Lower back pain and severe upper leg weakness.

Tagged: Chronic lower back pain and severe upper leg weakness

Viewing 6 posts - 1 through 6 (of 6 total)

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Norman
Participant

March 24, 2023 at 8:33 am

Post count: 3

#35550

Hi Dr Corenman
I live in Yorkshire, England. I am a 73 year old male.
In Feb 2019 I fell 30feet from a ladder. I landed on my left side. In hospital I was diagnosed with a dissected aorta.I had an emergency operation to insert a TEVAR stent. Unfortunately this procedure dislodged a blood clot which passed to my brain causing a stroke which caused temporary paralysis of my left arm and leg.
I also had a very badly broken pelvis.I had an “open book break” at my pubis bone which required a plate and several screws to stabilise. The rectus abdominus muscle was detached on the left side of the pubis bone and was reattached. (It has subsequently become detached again ).
I also had a fracture of the left ilium which was stabilised with a screw.
I also suffered fractures of the spine ,T11 and L1. I had no treatment for these but the spinal consultant assured me , no treatment was necessary.
I was 10 weeks in hospital , in which time the physio team taught me to walk again with a frame.
After discharge I had physiotherapy twice a week and exercised daily on my own. In the following months I regained a significant level of strength, walking several miles without a stick , learning to swim again. Life was good!!!!!!
I used to experience upper leg weakness in a morning but after exercise this disappeared. I also experienced chronic lower back pain whilst sitting in a low back chair. My physiotherapist suggested my core was weak. When we were assured by the Spinal Consultant ,in October 2019 ,that everything was OK with the spinal fractures she had me do a “side plank” exercise. I found this extremely difficult. I repeated it the next day on my own. The upper leg weakness had returned and was no longer relieved by exercise.
I have seen numerous specialists but to date no-one has been able to give me an explanation why I deteriorated in October 2019 when I did the plank exercise.
I’ve had several MRI scans of my lumbar spine. None have shown any evidence of central canal stenosis or disc damage. I’ve had nerve conduction studies which have not shown any problems with the muscles and nerves of my legs.
I am totally at a loss what to do next. I am unable to stand for more than a few minutes and have to spend most of the day lying down to be relatively pain free.
I am more than willing to pay you for your professional opinion.

Donald Corenman, MD, DC
Moderator

March 24, 2023 at 12:15 pm

Post count: 8660

#35551

The two potential problems that come to mind are missed upper lumbar foraminal stenosis and alignment issues. Do you have normal sensation in your groin and thighs or diminished? Do you have standing full spine x-rays (scoliograms)? I assume your MRIs covered the thoraco-lumbar 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.

Norman
Participant

March 30, 2023 at 9:13 am

Post count: 3

#35559

Hi Dr Corenman
Thank you for your reply. I have normal sensation in my groin and thighs. I have had an MRI scan of my thoracic and lumbar spine at (least 2years ago). I was told there were no areas of concern. All the subsequent MRI scans were only of my lumbar spine.
I have never had a full standing spine Xray. I have never heard of a scoliogram ?
What is the normal method of sending MRI scans to you?

Donald Corenman, MD, DC
Moderator

March 30, 2023 at 12:36 pm

Post count: 8660

#35560

If you want me to provide to you a full accounting of your condition (sans physical examination) including personally reviewing your images, you would have to evaluate the “long distance consultation” found on the home page.

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.

Norman
Participant

March 31, 2023 at 4:35 am

Post count: 3

#35561

Dr Corenman
I have looked at the “long distance consultation “. No problem with the questionnaire. I have to investigate accessing the MRI scans which are on our national NHS system. I have no means of downloading them onto a disc. Do you not use a USB memory sticks?
You mentioned a full standing Spinal xray. Would it be advisable to have this done in the UK before submitting the “consultation “

Donald Corenman, MD, DC
Moderator

March 31, 2023 at 10:00 am

Post count: 8660

#35562

I have used USB memory sticks before. I have also gained direct access to the NHS system with your user name and password in the past. I don’t know if it works every time. Yes, a full standing x-ray would be helpful too.

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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