opinion about discogel?

Tagged: Discogel

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Majid Zohrabi
Member

January 13, 2015 at 6:43 pm

Post count: 1

#12012

Dear Dr.Cornman,

Thank you for your reply.

I think a misunderstanding has occurred.

We use discogel for treatment of disc herniation

for the patients that have radiculopaty ( as you said).

I don’t perform discectomy prior to discogel injection.

Besides, I and my colleagues are preparing

an article about our result of discogel injection

in treatment of disc herniation.

Best Regards

Majid Zohrabi MD , Neurosurgeon

Donald Corenman, MD, DC
Moderator

January 13, 2015 at 8:40 pm

Post count: 8660

#12013

Thanks you for your reply. I am still confused somewhat. I now understand now that your indication for discogel is compressive radiculopathy by herniated disc. What I don’t understand is that you do not perform a microdiscectomy prior to placing the discogel but you insert the disogel into the disc space.

How do you gain access to the disc space? Through the herniation or on the opposite side? If through the herniation side, do you leave the herniation fragment against the nerve root? Do you insert the disogel through the full thickness annular tear that caused the herniation?

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.

ADR Seeker
Member

January 14, 2015 at 5:01 pm

Post count: 3

#12033

You may want to try watching a video Donald. Your site won’t allow me to put in URLs.

You may want to try watching a video Donald.

Keep in mind that the rest of the world is far more advanced in spine than the US.

Discgel is a radio opaque gelled alcohol.

There are many alternatives to putting plastic and titanium into people’s spines but as we know spine surgery is very lucrative and most spine surgeons are mobbed up with the medical device companies.

There are protein and stem cell injections that can rehabilitate disks. There are several methods of nucleoplasty that are safe and more effective than fusion but like I said, in the US it’s not about the patient but rather it is about the money and you know that so don’t act like you don’t understand how Discogel and other types of nucleoplasty work.

Bottom line Donny, it works and it is far better than fusion. You can believe the independent science or you can believe the US spine industry and companies like J&J, Stryker, Globus, Lanx, Medtronic who all have faced large criminal fines.

Keep in mind that the rest of the world is far more advanced in spine than the US.

Discgel is a radio opaque gelled alcohol.

There are many alternatives to putting plastic and titanium into people’s spines but as we know spine surgery is very lucrative and most spine surgeons are mobbed up with the medical device companies.

There are protein and stem cell injections that can rehabilitate disks. There are several methods of nucleoplasty that are safe and more effective than fusion but like I said, in the US it’s not about the patient but rather it is about the money and you know that so don’t act like you don’t understand how Discogel and other types of nucleoplasty work.

Here is more from the NIH

Bottom line Donny, it works and it is far better than fusion. You can believe the independent science or you can believe the US spine industry and companies like J&J, Stryker, Globus, Lanx, Medtronic who all have faced large criminal fines.

Donald Corenman, MD, DC
Moderator

January 14, 2015 at 10:52 pm

Post count: 8660

#12034

You note many things in your reply that are simply not accurate. You speculate that the “rest of the world is far more advanced in spine than the US”. From my lectures and travel to other countries, I would dispute that statement. The rest of the world does use some different techniques but unfortunatley these techniques generally are ineffective and and some are injurious.

Most spine surgeons I know do their best to help the patient and are not in the pockets of any medical device company. There is always a public suspicion that physicians are “bribed” but I can tell you this is not true. There might be some poor surgeons and even some that are misdirected but most surgeons have their patient’s best interest at heart. There is no conspiracy to make money and harm the patient.

I have been in spine for over thirty years and have seen new techniques come and go. The bottom line is if these techniques do what they say they will do, they will be adopted by the spine community. Many new techniques however are overblown promises that are simply not effective.

Stem cell injections are the current craze. The inside of the disc is avascular. Cells that survive in this environment work poorly. However, when taken out of the disc and placed on nutrient media, these cells thrive. This indicates the very low oxygen environment is one of the causes of cell demise and disc vulnerability. Please tell me how injecting stem cells into this avascular environment will allow these cells to thrive, let alone how they will morph into an appropriate cell line that will heal the disc.

Also, how many peer reviewed articles (the gold standard for publication) are out there for discogel? This substance I would love to support but the studies at this point do not support this product.

Nucleoplasty has been demonstrated not to work in multiple studies. Physiology does not support this technique and it has been proven to be detrimental. Same with IDETT and many other techniques (X-stop).

You have a bone to pick for some reason with all the large spine companies. That is all well and good but the best way to understand if a technique is effective to look at peer reviewed studies. These companies are in business to supply an effective product but the surgeon needs to determine if the product will ultimately help his or her patient.

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.

Donald Corenman, MD, DC
Moderator

January 15, 2015 at 4:31 am

Post count: 8660

#12039

Thank you for your last post. The reason I do not allow links is that identification is not HIPPA guideline appropriate. Also links can carry viruses which leads to other problems.

You apparently have an axe to grind with the spine industry. You are incorrect in some of your assumptions and you have a jaded outlook on doctor altrusim and patient care. You are certainly welcome to call the office for the reasons why I cannot carry your post but your information is not accurate and misleading.

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.

Mazi_dg
Participant

May 24, 2016 at 12:06 am

Post count: 2

#22243

Dear Dr. Corenman,
I am writing because next week I have planned Discogel injection in Poland. Today I found this topic and I am a little bit scared of it. As I can see you are opposed to Discogel. Your last post was 1,5 year and I want to ask if you change your mind on Discogel or maybe you collect new facts about this injection.
I will be grateful for any answer.
Best Regards,
Mathew
Author

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Donald Corenman, MD, DC

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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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