Post surgery

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rojotoni
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August 19, 2011 at 2:34 am

Post count: 9

#4786

Hi,
Hope you could help. Lots of things I want to ask. Did not get much help from doctor. It is getting better they just oked a ct of lumbar spine. Ok Had surgery on June 13th 12 procedures decompressive lumbar laminectomy on right L4 with decompression of thecal sac and the nerve roots and neural foraminotomies in far lateral aspect, comp;etely decompressing thecal sac and the nerve root. Same L5 and S1 prosthetic spacer at L4-5, L5-S1. Ok my question alot of my pain is standing more than one hour and laying down when I lay down I cry when I try to turn. Can only sleep 2-3 hours. Great toe right foot goes numb also pain in butt and calf. When I try to get up half way standing or trying to sit to use bathroom. My legs or back not sure will give out also if I drive and when I get out and start to walk. Know getting ct of lumbar is this muscle or nerve? And or what could this be. Thank you

Donald Corenman, MD, DC
Moderator

August 19, 2011 at 8:03 am

Post count: 8660

#4787

You report “12” procedures form a surgery performed about 2 months ago on June 13th. You report decompression of multiple levels. You then note implantation of “prosthetic spacers” at L4-5 and L5-S1. Were these interbody cages for fusion or artificial discs?

What is your pain now compared to prior to surgery? You must have had buttocks and leg pain prior to surgery for a decompression surgery. Did the pain shift or change in character? Do you have constant pain now or pain with standing versus sitting? Do you have back pain also or only leg pain? Do you have any weakness? If your bowel and bladder functioning well?

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.

rojotoni
Member

August 19, 2011 at 12:40 pm

Post count: 9

#4788

posterior lumbar interbody arthrodesis at L4-5, interbody arthrodesis at L5-S1, placement of an interbody prosthetic spacer at L4-5, same at L5-S1, segmental instrumentation at L4, L5 and S1, use of the allograft bone for the arthrodsis. Sorry didn’t know you needed that info. I feel dumb because I had the surgery and not really sure what they did. What do you mean by cages? I have not really been able to compare I can only stand for about one hour then have pain. Laying down and trying to turn also really hurts at a 10 pain level I can only sleep 2-3 hours. Then after that I can’t stand for about one min.that is about the only weakness I have. The pain is not as bad when I am sitting in desk chair. The pain is more right sided. Bowel and bladder are fine. Again thank you

Donald Corenman, MD, DC
Moderator

August 19, 2011 at 3:05 pm

Post count: 8660

#4789

By your description, you had a TLIF at L4-5 and L5-S1. That’s “Transforaminal Lumbar Interbody Fusion” (see website for details and video of surgery). The spacers used in between the vertebra to hold them in anatomic position are called cages.

You have current complaints of lower back pain but no leg pain. What was your surgery done for? Did you have incapacitating lower back pain or leg pain or both?

You are only two months out from surgery and even though I would expect your lower back pain level to be less at this point, you still have plenty of time to heal. With allograft, the healing typically takes longer so don’t despair. It may take up to a year to heal with allograft.

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.

rojotoni
Member

August 19, 2011 at 11:29 pm

Post count: 9

#4792

Thank you so much. One more question please. Because of the pain they are finally going to do another test. Myelography and CT scan on 8/24. Is this ok? I am so worried I will be flying and have cruise on 9/3. Please is this safe? Thank you again.

I used to work on an ambulance when I was younger. Not sure if that is what started it. But before surgery had discogram and they said I needed surgery. I am a supervisor and walk my hole shift. I do not sit until break or lunch. When I would leave work my pain was 9-10 hard to pick up feet and put in car lots of cramping. Leg pain is thigh, calf, foot and toes right side. The most pain is one hour or more standing and again when laying down great toe goes numb. Again thank you so much. I will let as many people I know about this site. You have been great with answering my questions so quickly. Thanks

Donald Corenman, MD, DC
Moderator

August 20, 2011 at 4:37 am

Post count: 8660

#4793

You mention pain but stated previously that you have only back pain. Do you have leg pain too? A CT/myelogram will define the position of the screws, the cage and any nerve structures. If there is residual compression of a nerve, this test will demonstrate it.

If something is found that needs to be corrected, the surgeon may want to fix it sooner than later. Make sure you know his or her plans before the cruise you have planned.

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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