Ice and rest helps.
My pain levels increase with activity, walking for 1//2 mile in OK any longer and my left leg does not work as well?
Back Pain 7 VAS
Left leg pain 3 VAS
Right leg pain 1-2 VAS
Left leg weak, left heal numb sometimes burning,tingling, outside of foot burning that come and goes.Cannot stand on toes.
Right leg cannot walk on heal foot drop since L4-L5 herniation seems to slowly get better.
My pain is 24-7 with flair ups to a pain level of 9 rest and Drugs with ice helps me manage.
MRI results 12-5-2012 L2 to L4 broad base disc buldge, endplate spuring… .There is some enhancing scar anterior to the thecal sac at L4-L5 and adjacent to the left side of the thecal sac and arround the left S1 nerve root at L5[S1…
Groin has some tingling that come and goes?

Occupational Restrictions I have not been involved in construction since my injury, now driving a school bus two hours in the am and two hours in the pm this is good on most days, but some days it can be very painful! No longer able to exercise, play sports, ride my bikes, hike,climb, ski, etc I am 53 and have a 13 year old son that I need to be involved with in activity this has been the most fustrating

Treatments, “Been there done that” PT for two years three times a week some help, Message, accupuncture, Chiropractor, Yoga, Pilates,
ETC all with no help some minor relief.

Can you help me/
Thank You for this great site and information

Gil
Jackson Wyoming

Donald Corenman, MD, DC
Moderator

April 10, 2013 at 5:50 pm

Post count: 8660

#8391

The Coflex implant is not designed for the treatment of lower back pain. It is a device that sits between the spinous processes and induces flexion of the vertebra. Flexion of the spine will load the discs. If the back pain is generated from the discs (as it typically is), then this device will increase the load on the discs and increase lower back pain.

You have concerning weakness of both the L5 and the S1 motor groups (see section under “nerve injuries and recovery” on the website for further explanation. What you need is a back pain workup from a thorough spine surgeon who can also explain why you have weakness.

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.

Mango
Member

April 10, 2013 at 10:57 pm

Post count: 4

#8395

Hi DR Corenman

Because of the travel distance would you consider doing the spine work up? I could send you my latest MRI, XRays, CTscan etc… and start this process before i can make the journey to Vail?

Thank You

Gil Denis

Jackson WY

Donald Corenman, MD, DC
Moderator

April 11, 2013 at 4:15 am

Post count: 8660

#8396

I have a program for long distance consults that is currently free but in the next month will require a fee. You can call 888 888-5310 for more information.

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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