Thoracic Disc Herniation Questions

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Mkilpatrick74
Member

October 17, 2013 at 10:13 am

Post count: 3

#9596

Hi There!

I just finished reading about your situation and want u to know that I hope all goes well with the surgery. I know how you feel in that our injuries are rare and can be a little scary not being able to find many in the community that are similar. I just posted my most recent Myelogram results under a new thread in hopes of getting the Drs input. I have many extruded discs that are compressing or flattening my spinal cord in the thoracic region. I’m a walking time bomb in my opinion.

I do hope you continue to post here as you move through the process and begin the heal and find comfort again! My prayers are with you!

Michelle

Mkilpatrick74
Member

October 17, 2013 at 10:20 am

Post count: 3

#9597

I forgot to add that my thread is listed as “Multiple Thoracic Extrusions T2 – T12”

syxx_35
Member

October 18, 2013 at 8:44 am

Post count: 26

#9602

I did read your post. I have been trying to read most of the thoracic related posts.

I had my pre-op, my INR was 1.5, to be expected. The hospital called and wants me to get a FFP transfusion which is fine. However, they will not do the order. Left a message with surgeons care team. Hope to hear back tomorrow as I need to get approval from my insurance as they want to admit me the night before.

syxx_35
Member

October 18, 2013 at 8:49 am

Post count: 26

#9603

I have been tapering my meds to, I figure I might get better management post surgery if I can get down to 1 oxycontin a day. I was only taking 20mg twice a day but still want to get best relief.

I have 1 question for Dr. Corenman, this is a anterior/posterior surgery according to my scheduling sheet. I was reading, what side will they go in on. I am hoping that they will be going in on the side that my liver is not on. I prefer them to stay as far away from that as possible. Do you normally go in from the right or left side for this.

Donald Corenman, MD, DC
Moderator

October 20, 2013 at 1:36 am

Post count: 8660

#9620

There are two types of spine surgeons-those from the orthopaedic world who have performed a spine surgery fellowship and those from the neurosurgical world. There should be no difference between the two in quality of surgical experience but if you do pick a neurosurgeon, pick one with a spine surgery fellowship.

Make sure this individual has had enough experience with this procedure. Also, make sure that if you are in a teaching program hospital (with residents and fellows) that the surgeon who is reportedly performing your surgery is the one to do the actual surgery.

Generally, the side of access is the side of the aorta (left) and not of the vena cava. The exposure should be small enough to not disturb the liver.

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.

backtolife
Participant

October 20, 2013 at 7:21 am

Post count: 10

#9637

Dr. Corenman –
I had ACDF 12/16/2012 with ultimately great results. I have questions related to my thoracic spine. I injured my cervical at the same time that I injured my thoracic. Thoracic problem now far more symptomatic. Recently diagnosed w/ thoracic spinal stenosis.
-Burning mid back below bra line, has radiated around to front of chest number of times, hard to deep breathe
-Left leg is weak, pins & needles under my foot, more prominently under 4 left most toes & big toe covering the whole underfoot. Whole leg is weak but is more difficult to lift leg up (like big muscle doesn’t want to work like it should), very slow to lift & it increases burning in spine.
-Standing and walking make mid-back burning greater, both legs feel crampy and weak.
-Do have limp, weight when walking is more on inside of my left leg & “ball area” behind left big toe (because pins & needles worse when standing & big left leg muscle weak).
-My ortho surgeon w/ spine fellowship does thoracic. He wants me to go back to neurologist. Would EMG/NCS show abnormalities related to thoracic spinal stenosis? Legs have gone out # of times over last 2 years. This is first time my left leg remains weak & walking/sitting & other activities increase symptoms.
Many thanks for all u do.
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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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