leg pain

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Wcsherwo1
Participant

October 21, 2019 at 2:05 pm

Post count: 8

#31341

I do sit/stand for 8 hours as I would on a computer for my job. Because of this I were compression socks. Why would like make my left leg hurt even more since my symptoms started coming back?

Donald Corenman, MD, DC
Moderator

October 22, 2019 at 11:48 am

Post count: 8660

#31345

Sitting stretches the sciatic nerve root so can increase symptoms if the root is inflamed. Compression socks are generally mildly irritating to the skin without radiculopathy. These socks can on occasion increase the skin irritability.

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.

Wcsherwo1
Participant

October 22, 2019 at 12:17 pm

Post count: 8

#31348

Please take a look at my MRI results before and after surgery and tell me what you think.

The first MRI was on 7/25/2018

L1/L2: This level is normal

L2/3: This level is normal

L3/L4: Mild loss of disc height and signal. The spinal canal is normal in caliber centrally. There is 1 to 2 mm of lateralizing disc material in the neural foramina bilaterally, appears some partial compromise of the neural foramina, left greater than right. The exiting dorsal root ganglia appear surrounded by fat.

L4/L5: There is mild loss of disc signal and disc height. There is 1 to 2 mm of disc material lateralizing to the right. There is some partial compromise of the right lateral recess as well as inferior aspect of the right neural foramen. The existing dorsal root ganglia are surrounded by fat.

L5/S1: Mild loss of disc signal with 1 to 2 mm of disc material localizing to the left. The is partial compromise of the inferior aspect of the left neural foramen. The exiting dorsal root ganglia are surrounded by fat. The spinal canal is normal in caliber centrally.

On 4/15/2019 I had surgery preformed:
1) Left L3 and L4. left L4 and L5, and left L5 and S1 lumbar laminectomies, medial factectomies, and foraminotomies.
2) Left L3-4, L4-5 and L5-S1 lumbar microdiskectomies
3) Intraoperative microscope and microscopic dissection use.
4) intraoperative fluoroscopy use.
5. Intraoperative short-latency somatosensory-evoked potential, electromyelogram and motor-evoked potential neuromonitoring use.

Second MRI was post-surgery on 6/6/2019

L1-L2: No evidenced of disc disease or protruslon, central canal stenosis, or neural foraminal narrowing

L2-L3: No evidenced of disc disease or protruslon, central canal stenosis, or neural foraminal narrowing

L3-L4: Status post left hemilaminotomy with microdiscetomy. Posterior left subarticular 2.0 mm disc protrusion-subligamentous disc herniation extends into the epidural fat and indents the thecal sac. Bilateral facet arthropathy with mild left neural foraminal stenosis. Central canal is patent.

L4-L5: Status post left hemilaminotomy with microdiscetomy. Posterior left subarticular 2.4 mm disc protrusion-subligamentous disc herniation extends into the epidural fat and indents the thecal sac. Bilateral facet arthropathy with mild left neural foraminal stenosis. Central canal is patent.

L5-S1: Status post left hemilaminotomy with microdiscetomy. Grade 1 (2mm) anterollsthesls with uncovering of the intervertebral disc. Posterior central 2.0 mm disc protrusion-subligamentous disc herniation extends into the epidural fat and indents the thecal sac. Bilateral facet arthropathy without neural foraminal stenosis. Central canal is patent.

Been having low back pain and ;left leg pain since I went back to the gym at the beginning of October:

Had another MRI done on 10/19/19:

T12-L1: There is no disc disease or herniation at this level. No annular disc tear. Central canal and neural foramina are patent.

L1-L2: There is no disc disease or herniation at this level. No annular disc tear. Central canal and neural foramina are patent.

L2-L3: There is no disc disease or herniation at this level. No annular disc tear. Central canal and neural foramina are patent.

L3-L4: There is no disc disease or herniation at this level. No annular disc tear. Central canal and neural foramina are patent.

L4-L5: There is no disc disease or herniation at this level. No annular disc tear. Central canal and neural foramina are patent.

L5-S1: There is posterior herniation of 3.1 mm of L5-S1 disc indenting thecal sac and abutting the traversing S1 nerve roots. No annular dis tear. No canal or foraminal stenosis seen.

What do you make of all this. Going forward what do you see is the best option? I got a second option from another spine doctor and he said that I should try PT, pain meds and massage. He wants be to come back in one month. If my symptoms don’t improve a fusion might be in my future, which I want to avoid.

Donald Corenman, MD, DC
Moderator

October 24, 2019 at 12:50 pm

Post count: 8660

#31362

I’m not clear as to why you had surgery initially. What were your symptoms? Why were three levels chosen? How do your symptoms now compare to your previous symptoms? See this to understand how to describe symptoms: https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-lower-back-and-leg-pain/

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.

Wcsherwo1
Participant

October 24, 2019 at 1:39 pm

Post count: 8

#31364

Ok so before I had my surgery I was having left leg pain. I tried PT, steroid injections. heat/cold therapy, walking, acupunctured, chiro. Nothing help for about a little over a year. I did no for the first few months what I had. This time I went back to the gym 6 months post surgery and I now have pain in my lower back and left leg. This time I have a better understanding of the symptoms and exactly what I have. This time I’m going to PT, trying decompression therapy and stopped going to the gym. biking and running.

Wcsherwo1
Participant

October 24, 2019 at 2:12 pm

Post count: 8

#31365

Oh also I sometimes have upper back pain too but not often
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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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