degenerative disc bulge L5/S1

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Anila
Member

September 19, 2012 at 7:18 pm

Post count: 13

#6978

Hello, dr. I’ve been through many treatments regarding this problem. I’m having it for the last 7 years. My age is 37. My weight is 90kg. How can I get rid of this pain. Do i need laser treatment, surgery or any other technique. Please suggest me which is the best method for the treatment of this disease.
Thanks.
( I am flight attendant but now on bed due to this pain. Kindly help me.)

Donald Corenman, MD, DC
Moderator

September 19, 2012 at 8:06 pm

Post count: 8660

#6979

I need more information regarding your disorder. Please see the section on the website under “Conditions”/ “How to describe symptoms” to fully convey what your symptoms are and how you were diagnosed.

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.

Anila
Member

September 20, 2012 at 9:44 pm

Post count: 13

#6980

Location And Quality of Pain:
Pain started from the coxes lower end of the back and radiate in leg and lower back. Quality of pain is like injury or swelling.Quality of Pain changes (increases) with activity and no skin color changes when touched.

Percentage of Pain by Location:
Pain originates from lower back and radiates in left leg and back and pressed the nerve root. 80% back and 20% leg. Severe pain in posterior and in coxes.

Intensity of Pain:
6-10-VAS- for 2 years. Lower back 5-6 and leg 2-4. Very severe pain like injury.

Weakness:
Yes, muscles are weak due to pain and always cramp occur in muscles.

Onset and length of Time symptoms have been present:
Pain started 7 years ago and gradually increased. I cannot sit and cannot stand even for 2 minutes. I feel most pain while sitting and standing.

Activities:
Activity causes severe pain in lower back and hurts me sitting and standing and bending towards. I cannot walk more than 20 minutes. Not mild pain rather severe pain in activity.

Pain intervals:
I never free from the pain in the day. Only feel relief lying in the bed straight. And I felt little bit better after physiotherapy only for one to two months but after that it came back to its original intensity.

Activity and Occupational Restriction:
Pain has changed my life. Every activity has been ended. I am on bed for the last 6 months and I am bearing this pain for the last 7 years.

Diagnose:
MRI Recent report 7 days ago is:
Degenerative Disc Bulge L5/S1 in the small posterior.

Liability:
No Liability of any corporation. A forceful impact occurred during plane landing. And after 3 years I joined gym. Then I got into this severe pain.

Previous Consultation or Treatment:
Within 7 years I’ve had many treatments but all were useless. Recently, Dr. advised me physiotherapy and some simple painkillers. And suggests me that you need no surgery but even after all these experiences I couldn’t get rid of this severe pain at all. I am very much disappointed. So, I am sending you my full history.
Kindly, Dr.Corenman help me getting rid of this pain.
NOTE: My pain is like needles are hurting/knocking inside me.
My nickname is Anila.
My real name is Attiya.
Previous Profession: Flight Attendant.

Donald Corenman, MD, DC
Moderator

September 22, 2012 at 10:56 pm

Post count: 8660

#6995

Your pain seems to be focused in your lower back with some radiation to the legs. Your MRI notes degenerative disc disease at L5-S1 with a bulge at that level. You do not describle the severity of the bulge nor the quality of the degeneration of the disc at L5-S1.

Your pain could very likely originate from this degenerative level. With years of symptoms now confining you to bed, you would do well to obtain a workup by a spine surgeon. This might include discograms and even selective nerve root blocks (see website for explanation of these). You might be a candidate for a fusion.

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.

Anila
Member

September 24, 2012 at 11:56 am

Post count: 13

#7005

Thankyou for your reply Dr. But the problem is that there is no fusion surgeon in my country. So what can I do to come to USA directly to see you? Is it possible that you send email to the embassy. If you need any other information regarding my disease (MRI reports etc) then I can send you these by email. Many times I visited USA when I was flight attendant. But I never visited any doctor there regarding my disease. So, can you help me coming to USA to get checked personally by you.
Thanks.
My real name: Attiya S……
“Anila” is my nickname.

Donald Corenman, MD, DC
Moderator

September 24, 2012 at 8:46 pm

Post count: 8660

#7007

You can travel here to have an appointment but a full workup is in order to determine if you are a candidate for surgery. In your case, this might take 3-4 days and I don’t want you to be disappointed if we find out you are not a candidate for this surgery. Contact Margaret at the 888 number at the top of the home page so we can do some preliminary work.

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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