T9-10, T10-11 Herniated Discs

Viewing 4 posts - 1 through 4 (of 4 total)

Author

Posts
Spinefriend
Member

April 25, 2013 at 12:37 am

Post count: 1

#8496

Hello Dr. Corenman,

I am writing in about a friend who is stubborn, and mostly computer illiterate (so he’d never find resources like this). Several months ago, he started lifting weights with some ex-marines from work, and trying to compete with them, did leg squats with far too much weight to start with. For his efforts, he got some spinal fractures and herniated discs between his T9-T10 and T10-T11 vertebrae. The doctor he went to see suggested operation as the only real option for recovery, but my friend didn’t think the risk was necessary, and I agreed. There were no suggestions made for injections or physical therapy. He was told to “rest” for as long and as much as he could and hope that things get better. Unfortunately, he works hard (physical labor) all week to support his family, and can’t “rest” without taking time off work.

For the first few weeks, he continued at work and heavily medicated with pain killers and anti-inflammatory drugs. It was to the point where he could hardly walk when he got home. He weened himself off the pain killers and over time his pain has reduced, and he has had fewer twinges and numbness. On last visit to his doctor, the fractures had healed. His pain is manageable, but the doctor is still only suggesting surgery for treatment of the herniated discs. I have to imagine that there are other options. From what I’ve read on this forum, there seem to be. What are your thoughts on the situation?

Thanks,

Concerned Friend

Donald Corenman, MD, DC
Moderator

May 12, 2013 at 9:11 am

Post count: 8660

#8641

Surgery for thoracic herniated discs is only called for if there is cord compression leading to myelopathy (see the section on myelopathy on the website) or significant deformity (an abnormal curve called a hyper-kyphosis greater than 30 degrees).

Conservative treatment includes therapy, medications and activity restriction. If it doesn’t hurt and the cord is functioning normally, there is no reason to perform surgery.

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.

WRL1994
Member

May 2, 2014 at 11:25 am

Post count: 1

#10867

Dr. Corenman – these forums are a godsend, thanks for creating them.

I also have a T10-T11 herniation (large 0.5×0.7×1.4 cm (AP by ML by CC) left foraminal disc extrusion extending superiorly, severely narrowing the left foramen). No spinal cord impact, but when it is inflamed, pain radiates around my rib cage into my belly button. When I go long periods with little activity, the pain recedes. But when I do something that impacts it, it comes right back.

Is this it for me, limit my activities for the rest of my life or have the chronic pain? I cannot even teach my son to play baseball, because the throwing and especially the swinging really creates stiffness followed by pain, so I am anxious to find non surgical remedies that will improve my baseline health level. You mentioned in one of the other forum topics about thoracic herniation that posterior chain muscle strengthening would help take pressure off the disc – but my doctors told me to not use a rowing machine or do sit up activities that cause my back to break its straight line, since that is where the injury is. Do you think it is ok for that kind of exercise? I have also read where some prescribe a combination of supplements involving glucosamine, Chondroitin and methylsulfonylmethane (MSM – which I have never heard of). Is this a regular treatment aid?

Also, I worry about the herniation worsening so that it does start to impact the cord, and I have to have surgery. Is it ok to continue seeing a chiropractor, or does create a risk if additional herniation? Also, I have avoided things that my kids want to do, like jet skiing or amusement park rides, or really anything where I am exposed to a jarring impact. Are they a real risk for me?

Any advice would be very welcome.

Donald Corenman, MD, DC
Moderator

August 6, 2014 at 1:35 am

Post count: 8660

#11262

Do not worry about a recurrent disc herniation causing further problems. There are case reports in the literature but these are so rare that you should not worry about this potential.

The irritation to your peripheral nerve (the chest wall pain and numbness) can be reduced most likely with an epidural injection. Time should also reduce this irritation. If this pain does not recede and continues to thwart your life, a posterior decompression and fusion of this segment can be done.

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.
Author

Posts

Viewing 4 posts - 1 through 4 (of 4 total)

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel