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laurasteele
Member

January 30, 2013 at 9:19 pm

Post count: 3

#7856 In reply to: Pain in the Neck |

I completely agree with you. I am an occupational therapy assistant and work in an outpatient therapy clinic. I have actually been performing formal therapy under the supervision of the occupational therapist at our clinic. I’ve been doing that for approx 2 months now. My ortho surgeon has actually recommended me seeing a neurosurgeon for now. I’m still awaiting further info on that but plan to see the neurosurgeon within the next couple of weeks. Over the last three to four days I’ve been having horrible headaches. They are worse than any migraine I’ve ever had. The headaches knock me off my feet. I’ve also noticed my chest becoming very red and blotchy when the pain is at it’s severist. I’m not on any new mess or anything. Also, there seems to be a spot around right posterior neck (maybe around c4-5) that is very sore and stiff. It hurts to turn my head to the right as well as left lateral flexion. This is still not “the pain” but something that has happened over the last few days with the intense headaches. Thanks for any info or help!!!

Deepcove22
Member

January 28, 2013 at 1:35 pm

Post count: 14

#7843 In reply to: spondylolisthesis |

Hello,
I had brief (1 hour) decrease in leg burning pain post injection along with muscle weakness. The usual burning I feel is icy…dry ice..like standing in a river in winter. When I was injected, on that side my leg went warm for a few seconds.

Since then, the leg pain is usual intensity and location pre-injection. I have increased back pain and new onset sciatica ( activated during injection). This is 3 days after injection day.

I am not usually able to replicate pain with a movement. I am always in pain. When I walk or stand I will feel increased pain or sometimes delayed by a hour. I wake in pain. But I know what helps: sitting if I have been walking, lying down if I have been sitting. Driving is painful

Squatting and TENS machine relieves back pain and traction and ice reduce leg pain. Traction can reduce leg pain and make back pain worse. My physio says this is a goal.

There is usually a “hot spot” to touch over about L4-5 and ice helps.

So, summary, I am worse than I was pre-injection

Thank you from Vancouver

AlbertDisuza
Member

January 27, 2013 at 8:43 pm

Post count: 26

#7833 In reply to: fingers numb/tingle/pain |

When you mention that your posture changes the pain intensity, it means that there is definitely a connection of the pain with the spine. Getting it checked on time and following a course of treatment with proper care can save you from making matters worse. So you can book an early appointment and see why you are getting this pain.

Donald Corenman, MD, DC
Moderator

January 27, 2013 at 7:59 pm

Post count: 8660

#7829 In reply to: my cervical mri |

We have to break down your symptoms into two separate sets; neck pain and imbalance/incoordination.

Neck pain generally has the origins of degenerative disc or degenerative facet disease for central neck pain and you can add mild to moderate nerve root compression to the list regarding neck pain that is one sided (unilateral). A good history and physical examination will help reveal if the pain is in one of those categories. After that, careful review of the images including X-rays with flexion/extension views and the MRI would be important.

Once the potential structure causing pain is identified, diagnostic testing is normally required (with some exceptions). This might require facet blocks, an epidural or SNRB (see website) or even discograms. Then it is a matter of treating that structure with an intervention that has a tract record of success (injection, radio-frequency ablation or surgery).

The imbalance/incoordination set of symptoms can be spinal cord related. Compression of the cord can cause myelopathy (see website) which includes these complaints. In this case, a careful physical examination can reveal the presence of signs of cord compression. If this is the case, an ACDF in my opinion would be required to remove the compression and prevent future irritation to the cord.

The impression of the radiologist is that the C5-6 level is impinging on the spinal cord. It is a possibility that this level is causing both neck pain and myelopathy from cord compression. It might be a simple matter that you need an ACDF at that level to solve most of your complaints. You need a consultation with a good spine surgeon, a careful history and physical examination, review of the images and diagnostic intervention.

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.

Pafrmboy
Participant

January 26, 2013 at 2:53 am

Post count: 8

#7809
Topic: Gastronemius weakness/Fatigue with walking in forum BACK PAIN |

Hi. Great Forum!! I’ll add my situation to the pile!

