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Donald Corenman
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May 25, 2011 at 1:14 am

Post count: 52

#4593

I had spinal fusion l5-s1 last October. I went to this doctor as he did it minimaly invasive. Somethings are better but went and had CT mylegram 3 weeks ago and still hurts when a I walk. Gave me a SI shot as he thought it could be sacroiliitis, the pain went away for a few days and now is back. I know I am older , but used to run around 25 miles a week and now can only ride the bike as it does not hurt when I do that. Any thoughts or ideas?

Donald Corenman, MD, DC
Moderator

May 25, 2011 at 1:16 am

Post count: 8660

#4594

You don’t mention why surgery was performed, at what level, what your preoperative symptoms were or your current symptoms are now. You don’t mention if the new CT Myelogram demonstrated solid fusion or pseudoarthrosis (lack of fusion), any nerve compression or arachnoiditis. Please be more specific so I can determine what could be causing your pain.

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.

Donald Corenman
Keymaster

May 25, 2011 at 1:17 am

Post count: 52

#4595

Dr. Donald Corenman,

Thanks very much for your response. I will fill you in quickly as I can with the information.

Had a lamenectomy back in 1979,

My left calf or gastroc never really came back. Much smaller then the right.
My back has been great until 2009.

July 2009 back bothered me went to chiropractor for around 2 months did not get much better but could walk with not much problem.

September. 2009 did fall down sprained my ankle.

Oct. 2009 bent over and could not straighten up went to chiropractor for a couple more months did not get much better.

Jan. 2010 Had an MRI and CT scan. Had bulge at L3-L4 and had a crack in vertebra where I had my surgery back in 1979 which was L5. They said I should fix both but I would be on my back for close to 12 weeks as they were going to fuse L5 to S1.

March 2010 Received a different opinion said to do Cortisone shot at L3-L4 seemed to take a lot of the pain away but still hurt very bad when I would walk.

September 2010 Had a nerve block shot at L3-L4 to get rid of pain when walking and pain did not go away. Same month went for a nerve block shot at L5- S1 went for a walk and felt great, better than I had in about a two years.

October 2010 Fused L5- S1 minimally invasive. Started swimming 4 weeks later after the first x-ray said things looked good.

Jan. 2011 another x-ray and all looked good but told him is still hurt when walking.

April 2011 Is when we did the CT mylegram. Said everything looked good, no blocked nerves and good fusion. That is when I got the Sacro Iliac Joint injection for sacroiliitis and they did a MRI on my hip to see if that could be the problem.

As of today they have not told me about the hip as of yet. I have waited for a response for 3 weeks so I feel like they have given up on me.

Things that have improved since the surgery. I can at least walk normal for a while and I can go up the stairs with out pulling myself up on the hand rail. But when I try to walk a few hundred yards it hurts very bad at times always on the right side, and would not think of trying to run. Still hurts to sleep on my right side also, but feels much better after riding the bike.

So I think my best options today would be to try to get the 2 imaging companies to send you a copy, so you can look at them. Then I should make an appointment with you at the same time, to see what you think.

Once again thanks for your response and hope this helps and I will wait for your advice before I do anything.

Donald Corenman, MD, DC
Moderator

May 25, 2011 at 1:19 am

Post count: 8660

#4596

Answer-

I still will have to interpret your answers but I think I have a better understanding of what is going on. You had a laminectomy in 1979 and note your “left gastroc never really came back”. You note the muscle atrophied which means you had a large herniated disc at L5-S1 that injured the left S1 nerve and even with the microdisectomy surgery, the nerve never recovered. You had no back pain after surgery until 2009.

In July 2009, you developed back pain and you were treated by a chiropractor. You had a re-aggrevation of your back pain in Oct. of 2009.

In Jan. of 2010, you had an MRI and a CT scan because of the back pain. You had a “bulge” in the L3-4 disc (“bulge” could mean torn disc, herniated disc or spur formation) and a “crack” in the vertebra at L5-S1. The “crack” could mean a pars fracture or an endplate fracture- I cannot tell from your description. You finally had a nerve block at L5-S1 which diagnosed the pain generator as the L5-S1 level.

October 2010- you had a fusion of L5-S1 but you don’t mention which type of fusion (check neckandback.com for the type you might have had). You then started swimming 4 weeks after “things looked good”. Does that mean four weeks after surgery or four weeks after the surgeon thinks you have had a solid fusion?

You mention a sacroiliac injection after the fusion but don’t mention what the results were. Did you get relief for the first three hours?

You then mention a hip MRI. It sound like you have buttocks or hip pain now. Did you have the same symptoms prior to the surgery?

You then mention right sided pain with walking but you fell no pain on a bike. Is this the hip pain you mentioned? This could be consistent with foraminal stenosis. Again, check the web site (neckandback.com) for this diagnosis and let me know if that might fit with your symptoms.

I would be happy to look at your images. Please contact my office at (970) 476-1100 and ask for one of my nurses.

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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Question from Email – Back Pain