Need Help - ACFD Surgery

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Lucky
Participant

February 20, 2015 at 2:45 am

Post count: 8

#12285

Dr. Corenman post=8038 wrote: I am assuming you have significant stenosis as you did have a central cord injury based upon your symptoms and you have two surgeons who want to perform surgery. If you have no stenosis and you developed SCWORA (spinal cord injury without radiological abnormalities), this would be very rare and unlikely.

Stenosis from fracture (injury) is different from developmental (degenerative) stenosis. In fracture stenosis, you probably would have had surgery that first fateful day. WIth developmental stenosis, you don’t have to have surgery immediately but the trend of surgeons is to put you in a neck collar to protect your cord and do surgery as soon as is feasible.

Dr. Corenman

Thanks, I’m still learning about this stuff and you’ve been a big help. I luckily did not suffer a fracture but reviewing the MRI with the doctors they showed me that I do have disk herniation/stenosis.
I’m meeting with an orthopedic spine surgeon soon and will input any updates I have in this thread. Thanks again Dr. Corenman for the fast replies, this is a great site.

Lucky
Participant

April 14, 2015 at 12:59 pm

Post count: 8

#18980

I had my surgery about four weeks ago today. The surgeons decided to do a multilevel fusion after reviewing the MRIs and CT Scan, C3 – C6. After awakening from my surgery I was told they found they only needed to do a single level fusion : ), C3 – C4. I was in the hospital for two days recovering, then sent home with pain pills. I have been resting and am not to drive or do any form of exercise for another two weeks. I also had two follow up visits since the surgery with x-rays and all is well. There is some tingling in my arms and hands which my surgeon expects to go away on its own. Besides the arm/hand tingling I am no longer in pain. The incision area has minimal scaring at only four weeks post surgery. The incision area is numb, under my chin but has been slowly regaining feeling. So, so far my surgery has been a success and I hope to soon return to all of my activities.

Donald Corenman, MD, DC
Moderator

April 15, 2015 at 9:40 am

Post count: 8660

#18986

I have to say that it is really unusual that a three level surgery would be planned but only a one level surgery was carried out. They should have discussed that with you beforehand.

Nonetheless, it seems that your symptom generator has been eliminated and that you are on the road to recovery. I would still ask your surgeon why the other two levels were not addressed and if there is any remaining danger now that they were left alone.

Good luck!

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.

Lucky
Participant

April 16, 2015 at 6:35 pm

Post count: 8

#19028

Before they put me under anesthesia they told me the 3 level needed to be done. But, one they started the operation they found that only the one level (C3 – C4) needed to be done. I found that out upon awakening and was happy being it was less surgery that needed to be done.

I will ask about the other levels, if there is any risk. I am a little concerned after reading your post. I was playing foosball (table soccer, not football) at home and noticed the next day there was, what appeared to be a slight shoulder/forearm weakness feeling. Also my fingers are tingly and starting to feel slightly numb at the tips sometimes. I stopped doing things that require any quick movements or grip strength to see if it gets better. My surgeons have done hundreds of these surgeries and I do trust them, but I hope the surgery addressed all problem areas and nothing was missed : (

Donald Corenman, MD, DC
Moderator

April 17, 2015 at 9:41 pm

Post count: 8660

#19043

I am unclear why you were told that you needed three level surgery and that only a one level surgery was performed. There is no way to know that a one level surgery is needed while in surgery as this plan should have been made prior to the surgery based upon symptoms, physical examination and imaging. You don’t simply look at the outside of a disc during surgery and determine what is needed based upon a superficial appearance.

Please keep us updated as to the discussions with your surgeon.

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.

Lucky
Participant

May 24, 2015 at 12:53 am

Post count: 8

#19522

I may have been mistaken with the surgeons deciding a single level during surgery. I was out of it when I woke up. The decision must have been made beforehand. It was kind of up in the air whether or not a multilevel needed to be done. I just told them I trust them and to do whatever surgery is needed.

I have started physical therapy three weeks ago and have three weeks left. I’m getting some body strength and mobility of my neck back with PT. I have also been going on almost daily long walks or walking up and down the stairs in my house for exercise. The incision area is still regaining feeling but is a little better. The tingling sensation I have throughout my body/hands seems to be getting better. The tingling seems to linger in my hands a lot of times, even now as I type. The tingling sensation throughout my body is much more intense but only happens for about a second at a time. I noticed it happens often when I look down, especially while walking. I asked one of my surgeons about this and he said it is a result of my spinal cord injury and may or may not go away : ( I had some hand tingling about a week before the surgery but not the body tingling (my arms also started to fall asleep while sleeping about a week before the surgery, but have not again after). But my surgeons were electronically monitoring my spinal cord during surgery and there showed to be no issues from the surgery. My right palm side up forearm also seems to have a slightly different sensation in an area than it did before I was injured. On the plus side I do not appear to have any muscle weakness from the injury (although my muscles have atrophied from inactivity). Does anyone know if this tingling is bad? My physical therapist told me it was okay as long as there is no muscle weakness.

Also, my surgeons have told me once fused I will be able to regain all activities with no precautions, I am getting teary eyed as I type this : )
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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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Need Help – ACFD Surgery