Will surgery help me? And how long is recovery?

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Tank98
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January 9, 2012 at 5:55 pm

Post count: 4

#5328

Hi doc I’m a 31yr old I have a herniated disc 9mm gonna have surgery jan 16th on L5-S1 my symptoms started January 28 2011 had back pain which flared up my static nerve and led to numbness in my right buttock and thigh I had lil pain I’ve been of work for over a year now although I have numbness I can still bend down and twist with no pain and squat as well as other things I sleep fine only some tightness but that’s it also just had gastric by pass surgery so I’ve lost several pounds (35)lbs since nov7th I’m doing cardio workout 45min of treadmill and some elliptical only negative things I have is the numbness in right side hasen’ t gone away and my right leg is deteriating and right foot gets numb while walking but no pain Now will my surgery help ? And how long will recovery be?

Tank98
Member

January 10, 2012 at 3:44 pm

Post count: 4

#5333

My back pain is between 4 lowest and highest -6 no haven’t used any machines or treatment other than physical therapy I’m on workmans comp for the state and was recently approved for back specialist and once I was viewed by him he recommend surgery due right leg deteriating no strength in leg no calf muscle I advised him that I can’t lift my leg up of my toes like a calf raise and on my left I could and with no change in 11months till I saw him he wanted me to do surgery

Donald Corenman, MD, DC
Moderator

January 11, 2012 at 3:42 am

Post count: 8660

#5337

You have had a disc herniation at L5-S1 for a year now. Your symptoms are of no leg pain but continuing numbness of your right thigh and numbness of your foot, only when walking. You do have lower back pain from 4-6 on a VAS (visual analog scale). You note your “right leg is deteriorating” and later note weakness of the calf muscle.

This sound like a classic case of an S1 compression radiculopathy. S1 is the nerve that becomes compressed with a disc herniation at the L5-S1 level. It is disturbing to hear of weakness one year out from the disc herniation. I am not sure that the muscle will recover even with surgery but I do agree with your surgeon that surgery sounds indicated. The best chance for motor strength recovery is with a decompression.

Since it has been one year since the herniation, consideration of a new MRI is warranted to determine the extent of compression and to look for bone spur formation. I am also somewhat concerned about your lower back pain. Is the pain central (in the center of your back) or is it off to the side? If the pain is central, it may not respond to a microdiscectomy but that remains to be seen.

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.

Tank98
Member

January 11, 2012 at 4:15 pm

Post count: 4

#5338

Well unfortunately with the state it took almost 10 months to get MRI approved and I have pain in the center and lower part of my back but pain is only in the morning when stiff once I’m up walking around I have very little pain if any as far as getting another MRI don’t think state will go for it plus don’t wanna wait another 10 months for approval I do have a question 1.why don’t I have pain like other people in same situation ? 2. Will I have success with this surgery after losing good amount of weight from gastric by pass surgery? And 3. How will my recovery be ? 4. and will I be able to run again with out numbness?

Donald Corenman, MD, DC
Moderator

January 12, 2012 at 12:28 am

Post count: 8660

#5340

It is good to hear that your lower back pain disappears after you rise in the morning. I also assume the MRI was done within the last two months as you stated you had to wait 10 months for the images. This means that the images are current and reflect your pathology.

Weight loss is good as there will be less pressure on the disc during rehabilitation and for the rest of your life.

The reason you do not have pain but only numbness could be good or problematic. The nerve root can adapt to a compressive herniation and pain can decrease by this adaptation. The nerve can also stop functioning and this can also decrease pain but this means the recovery is less complete after surgery.

Numbness always takes much longer to diminish than pain. I have seen cases that take six months to recover and some that do not completely recover. Most likely you will be able to run again with less numbness after surgery.

It has been studied that if surgery is performed more than six months after the nerve compression, the results are less compelling than if you has surgery before six months. None the less, surgery seems to be called for here.

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.

Tank98
Member

January 19, 2012 at 5:54 am

Post count: 4

#5409

Well doc had my surgery on monday jan 16 th 2012 had right sided L5-S1 hemilaminectomy and microdiskectomy went well had lil pain after waking up was given pain meds which helped stayed over night around 7pm I attempted to walk and ended up walking around nurses station till 7:45 pm lost count of laps now I’m on my 2nd day out have no pain just soreness little tight in the am but once I’m up and back warms up tightness goes away still have numbness in right thigh doc said will take time to regain feeling so now I’m looking forward to a speedy recovery of 4-6 months wanna say thank u for your info and for answering my questions . And if u have comments or suggestions of my surgery received or any tips for after surgery recovery they would be much appreciated thank u
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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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