Help needed to understand my situation

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Susan117
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September 13, 2014 at 10:54 am

Post count: 18

#11412

I went to the new doctor who ordered a complete bone scan from head to toe after seeing my most recent cervical MRI and lumbar MRI results. He was concerned that there was no concern or follow up offered by the previous surgeon for my L4 segment, which shows pretty significant degenerative changes and the most problems. Plus there are concerns about the L5 fusion. For my cervical concerns, he was concerned that there was no follow up since my MRI showed “possible metastatic disease at C5” and the radiologist recommended a bone scan as immediate follow up back in July :/ I wasn’t told anything at all about the results at my follow up appointment….just that I had a possible hemmangioma and it was nothing to worry about.

Happy to have found a doctor who is concerned enough to do what it takes to see what is going on and not tell me that all I am experiencing is “sympathetic pain” and nothing is really wrong with me ( which may be true but it is best to find out)!!! I go back for the bone scan results next week. I will follow up with the forum then! Thanks again for all you do! I have enjoyed your Facebook posts as well!

Donald Corenman, MD, DC
Moderator

September 14, 2014 at 4:29 am

Post count: 8660

#11413

You have found a good surgeon who will follow through. Let us know here what the results of your bone scan and further plans for your spine.

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.

Susan117
Member

October 25, 2014 at 1:57 am

Post count: 18

#11589

Dr. Corenman,
Sorry it has been a while since I have followed up. Since my bone scan, I have received the results. Good news for me…the place of concern in my C5 is not cancerous but will be watched to make sure it doesn’t grown or migrate. It was suggested that I have another bone scan in 6 months or so. The bone scan report says “multiple area of irregular increased uptake seen scattered throughout the lumbar and thoracic spine. Consistent with postoperative and degenerative changes with photopenic defect also seen consistent with instrumentation. There is focal increased activity at the cervical spine level consistent with C5 vertebral body lesion. Follow up with CT scan to evaluate degree of calcification and trabecular architecture to discriminate between a benign sclerotic lesion or other etiology.” A CT has not been mentioned at all or done for me. The new doctor, a physiatrist …not a surgeon, also has given me a shot in my Si joint to help with some of my pain. It has helped but I still have the lower back pain and leg weakness…..now I also have big toe burning/breaking pain and terrible muscle spasms and bad cramps/pain from my hip to ankle on my right side. I went back to he physiatrist for follow up after the shot and he told me that because of the instrumentation, he would not be able to inject my lumbar spine and that there is nothing more he could do for me. He ordered physical therapy and I just finished 8 weeks of that.
Do you have my suggestions/ advice as to how I can find a doctor who will do the necessary tests to determine what is going on? I feel like I am at a dead end with no one willing to help. I do not want to take pain meds for the rest of my life or wait for something major to happen to me before someone takes this seriously!

Donald Corenman, MD, DC
Moderator

October 26, 2014 at 12:34 pm

Post count: 8660

#11594

It appears that a CT scan of your lower back might be in order. You might not have a complete fusion (pseudoarthrosis) or that Bartolotti’s syndrome segment might be moving enough to cause pain at this level. A fusion down to the sacrum that is solid can occasionally cause sacroiliac pain. SI injections can diagnose that condition.

Was your leg weak prior to the last surgery? If not, was there a nerve injury during surgery or a stretch of a nerve?

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.

Susan117
Member

October 26, 2014 at 8:48 pm

Post count: 18

#11596

Thanks again for the reply! Can my family doctor order a CT? I believe he would do it if I asked.

Yes, my legs were weak before surgery but not this bad and I feel like that is getting worse….wake up with cramps and spasms,. My feet, ankles, toes, calves hurt upon first standing in the morning, etc. I have lost total feeling in the outside left hip area since surgery and the top of my right foot….I never got feeling back in those two areas after surgery. I have had a left side SI injection and it has helped but my lower back still hurts on a 7-8 out of 10 level without meds….4-5 with meds. I worry about the use of Medtronic Infuse bmp also (Which was used in my surgery and I know it is a questionable product with some pretty bad side effects). Do you think that could be causing any of my problems?

Donald Corenman, MD, DC
Moderator

October 26, 2014 at 10:03 pm

Post count: 8660

#11599

I use BMP on almost all of my fusions so I know it is a great produce if used appropriately.

Your symptoms could be from stretch of the nerves during surgery, compression of the nerves from hardware, incomplete decompression or simply that the nerves need to heal.

Yes, a family doctor can order your CT scan and it will be read by a radiologist but really, you need a spine surgeon to evaluate this scan as this individual will know what to look for. Sometimes, the radiologist, without knowledge of your symptoms, will not know what to look for.

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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