Progressive thoracic spine pain 10 months

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Lovelife
Member

February 29, 2012 at 2:54 am

Post count: 16

#5680

Just contacted Dr. Kaiser’s office in Marin. She’s going to give him the message and see what he says about doing a read of my MRIs. I don’t live very far from his practice so hopefully I can have him take a look.
Thank you Dr. Corenman

Lovelife
Member

March 1, 2012 at 5:33 am

Post count: 16

#5688

Dear Dr. Corenman,
I never heard back from Dr. Kaiser’s office, so it looks like he’s not interested in doing 2nd reads on an MRI. That’s fine, I will keep plugging away and trying to resolve this myself. Hopefully by August so I can get back into grad school.
I appreciate your kind and generous time and the suggestions you have given.
Thanks so much for everything.

Lovelife
Member

March 9, 2012 at 8:54 am

Post count: 16

#5737

Dr. Corenman,
I did work with another radiologist (remote) on my issues and the MRIs.
The enhancement of the paravertebral vessels in particular at T5 (seen on Water:SAG T2 IDEAL, SAG T2, Post Contrast images) he indicates to be flow artifacts.
He said the thickness of enhancement (and thru the foramen) wasn’t something he’d seen before (It’s about 1 inch thick across the vertebrae) but did not believe it to be pathology nor a causative factor.
I hope I can keep working hard to resolve this on my own. If not, maybe a chiropractor will have an answer. I’m not ready for that yet since my MRIs at the T4/T5 level seem to not explain the stabbing pain and radiation down my spine.

Thank you again for this website and your kind advice.

Donald Corenman, MD, DC
Moderator

March 9, 2012 at 9:39 pm

Post count: 8660

#5742

If there is no significant pathological process in the spine, a chiropractor would be a good choice along with a strengthening program.

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.

Lovelife
Member

March 23, 2012 at 1:46 am

Post count: 16

#5818

I did end up seeing a chiropractor. He said my spine is indeed very painful upon touch/palpation from T4-thru probably T-6 right down the midline.
Attempted to read my MRI’s and Bone scan but didn’t feel much info could be obtained other than he was curious about the level of uptake on the bone scan in my T-Spine. Was told by radiologist it was a homogenous uptake of no concern. Have to trust in that.

The chiro took one x-ray (machine was SUPER old… like from the 50s) and
indicated my spinous processes in my T-Spine were misaligned indicating misaligned vertebrae. I had an x-ray at the beginning of all this and the orthopedic surgeon did not mention misalignment. The chiropractor performed several rapid thrust adjustments of neck, t-spine and lumbar. I was a bit scared with that, especially the neck, which I did not know he was going to do. Was told most chiropractors believe in adjusting the entire spine. Care needs to be taken in my T-Spine because I have had a median sternotomy to repair an Atrial Septal Defect. I do not know how many adjustments are typically needed to get vertebrae back into alignment, if they are indeed out of alignment.

In your experience as a chiropractor Dr. Corenman, did you generally take a whole spine approach when trying to alleviate pain in one region of the spine? This mid back pain is coming up on a year so chiropractic might not be the right solution.

The Radiologist I consulted originally did not feel my spine was out of alignment, so was uncertain what the chiropractor saw that he did not. I will continue on with stretching, the foam roller, tennis balls, etc. I am a runner and cyclist and will continue these activities as much as possible as well. hope to feel better soon so I can get back into grad school.

Donald Corenman, MD, DC
Moderator

March 23, 2012 at 10:49 pm

Post count: 8660

#5824

I know that chiropractors use the X-ray as a tool to determine if the vertebra are “out of alignment” but the findings on X-ray indicating alignment issues are really not accurate. It is the palpation of the vertebra that really indicates restriction of motion. Using palpation skills, a chiropractor can “feel” restrictions in movement of one vertebra to the next and then deliver a thrust (adjustment) to mobilize that motion segment.

Many chiropractors manipulate the entire spine as they believe that a spine without restrictions of movement, even in non-painful regions, will allow the painful segments to function better.

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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