Soft tissue damage, or a possibly undiagnosed underlying problem.

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Rubylee
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August 14, 2012 at 11:07 am

Post count: 7

#6754

Thank you for considering my question. I previously posted but assumed it would go unanswered. I shortened the info in hopes you could alleviate my fears.

Chronic low dull backache left side, never lets up. VAS 2-5 increases with activity. Moderate paced walking causes pain to radiate in to left buttock VAS 3-6 resulting in an altered gait or slight limp. Occasionally sharp pains wrap around into left knee VAS2-4. Eventually pain reaches into left hip VAS 2-6 causing a throbbing ache that diminishes with rest. During sleep only sharp pain radiates down into posterior part of thighVAS5-7. Also while sleeping hip pain increases to VAS3-7.
Tailbone has excruciating VAS 5-8 upon standing only. Pain immediately goes away upon walking. Tailbone soreness VAS 2-3 while driving longer than 15 min and upon sitting on overly soft cushions. This was ultimately relieved by using coccyx pillow. Although going to standing position still causes pain.
Additionally, chronic neck pain VAS 2-5 accompanied by tightness moves up over skull and behind left eye causing throbbing headache VAS 4-7 that lasts about 10-16 hrs. This sometimes radiates behind left ear and resembles an earache with area just below earlobe sore to touch.
I have periodic numbness and pins and needles in elbow pinky and ring finger left hand. VAS1-4 more annoying than painful and nerve test could not confirm ulnar nerve damage. It did however confirm early onset carpal tunnel syndrome bilaterally .
Initially(4months ago) there was extreme hypersensitivity anterior left thigh that caused intense burning pain just lightly running fingers over the area. That has since dissipated.
New onset symptoms that have started this week are both legs have gone numb from thighs to feet (pins and needles) while sitting on the toilet and passively sitting on a fully supported swing.
My question is could there be an underlying cause to these symptoms other than SOFT TISSUE DAMAGE from MVA? Or if not what are your thoughts on manipulation under anesthia? My family has a history of over producing scar tissue and adhesions.
My current doctors feel I should be progressing faster than I am.

Donald Corenman, MD, DC
Moderator

August 14, 2012 at 6:49 pm

Post count: 8660

#6756

Thank you for shortening the question. I get quite busy and the shorter questions are answered first.

You report pain in the back, coccyx, leg buttocks and leg. This pain increases with walking/standing. The neck pain is unrelated most likely and is from a different source.

You note no imaging studies that can confirm or deny the source of your pain. WIthout knowledge of structural problems, I can only speculate what could be causing pain.

Do not consider manipulation under anesthesia. The risks are greater than the benefits.

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.

Rubylee
Member

August 15, 2012 at 9:49 am

Post count: 7

#6762

Thank you for your answer. The coccyx pain is intense when standing from sitting position. Goes away upon walking. Could this be related to lower backache (weakness) and hip pain left side? Would problems with this area show up on an X-ray of lumbar spine, or is an MRI warranted? I’m disinclined to accept what I’m feeling is normal and requires a few more weeks of healing considering it is unchanged in 4 months. Coccyx pain went completely away for about 3 weeks with injection into area, but is back now. Low backache, hip pain, and pain into left buttock increases with activity, but again has never gone away. Burning pain down left thigh wakes me up at night only. Im wondering if this could be a problem with SI JOINT, and how would this be properly diagnosed? Thank you again.

Donald Corenman, MD, DC
Moderator

August 15, 2012 at 7:58 pm

Post count: 8660

#6765

Coccyx pain can be caused by a coccyx disorder (trauma or dislocation), a sacral plexopathy (irritation to the sacral nerves) or by referral pain from the lumbar spine. An injection that caused the pain to temporarily disappear could have been mediated through the steroid effect and is not helpful for diagnosis.

The chance that this coccyx pain is originating from the sacroiliac joint is minimal. You need to see a spine specialist for a thorough work-up and imaging studies.

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.

Rubylee
Member

August 16, 2012 at 9:23 am

Post count: 7

#6773

Thank you so much. My Dr. Has finally ordered a weight baring MRI.

Donald Corenman, MD, DC
Moderator

August 16, 2012 at 7:19 pm

Post count: 8660

#6775

Be careful with a “weight bearing MRI”. These examinations are performed on a lower strength MRI machine and the images can be less diagnostic. I prefer a standard MRI machine and then x-rays that are weight bearing.

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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