Incomplete Spinal Fusion

Tagged: failed back surgery syndrome, Incomplete Fusion lumbar spine

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Renee123
Participant

January 19, 2016 at 10:35 pm

Post count: 130

#21180

Did you check Hospital for Special Service? They are #1 in orthopedics in the US !

Did you do any early exercise, lifting or anything like that ? Let us know what the Dr.s say. I am going to schedule my TLIF soon…

Thanks again !

sperryguy
Participant

January 20, 2016 at 7:00 am

Post count: 68

#21181

Hi

Yes, I will be looking into HSS, awesome facility. I had my surgery at Lennox Hill, also quite good. I like/d to work out, though not into weights. Before surgery, despite all the pain, was working out. After surgery, walking quite a bit. My pain doctor indicated that I may benefit from an SI ablation. His thinking is that due to the stiffness of the interbody device, is transferring the stress to the SI Joint. He wants to do a SI block and see if that stops the pain. Despite it all, still doing my best to keep fit.

I found eating nutritiously before and after surgery is tantamount to healthy recovery. Walk, walk, and walk some more. Get plenty of rest, and have someone to help you around your home for the first few weeks. I only used a walker for a few days, and never moved on to a cane. My doctor did give me a spine stimulation device, and that is helpful. I was very careful to eat high fiber foods to avoid constipation, and to avoid nausea post surgery, was put on a anti nausea patch the night before, and kept it on for a week after the surgery(have a sensitive stomach). Will keep all of you up to date. Hopefully my body will continue to fuse, one never knows, though planning for it not happening at this juncture(15 months out)

Steve

sperryguy
Participant

January 26, 2016 at 9:17 am

Post count: 68

#21201

Hi Dr Corenman

I had another meeting with my Pain doctor and hes pretty certain my pain is coming from the S1 joint. He wants to test it out with a SI Block and prove it out. He said if the pain subsides, he would proceed with an RFA of the SI joint. He mentioned doing via an Endoscope to obtain a better result. I mentioned that the CAT Scan showed a finding of “Increased End Plate Sclerosis with Subsidence”. The doctor said that is a normal finding as one ages? I was under the impression that could be from the TLIF procedure and not preparing the surfaces properly? I’m mentally preparing myself for a Revision surgery. Any increased activity causes days of pain and that’s not acceptable. Any inputs from you make this ordeal much more tolerable.

Thanks

Steve

sperryguy
Participant

January 27, 2016 at 4:33 pm

Post count: 68

#21226

Hi Dr C, just an update

I did have the SI pain block, not a great response. A tad better, but the stiffness and weak and dull leg pain is still persistent. My pain doctor said if the procedure fails all that’s left is a visit to my surgeon.

STEVE

Donald Corenman, MD, DC
Moderator

January 29, 2016 at 11:39 am

Post count: 8660

#21233

This anesthetic block does rule out the SI joint as the pain generator. SI joints commonly become degenerative but do not cause symptoms.

You need a full workup for FBSS (failed back surgery syndrome). This might include a CT scan, a new MRI, possible nerve blocks and possible investigation of the levels above. Other tests might also be helpful.

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.

sperryguy
Participant

February 12, 2016 at 8:25 am

Post count: 68

#21325

Hi Dr. Corenman

I recently saw my orthopedic surgeon to discuss my outstanding issues. He indicated that based on my symptoms(weakness in my left leg, numbness and tingling in the left foot, back pressure in the surgical site), and from the CAT Scan, there is only a partial fusion on facet joints. No additional fusion in and around the L4 area. The doctor feels the best next step is to do a Mylegram. to say the least, I am not happy at all having that test. Prior to the surgery it was suggested, though the doctor went with a Bone Scan.

Is this the right thing to do? This is a very severe invasive test. Would a bone scan accomplish the same thing? He did say that if i need additional surgery, it would be easier and only the spacer would be removed and replaced with excessive bone material. The whole process is becoming very daunting.

Again, thank you for your patience and help

Steve
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Donald Corenman, MD, DC

Average rating:

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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