Pain with lots of back issues

Tagged: arthritis, Bertolotti's syndrome, DDD, PAIN, Scoliosis

Viewing 4 posts - 1 through 4 (of 4 total)

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cookie0417
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November 14, 2017 at 4:19 pm

Post count: 2

#26825

I am trying to decide what my next step is with my back issues. When I was 12 I was diagnosed with scoliosis. Then this year (I’m now 30) I started having more and more pain, the pain had been on and off for a few years, but this year it became much worse. I found out I actually have degenerative disc disease and then found out I have Bertolotti’s Syndrome and the area that my L5 vertebra connects to my sacrum because of the Bertolotti’s, there is arthritis. All these issues give me pretty bad back pain. I have several days my pain is at a 10 on a scale of 1-10. I am trying to keep working as a dog groomer (I have my own shop), but I am in pain all the time I am working, its hard to stand long, lift much, and even driving hurts my back. My scoliosis has gotten worse since I was a kid even though I had quit growing already. Was 14 degrees as a kid, now I have 2 curves, lower 20 degree and upper 27.

I have done both physical therapy and gone to the chiropractor on and off for several years. With the chiropractor I get a bit of temporary relief in my middle and upper back, but not so much in my lower back. The physical therapy doesn’t really help and I’ve been continuing to do the exercises given to me. I have some of the exercises I can’t do because it irritates my lower back. I have been working on strengthening my core but it doesn’t help my lower back. I saw a pain doctor, who is the one that found the Bertolotti’s, but the only advice he had for me was to stay active and keep a healthy weight. I have been taking 3 meds to help my pain, but at this point its not doing enough. I feel like my only solution now may be to have surgery for my Bertolotti’s. I hurt so much and its making it very hard to work. I’m afraid it is destroying my back.

Donald Corenman, MD, DC
Moderator

November 15, 2017 at 7:27 am

Post count: 8660

#26828

You might have pain from Bertolotti’s syndrome but pain from this is unusual and generally, there are more common problems that cause back pain. You need to see an experienced spine surgeon who can properly diagnose and treat you. You might be a candidate for physical therapy, injections and even radiofrequency ablation (RFA). Finally, if nothing works, surgery might be an answer.

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.

cookie0417
Participant

May 30, 2018 at 1:54 pm

Post count: 2

#28411

Hi there, just updating. I ended up also finding out that my disc between L4 and L5 is torn and bulging. I have now tried steroid injections in 3 places, one epidural in the area of my torn/bulging disc, one in my left SI joint and then one around the false joint formed because of my Bertolotti’s Syndrome. I got some relief with the SI joint injection, but then when I had the injection in that false joint, I had about a week of relief. Because of that my doctor then did just a local anesthetic injection to make sure it was that causing my pain, and it relieved pain for a few hours. I am now set up to get a nerve ablation of those nerves around that false joint. I’m hoping this will relieve pain for a long period of time. I know this will likely be temporary since nerves grow back, and I’ve read that over time it could just not work anymore.

If I should need surgery, how will I know that a spine surgeon here will know what to do to correct the Bertolotti’s? I’ve done a lot of reading and research and am part of a group on Facebook of others with this condition. I believe because there is other damage to my spine, that I would end up needing a fusion of that false joint, is this right? Should I be concerned if the surgeon here has never done this for a Bertolotti’s patient? I haven’t spoken with a surgeon yet, so I don’t know what they have and haven’t done before. I am located in Nebraska so I could potentially come to Colorado for surgery if there is not a surgeon here that could do the operation correctly. This has been a long process so any help is appreciated. Thanks.

Donald Corenman, MD, DC
Moderator

May 31, 2018 at 1:43 am

Post count: 8660

#28419

Be careful with the absolute diagnosis of Bertolotti’s Syndrome as many other disorders can cause back pain. If you have a scoliosis, this could cause premature wear of discs and facets which mimic Bertolotti’s syndrome. Radio-frequency ablations are OK but a Bertolotti’s surgery which requires a fusion might work as long as all the other pain generators have been ruled out. You are certainly welcome to come to Colorado.

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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