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

Tagged: PAIN, spine, thoracic

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Jtal19305
Participant

December 24, 2015 at 8:18 am

Post count: 43

#21076

Dr Corenman
Thanks again. Yes the price was lower than I thought. I will have to inquire about the quality, power and type of machine. I am still hoping the insurance company approves.

I had a mid line incision which is about 6 or 7 inches long. If there was even a chance of cord irratation I don’t know why my surgeon would take such an unnecessary risk. Given the fact that I woke up with a burning pain in my left foot and still have burning in my left sole. I’m very upset that this has happened. This pain as well as the other pains has really cost me gravely. It has affected me big time. Why would a surgeon do this procedure on me knowing the risks? It doesn’t make sense to me. I wonder if I would be better off not having this surgery . I suppose if you saw the pre op MRI you could know the answer to this. But it doesn’t matter now. For better or worse I went ahead with the procedure. I just hope I can get better over the 12 to 18 months you stated it may take. The fusion surgery is hard enough to recover from let alone this additional nerve pain I have and the fasiculations.

Would a post op cat scan show possible cord retraction because it show the alignment of the spacer and entry point? Would the the pressure from the pedicle screws cause the bone spurs on the other side of the thecal sac to contact the cord with more pressure? that seemed to be my issue from the pre op MRI; I had narrowing in the center due to the bead like bone spurs forming on both t12 and l1. I assume those bone spurs were forming to self stabilize that area of my spine for whatever reason.

Would removing the hardware cause instability in my spine? I would like to eventually get this metal put of my spine. I don’t feel it but if it can be removed at done point why not. I just want to get better and I’m not happy with myself for allowing such a risky procedure to go forward not am I happy with my surgeon for suggesting it. I should of been more careful but I also thought I could not wait around too long.

I think I will have to use your long distance consultation where you can actually review my imaging and reports.

Thanks and merry Christmas!

Jtal19305
Participant

December 24, 2015 at 9:43 am

Post count: 43

#21077

What bothers me alot is whether the surgery was even the right thing to do. My spine was probably like this for a long time and something aggravated it to cause the leg weakness to come on. Once I was given oral steroids by my surgeon the leg weakness was better. I could walk fine and had not bladder issues. I took the doctors recommendation and felt at the very lesser the surgery would prevent a y future issues. I realized afterwards how rare thoracic herniation and none spurs are as well as bulging disks which is what I had at t12 l1. I had no idea the risks involved. So for my peace of mind I would like someone like yourself to not only review my post op MRI and cat scan but my pre op MRI. I would like to know if surgery was the weight choice. I did some things in the months prior to surgery in hopes of relieving my left leg outer thigh pain and numbness which was my only issue for the longest time. I started using an inversion table and I had one chiroputrestment about 4 days before my legs started feeling weak. I don’t know if it is just coincidence or if the see things caused my legs to weaken and the calf fasiculations. Maybe my back was headed to surgery and these things just brought out the eventual issued. I don’t want to answer my own questions but would like to know your thoughts. I know it is already past but this will help me understand why I got here in the first place.

I also will contact your office to arrange this consultation.

Thanks
Jerry

Jtal19305
Participant

December 26, 2015 at 6:42 am

Post count: 43

#21078

Would compression on t12 l1 level cause bilateral leg weakness? My fear is I could of been wrongly diagnosed although I had a narrowing canal at T12-L1, it may of been like that for years. And possibly L2-L3 which was had moderate to severe stenosis was irritated during the chiropractic treatment prior to the leg weakness. I worry I has unneeded surgery and fusion at T12-L1. And now I have pain because of it and set up for future issues.

Thanks

Donald Corenman, MD, DC
Moderator

December 26, 2015 at 12:58 pm

Post count: 8660

#21079

Whenever a surgery is around the cord in the thoracic spine, there is always a chance of cord irritation. Your surgeon might not have told you that but no matter how careful a surgeon is, there is a possibility of cord irritation or dysfunction.

Developing motor weakness in the face of significant narrowing (stenosis) in the thoracic spine requires decompression surgery. It appears your surgeon did get an adequate decompression as your motor weakness disappeared. Yes-the burning in your foot developed but you can walk now and you have bowel and bladder control. It seems that the burning is reducing in intensity and should continue to reduce over the next year.

It is possible that placing the cage could have created the burning pain due to cord retraction-yes. An MRI might be helpful in determining the “tract” of the cage and if retraction was necessary. Nonetheless, the cage was not something that was not appropriate as some surgeons place these cages routinely.

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 26, 2015 at 1:36 pm

Post count: 43

#21080

I am afraid to bring it up but could I have developed arachnoiditis? I hope not but have to ask. This was my only spinal surgery. I don’t have back pain. Just pain in my left outer thigh calf and the heel of my left foot. I also get the calf fasiculations.

Thanks

Donald Corenman, MD, DC
Moderator

December 27, 2015 at 4:53 am

Post count: 8660

#21082

It is possible that this could be arachnoiditis. Arachnoiditis symptoms typically are bilateral but it is not inconceivable that it could occur unilaterally. The MRI (if it is of good quality and the metal artifact is not too problematic) could be helpful with that diagnosis.

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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