Walking disorder/ quadricep paralysis

Tagged: far lateral lumbar herniation

Viewing 5 posts - 1 through 5 (of 5 total)

Author

Posts
roger phil
Participant

March 2, 2017 at 6:09 am

Post count: 3

#24447

Dr. Corenman, After reading your article on Walking Disorder/Analysis of a Limp, I thought I would ask for your input as to my recent disability.
I am a 69 year old male in relatively good health, 5’11” 215 lbs and fairly muscular. I had been on NO medications since Oct. of 2015 after a successful heart ablation for A-Fib. I’ve always stayed active and been a Blue Collar worker all my life. I don’t smoke and drink alcohol moderately,1 drink a day usually. I attend a gym and Healthy Posturing classes fairly regularly.
This past fall my wife and I took a part time job on a horse ranch to fill in for the regular caretakers who needed some time off. We had done this job before and enjoyed it in our R.V. It was only for 3 months. As our time there progressed the weather in No. California deteriorated badly and we spent many very rainy days mucking wet stalls and tending the horses. We usually went to bed tired and a little sore. The day before leaving I drove 3 hours to see an old friend from the service. I spent many hours in the car that day through freeway traffic. I got home to the R.V and was glad to get out of the car finally. Went to bed and woke up pretty much incapacitated in my left hip and leg. Extreme pain and falling down because my left quadricep has become paralysed. Along with that I have severe numbness in my left shin from the knee cap down to the ankle. This all occurred on Dec. 20th as we were packing up and heading for home in St.George, Utah. It took us 4 days to make the 400 miles home because of the pain while trying to drive. Ibuprofen was my only help and very little at that.
Christmas eve I was in the emergency room here at Intermountain HealthCare in St. George. That day they did and MRI on my lower spine and Xrays also. Since then I have seen an Orthopedic doctor twice, a pain specialist twice or trice, (I can’t remember), a neurosurgeon twice, a pelvic specialist once, had more xrays on my spine from a different angle, femur xrays, and EMG on my left leg, cortisone injections in L3,L4,L5 and above and below my left SI joint, not in it. Through all these doctor visits, they have all decided that all my vertebrae look in fairly good condition with very little chance of pinched nerves.
The quadricep problem has lead me right to your article on Walking Disorders. Your description of my condition is SpotOn. I try working it at the gym to revitalize it and just started riding my bicycle again in hopes of it regenerating the strength. The pelvic doctor I saw last put me on Prednisone(50MG a day) and tapering down till all 60 pills are gone. I’m due to finish them in a week. He’s thinking some type of Myopathy. They seem to give me some relief but aren’t doing anything for the paralysis. With out the quads working I still tend to fall if not paying attention to locking my knee. Its all putting quite a strain on my hip, lower back and knee.
I don’t where to go next!! Should I keep exercising or is that possibly worsening my condition til the paralysis is properly diagnosed. None of the doctors seem to address that quad problem.
I’m hoping you can give me some guidance.
Sincerely,
Roger Phillips

Donald Corenman, MD, DC
Moderator

March 3, 2017 at 5:35 am

Post count: 8660

#24454

It would be quite surprising that with all your providers who have seen your films, there could have been a missed far lateral disc hernation at L3-4 or L4-5 but I seen that missed disorder before. Just make sure that there is no compression of the L3 or L4 nerve root in the far lateral position. What did the EMG denote? Do you have damage to either of those two roots? There are conditions that can cause nerve injury that are not nerve root compression syndromes. Many are associated with diabetes. Do you have that condition?

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.

roger phil
Participant

March 3, 2017 at 7:10 am

Post count: 3

#24457

The EMG report reads “There is electrodiagnostic evidence of an acute left L3 radiculopathy.”
The neurosurgeon seemed reluctant to diagnose it for certain. I liked him and he did come recommended by two of the other doctors I’ve seen so far. I will reschedule with him and ask for another evaluation and possibly more xrays and
maybe a new MRI.
I have never had a blood sugar problem and diabetes does not run in my family.
Thanks very much,
Roger Phillips

roger phil
Participant

March 8, 2017 at 6:56 am

Post count: 3

#24462

I saw my neurosurgeon Monday and revisited my MRI with him. I felt very prepared to discuss your thoughts on the Far Lateral Herniation. He pointed to the spot on the MRI that indicated to him that was a likely diagnosis, even though a bit more rare. I asked why he didn’t suggest that at my last visit. He explained that he doesn’t like to rush into surgery without trying other options first. I told him that I was done with other options and it was time for me to get my quadriceps back. I am scheduled for a discectomy March 30th. He has done them before with good results.
Thank you for your insightfulness and this online information. As you can see I’m not a passive patient. If a doctor is offended by that than they need to get over themselves.
Gratefully yours,
Roger Phillips

Donald Corenman, MD, DC
Moderator

March 8, 2017 at 8:20 pm

Post count: 8660

#24472

I am happy that the far lateral herniation was diagnosed and you will get it surgically corrected. Please let the forum know of your outcome after 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.
Author

Posts

Viewing 5 posts - 1 through 5 (of 5 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