Post L5 S1 surgery

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Anonymous
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November 4, 2011 at 3:59 am

Post count: 8

#5074

Dr, I’ve written to you before my surgery describing my symtems. Left side pain with pinching burning etc. Dicogram showed L5S1 disc was shot. Anway, I had my tlif on the 24th and they said I was doing better than most, walking on my own etc. Chacteristic of my pain seemed to be alittle better than before surgery but immediately after surgery I had bad pain down left side ( like a charlie horse) My mom and wife rubbed it and it finally went away. Two days later it came back and I mentioned it to the dr and he said it was nothing to worry about. I came home on the 27th and have been doing everything I’m suppose to do and walking. Dr said walk as much as I can so even after being home 2 days, I’m walking 2 miles with no discomfort. Monday I was riding in the car feeling some discomfort and pinching on the left side and it has increased since then. Brusing is even popping up over my left side where the pain starts. Most of these symtems are the same as before surgery, pinching, burning, throbbing down the leg. All test before showed no pinching of the nerve and even ct of pelvis and hip ws normal, just that the disc was bad. I’m praying this isn’t bad news for me, that the surgery wasn’t needed. I’m waiting on a call from the dr. but I wanted to see what you said as well. You really helped me before and I value your input…Thank You…ps any tips cause mybowels have bailrly moved 2 times since the surgery on the 24th
Tim

Donald Corenman, MD, DC
Moderator

November 4, 2011 at 9:13 pm

Post count: 8660

#5075

The leg pain might be from the exposure of the nerve root to surgery. If the TLIF was performed on the left side, the nerve root is temporarily retracted. Some stretch of the root can cause irritation. Also, if the surgeon used BMP (bone morphogenic protein) in the disc space, this can be temporarily irritating to the root.

For bowel immobility after this surgery, this is very common. Normally, the narcotics taken after surgery will slow down the motility of the bowel. Patients need to take propulsive substances such as Metamucil, Senocot, Colase or other similar substances.

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.

jasbir singh
Member

November 5, 2011 at 1:01 pm

Post count: 1

#5085

Hello Dr. Corenman my dad have back pain since 1996. First time his right leg started paining and he conselt in india the dr stretched his lag,s and gave him madicenes but he did not get any relef from his pain and now in these days his pain is increases with time. His neck is also started paining and his back is beds in forward direction and his chest is also not expand easily. his treetment was startsd in P.G.I also but they also given him only paincilers now my dad is so tired from this problum so please dr help to my dad. thanks to read it.

Donald Corenman
Keymaster

November 5, 2011 at 11:00 pm

Post count: 52

#5087

This question has been moved to its own thread. Please subscribe here: https://neckandback.com/general/764-disabling-neck-and-back-pain#764 for updates.

Tiku311
Member

December 8, 2011 at 1:24 am

Post count: 4

#5189

I’m a 35 year old cardiologist and unfortunatley have a h/o back surgeries. The first was an L5/S1 lami/discectomy on the right in ’97 with immediate relief of symptoms. I did well for over 10 years until ’08 at which time I developed left sided back and leg pain. I underwent an MRI revealing a left sided L5/S1 herniation. The pain distribution was different on the left then the right but I assumed that was due to some degree of asymmetry in my dermatomal distribution. I dealt with the pain conservatively for 3 years (including a couple of epidurals with minimal relief). Finally the pain progressed and I finally had surgery in 6/11 with a left sided L5/S1 microdiscectomy. Since surgery I’ve had ongoing radicular left leg pain though my back pain is significantly improved. I had an epidural in 10/11 with some improvement but now the pain is back. Interestingly the pain distribution now includes the prior area before the surgery but also new areas in my left leg as well. The pain is not as severe as it was before surgery but it is now almost constant and especially when I sleep on either side. Unfortunately due to the constant symptoms and difficulty sleeping, I’m considering a repeat procedure (even “laser spine” surgery for FBSS). Please advise.
Any assistance would be greatly appreciated.

Donald Corenman
Keymaster

December 8, 2011 at 4:51 am

Post count: 52

#5190

Hi Cardiologist, please move this to a new thread here: https://neckandback.com/new-back-topic in order to receive the quickest reply from Dr. Corenman.

Thanks,
NeckandBack Admin
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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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