Donald Corenman MD DC | Spine Surgeon Colorado

Jtal19305

Participant

November 28, 2015 at 9:27 am

Post count: 43

#20862

Hello Dr Corenman

All of my physical tests and reflex tests were normal. My left ankle reflex was faint but still there. After further review with another independent expert on spine MRI, it appears that the decompression of L2/3 (left side hemi laminectomy) was not complete. There was evidence of something (e.g. scare tissue, bone spur, ligament, etc) pressing on a nerve root on the left lateral recess area. The surgical report stated that the part of the facet joint was removed on the left side but the MRI did not show that. So the pain that I still have on my left anterior thigh may be due to the inadequate decompression. He suggested a selective nerve root block at L2/3 to see if the clears up the thigh pain. If it does, then a steriod injection. If that doe not work, then finding a surgeon to decompress that area without fusion.

What are your thoughts about revision surgery? In a case such as I described where there is a definite compression, can revision surgery over the same area resolve the issue? I understand the concept of scar tissue but if there is something compressing a nerve, something should be done to remove it while minimizing scar tissue.

The expert thought a spine fusion at t12/l1 may have been too drastic for someone my age (48). His suggestion was a laminectomy or just a disectomy to remove the protrusion. I could only recall that my surgeon thought that area of my spine would be unstable due to some khyphosis. In any event, I cannot undo what as done. He felt that my conus was most likely irritated during surgery, and the foot, back of calf and genital pain which are the s1, 2, 3 nerve roots are in that area where surgery was done. Its a little strange that the pain is mainly on my left side but that is the side the interbody cage is placed in. The expert said it may take many more months for things to settle down and the pain to reduce. There were also good size bone spurs behind the canal at t12/l1 which were not removed during my surgery. The expert did not know why the surgeon did not address that. I could not tell him other than maybe he felt it was too risky to move the cord in that area to get around to the spurs. Again, the expert recommended a selective nerve root block bilateral at t12/L1 to see if that resolves any of the foot, calve, genital pain. In a good note, the expert felt the decompression of t12/l1 did resolve the bilateral leg weakness, and there was a little more room created by the laminectomy disectomy and fusion at t/12/l1.

So I am a bit upset at myself, and my surgeon for getting into this position. It appears some of my surgery (t12/l1) may have been overkill, and the other part was not done sufficiently. So, I am left (5 months and going after surgery) with pain in my left anterior thigh, left back of calve, bottom of left foot and some pain in genital area as well as fasiculations in my calves. I am looking at the prospect of revision surgery to clean up and properly decompress those areas. Unfortunately, I was not as educated and informed prior to my surgery as I am now. I realize how important knowing what is going on, and working with the right surgeon to do all the necessary pre workups to come up with the best surgical plan. Also, having a surgeon that is good and thorough at what they do is critical.

So, I would appreciate any advice on how to proceed from here. I can chose from three areas to have revision surgery – the Philadelphia area (where I work), South Florida (Where I had my original surgery, and have a condo) and Detroit Michigan (where I grew up and have family). I need to select the best practice, and was told to look at a teaching hospital. Any suggestions or advice on proceeding with revision surgery, and the what type of outcome I can expect if I have the best team/practices in place.

I know this is a long reply, but please understand that I am desperate to fix my situation. I never expected to be in this situation. I trusted my doctor, and realize I was not treated with the best care possible. All along the way after my surgery, my doctor has ignored my calls for help only telling me to give it more time. He did not look at the post MRI images in the detail necessary to see the issues. He did not suggest any diagnostics like nerve root blocks, emg/ncs, etc. I have been through your site, and information. I realize there are many levels of surgeons out there and to be very careful on selecting someone to operate on you.

Any help/guidance would be greatly appreciated.

Thanks
JERRY

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.

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