Plated C5-T1, obvious non-union C7-T1 w/excessive segment motion X-ray

Viewing 6 posts - 7 through 12 (of 28 total)

Previous 1 2 3 4 5 Next

Author

Posts
waderoberts
Member

June 10, 2014 at 12:08 am

Post count: 17

#11007

Thank You for your response.

I am encouraged by your confidence and wealth of experience in revision surgeries and optimistic prognosis of a return to a more active lifestyle following a successful fusion and resolution of the problems that I am currently having, which are considerable.

It has been some time since I sought out surgical opinions regarding revision surgery. (In 2004) I had the opinions of 2 orthopedic surgeons and a neurosurgeon, but there was no consensus regarding a surgical approach or prognosis, so I didn’t feel confident in going ahead with a 3rd surgery. I have a problem joint in the great toe of my right foot that requires replacement or fusion and further limits what I can do regarding aerobic exercise.

I would still like to know what activity restrictions and exercises you would recommend in the interim, as it seems that I struggle to find a happy medium between avoidance of activity to prevent increased radicular symptoms and neck pain and becoming so sedentary that my overall general health and fitness level falls into decline to the point that I suffer from an increase in muscle spasms in my neck and shoulders that seem to further limit circulation, drive up my blood pressure and create a greater dependence on flexeril and anti-inflammatory medications.

Again, I’d like to thank you for your confidence and reassurance that a revision is not only possible, but likely to be successful.

Donald Corenman, MD, DC
Moderator

June 10, 2014 at 8:48 pm

Post count: 8660

#11016

I tend to like stationary bikes and ellipticals for aerobic exercises in patients with your current condition. These devices do not cause much neck motion and are low impact. You could try stationary machines for weight training if you want to strengthen muscles. Outdoor activities will cause more impact and more angular forces. You might be able to tolerate this but it will be trial and error.

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.

waderoberts
Member

June 11, 2014 at 12:38 am

Post count: 17

#11021

Thank You once again for your response and advice.

My former employment was as a Corrections Officer with the Michigan Department of Corrections. It was a collision with a resisting inmate as I ran into a violent situation that caused the initial damage to my cervical spine, not any genetic predisposition towards degenerative disc disease or defect that I’m aware of.

I have been on Long Term Disability since the accurate diagnosis of my cervical spine condition in March of 1997, as my employer decided not to continue with light duty assignments and following 6 months of conservative therapy I had a single level C6-C7 diskectomy in November of 1997 that resulted in a non-union and a revision surgery in November of 2000 that left me as I am today.

Is there any chance that I could return to work as a Corrections Officer or other related career field such as a policeman or probation officer following a successful revision surgery and solid fusion of C5-T1?

Or will I remain restricted to sedentary or extremely limited light duty type of tasks regarding physical work as I am today as even driving for more than an hour can be difficult and a few hours at a desk or on a computer is normally all I can manage in a day?

I am assuming I will remain restricted from contact sports or and high impact activities, employment that would be likely to involve the use of force or physical work that involves repetitive motions and medium to heavy lifting, even with a solid fusion from C5-T1, though I don’t believe I have DDD or any other serious spinal defects.

A fairly recent MRI (05/31/2013) does indicate some existing problems both above and below C5-T1 where I am currently plated, though not solidly fused.

waderoberts
Member

June 13, 2014 at 7:08 am

Post count: 17

#11037

I am very encouraged and hopeful regarding what you have told me thus far regarding your ability to perform a 2nd revision surgery with confidence in a positive outcome.

I fully realize that even if my radicular symptoms and neck pain are markedly reduced, that I will still have some impairment of movement and activity restrictions.

Your honest expectations of what I will be able to do physically in the future, especially career wise is important to me.

This spring there was an opening in a related career field working supervising nonviolent offenders on various community service programs in my home area, that I went to the trouble to investigate, but was discouraged from applying for because of the current condition of my cervical spine and the need for a successful third surgery to enable me to work a full time position dependably.

Addressing the issues raised in this and my previous post will be of great benefit to me in opening the door to a happier, healthier and certainly a more pain free life.

I realize, far better than most that there are no guaranteed surgical outcomes.

That said, I believe you and those you work with at the Steadman Clinic represent my best hope for a positive surgical outcome and new lease on life, here in these United States of America.

waderoberts
Member

June 18, 2014 at 12:18 am

Post count: 17

#11048

Care and Feeding of Your New Neck

Once the neck is healed, there may be recommendations for activity changes. A one level fusion will allow you to play in the NFL. Even a two level fusion may play tackle football. If a patient needs a three level fusion, activity restriction is necessary to prevent further stress to the remaining discs.

~Donald S. Corenman, M.D., D.C.

This is of course non case specific information taken directly from a page on your website.

I would very much appreciate your expert opinion addressing the issue of activity / work related restrictions for my particular case.

I have an obvious non-union and excessive movement at the C7-T1 level due to the plating of C5-T1 without proper removal of the C7-T1 disk and placement of a proper bone graft.

This causes me a great deal of neck pain as well as left sided radicular symptoms, particularly in the long and ring finger of my left hand. It feels as though I have something stuck under those fingernails, as well as a dull pins and needles sensation and/or numbness.

I would also appreciate a best case scenario regarding activity / work related restrictions following an anterior revision surgery that solidly fuses my spine from C5-T1; if that is what is deemed as the best surgical correction for the problems that currently exist behind the plate.

Thank You in advance for your response and expert opinion.

I am very interested in an e-consult that will provide me an opportunity to explain how and why my spine came to be in its current condition with more specific information to enable you to provide a more informed and detailed prognosis.

Again, I would like to thank you for the encouragement and acknowledgement that you have provided me with your previous responses. This forum is an excellent educational tool for patients and providers as well.

Sincerely, waderoberts

Donald Corenman, MD, DC
Moderator

June 20, 2014 at 10:39 pm

Post count: 8660

#11076

I can give you my parameters for a solid fusion of C5-T1 but the parameters for a pseudoarthrosis are something else. The pseudoarthrosis may be stable in which case the standard parameters for a solid fusion would be appropriate but if there is motion and instability, these restrictions would have to be on a case by case basis.

With a solid fusion of C5-T1, I have my patients restrict some of their outdoor activities. Impact sports need to be modified. If the patient was a long distance runner, I would have them consider long distance biking or swimming instead. Even though I have some patients with a three level fusion that do run distance, I am concerned about their genetic propensity for further disc injury with prolonged exposure to impact.

Contact sports (football, boxing, lacrosse, etc..) should be eliminated. Simple pickup games of friendly basketball should be OK. Skiing should be fine as long as no unnecessary risks are taken (cliff jumps, icy steep mogul runs). Mtn biking should be OK as long as no steep, rocky descents where an endo can occur are eliminated.

There are other considerations but I hope you get the picture.

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.
Author

Posts

Viewing 6 posts - 7 through 12 (of 28 total)

Previous 1 2 3 4 5 Next

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel