Reply To: Re: Back & Leg Pain 6 months post microdiscectomy

Member

December 3, 2013 at 9:05 pm

Post count: 1

#9890

Dear Dr. Corenman,

I was involved in different sports which required heavy lifting since i was 13.I am 28 now and my spine is very damaged.
I had a discectomy surgery back in February at L4-L5 and L5-1, after sigificant back and leg pain for more than 4 months.I couldn’t walk on my left heel and my left toe had no strength and coudn’t bend to tie my shoes.

Unfortunately i have a recurrent herniation at both levels.In the MRI report it says:
– left foraminotomy with minimal protrusions at L4-L5 associated with osteophytes which are in contact and fibrotic modifications in with L5 roots bilaterally the 1/2 part of thecal sac post surgery.
– left hemilaminectomy with fibrotic modifications in left 1/2 part of the spinal canal with the “encapsulation” of S1 root into canal/(intracanalicular?)
– median and paramedian minimal discal protrusion on the left at L5, apparently not compressive
– dehydration of L4 and L5 discs
– posterior discal protrusion of T11-T12 with small compression of thecal sal without associated radiculopathy/nerve compression
– minimal/small intraspongious hernia of L2
– small spaces between T7-T11 verebrae associated with small intraspongious hernia
– round thoracic kyphosis
– diminishing of the normal cervical and lumbar lordosis
– small thoracic-lumbar scoliosis
– dehydratation of C4-C5 and C5-C6 in the initial phase
– small discal protrusion at C5 without compressing the nerve
– small posterior lateral left disc osteophyte herniation at C3 and C4 neuroforaminal narrowing, apparently not compressive
– vertebrae osteochondritis of thorachic-lumbar spine

There are a few more problems.

I feel a burning sensation in my left leg and some “pins and needles” occasionally.

I have similar symptoms like the one who started this topic:

“When I wake up in the morning my back and hip/buttock area are fine, however as the day goes on the pain becomes progressively worse until i am at the stage where i can neither sit or stand. The pain is in the lower back and hip/buttock area, and can feel tension down my leg all the way to my foot. The only relief I can get is lying down on my side, and actually lying on the side that is painful.Whilst i have been having this episode i have been contining with the walking, but this is probably only 3 miles per day, and with the exercises, i finally managed to start seeing a physio 3 weeks after i started back at work.”

The lower back pain is a 4-5/10 right now but has increased in the last month and the leg is not hurting but is annoying to feel the ocassionally leg burning/pins and needles(paresthesias).

Last time i have done decompression machine, chiropractic care, AINS, dexamethasone/xilin shot, all without effect.when i had the injection my pain was down and i could sleep but after the efficiency i had a drop foot.
For the moment i am not going to the gym and i am doing daily stability for the core muscles.I really hope that it will be better but it’s getting worse.

What do you suggest to do or what do you think is the best solution in my case right now?
It is neccesary to think at a fusion although i am scared to do this thing regarding my age and the stifness and incapacity that comes with it or a microdiscectomy although the chances to reherniate them a 3d time are bigger?
I have any other chance instead of surgery for the nerve symptoms to go away?Do you know people that the nerv symptoms subside without surgery?
Do you know if it is possible the compression to subside?

I really appreciate if you can help me with an advice based on your experience.

Thank you,

Dan

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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