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Big nerve
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July 13, 2011 at 11:14 pm

Post count: 11

#4696

Hi Doctor thanks for this forum it has been very helpful to me for what has been going on with me I had a lacectomy about 17 years ago been pretty good still had a few problems along the way then about 5months ago re injured my back again oh the first op was l5s1 this time had ct scan it showed narrowing of the l 5 disc and some nerve pressure went to neurosurgeon he said instead of doing a fusion at that level he would do s1 nerve decompression considering I got so long out of the first op I had the op on the 19/52011 after a week still had a lot of pain in left buttock and left leg numbness in the the left foot and pain in the middle of my back so my doctor sent me for a nerve block injection after injection still had a lot of pain but the pain seemed to be all over the place went back to surgeon he got me to start taking nerotin he said after 10days should start to feel better went back to nerosurgeon with still no improvement he then sent me for another MRI it came back with a few findings but when I phoned his office the secretary said there was no sinister findings and all it was inflammation and that to have a nerve block injection and I would be find after 10days so that period has now passed and I desperate to get back to work in the second MRI they said there was clumping of the nerves about l4l5 I did not have a problem with that area and it Also said something about acroditis not sure of spelling just not sure what to do the doctor said when I ask him why I am still in pain he said because that is how god made it he is a very good surgeon but I do not know what to do my gp said sometimes these ops just don’t work out the way they should for one way or the other and bye the way still in pain and lots of it help please with some of your advice thank you for the wonerful service you provide also do the nerve block injections work for everybody or does it depend sorry if I have repeated my self just in lot of pain and trying to keep my mind of it

Donald Corenman, MD, DC
Moderator

July 14, 2011 at 7:57 am

Post count: 8660

#4697

It appears by your description that you had a laminectomy at the L5-S1 level 17 years ago and did pretty well. 5 months ago you “reinjured” your back but don’t state if you developed back pain or buttocks and leg pain (problems stemming from different sources). You had a CT scan (not the best first test in my opinion as it only accurately demonstrates bone and is poor to show nerves and discs).

You went to a neurosurgeon who recommended another decompression. If you had significant buttock and leg pain from a new herniated disc or bone spur, this is the recommended procedure. If you had back pain from the degenerative disc or foraminal stenosis (see web site), this procedure will have limited success.

After surgery, the pain did not improve and a new MRI noted “clumping of the nerves around L4-L5”. This condition could be arachnoiditis (see web site for description) but you really may have chronic radiculopathy (again- see web site for description).

Since your surgeon hasn’t showed you the films, I think it might be in your best interest to garner a second opinion. Have the new surgeon show you your films and explain what he sees and thinks. If there is further nerve compression, he or she will tell you. If your diagnosis is either arachnoiditis or chronic radiculopathy, you might need to see a chronic pain physician. There are medications, injections and stimulators that can help with pain management.

Good luck.

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.

Big nerve
Participant

July 14, 2011 at 8:11 am

Post count: 11

#4698

Hi doctor you explain things so well sorry for the long drawn out question last time I will try to make this question really short does nerve block injections work on everybody I just want some releif from this pain just even for a little while would be of great benefit thanks again doctor for your answers

Donald Corenman, MD, DC
Moderator

July 14, 2011 at 8:33 am

Post count: 8660

#4699

Nerve blocks have two medications in them. One is a numbing medication like lidocaine or novacaine and the other is a steroid. If you have an injection of the nerve that is causing pain, the injection should yield three hours of relief- the same as when you go to the dentist and your jaw is injected.

If you do not notice relief from the injection, the wrong nerve was injected, the injection was technically poorly done or you are resistant to the “caine” anesthetics (an injection in the jaw from the dentist does not cause numbness).

Keep a pain diary (see website for details) if the nerve is injected again. You should get relief- at least temporarily if you have an injection into the correct nerve.

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.

Big nerve
Participant

July 14, 2011 at 9:03 am

Post count: 11

#4700

Hi doctor you have been a great help just one more question I have had the injection and there was a numbness feel there I could not sleep and I got pain on the right side the left side was not completely numb just felt different

Donald Corenman, MD, DC
Moderator

July 14, 2011 at 9:06 pm

Post count: 8660

#4701

The injection will only help the side that it is injected in. You didn’t mention right leg pain before and of course, a left injection should not relieve right sided leg pain. You would expect only left sided anesthesia with a left injection. The numbing of the nerve root only lasts three hours, so including the time in the injection suite, recovery room, the drive home and preparation for bed, the effectiveness of the injection likely wore off.

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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