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derrick004
Member

October 5, 2012 at 5:08 am

Post count: 3

#7108
Topic: To be microdiscectomied or not to be? in forum BACK PAIN |

Thank you Dr. Corenman for this invaluable website for people like me thats been suffering for years of debilitating back pain. Been lurking around here and finally posted something . Not a stranger to back problems, having it for the last 25 years off and on. Seven years ago, I was diagnosed with a DDD. Epidural injections are the only thing that works for me. I get it about once a year (series of 3 shot), it gives me about 10 months to about a years worth of pain relief. I got 2 MRIs total, heres the latest.
MRI FINDINGS
Degenerative disc disc is present at L4-5. L4-5 contains a small posterior annular high intensity zone. Disc height loss is most prominent at L5-S1 whre discogenic endplate changes are present. the vertebral bodies are maintained in height and allignment. The conus is normal caliber and signal.

At L2-3,L3-4 and L4-5, there is no significant central canal or neural foraminal narrowing.

At L5-S1, a 5-6 mm right paracentral disc protrusion causes narrowing of the subarticular right lateral recess and probably abuts the traversing right S1 nerve root. There is no significant neural foraminal narrowing.

Doctor Corenman in your experience, would it be the size alone be indicative of a microdiscectomy?. The reason I ask is, the ortho that i saw 7 years ago did not want to operate because it was a small herniation(5-6 mm). In hindsight I’m kinda happy he didn’t operate on me right away. Secondly, How safe is epidural to your spine? I’ve been doing this for the last 7 years (21 total shots to the back) so far been lucky that it’s still working and the only thing that works. I get the L5-S1 transforaminal epidural to the right and sometimes bilateral.Thirdly I’m considering surgery (microdiscectomy) , The thing that stop from having one is that I read somewhere that microdiscectomy is not indicative for back pain but for leg pain. Is this true compared to your experience? My pain is in mainly the buttocks, lateral to my sacrum. I also lean to my left side about 25 degrees and and bend forward . Recently, I’m having a very little foot numbness. It’s the lateral side of my right foot, and sometimes when i wear socks I would feel my pinkie toe having a little spasm, very minute no pain at all, Back 100% Leg 0% (Pain distribution). Dr. do you think my L4-L5 is also a pain generator by just looking at the MRI results? When I get this episode of flare up because of the cortizone wearing off, it’s a hellish life. I’ve been very good with timing it . When I feel it coming, I’ll just call my pain management office and schedule for some shots. I can’t keep doing this forever tho. Dr. do you think I will benefit from a microdicectomy. My family, friends tell me not to have surgery because I will get worse,but there not the one living with this pain. By the way Dr., I have not seen any spine specialist since 7 years ago. Sorry for this long post, hope I don’t bore you with my life story. Thank you for your patience and thank you also for a speeedy response.

brandon8
Member

October 3, 2012 at 11:35 am

Post count: 2

#7096 In reply to: antalgic scoliosis, can it become permanent? |

Hi Dr Corenman,

About a year and half ago I tweaked my back by lifting a light box and tossing it to my left. I had severe back spasms which eventually went away. I was ok but still noticed a tilt that resulted from this injury. I would do stretches to try to straighten it out but tilt never went away. I’m tilted to right, left hip higher. I started feeling really tight pull from my left QL muscle and decided to see a sports therapist to help with my tilt and tight QL. He told me my tilt was due to muscle imbalance and he attempted to re-lengthen my quads, hamstrings, and psoas. It was pretty painful.

I was seeing the sports therapist for about a month then one day I came home after walking and felt a really bad sharp pain down my left buttock and now feel it on my left calf and shin. I couldn’t take two steps without feeling sharp intense pain on my left buttocks. I was referred to a chiropractor, he took x rays and determined that I have a herniated L5 disc. He advised me to get treatment 5 times a week, pain has subsided a bit, I would say about 45% better. He performs manually decompression. I can now walk around without my crutches but cannot walk too far because my left buttocks and calf will have nerve pain.

Do you think this is progress? Or is my body naturally trying to heal? Pain is felt on my calf and top of my foot now, is this a phase of progression? My chiropractor informed me that I have a antalgic tilt from nerve being compressed. Other than getting pain free and resolving my disc issue, will my tilt straighten out without surgery? I’ve had this tilt for about 18 months now.

Please let me know your thoughts. I’m considering surgery depending on now I feel in the next 30 days and if I know for certain that surgery is the only way I can correct the antalgic tilt.

Thank you in advance,

Brandon

Donald Corenman, MD, DC
Moderator

October 2, 2012 at 10:47 pm

Post count: 8660

#7088 In reply to: Cervical Instability C1 C2 |

Grinding and pain at the base of the skull (I assume you don’t mean base of the shoulders where the neck joins the shoulders) is consistant with arthrosis or wearing of the occiput-C1 and/or C1-2 joints. The Occiput-C1 joint will cause more pain with flexion-extension (“yes”) motions. The C1-2 joint will cause more pain and grinding with rotational (“no”) motions.

These are not easy to treat but I would start with gentile manipulation and consideration of facet injections. You need a really good and experienced injectionist for these injections.

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.

melbrock12
Member

October 2, 2012 at 10:24 pm

Post count: 2

#7087 In reply to: l4-l5 spondolythesis |

Pain in abdominal over your same back although on and off for a few years

Pain intensity abd when sitting is 100 also if tighten muscles or walk limp makes pain worse over 10

Radiating pain down left leg constant 100 and have swelling in lumbar region. Weakness in both legs and I hope I am explaining this right

Pain doc said spondylolithesis is this what I have.

Sorry taking pain meds to alleviate pain

Only thing that helps is lying sideways on couch

Donald Corenman, MD, DC
Moderator

October 2, 2012 at 10:17 pm

Post count: 8660

#7086 In reply to: neck and shoulder pian and spasm from cervical stenosis |

The first questions are what were the symptoms prior to you ACDF at C5-6? Did the symptoms improve or change after surgery? Did you develop new symptoms further down the road after your surgery or did they occur immediately after your ACDF surgery?

The work-up you have had after your surgery sounds extensive. Did you keep the results of the muliple injections with a pain diary (see website for description)?

Unfortunately, the artifical disc implant in your lumbar spine did not work effectively. What work-up did you have prior to that surgery? Discograms? Epidurals? Facet blocks? How did you symptoms change after surgery?

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

October 2, 2012 at 7:38 pm

Post count: 8660

#7079 In reply to: Disc Replacement |

A three level ACDF will stiffen your neck and increase the load on levels above and below. However, it might be helpful for you to measure the motion from flexion to extension on the lateral motion X-rays. IF you have a highly degenerative neck to begin with and the motion of these three segments is less than ten degrees total, a three level fusion will not cause a significantly notable difference to you.

Surgeons can perform hybrid surgeries. That is a combination of ADR and fusion. You might be a candidate for that procedure but again, this depends upon the quality and degenerative nature of your discs.

I can review your MRI and X-rays if you like. Please call the 888 number and talk to Margaret.

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 - 1,891 through 1,896 (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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