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Auric
Member

June 12, 2013 at 4:17 am

Post count: 22

#8874 In reply to: MRI Finds "Disk Bulge" after Discectomy |

Eventually I stop saying thank you because it seems so inadequate in light of your on-going help. I have been in contact with your office, and I intend to send you a package soon.

So, I spend the day getting an x-ray script, go to the diagnostic center, and the tech tells me that extension / flexion was not requested on the RX. My doctor’s office is closed for the day. So I get the pictures taken anyway, according to the script I have.

Dr. Corenman, would X-Rays without flexion / extension be of any value here?

exercise453
Member

June 12, 2013 at 3:12 am

Post count: 53

#8873 In reply to: assorted cervical questions |

Dear Doctor,

Rising liver enzymes have become an issue.

For 2-3 years I’ve taken Ultram 125mg daily 1 x 75 1×50
Gabrapentin 800mg daily 2 x 400
Advil 800mg daily 1 x 800

The symptoms from a fall and 2 weight lifting injuries have damaged the spine from c2-3 thru c7-t1 with each trauma claiming its own area. As I remain functional and grudgingly “active” the medication is for chronic symptoms of nerve, disc, facet, arthritis, and pain (no myelopathy…..yet). I have studied the spine upwards of 2500 hours, the last 1000 with you.

To attempt to lower liver enzymes I have eliminated advil but I wonder:

Is any of these three medications (or two) easier on the liver than the others???
Am I eliminating the right one for the symptoms described???
Is this assortment redundant???
Is this amount of medication in a 65 year old man unusual to drive up liver functions???
Is there any suggestion you would make with the liver enzymes in mind???

(As I have mentioned before, what you are doing is unheard of. Who knows how many thousands or tens of thousands of people you have selflessly educated and helped. Deep down I know my last stop is you.)

Thanks

carolns
Participant

June 11, 2013 at 7:46 pm

Post count: 88

#8871 In reply to: please see my mri and explain it some to me….thank you |

Just got word to go to Halifax August 7/13 for a flexion/extension xray and then the neuro wants to see me. This was fast.
If there is movement this puts me at risk for spinal cord injury so I will have to have surgery. I will ask him what type of surgery and what else? recovery period etc. What about my celebrex that I can’t live without…..read they take you of it……pain .Thank you for helping all of us….wish I was there at your hospital. thanks Carol

Donald Corenman, MD, DC
Moderator

June 11, 2013 at 6:04 pm

Post count: 8660

#8867 In reply to: MRI Finds "Disk Bulge" after Discectomy |

The ACDF surgery should include a posterior decompression with the procedure. I can understand the “disc bulge” if the posterior decompression was not fully completed. Also, foraminal narrowing can occur if the foraminotomy (that goes along with the posterior decompression) is not thorough or the PEEK cage recesses into the vertebra body allowing collapse of the level.

If there is an incomplete fusion (pseudoarthrosis), the cage could very well erode into the vertebral body and loss of disc height could occur. This could cause foraminal stenosis. Start with X-rays including flexion/extension views to determine if there is or is not a solid fusion. Possibly a CT scan might be needed.

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.

shobhan
Member

June 10, 2013 at 7:05 am

Post count: 2

#8845
Topic: Could it be my spine? in forum GENERAL |

Dear Dr. Corenman,
I am a 35 year old male of erstwhile good health.

I have been suffering from mostly neurological symptoms for the past 7 months or so. It started with dizziness, then tingling in hands. Finally, about 5 months ago, I had a “explosion” of symptoms which with minor variations I have to this day. These include tingling in all four limbs, mild weakness in all four limbs (specially left leg and the area around the right should), mild tremor throughout the body; and jerks, stiffness and mild pain in the neck area.

I was tested for lyme disease (negative), had brain mri (clean) and spine mri. On the spine MRI a small central herniation at c4-c5 was discovered causing “mild central canal stenosis” ( I have included the complete report below).

I have seen two spine surgeons (one neurosurgeon and one orthopedic surgeon), both of whom, after reviewing my MRI described my problems as “mild” and my spine to be “essentially normal”. I was initially convinced, but after getting no diagnosis from a Neurologist as well, I am starting to wonder if it could be my spine after all, specially since:
1. I typically feel much worse when lying down on my back, and
2. Carrying even a mildly heavy backpack (say with a laptop and two books) cause my symptoms to worsen.

I would like your opinion of this.

MRI report: There is normal marrow signal noted throughout the visualized osseous structures. There is preservation of cervical lordotic curve. Vertebral body height appears preserved. There is a normal appearing posterior fossa without evidence for tonsillar extension below the level of the foramen magnum. The cervical cord shows normal signal intensity as does the CSF space. The facet joints appear in satisfactory anatomic alignment.

Examination of c2-c3, c3-c4, c5-c6 and c6-c7 demonstrate no evidence for significant disc bulge, protrusion or herniation. There is normal disc space height and signal. There is no significant central canal or neuroforaminal stenosis.

Examination of c4-c5 shows a small central hnp with resltant mild central canal stenosis and the neural foramina are patent. The facet joint are unremarkable.

Donald Corenman, MD, DC
Moderator

June 8, 2013 at 8:06 pm

Post count: 8660

#8831 In reply to: neck muscle spasms misdiagnosis? |

The MRI does not note degenerative changes at any levels but C5-6 and C6-7. These levels are unlikely to cause upper neck pain. You did have neck X-rays but unfortunately this series did not include flexion/extension X-rays. These additional films can be quite revealing as they are the only images that allow motion. All your other images are static (your neck is in one position only when the images are performed).

Your upper neck pain could be originating from the upper facets at C2-3 and C3-4. These facets generally will not demonstrate findings on MRI as the MRI can only resolve pathology down to about 2-3mm and facet inflammation can be microscopic (therefore not visualized on MRI).

If you want to determine if the upper facets are causing your pain, find a physician who would consider facet blocks of these levels (see the website for further details). You would need to follow the instructions for a pain diary (again-see website).

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.
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Viewing 6 results - 1,681 through 1,686 (of 2,199 total)

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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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