HAVE PAIN IN NECK NOM

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Big nerve
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September 6, 2011 at 10:08 am

Post count: 11

#4858

Hi doctor
I have been on forum previously and you have been very helpful with your answers and thank you very much for the service you provide well i will start with i had decopression surgery on L5 s1 nerve on the 19/5/11 and i am still having massive problems my phsio thinks i might have adhesive acranoiditis because of the way i describe the pain and on my last mri it says there is some clumping of the nerves my other problem being at the moment is that i have a very sore neck and that i get numbness and pins and needles in my left pinky finger and half of the one next to it not constant but very often also my right hand goes numb and pins and needles all over i was wondering if you could let me know what you think it could be thankyou doctor

Donald Corenman, MD, DC
Moderator

September 6, 2011 at 1:33 pm

Post count: 8660

#4859

Arachnoiditis in the lower lumbar spine will not cause neck pain and arm symptoms. Why did you have L5-S1 decompression surgery? Did the symptoms get better after surgery or did they get worse? Have the symptoms changed? What did your surgeon say about your symptoms? When did your neck and arm symptoms start?

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.

Big nerve
Participant

September 6, 2011 at 2:43 pm

Post count: 11

#4860

I had my first surgery approx 14 years ago on L5 S1 it was laciectomy and had been pretty good unless i did something that i should not have been doing but on the whole pretty good just every now and then i would have pain then at the end of march 2011 i lifted a keg of beer which was wedge then after that i got pain in lower back also in my buttock as well as my left leg my symtoms have got worse since surgery because the pain is in all different places and it just does not let up and with all that my neck is killing me.He looked at my mri before surgery and after surgery ang said that the disc looked irratated which might mean that there is a infection there he said that there was clumping on the first mri but there was more now but he does not think that it is a problem because it was clumped before and i did not have any trouble i first started to get neck pain approx 3 weeks after surgery but was not that bad just thought it was the way i slept but it is getting worse and the numbness in my fingers is getting more frequent some times i think i am in one big bad dream this has been going on too long i have 3 kids and i need to get back to work i hope i have answered the questions correctly sorry for the long story and again doctor thanks for this great service you provide

Donald Corenman, MD, DC
Moderator

September 6, 2011 at 9:03 pm

Post count: 8660

#4863

Please slow down to describe your history.

14 years ago you had your first laminectomy at L5-S1. You did well until March of this year when you lifted a keg of beer. You developed back, buttocks and left leg pain. You apparently had surgery again- I will assume another decompression laminectomy.

Your symptoms became worse and changed after surgery. By your description, the original symptoms intensified and new symptoms developed. Forgetting your neck symptoms at this point- did any new symptoms occur in your lower back, left leg or right leg? Do your back and leg symptoms become worse with standing or sitting? Do you have new pain in your right leg? What is the ratio of pain in your back to pain in your leg? Is your back pain worse than your leg pain in a 60/40 or 70/30 ratio or is it reversed?

The surgeon stated to you that there might be an infection present. Did he work that up to disprove it or could there still be an infection present?

The clumping of nerves in the spinal canal is from arachnoiditis. The surgeon identified arachnoiditis before your March 2011 surgery and thought that it was not causing problems. Does he now blame the arachnoiditis for your current symptoms?

You developed neck pain and arm paresthesias 3 weeks after your latest lower back surgery. Most likely your neck symptoms are from a problem in your neck and not related to your lower back. These symptoms could have developed from a preexisting problem that just surfaced, an aggravation of a problem from the intubation during surgery (preexisting foraminal stenosis that was aggravated by the extension maneuver necessary to intubate your trachea), or something else. There is an extremely rare possibility that if you did have an infection in your lower back disc, you could have seeded your neck with a new infection.

What does your surgeon propose as the next step?

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.

Big nerve
Participant

September 6, 2011 at 10:51 pm

Post count: 11

#4865

Thank you again doctor for taking the time to answer my questions as am very worried with what is going on yes it was a decompression laminectomy that i had in may of this year yes my symptoms did become worse after surgery i get pain in my right calf and right buttock and right thigh and also my left toe goes numb as well as my right toe but not at the same time and my right thigh goes numb as well and my lower back is sore both sides ican not sit for to long because i get really sore in my lower back also my toes go numb and i can not stand for to long because my left or right buttock gets a ache in it 50/50 i just seem to have pain constently no i am having a test tommorrow i think it is called a nuclar test he did say he does not think there is a infection but just wants to elimanate it No when i ask him about arachnoididitis he said if i had no problem with it before that he does not think it would cause a problem now even though they are more clump now sorry doctor i am not very good at explaining things and being in pain i just seem to rave on and on thanks doctor for answering my questions you do help alot

Donald Corenman, MD, DC
Moderator

September 6, 2011 at 11:15 pm

Post count: 8660

#4867

You now have both increased left and new onset right leg pain after a decompression surgery of the lumbar spine. The differential includes recurrent herniation, lateral recess or foraminal stenosis, instability, infection, chronic radiculopathy, aggravation of arachnoiditis or iatrogenic injury. (see website for explanation of all diagnoses)

Have your surgeon go through the various possibilities. There is an answer and with careful workup, the answer can be found.

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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