L5-S1 DISC HERNIATION, TWO BACK SURGERIES.

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catmadni
Member

December 7, 2012 at 6:39 am

Post count: 25

#7545

Thanks Doc.m I will keepnthe forum posted.

My appointment with the NS is this Monday. Thanks.

catmadni
Member

December 10, 2012 at 7:39 am

Post count: 25

#7563

PFCRANGER

How are you doing? Have you seen your doctor about your continued pain yet?

I feel like I am going through the same progression as you. A fusion may be in my future. Right now I am struggling with my nerve damage causing significant calf motor weakness.

PFCRANGER
Member

December 12, 2012 at 2:12 am

Post count: 36

#7581

Hey sorry to hear about the pain you are having, the progression in my case as not been great. I am going for an MRI to see what is going on inside the surgical site, hope to see why i am having so much pain in my back, with my leg pain has come back, and the numbness and motor weakness that i am having. It has not been an easy road three surgeries a fusion and now this i only hope for the best but i am not feel good at all. The fusion surgery was good a few weeks after it then i started having problems after getting up off the couch one day. Then with my luck i fell 2 times so i think that may have done me in. Have you gotten an MRI to see whats going on in your case ?

catmadni
Member

December 13, 2012 at 8:13 am

Post count: 25

#7594

I got the MRI. The results were negative except for a lot of scar tissue .

My main problem is my weakness in my calf. I can’t walk without a limp. I suppose I can live with the numbness and weird sensation in my legs. Just don’t want to be disabled

I guess I am through with surgeries for now. If I become unstable then I will have the fusion like you

I will follow your progress through this website. I hope you do well. Your fusion surgery is very complex and recovery will take a lot of time. Good luck. I’ll be in touch

Donald Corenman, MD, DC
Moderator

December 14, 2012 at 7:59 pm

Post count: 8660

#7601

I have just posted three new threads regarding nerve root injury on the website. One is general nerve physiology and healing potential for nerve root injuries (Nerve Injuries and Recovery). The other two specifically pertain to either cervical or lumbar nerve root injuries (Symptoms of Cervical Nerve Root Injury or Symptoms of Lumbar Nerve Root Injury).

These might help to allow some understanding of nerve healing.

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.

catmadni
Member

January 3, 2013 at 4:04 am

Post count: 25

#7672

Doc,

An update and a question.

I am 8+ weeks post op of my posterior partial discectomy L5/S1. My back seems a lot stronger now. Although my back has never been my concern. I understand that it is the location of the degenerative disease, but the peripheral nerve issues are the real lasting damage. My calf strength is only marinally better. The denervation atrophy is ovious.

I have studied the information from your web site, your answers to my questions on the forum, and many other articles.

Considering all of that I am trying to decide the best course of action for me, if any. It seems to me that if upon reinnervation, if the gastronemus muscle has not been so long denervated that the cells can recover, then I will be in a good poition for ‘full’ recovery. However there seems to be no method of determining the length of time to reinnervation. Therefore, to be certain the muscle does not fail irreparably prior to reinnervationin, an artificial way of contracting them muscle must be employed some time prior to the ‘point of no return.’

I understand that things are not quite as simple as I described above. However, if I risk impairing the spontaneous budding and sprouting nnerve healing mechanism with electical stimulation (ES) of the muscle, then is no action, or waiting and hoping the only way to treat? Can I plan on introducing ES at a time certain along the recvery period?For example, at 6 or 8 months post decomression, treat with ES.

This raises another question I never asked. Does one notice the spontaneous recovery from nerve denervation/atrophy, suddenly or gradually? It seems that if an axon recovery can take many months to ‘reach’ the gastronemus muscle, then the only signs of reco ery would be from budding and sproutling or hypertrophy.

I would like to make a plan, even if the plan is not action for several months, then do it. I seem to be lost thinking about it without assistance from a health care professional. My neurossurgeon and physical therapist are not able to help me with developing a plan. Possibly there expertise is not what I need. Do you recomend another ‘type’ of care giver to develop this plan of treatment for/with me? I appreciate your time. Thank you again.
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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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