thomas Italy - L4-L5,L5-S1, D12-L1, C4-C5-C6-C7 ernias and spondilosis

Viewing 6 posts - 13 through 18 (of 41 total)

Previous 1 2 3 4 5 6 7 Next

Author

Posts
Donald Corenman, MD, DC
Moderator

February 24, 2014 at 8:45 pm

Post count: 8660

#10423

The Coflex device is actually contraindicated in the presence of lower back pain from degenerative discs. This device produces increased loads on the disc which makes disc pain worse. I am unclear what discoliosis is after looking this upon on the internet.

Coblation or rhizotomies can be effective if the pain originates from the facets but in the lumbar spine, this is unusual.

If your pain originates from the discs, you might be a candidate for lumbar fusion.

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.

thomasvenice
Member

February 24, 2014 at 11:30 pm

Post count: 23

#10425

The last question:
What would you do with the disck builging D12-L1?
causes me pain on the left side of the back and I have to crack the back to release the pain for a few hours ..
would operate in the same session of the lumbar?
thank you is very nice and helpful!

Donald Corenman, MD, DC
Moderator

February 25, 2014 at 10:29 pm

Post count: 8660

#10430

You have to look at the total of symptoms and the relationship of the T12-L1 level to the total symptoms. This relationship is generally discovered by an epidural performed at T12-L1 and looking at the temporary relief that is obtained using a pain diary and your focus on what symptoms are relieved vs. what symptoms are not.

The T12-L1 surgery can be performed at the same time as the lower lumbar surgery but this is generally much surgery to recover from. I generally recommend two separate surgeries but I have performed these together in the past.

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.

thomasvenice
Member

February 28, 2014 at 9:03 pm

Post count: 23

#10443

Hello DEAR DOCTOR,
IF INSTEAD OF DOING THE STABILIZED TLIF WAS ONLY THE TRACT L4-S1, RISK THAT LEAD TO RECORD ME PAIN? DISCS MUST take it away?
THANK YOU
I ask because ‘HERE IN ITALY WOULD DO THE TREATMENT “MIS ILLICO SYSTEM” Percutaneous BUT NOT REMOVE THE DISC ..

youtube video:

ILLICO SE – MIS Posterior Fixation System

Donald Corenman, MD, DC
Moderator

February 28, 2014 at 10:53 pm

Post count: 8660

#10444

I generally do not recommend a “minimally invasive” system to perform a fusion. The whole purpose of a posterior fusion is to have bone grow between the two facets and transverse processes. This requires preparation of these bony structures and the minimally invasive systems do not allow for great preparation of these surfaces.

In addition, the purpose of a minimally invasive fusion is to “preserve the muscles”. The whole point of a fusion is to get the two separate vertebrae to grow together. The small muscles that cross these joints are not needed after a successful fusion so preservation seems besides the point. The other fact is that the insertion surface area of these small muscles has to be removed to gain bone surface for the fusion. Preservation of the small muscles is not needed and actually contraindicated for successful posterior fusion.

In addition, for a younger active individual, I recommend the TLIF (intradiscal fusion) along with the posterior fusion as the fusion mass is stronger with a greater chance of a solid fusion. This can be performed by a “minimally invasive” procedure but my preference is for a smaller incision in the midline.

Although not really relevant, the cosmetic nature of a central incision is much more pleasing than two para-midline incisions.

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.

thomasvenice
Member

February 28, 2014 at 11:12 pm

Post count: 23

#10445

thank you, Doctor.
wants to know the absurdity in all this?
in Italy we have a health care system that pays us the speeches, but all visits for assessments “series” are extra. The Italian super doctors, asking for € 250-300 each visit and do not assess whether a person is at home from 4 to 11 years and psychologically if a person is on the ground, no matter if a person has failed his life to the cause of evil. Those who visit a free trial to operate on you with the minimally invasive and then leave you hanging.
The super doctors who pay a madness then you will operate between 6 months or a year … then when you think about suicide ..
Unfortunately, I was born in Italy ..
thanks for the answers very helpful.
thomas d.g.
Author

Posts

Viewing 6 posts - 13 through 18 (of 41 total)

Previous 1 2 3 4 5 6 7 Next

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

thomas Italy – L4-L5,L5-S1, D12-L1, C4-C5-C6-C7 ernias and spondilosis