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exercise453
Member

March 19, 2013 at 1:08 am

Post count: 53

#8216 In reply to: assorted cervical questions |

Dear Doctor

I anticipate a new mri, both cervical and thoracic. Two years ago the mri was done at a stand alone imaging center, an outpatient extension of a local hospital. It was1.5 tesla I believe to be adequate and an adequate facility. Many spine surgeons recommend a facility they affiliate with and most are tesla 1.5. It is an easy matter to go back to the same facility, more difficult to uncover a facility using 3.0 that is on the insurance. They seem to be few and far between.

1- Is a tesla 1.5 mri adequate or do you recommend going through whatever is necessary for a 3.0??? (You did mention your clinic has 3.0)

2- On the website you say that you can go back to doing most anything after a single level fusion but a two level carries greater restrictions and a three level even greater than that. Can you provide some specifics, especially regarding activities, sports and general daily lifting. What is this life.???

3- Is the choice of using cadaver bone for multi-level fusion still the same as single level. I have read that two and certainly three levels begin to require your own bone???

Thank you

Queen Mush
Member

March 18, 2013 at 8:58 pm

Post count: 4

#8215 In reply to: Issues 7 Years After C6-7 ACDF Surgery |

I should also mention that I’ve been sleeping on a posure pillow since surgery. As far as exercising goes, I can’t do things above my head with my arms for very long because the achiness/tightness between my shoulder blades gets very intense. I saw the neurosurgeon after a year and she released me to full activity. I don’t have any tingling, shooting pain, etc. that goes down either arm. I have noticed that if I put my arms against the wall (to do exercises) that after 30 sec or so I will get a tingling feeling running from the middle of my upper back down both arms. Sleeping is starting to become an issue because I can’t stay comfortable. I sleep on my side most of the time but after a while, my neck starts to hurt. Sleeping on my stomach is a huge no-no and impossible, and after a while, sleeping on my back causes issues. Most mornings I feel like I’ve been hit by a truck until I get in the shower, which helps the achiness some. I am a secretary and after my surgery I had a headset to quit from cradling my neck against my shoulder which I’m told is very bad for someone with my neck issues. Now, I have a headset again. Sometimes it also feels like someone’s hands are ‘pushing’ against my shoulders which also makes them ache and tight. I am continually shifting my weight during the day at work and will get up to ‘stretch’. The massage does help but it doesn’t hold for very long.

Queen Mush
Member

March 18, 2013 at 8:46 pm

Post count: 4

#8214
Topic: Issues 7 Years After C6-7 ACDF Surgery in forum GENERAL |

In February of 2005 I was playing rec volleyball and after several serves felt twinging in my upper back between the shoulder blades and chalked it up to a pulled muscle. The pain/irritation never really got worse so I continued to play. One day as I was getting out of bed to get my son, I felt excruciating pain as if someone has stuck a knife in my back. I got into the shower to see if that would help, which it did not. I went to my doctor who referred me to a pain specialist and I ended up with two cortisone shots in my upper back, both which didn’t do anything. I saw a neurosurgeon and we did physical therapy (neck harness, some exercises). The pain was so intense that I wore a TENS unit to just control the pain I had. Finally, in July of 2005 I had ACDF surgery at the C6-7 level with bone graft (donor) and plate with screws. Unknown to the doctor at the time, when I had risen to get my sone (he was 5 at the time), I had broken a fragment from the herniated disk and it had lodged in my spinal nerves. I’m told it was about the size of a thumbnail. I wore a soft collar for a month and couldn’t drive. I don’t remember doing any physical therapy afterwards. Three fingers on my right hand are numb and tingly like something is rubbing against them all the time. My neurosurgeon at the time informed me that if that didn’t go away after a years’ time, then it was permanent nerve damage. Today, my fingers get really cold and I drop things. As far as the neck pain goes, in the beginning I didn’t notice it much but between my shoulder blades it feels as if someone has their hand against me all the time. I get really achy and burning sensation which varies. Some days it’s really bad and others not too bad, but it’s always there. I know I have lost some range of motion as I can’t look up without it hurting nor down very far or to the left/right. I’ve also been noticing that it’s starting to hurt when I turn in my car to look behind me when driving. I’ve been seeing a licensed medical massage therapist for some time to help with the achiness. The muscles from my neck, to the middle of my back, across my shoulders get very tight and very achy. Some days I get pounding headaches. My temples are also tight and tender. I am curious to know if what I am feeling is permanent nerve damage. Thank you for your assistance in this matter.

Donald Corenman, MD, DC
Moderator

March 12, 2013 at 8:05 am

Post count: 8660

#8176 In reply to: neck pain and problems |

The numbers that you describe are recordings of your range of motion. “Normal” range of motion (ROM) flexion-chin to chest, extension of 60, lateral bending of 45 and rotation of 90 degrees. These figures are for a young, normal, never injured individual. Most of us have restrictions in ROM due to degenerative changes, trauma and disorders of aging and disease.

I think the numbers noted as fractions (3/4, 1/2) are the indications of restriction from full ROM.

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.

Donald Corenman, MD, DC
Moderator

March 10, 2013 at 7:56 pm

Post count: 8660

#8156 In reply to: t9-10 hernia mri?help please |

Your images are unfortunately not accessible to me. Thoracic disc hernations do cause significant pain but typically (with rare exceptions) do not cause cord compression. The most effective treatments I have found include epidural injections, an extension strengthening program and NSAID medications. Occasionally, membrane stabilizers in low doses (Lyrica, Neurontin) can be effective. Time is really the most important healer. These discs will shrink down over time as you have noted from you T11-12 HNP experience.

Only rarely does a patient need a thoracic surgery for these and mainly due to cord compression.

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.

Donald Corenman, MD, DC
Moderator

March 10, 2013 at 7:46 pm

Post count: 8660

#8154 In reply to: Compressed nerve at L5 at night. Protrusion L4/L5 |

I cannot answer the permanent nerve damage question as there is a possibility but this possibility is not high. The fact that you have no weakness is in your favor as there is no rush at this point. Could you be getting worse? Increased pain and further radiation of pain is an indication of increasing nerve root dysfunction. As long as there is no weakness, I generally don’t become too concerned.

The nerve seems to become more inflamed with flexion (bending forward) and less irritated with extension (bending backwards). However, sleeping on your belly with a pillow under the belly causes more lumbar flexion. You might try sofa cushions under your knees when you try to sleep on your back. This will flex the knees and the lumbar spine.

I think you should consider an epidural steroid injection to reduce the root inflammation (see website). Medications might also help you to sleep through the night. Finally, if nothing works, you could consider a microdiscectomy.

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 - 1,765 through 1,770 (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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