Thoracic back pain

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anelsen15
Member

May 24, 2013 at 4:18 pm

Post count: 12

#8739

Just to add my thoracic back pain experience, I herniated the T6-7 disc and it was found through discogram that I had tears in T5-T8 with the T5-6 generating pain and T6-7 also. I had 3 ESI up to that point targeting the T6-7 disc herniation to no avail, but I had one more after learning of tear and the doc put it as close to the tear as he could and within two weeks the stabbing pain that was the absolute worse was gone and I can say two years later never came back an I rarely have issues in T spine anymore. I was same as the original poster of this topic, I had absolute pain releif while lying flat and while in inversion. In my humble opinion the tear caused the stabbing pain vs the herniaton, but it took 6 years to find. Good luck

Donald Corenman, MD, DC
Moderator

May 24, 2013 at 11:07 pm

Post count: 8660

#8740

This is a typical history with thoracic degenerative disc disease but with a happier ending. Epidural injections are the mainstay of treatment along with extension strengthening exercises. Most patients, if they can “wait it out” will slowly improve. Rarely, some patients have to undergo 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.

anelsen15
Member

May 25, 2013 at 8:15 am

Post count: 12

#8742

sorry I was trying to post within another topic about thoracic but it looks as it started a stand alone. Still learning site.

zahul
Member

May 26, 2013 at 3:03 pm

Post count: 8

#8747

What are some extension strengthening exercises? I’m afraid to exercise because I think I might make the herniations even worse but I would love to try some beneficial exercises.

I haven’t yet tried epidurals because from the stories I’ve read online they don’t seem to work for everyone and when they do there is not great relief. What is the cause of this? When an epidural provides no relief is it because it wasn’t done right or it just doesn’t work for that patient?

Donald Corenman, MD, DC
Moderator

May 27, 2013 at 9:05 am

Post count: 8660

#8750

Extension strengthening exercises include rowing on a rowing machine and exercise ball extensions where you lie face down with the ball touching your belly and extend up. You can increase the difficulty with your hands behind your neck.

Epidurals will work under the right circumstances. If facet pain is the cause and not disc pain, the epidural will not be effective. If the disc bulge is “contained”, the steroid may not contact the painful structure. There is the slight possibility that the fluid is placed in the incorrect space.

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.

zahul
Member

June 2, 2013 at 11:03 pm

Post count: 8

#8774

Thank you Dr. Corenman.

I’ve visited a surgeon this week. He said I don’t need surgery. He also said that he can operate from the back. I asked how he does it, he seemed to explain a laminectomy. He said it has a great risk of paralysis. From what I’ve learned online, laminectomies aren’t recommended for thoracic herniation as a lot of patients were worse than before surgery.

What was strange was that he said my MRI doesn’t match my pain. My entire shoulder blades are hurting very much and there is also some discomfort between them, I also have a very painful spot in my upper lumbar spine. My lumbar bulges are L3-L5, my thoracic bulges are T7-T9 and 2 “minimal” bulges at C3-C4, C5-C6 and a 1-2 mm C4-C5 bulge.

I really don’t know what to do with this pain that’s starting to take over my life and nobody seems to care about me, I think due to my age.

Two years ago after lifting some weight lifting sessions I started having severe pain in my upper lumbar spine in a relatively small spot right on the spine. The pain got better very very slowly and I starting noticing the pain(more like discomfort) in my thoracic spine when I tried to stand straight because I wanted to take care of my back. I had a lumbar MRI that showed the thoracic and lumbar bulges but because by that time my pain went from a 10 to a 5, sometimes even 3 I was hoping eventually I will be left with only some pain. I lived with this tolerable pain but recently I’m having really bad pain but this time more diffuse and all over my back but mainly thoracic. My lumbar spot still hurts very often, sometimes even considerablty but my constant pain is my thoracic back that hurts continuously and on a large area.

My thoracic MRI from nearly two months ago showed the same disc problems, they didn’t got worse. My pain is worst than two months ago so I think maybe I should get another one but my doctor doesn’t want to send me for one.

Is there really no way to ease my pain?
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Donald Corenman, MD, DC

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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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