Post Surgery Pain Issues related to Thoracolumbar Laminectomy, disectomy and fus

Tagged: PAIN, spine, thoracic

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Donald Corenman, MD, DC
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December 17, 2015 at 6:03 am

Post count: 8660

#21045

Read the EMG section on the website. You will see that central (spinal cord) injuries generally will not show up on EMG findings.

The MRI will be helpful to determine if there is any significant cord compression remaining.

You calf faciculations could be cord derived. If they are, again, it will take up to 18 months to determine if they will be permanent or just fade away.

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.

Jtal19305
Participant

December 17, 2015 at 11:51 am

Post count: 43

#21046

Hello

I read the emg section and see that it does little for small fiber nerves. I appreciate your comments. I never though I would be in this situation and would need surgery. I felt so good with the exception of the anterior left thigh pain. Then I got the calve fasiculations and leg weakness so suddenly in a short course of time. I don’t know if a chiropractic treatment I had a 5 days before the legs got weak contributed or not? Everything was sudden and to go from being pretty healthy to having major back surgery and now dealing with nerve pain has been overwhelming. The link below are images I clipped of my spine. There are a few prior to surgery but most are aftererds. I’ve been told my back, especially user lumbar was in bad shape for someone of my age 48.
https://goo.gl/photos/wwQcbJffcVqkFnb77

Donald Corenman, MD, DC
Moderator

December 18, 2015 at 6:18 am

Post count: 8660

#21047

I am sorry but I cannot open images due to viral concerns.

I cannot tell you if your chiropractic treatment had anything to do with your advancing weakness. It sounds like you needed surgery and that you no longer have weakness although you do have the allodynia of your foot. That symptom is improving and only time will be able to allow symptoms to decrease.

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.

Jtal19305
Participant

December 18, 2015 at 8:59 am

Post count: 43

#21048

Hi Doctor Corenman
Again thank you for your advice. I still have numbness and pain in my left outer thigh and pain off and on in my left calf. The pain in my left outer calf and the area anterior to my left knee is a biting stinging pain’ I did not have this pain prior to surgery. Yes the sole of my left foot burns too but I think it’s getting better slowly. I just find it strange that almost six months later I still have leg pain, and it is predominantly my left leg. I thought the L2/L3 left side laminectomy would have taken care of that. Of course, if the MRI can show pinching of the nerves still, maybe something more needs to be done. Or, is it still a matter of time?

I can ensure there are no viral concerns with the link as it just goes to a folder I created in Google photos. But I understand that you cannot take the risk to open it. Also, maybe I am being a bit pushy seeking your advice. If I did not have all this strange pain, I would be more at ease. Hopefully in time, things settle down and get better. I am also trying to find that detailed meticulous doctor that can give me honest answers. I’m also waiting for my MRI to be approved which may provide details and insight into what may be causing my pain. Although I hope you are correct indicating it may be a matter of time to heal due to cord level irritation. I just feel, in my body, that something could be off. I never had pain of this type for so long. Maybe the biomechanics of my spine which was already unique to the the minor curvature of the spine (scoliosis) I developed when I was 11 or so, and that curvature was to the left in my lower thoracic and upper lumbar area. This could explain the bone spurs that were forming in attempt to stabilize my spine. The surgery to remove the lamina, facet joint and disk at T12/L1 could have caused a shift which may be putting pressure on the nerves/cord on the left side, which may explain the left leg, calf and foot pain. Just a thought.

As it may be helpful to understanding my case, the images of my spine that is, I can print then and mail them. Again your the only doctor that I met that has had the compassion to address my concerns as I go through this difficult time. You have given me some hope that better days may be ahead and that I must be patient.

Thank you again!
Jerry

Jtal19305
Participant

December 20, 2015 at 7:45 am

Post count: 43

#21050

Dr Corenman
I appreciate your feedback on my case. I’m just very concerned about the pain I have in my left outer thigh, calf and some of my left foot. It has been six months and this pain is mainly caused after my spinal surgery. I feel something went wrong during surgery to cause me this constant pain. I hope you are correct in that it is only cord irratation but I worry it could be something else as well.

It just doesn’t make sense I have this pain all the time. It is a stinging burning pain. It is as bothersome in my calf and thigh as my foot. Isn’t there testing or imaging that can help figure out what is happening? I don’t feel my doctor has been straight forward with me. They seem to be at a loss to explain what is or has happened to me. There must be somethings I can do. Living in this pain is not fun.

My images way a lot but I believe I need more imaging done and read by the right and best doctors.

Thanks

Jtal19305
Participant

December 20, 2015 at 1:01 pm

Post count: 43

#21051
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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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