Keep hearing "too young"

Tagged: leg weakness from a lumbar disc herniation

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denny3027
Participant

December 20, 2019 at 11:24 am

Post count: 7

#31754

Hi Dr. Corenman. I am a 32yr old female. I’ve been a travel nurse for the last 2 years working med/surg and driving long distances. I am overweight as well. Last year I had really bad mid lower back pain and did PT and it resolved. This October I had the same pain but in my left lower back. Could barely stand straight in the mornings. Did PT for 2 weeks and it resolved. However,the week I went back to work (did not have heavy patients) I felt thigh discomfort. That same week I had bad muscle spasms. PT thought strained quad. I woke up the next morning with severe pain and had to have an ambulance take me to the hospital. This was Nov 6. MRI shows left extraforaminal annular extrusion at L3L4 adjacent the exiting left L3 nerve root. I had to use a walker and crutches to walk the first week I was in so much pain. Main pain is left lateral thigh radiating to mid thigh and sometimes groin pain and thigh/knee swelling. Injection didn’t work. The neurosurgeon I saw in Oregon told me to consider surgery if it was still weak in 3 weeks. I made my way back home to Maryland and followed up with a well recommended neurosurgeon here who at first said I was too young for surgery but when I told him about my weakness he then suggested surgery. Im scheduled Monday for microdiscectomy but have been so confused. I followed up with the neurosurgeon again this week because my walking is getting better, the pain is less however I still have weakness in what I think is more my hip flexors (can’t put socks on, can’t sit for long periods on hard surfaces without my pain coming back, knees buckle couple times a week, i feel like i don’t have control going up and down steps,inside of left lower thigh numb). When sitting I cant lift my left leg/thigh off the chair. Im walking better without a limp however I still notice my left thigh is severely weaker than my right thigh. This has been an extreme life changing event. I can’t work right now.I’m not married and don’t have much supportive family and am staying with friends. It’s been 6 weeks and I don’t think PT is helping me get any muscle strength back. My leg is still weak. I’m worried about long term permanent damage to my leg if I don’t do surgery soon (and I understand we won’t know if surgery can alleviate my weakness) but the neurosurgeon I’m seeing told me once you go in the spine it can lead to many many more surgeries in the future and I was so young and have so many years of being active. He scheduled me for surgery monday because I do have the weakness but he told me if it were him he’d keep non conservative treatment. Do you think if I do everything in my power to heal after surgery, lose weight, maintain PT/exercise program that a microdiscectomy would be detrimental for a young person to have?

I know this is long and I apologize. I’ve just been feeling so conflicted. I want to move on with my life and my gut tells me to attempt the surgery to decompress the nerve and hopefully I’ll have a good outcome and be able to complete PT with better overall outcomes and return to work. It’s just hard when there’s so many opinions out there and being 32 yrs old and a lot of the patients are older than me that I compare myself to. I truly am grateful for the time you took in creating your webpage. The information and explanations you provide are so valuable. Thank you!

Donald Corenman, MD, DC
Moderator

December 21, 2019 at 2:20 pm

Post count: 8660

#31764

I am very surprised to hear that you are “too young” for a microdisectomy, especially since you had motor weakness and extremis type pain. You should have been taken to the OR that week and underwent a far-lateral discectomy. Motor weakness is an absolute indication that surgery is required in my opinion.

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.

denny3027
Participant

December 21, 2019 at 2:53 pm

Post count: 7

#31766

Thank you for your opinion Dr. Corenman. I truly appreciate you taking the time to respond to this forum as I know you are a busy doctor. It really makes me feel more comfortable with my decision. Happy holidays.

Donald Corenman, MD, DC
Moderator

December 21, 2019 at 3:28 pm

Post count: 8660

#31768

Please let us know how you do.

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.

denny3027
Participant

January 2, 2020 at 12:51 pm

Post count: 7

#31851

Hi Dr. Corenman. I’ll be 2 weeks post op Monday. I did well but definitely in that time will tell phase lol. I still have numbness and a part in my thigh that feels like a knot but I’ll be praying for the best :)

I do have a question. I should be cleared to drive again next week and was wondering if there was a safe limit to stay in with the amount of daily walking you should do? One of my struggles has been my loss of independence and inability to work at this time. Also my neurosurgeon sends his patients to PT 6 weeks post OP so I thought I’d set up a routine just to get out the house and go to the gym every day. Dont plan to do anything crazy, just walking on the treadmill. But wasn’t sure how many miles/how much time I should spend walking on it.

Thank you and Happy New Year :)

Donald Corenman, MD, DC
Moderator

January 3, 2020 at 7:32 pm

Post count: 8660

#31855

This is my protocol for rehabilitation after microdiscectomy.

https://neckandback.com/pre-and-post-op/microdiscectomy-and-lumbar-decompression-recovery/

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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