Post Surgical Pain ACDF Spect imaging

Tagged: chest pain, thoracic spine, vertebral tumor

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JBoz
Participant

November 13, 2015 at 5:59 am

Post count: 51

#20727

Dr. Corenman, when you say midline, I’m assuming you are talking about the center of the back, but you say in a lateral position, so that would imply I’m laying on my side, is this correct? Therefore the midline you are referring to is not the center of my back?

I could probably get a set of medial branch blocks, or an epidural. The surgeon however requested I not proceed with those. I don’t know if that is because I have had this pain for such a very long time, that it may be obvious we now know the reason, due to the MRI. I must believe that decompression is going to result in many positive changes regarding my current health.

This appears to be such an uncommon surgery, it has brought me more questions than answers. Again I have no idea how common a T4 T5 laminectomy and microdiscectomy is in this day and age. I think the internet can be very distracting in nature. My cervical surgeries were very easy to understand. This surgery is presenting me with a large learning curve from the two cervical fusions I have had performed in the past. I think the bottom line is the best approach is different with every surgeon.

I believe your use of the word midline isn’t referring to the center of my back, since I would be lying on my side.

Thank you again,

JB

JBoz
Participant

November 18, 2015 at 3:25 pm

Post count: 51

#20747

Dr. Corenamn, I apologize for the repetition of my previous questions. I now understand the approach you were speaking of in a matter of degrees, in the responses previously. I’m getting the guided marker CT on the 30th, I imagine the surgery will come soon after. It will be a cut just off the left side of the spine at T4 T5. I’m not too worried about the surgery, due to the experience of my surgeon. I cannot wait to feel the relief it will bring. I will always be very thankful for individuals such as you and my current neurosurgeon. I want to say again, I appreciate your time and wonderful information. I wish I could do this type of open discussion with my own surgeon. That would be really neat. It would be nice for him to know how very much I appreciate his moving forward with this uncommon surgery, I will make a point of thanking him in the near future. I think I’m one of those patients that drives him bonkers with questions. I’m certain you know the type.

Anyways, if you had one best word of advice to prepare for a surgery, what would it be?

Thank you,

JB

Donald Corenman, MD, DC
Moderator

November 19, 2015 at 6:15 am

Post count: 8660

#20753

The best advice to prepare for surgery is covered in this website “preparation for spine surgery”. Stop NSAIDs 5-10 days before surgery. Any supplement that begins with “G” needs to be stopped too (ginseng, gurarana, etc) as these can affect surgery. Relax and trust your surgeon.

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.

JBoz
Participant

November 19, 2015 at 8:54 pm

Post count: 51

#20763

Dr. Corenman, thank you.

I will let you know how it turn out soon. I am working on the relaxing. Surgery is always a bit of a stressful event, but the stress from the quality of life in my case, far exceeds the stress of this surgery. I have a bit of fear, but a lot more excitement of being relieved of such a long term health crisis. I worry about my 11 year old boy more than anything. I cannot imagine what is running through his mind. He has met with my surgeon, and he knows how successful he is, so I think that helped him out a lot. It’s tough going through three spine surgeries in 3 years. I secretly wish my surgeon would video tape the surgery. This stuff is fascinating to me.

Again, great advice, and I will be updating in the near future. That link was very helpful indeed.

JB

Donald Corenman, MD, DC
Moderator

November 21, 2015 at 4:25 pm

Post count: 8660

#20767

Please keep in touch. Your results and experience will be helpful to others on this site.

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.

JBoz
Participant

May 3, 2016 at 6:34 am

Post count: 51

#22092

Hello Dr. Corenman,

I’m sorry I have not responded about my thoracic surgery. The surgery was done in December and the chest pain continued. If fact the situation worsened. I’m reaching out today because a follow 3T MRI of my thoracic spine shows worsened edema, and or myelomalacia. The MRI shows the epidural hygroma as being resolved. The report closes with the worsened part. I’m having new issues. My right leg is very hot and my hip has pain as well. My right hand is starting to have symptoms and the pain in both the back and the chest have become worse.

The edema and or myelomalacia has me scared. My surgeon has the information, I’m just waiting for a plan of action. I’m curious of what your take is on the term moderate to severe edema, and or myelomalacia, and if this can be fixed. It’s been almost 5 months since the surgery. There was a cut in the wrong place, but no operation done. They closed it up and performed the operation above, in the correct spot.

Any advice would be very helpful, as I have something worse than before it appears. I pray this is something that can be managed, but my symptoms are getting worse.

Sincerely,

JBoz
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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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