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Donald Corenman, MD, DC
Moderator

January 17, 2013 at 4:18 am

Post count: 8660

#7751 In reply to: When is it time for surgery? |

The interbody grafts used should be made of allograft (cadaver) bone. Are you sure these were made of titanium? The X-ray would show a thick “very white” spacer in the disc space if these were made of titanium instead of bone (which should look similar to the density of the vertebral bodies next to them).

It would be unusual to use titanium implants for fusion. It also would be unusual not to use graft bone (or your own bone) to fill these cages. I would think that these are allograft Cespace struts in which case there would be no need for fillers.

Using a plate in front is typical but not absolutely necessary.

The fusion of allograft spacers or struts takes between 3-4 months before solid incorporation occurs. Serial X-rays including flexion/extension will determine if these grafts have incorporated. If there is any question, a CT scan can be used.

Not every surgeon uses physical therapy to rehab a patient but you might ask if he or she would write out a script for you.

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

January 16, 2013 at 9:39 pm

Post count: 8660

#7744 In reply to: Abnormal signal intensity… |

You bring many unanswered questions to this thread. What are your symptoms? What surgery did you undergo, why and when? What were the results?

Please seee the section under “Conditions”, “How to describe symptoms” to fully inform the forum of what your current situation is.

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.

seymor23246
Member

January 16, 2013 at 8:10 am

Post count: 2

#7743
Topic: Abnormal signal intensity… in forum GENERAL |

My latest MRI results sound scary and I cannot see surgeon until next year due to finances. I won’t go into issues above L4-L5 but regarding L5-S1 I need to know if I could create futher permanent damage by waiting. Results:

Abnormal signal intensity involving vertebral bodies and pedicles.

Degenerative marrow change realted to previous discectomy.

Possibility of active infection indictes correlation with sedimentation rate and CRP

Questionable superiorly extruded disc at L5-S1 in the right subarticular region, possibly a free fragment. Apparent disc fragment appeared to be positioned adjacent and lateral to the right L5 nerve root sleeve.

Severe foraminal stenosis at L5-S1 on the right.

Please excuse any spelling or typing error. I am miserable every minute of every day. The nueosurgeon who did my previous surgery can’t see me until I can completely pay off the firt surgery so I have had no professional explain this to me. Any education would be greatly appreciated.

Donald Corenman, MD, DC
Moderator

January 14, 2013 at 2:37 am

Post count: 8660

#7727 In reply to: Post ACDF pain |

The question is where is the origin of the left neck pain. If the pain radiates into the shoulder or down the arm, the origin could be from the foraminal narrowing of the left C5-6 level that compresses the nerve root here. I would also be suspicious of a pseudoarthrosis (lack of fusion) at one of the two levels of your prior surgery. This can be revealed by X-rays including flexion/extension views.

If there is no pseudoarthrosis present, a selective nerve root block (see website) of the C6 nerve with good temporary relief (see pain diary) would indicate that compression of the C6 nerve is the most likely cause of your pain. If this is the case, a posterior foraminotomy can be performed (see website) to decompress the nerve. This is of course assuming that you have failed conservative therapy.

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.

ima164
Member

January 14, 2013 at 12:36 am

Post count: 2

#7722
Topic: Post ACDF pain in forum NECK PAIN |

I am a 48-y.o. woman s/p ACDF C4-C5 and C5-C6 9/11/2012. I present now with left neck pain. My hx was prior severe right neck pain and arm numbness/weakness + many, many failed nerve blocks, facet injections and epidurals.

My MRI from this past week shows:

“….discectomy and fusion of the C4-C5 and C5-C6 levels….At C5-C6 there is some osseous productive change of the uncovertebral joins with moderate narrowing of the left neural foramen. There is minimal narrowing on the right.”

I didn’t want to bother with the rest of the report, because this is the part which seems abnormal in the area where I am experiencing moderate to severe neck pain. There is extension to my shoulder, but not down my arm/hand. I am just confused because the discectomy surgery seems fine and I did not really have pain on the left neck prior to the surgery.

Thanks for any clarification/advice you can provide me with.

Donald Corenman, MD, DC
Moderator

January 14, 2013 at 12:26 am

Post count: 8660

#7721 In reply to: C3-C4 Anterolisthesis and C4-C5 Retrolisthesis? What Does This Mean? |

You have two separate problems. Your lower back pain is generated from your lumbar spine and your neck pain (and possibly headaches) are generated from your neck.

You have degenerative changes of your discs and facets in your neck. The anterolisthesis (forward slip) of C3 on C4 occurs from facet wear and retrolisthesis at C4-5 is generated from degenerative disc disease. You probably do not have significant ligamentous instability unless there is significant shifting of one vertebra on the other with flexion/extension views.

Most of the time, neck pain is generated by degeneration of the discs and facets. If you have failed chiropractic treatment and a good course of physical therapy, you should seek out a well experienced interventional PM&R doctor or interventional anesthesiologist for potential injection therapy as the next step.

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 - 1,819 through 1,824 (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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