Donald Corenman MD DC | Spine Surgeon Colorado

Participant

September 9, 2016 at 9:25 am

Post count: 51

#22934

Hello Dr. Corenman, I figured it would be better to post the actual report. It was confirmed to be myelomalacia and not fluid build up.

TECHNIQUE: Sagittal T1, T2, STIR and axial T2-weighted images of the thoracic spine were obtained without contrast. 10 cc OptiMARK was given. Postcontrast Tl -weighted axial and sagittal images were obtained.

FINDINGS: There is a smooth physiologic thoracic kyphotic curve. Vertebral heights appear generally maintained. Disc degeneration is mild from T4-5 through T8-9 ar.d at T10-11 .vitfi. dehydration and narrowing. There is a moderate-sized vertebral hemangioma to the right posteriorly at T7. There are laminotomies at T3-4, T4-5 and TS-6. There appears to be a posterior fusion at T4-5, No worrisome marrow replacing lesions are seen. The extraSpinal soft tissues appear normal. These findings appear stable.

T4-5 demonstrates a 2 mm left paramedian broad disc protrusion with a peripheral annular fissure. There is mild spinal cord flattening to the left with stenosis and midline AP canal diameter of 8 mm. No hypertrophic facet DID. No foraminal stenosis. No significant change.

T10-11 demonstrates no significant disc bulge. Facet DJD is mild on the left and mild to moderate on the right. No spinal cord flattening or central stenosis. No foraminal stenosis. No significant change.

The remaining thoracic discs do not show evidence of significant bulge, protrusion, or extrusion.

There is moderate to severe spinal cord edema and/or myelomalacia from mid T4 through mid T5, unchanged. The remainder of the thoracic cord has a smooth contour and is without focal atrophy, edema, or myelomalacia. No mass. Following contrast injection, there is enhancing granulation tissue in association with the laminectomies at T3-4 and T5-6 as well as in the posterior midline soft tissues from T3-4 through T10-11, also consistent with postsurgical granulation tissue. No significant abnormalities of intrathecal contiast enhancement are observed.

IMPRESSION:
1. Disc degeneration is mild from T4-5 through T8-9 and at T10-11; laminotomies at T3-T4, T4-5, and T5-6.

2. T$-5 mild spinal cord flattening to the left with stenosis.

3. Spinal cord edema and/or myelomalcia is moderate to severe from mid T4 through mid T5.

4. Allowing for minor variation in partial volume averaging, no definite interval change is lidentified since April 29th, 2016

I should add there was no fusion, and the surgery was only at the T4-T5 level. I only know there is very little information on myelomalacia, and I wonder if most doctors even know about it. This entire battle with my spine has reduced my quality of life tremendously. I cannot function due to severe pain, in both my chest and now my back. It feels like a spear going through me at times. I did file for disability back when my cervical fusion failed, then I had the posterior fusion to fix that, I’m currently in a rock and a hard place, considering my pain doctor will not treat my thoracic spine, due to these findings above, we waited the 3 months, and there was no improvement. I don’t know how to explain this to others, but the problem is more severe than I can put into words. I ended up worse than I was before taking the risk to do this surgery. It was previously a rare herniated disc, causing severe enough chest pain to take the risk. I wish I had some more hope than just time. I don’t know what a second opinion could do, but I may try and get one. I never thought this would be my situation after surgery.

Do you think most doctors have any knowledge on this condition?

I wonder if you have ever treated a patient with this condition, or would you even touch a patient with this condition?

Thanks Dr. Corenman, you have been of great help to me the past couple years. This is directly copied from my report to this page

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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