Post ACDF did great, played volleyball, now not great.

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backtolife
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February 13, 2013 at 8:31 am

Post count: 10

#7998

Dr. Corenman-

I had ACDF 12/17/12, C4-C5, C5-C6 (C5-C6 was taken out), allograft with titanium plate and 6 screws. Did wonderfully, upper arm weakness resolved practically immediately, no post op complications. Flexion extension x-rays at 2 wks and 6 wks post op did not reveal any problems with hardware not being in place/other issues. Played 20-30 minutes of volleyball this past Saturday with neighbors. Served the volleyball 3 times (not on 3 different rotations–3 times in a row) and jumped up in air 3 to 4 times to hit (return) ball back to other side of play. I made no contact with any players (physical contact, colliding, etc) at any point during the time I played. Did not have/feel any problems during or after limited playing time, however, Sunday, my left pinkie went intermittently numb/tingly. Monday & today continuous numb/tingly pinky,ring finger tingly on same hand, headaches, pressure low mid cervical spine (guess around c6-T1 area), some burning. I think I need to call my surgeon. Could I have messed up the fine work he did and caused the plate to shift, crack or something else.

Donald Corenman, MD, DC
Moderator

February 13, 2013 at 9:24 pm

Post count: 8660

#7999

Your results from surgery were very good and actually should be expected. The ACDF surgery is a very good surgery under the correct circumstances.

The use of an allograft in my opinion takes about three months to incorporate fully (and sometimes longer). It might have been somewhat premature to play volleyball at the six to seven week mark post surgery.

“Pinky” numbness however does not typically result from either of the nerve roots that were surgically decompressed (C5 or C6 roots) as the little finger is innervated from the C8 root which exits at the C7-T1 level. It is possible that you might have developed thoracic outlet syndrome after surgery which is not unheard of or very unlikely, a disc hernation at C7-T1.

Certainly, visit your surgeon and allow him to review new X-rays of your neck and perform a physical examination.

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.

backtolife
Participant

February 14, 2013 at 12:43 am

Post count: 10

#8001

Dr. Corenman-
Thank you kindly for your response to my inquiry. I will not play any volleyball again and I am going to call his office. My surgeon, his staff, everyone was wonderful and I am almost afraid to call and ask for an appointment in light of it being my own stupidity that may have caused a problem but my pinky on my left (whole pinky) extending all the way down the outer aspect of my left hand and my left ring finger (more prominent in top of finger) remain numb/tingly. No headache, still pressure. In thinking about things, my ACDF was necessitated by a retrolisthesed C5-C6 with severe chronic endplate trauma and bulging C4-C5 with kyphotic angulation. I had had 2 EMG’s/NCS’s thru diagnosis process & the impression of the most recent one (6/18/12) showed “there is electrophysiologic evidence of left median mononeuropathy at the wrist consistent carpal tunnel syndrome. This finding is mild. My surgeon’s practice is huge (he is an ortho surgeone w/ spinal fellowship) & they do have board certified hand specialist. Could it be that left median nerve? I will tell him everything. I feel foolish & embarassed that I felt so well & may have hurt my own recovery. Thank you immensely.

Donald Corenman, MD, DC
Moderator

February 14, 2013 at 5:18 am

Post count: 8660

#8002

Don’t throw out volleyball as an activity as you will be able to play again once your neck heals. Median neuropathy (carpel tunnel syndrome) will radiate numbness into the thumb, index and long finger but not into the pinky finger.

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.

backtolife
Participant

February 14, 2013 at 6:45 am

Post count: 10

#8003

Dr. Corenman-
Thank you again for your time and response. I look forward to volleyball in future. I will wait for volleyball, ask my surgeon about when I can do activities such as that and stick to my walking until then. The numbness/tingling remains constant and is my whole left pinky down the outer side of left hand (very prominent), the outer palm side of the left hand (very prominent) and the whole digit of my left ring finger (the part with the fingertip very prominent) and a little less prominent in the middle and bottom parts of my ring finger (gauging this by rubbing the areas). I will call his office tomorrow as there has been no improvement in my symptoms and I did not have any of this until my volleyball play. I hope and pray I did not do anything to harm my outcome or his wonderful work. My life had been so negatively impacted before surgery for so long, I was doing well & thought I would try my hand at something I once did but could not for so long. Thank you again for your time and information. I greatly appreciate all insight and information.

Donald Corenman, MD, DC
Moderator

February 14, 2013 at 8:58 pm

Post count: 8660

#8005

Please keep the forum posted as to your diagnosis. 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.
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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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