Failed neck surgery

Tagged: Cervical Spine Surgery Failed

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Donald Corenman, MD, DC
Moderator

February 5, 2017 at 1:21 pm

Post count: 8660

#24280

Some problems you might not have been informed of. The fusion at C2-4 and then the fusion at C6-7 will increase the stress on the C4-6 levels. These levels were already severely degenerative (” C4-C5 with mild to moderate disc space loss. At C5-C6, severe disc space loss & hypertrophic endplate spondylosis”). This is a setup for significant further wear of these worn levels and the probably need for a fusion eventually.

The cervical kyphosis (abnormal forward curve which should be a backwards curve) is due to the degenerative discs which collapse and allow the kyphosis to occur.

Your report of the “Surgical procedure 1/9/2015: Corpectomy at C5 with extension and hopeful reduction of her kyphosis posteriorly. Requiring posterior stabilization with the placement of facet and pedicle screws at the C5-C6-C7 levels connecting them into the existing C2-C4 construct. Posterior decompression to to reduce slip. Plate removed at C6-C7 and lower plate at C4 to place Corpectomy plate anteriorly” makes no sense. Did this surgeon remove the entire C5 vertebra? Was it because of stenosis narrowing the spinal canal? Did he replace it with a graft (her own bone or donor bone)?

The “Radiology report. Patient is severely osteopenic. C5 vertebral body is not identifiable” makes me think there was removal of this C5 vertebral body without replacement but that would be highly unusual. Maybe he placed a graft that for some unusual reason fully absorbed but that is speculation.

He then took out the posterior screw that could have been irritating the nerve root but there is no report of a solid fusion.

Your wife needs a new opinion with an experienced spine surgeon, a through physical examination, new CT scan on a 128 slice scanner with 1mm cuts and a new MRI (probably on a 1.5 and not 3.0 tesla MRI scanner). She might need nerve blocks to identify the pain sources.

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.

MarieTaylo
Participant

February 5, 2017 at 6:31 pm

Post count: 13

#24285

Hi Dr. Corenman,
I’m Rich’s wife.
Since the revision, I’ve been told to see a “Wound Care Specialist”, “Physical Therapist”, “Dry Needling”, “TENS”, “Cognitive Behavioral Therapy”, “Pain Specialists.” Finally, I was told to see my neurosurgeon as the damage to my cervical spinal nerves is beyond the scope of the “Interventional Pain Specialist.”
I cannot return to the neurosurgeon. I need fresh eyes on a complex case. I need to be released from intractable, untreated pain.
I understand my case is complicated. I had to stop most of the medications that left me lethargic & depressed.
As you can imagine, we’ve been through everything with zero improvement in my situation.
We are going to a Major Medical Center this Thursday with the recommendations you posted.
I agree 100% I need a complete medical evaluation to determine the best medical treatment to pursue.
Do you provide the medical care that I require?
2 1/2 years ago, a single poorly planned cervical fusion disabled me.
I’ve been in intractable and untreated pain due to the new CDC/FDA/DEA regulations.
Certainly, I would prefer a non-pharmaceutical treatment and start a physical rehabilitation program.
I’m very concerned as my overall physical health has been parceled out to so many sub-specialities and I’m no better.
Currently, I can bathe (provided someone is home), dress myself and use the bathroom without assistance.
I was a healthy, active, registered Nurse, active in our community and had so much to look forward too.
Despite having adequate insurance and financial resources, I cannot find appropriate and timely medical treatment.
I appreciate all of your feedback.

Donald Corenman, MD, DC
Moderator

February 5, 2017 at 8:53 pm

Post count: 8660

#24288

I hope you find this new surgeon is smart and meticulous. If you want to come out to Vail, yes I do this type of work (50% of my work is revision surgery from out of town patients). Please keep in touch.

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.

MarieTaylo
Participant

February 5, 2017 at 10:22 pm

Post count: 13

#24292

Dr. Corenman,
Thank you for posting so quickly.
We’re in the MidWest area of the US.
The appointment on Thursday is for an evaluation and options available.
We’ll be in touch with the information gathered.
God knows, I would enjoy a trip to Vail. Even if it’s for medical care.
Thanks again,
MarieTaylo

Exames1934
Participant

February 6, 2017 at 3:11 am

Post count: 1

#24293

So sorry to hear that your wife is in great pain. Take her to a chiropractor, he can help you. I had a similar neck injury That treatment was very effective.

Donald Corenman, MD, DC
Moderator

February 6, 2017 at 7:22 am

Post count: 8660

#24295

Certainly this poster has another agenda. This patient would be contraindicated for any cervical manipulation. The entire neck is almost fused, there is a possible missing anterior structure (the C5 vertebra) which would place the neck in jeopardy with a manipulation and the pain generators have yet to be ascertained. Being both a spine surgeon and a chiropractor, I can certainly say this is not the place for a Chiropractor.

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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