Help! Effectiveness of prior surgery without disc removal?

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texasspondy
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November 29, 2012 at 8:38 am

Post count: 25

#7497

Jaime, something you might consider. If or when you have exhausted other sources as local doctors or treatments is, that Dr. Corenman, sees patients from all over the world. An unhealthy back is a life of pain and misery as you are well knowledged by now on this subject.

I don’t work for Dr. Corenman, or get paid, or on his staff, but I too have spondy of the l5 level. It has changed my life the last ten years and drastically the last 15 months. So much research I have done on this matter that I actually flew a couple hours and drove a couple more hours to have a consultation with Dr. Corenman. No it wasn’t as convenient as a Spine surgeon across town but, you do have options. When my life will allow for me to take some time out to fix my back, Dr. Corenman’s hands will be the ones to do it.

Donald Corenman, MD, DC
Moderator

November 30, 2012 at 8:32 pm

Post count: 8660

#7504

I just saw a patient yesterday that fits perfectly with this discussion. She had a fusion surgery of L4-5 back in 1965. In those days, fusions were performed for many times, unreliable diagnoses. This fusion became solid (as did 60% in those days). This patient had a normal appearing disc at L4-5 (the fusion level) and degenerative discs at all the other levels in the lumbar spine. The fusion prevented loading of this L4-5 disc and preserved it.

Hopefully, these days a normal disc will not be fused (but there are some exceptions) but a fused level could demonstrate some degenerative changes over time. This is the exception however and not the rule.

If you would like me to review your films, please contact Margaret at 888 888-5310 to schedule delivery.

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.

Purduejaime
Member

December 25, 2012 at 8:13 am

Post count: 6

#7639

Thank you for all of your help so far.. As the spine surgeon I’ve seen has been of no help other than to get new films and generally upset me. The ct films and X-rays done showed a solid fusion, supposedly. I say supposedly because the radiologist report stated that I had a plif procedure when I very clearly have a disk remaining. I checked the films myself and it does look like a solid fusion, however of course I am untrained. So, I will be sending my films as you suggested, for review.

The surgeon that I saw said that although my disk has completely degenerated since fusion, it cannot cause pain unless there is movement in the fusion, which he said couldn’t happen since I have a solid fusion on films. Is this really true or can a disk cause pain even if not being applied force?

I’m very upset as I’m such a “young person” and I am in SEVERE pain at every moment of the day which has worsened a lot since being pregnant and giving birth to my son 14 months ago. The pain is very centrally located in my spine at the level of my fusion, as well as severe permanently spasmed muscles to the sides of my fusion, particularly on the left side, and they increased when I had an RAF procedure that was unsuccessful. Those muscle spasms initially did disappear for a few months directly after my 2002 fusion.

The spine surgeon also told me there was nothing that could be done for me surgically. If there is nothing that can be done to “fix” this, is there any way to have my nerves to that area permanently severed so that I don’t have pain? I’m willing to accept paralysis in exchange for pain relief from this debilitating problem.

Again, I’m sending my films CDs, and hoping there may be treatment as I’m not satisfied with ongoing narcotic treatment. The only time in 8 years that I’ve had complete relief is when I had an epidural and delivered my son.

Donald Corenman, MD, DC
Moderator

December 26, 2012 at 2:14 am

Post count: 8660

#7642

If the disc is fused, it would be unlikely that this disc is causing pain. I have seen unusual presentations of solid posterior fusion causing pain if the amount of fusion bone formed is minuscule but that would be the exception to the rule.

I will not assume that there is “nothing to do”. A work-up can reveal pain generators. If the pain generator is not amenable to surgery, there are other treatments (spinal stimulators and medications) that can 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.

Purduejaime
Member

August 13, 2014 at 4:03 am

Post count: 6

#11280

Thank you again for all of your responses and for giving me second opinions. I just wanted to follow up. I went back to my original surgeon who did a discogram which gave me a positive pain response. I had a new anterior fusion done with disc removal. The surgery successfully brought me back to my “baseline” of chronic pain, that I experienced prior to having my first child. My spine finally feels more stable in that area!

I have finally learned the “cause” of the problems I’m experiencing (spondylolisthesis, multiple shoulder subluxations, other joint issues) and am having genetic testing done to determine which type of Ehlers Danlos I have, as I meet the clinical criteria. Do you have any experience with this disorder? I still have chronic intractable muscle spasms in my spine, despite it feeling very well fused.

Thank you again for your guidance and your willingness to help people all over who you may never meet!

Donald Corenman, MD, DC
Moderator

August 20, 2014 at 10:32 pm

Post count: 8660

#11311

Ehlers Danlos syndrome is a collagen disorder where the normally nonstretchable ligaments stretch like elastic tissue. I do have ED patients in my practice and they do seem to have more myofascial (musculotendonous) complaints.

This disorder has to be managed but not cured. Strengthening activities, aerobic conditioning and medications like NSAIDS seem to help.

ED patients can have spinal degeneration just like anyone else and need to be monitored for these degenerative changes.

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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