I developed this issue some 5 years ago when I was running and began to feel some numbness in my left foot.(I used to run about 10-12 miles per week). It was like I lost orientation of my left foot. I felt that I might trip. It was not every time I ran though. I’d slow down and it would go away.

It progressed to having some medium type back pain attacks over the next year and then the back pain all but disapeared. Sciatica and left leg occasional numbness then developed over the next 2 years to the point that I had to sit down sometimes. As soon as I sat down for 5 mins, all was OK.

During the last 18 months all sciatic pain is gone, but I developed left medial gastronemius weakness. It affected my gait and I could not stand on toes on the left side with the right foot elevated. Of course this led to knee pain, as the lateral gastronemius picked up the slack.
I had atrophy in the left medial gastronemius too.

Amazing the right leg was always OK and then suddenly a few months ago..like overnight, the right medial gastronemius was quite weak. I was alarmed! It happened so quickly. What is more weird is that the left leg is regaining strength!! ( I can stand (weakly) on toes using both feet), but feel that the left leg is doing most of the work. Both the right and left LATERAL gastronemius(s) are strong.

Again I have NO significant back pain except some tightness and an occasional ache. I take no meds except NSAIDS and not even those daily.

My main issues are now “push off” during my gait. If I walk long distances, I am exhausted. (My legs anyway) I feel I’ve climbed a mountain. I sometimes feel that I might fall backwards, as the plantar reflex strength is quite weak in both feet. However at times during the day, the strength suprisingly better! It’s up and down. If I do inversion therapy for 10 mins, the strength is better, but it does not last.

I am a Registered nurse and do spend alot of time walking. I also can’t run well and get knee pain on the push down stroke, while riding my bike. I know this is form the compensation of the lateral gastro and tendons doing all the work.

I have had (2) MRIs and the last one 7/2012 was similar to the first. Revealing:

1. The L5 S1 disk is dehydrated and mildly narrowed.
2. There is a 3 mm left paracentral disk protrusion of L5 S1 that compressed the thecal sac and abuts the left S! nerve root. This could account for left S1 raduculopathy.
3. The remaining lumbar levels are normal.
4. Note is made of a transitional s1 s2 intervertebral disk space.

I also had a nerve conduction/EMG done and it revealed:

1. Active and chronic denervation in L3/4 and L5 S1 myotome, suggestive of LS polyradiculopathy. Left worse than right.
2. It also demonstrated evidence of sciatica, left worse than right.
3. Differential diagnosis include lower LS plexopathy and multifocal motor neuropathy. Motor neuro disease is possible, but patient’s clinical presentation is not suggestive of this issue.

I’m 48 male, not overweight, or diabetic. No other chronic diseases, no hypertension, essentally pretty healthy.

How can this issue/disk shift from left side to right so fast? Do disks move? Maybe a loose fragment? Could a rupture have happened and spread to the right side that fast? Ideas?

I have not had a surgical consult and really don’t like the idea of surgery. (Nurses HATE surgery and I’m an OR.ICU nurse)!! Am I a fool to NOT want surgery?

I have tried a steroid dose pack about a year ago and it helped significantly.

I guess I deal with this, as I have little to no back pain. But I feel the weakness, although manageable, is starting t

Will this resolve with conservative treatment, or might this be permanent? I mean this has been an issue for years. (Hoping for resolution).

Scared and worried!(and being a typical nurse)!

Todd

Donald Corenman, MD, DC
Moderator

January 19, 2013 at 1:11 am

Post count: 8660

#7776 In reply to: new injury, same disc? |

You have a recurrent herniation at L4-5. This is not uncommon as the chance of recurrent herniation is about 10% in the general public.

A large recurrent herniation can create some problems that need to be addressed. Makw sure you have no motor weakness as this is the one problem that needs surgery sooner than later. If no motor weakness and no cauda equina syndrome (see website for description), then therapy, epidurals and medications can be used.

If the pain to too intense and surgery is called for, a managed care system does limit your choices of surgeons. Pick the one that has more experience, compassion and seems to “understand” what you are going through. The technical ability of the surgeon is very difficult to judge unfortunately.

It is nice to know that redo surgery is still not that difficult in good hands.

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 - 1,807 through 1,812 (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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