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Outdoorsy
Participant

December 2, 2020 at 7:59 pm

Post count: 5

#33428
Topic: Continued Pain 3+ months post microdiscectomy in forum BACK PAIN |

Dear Dr. Corenman,

I herniated my L5/S1 disc in February 2020. It was a 6 mm left lateral disc herniation that displaced the S1 nerve posterior laterally. Due to Covid, I didn’t start PT until early May. In June I saw a surgeon because I continued to experience buttock, back of leg and foot pain. Surgeon recommended surgery but I wanted to avoid it. I agreed to another MRI to see if there was improvement which occurred in July. The MRI results showed I still had a 6mm disc herniation but this time it was classified as an extrusion. On August, I finally had a microdiscectomy, after my pain symptoms intensified.

Recovery went well initially. I never had to take any narcotics post surgery. I suppose I have a high tolerance for pain. By three weeks I was walking 2+ miles a day. I started PT at 6 weeks and have been diligent in doing my exercises. I’m also walking 4+ miles a day now. Around the 5th week, I started to get some radicular pain on my buttock, thigh, leg and foot. However, instead of it being in a straight line, like pre-surgery, it was more a patchwork. I also started to experience pain in parts of my leg and foot that are not associated with L5/S1.

I got another MRI this past Monday and this is what it reads:
L3-L4: There is a 1.7 X .4 X 3mm left foraminal and paracentral disc extrusion which displaces the left L3 nerve root within the neural foramina. The left L4 nerve root is displaced within the lateral recess.
L4-L5: There is a 1.2 X .03 X 3.6 mm disc extrusion with spondylosis which displaces the L5 nerve roots within the lateral recesses. Central canal and neural foramina are patent.
L5-S1: Operative changes of left laminotomy are noted. There is a recurrence/residual left foraminal 1.3 X .4 X 2 mm disc extrusion which displaces the left L5 nerve root wihtin the neural foramina. The left S1 nerve root is displaced within the lateral recess.

My MRI from July 2020 reads:
L3-L4: At the L3-L4 disc space, there is a 3 mm far left lateral bulging annulus with minimal distal foraminal stenosis. Disc is seen contiguous without displacing the sensory root ganglion. There is a minute Schmorl’s node of the superior endplate.
L4-L5: At the L4-L5 disc space which is desiccated, there is a minute Schmorl’s node of the superior endplate and a 2 mm bulging annulus without central or foraminal stenosis.
L5-S1: At the L5-S1 disc space, there is a 6 mm left lateral extruded disc herniation displacing the left S1 nerve root posterior laterally. There is no central canal stenosis. There is a quite capacious spinal canal. There is no foraminal stenosis.

What would you recommend as a next course of action? I’m meeting with my surgeon on Friday to go over my MRI results so I’m curious as to your recommendations. I am a 44 year old female who was extremely active prior to this injury. I did sprint triathlons, ran and did boot camp style workouts 4 days a week. I can’t help but feel those days are behind me now.

Donald Corenman, MD, DC
Moderator

November 17, 2020 at 7:40 pm

Post count: 8660

#33379 In reply to: Thigh Pain after discectomy |

You had a disc herniation at L5-S1 that was surgically removed. You then note; “But ever since the surgery the back of my thigh has had pain. Its not the same level as pre-surgery. In weeks 1-6, it would come about with no provocation. An aching pain in the back of my thigh that would eventually go away in about 30min or more”

You then note; “Since weeks 6, the pain in my thigh would come & go like before. But it will now happen if I sit down for any length of time”

Finally:”its been 18 weeks now. I have the same pain in the back of my thigh & tailbone whenever I sit in a chair for more than 15 minutes. The pains will gradually go away if I lay down or walk around”. Nerve tension when sitting that gets better with standing or lying down is consistent with a recurrent disc herniation. A new MRI is a good idea.

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.

JR
Participant

November 17, 2020 at 11:25 am

Post count: 2

#33376
Topic: Thigh Pain after discectomy in forum BACK PAIN |

Hello, I had a question about pain Ive had ever since my discectomy surgery.

Some background to my situation, I had a torn meniscus in my left knee & a herniated disc L5/S1, which was giving me sciatica pain on my right side.

My primary doctor got a referral to a orthopedic clinic & ordered a MRI. MRI showed that I had a moderate herniation at L5/S1. At this time, the MRI session also showed that I had a meniscus tear in my left knee as I mentioned. The surgeons wanted to take care of the knee first. I got the surgery for my knee & then I had to wait 6 weeks later to have the surgery for my disc herniation. The knee healed up very quickly. But the 6 weeks waiting time for the discectomy was hard to handle.

The sciatica pain I had pre-surgery was so intense that I couldn’t go to work, stand up, walk, use the bathroom, etc. It was the worst pain I have ever had in my life. The pain was on my right side. Stabbing pain in the buttock, back of thigh & the outside part of my foot was numb. I only felt relief if I laid down. I could sleep fine. But sneezing & coughing would send zingers of pain.

I had the discectomy surgery on July 2 for the herniated disc at L5/S1. The first week was ok. I did get up & walk for the first time in 2 months. I took everything very very slow. No bending or anything. Log roll out of bed, etc. I had my wife tape my back up with strapping tape to keep me from doing any bad movements. This helped a lot.

But ever since the surgery the back of my thigh has had pain. Its not the same level as pre-surgery. In weeks 1-6, it would come about with no provocation. An aching pain in the back of my thigh that would eventually go away in about 30min or more. Really had no pain in my back at all. Just some zingers in my buttock ever now & then.

Since weeks 6, the pain in my thigh would come & go like before. But it will now happen if I sit down for any length of time. At week 6 after my surgery, I went back to work. I got an expensive ergonomic chair hoping that it would help with anything related to my situation.

I also get pain in my tailbone. Or at least it feels like it is my tailbone. I can squeeze the muscles around the tailbone and it will hurt as well. But lying down or walking around will help relieve it.

Its been 18 weeks now. I have the same pain in the back of my thigh & tailbone whenever I sit in a chair for more than 15 minutes. The pains will gradually go away if I lay down or walk around. As since surgery, I can walk with no problems. Just when I sit in a chair for any length of time.
A heating pad seems to help some.

I just called my surgeon today & asked about getting another MRI just to rule out another herniation. Again, I can walk, stand up, etc. Just sitting causes the pain in my thigh.
They informed me that they are in the process of getting the MRI approved.
I hate being so worrisome about all this.
I didnt know if I am being too overly dramatic about all this.

thanks for reading my story
jeff

slider9499
Participant

November 16, 2020 at 8:51 am

Post count: 1

#33374
Topic: Abdominal distension and pain after post-laminectomy surgery in forum BACK PAIN |

On July 24, 2020, I had post-laminectomy surgery. I also had a broken back which was repaired at the same time. My surgeon went through my back. The surgery was to be 6 hours, it lasted 13 hours and I had 7 blood transfusions and 2 platelet transfusions. I was in the hospital for 2 weeks, 6 of those days being in ICU. My surgeon never gave me a straight answer as to why it took 13 hours and I had so many transfusions When pressed it only said that “it is a complicated surgery and the amount I received was normal.” EVERY doctor I spoke to said that this is not the case. My left thigh was numb when I woke up from surgery and remains so to this day. A week after I was released I noticed my belly button was 2 inches off-center and the left side of my abdomen was quite distended. I was also tachycardia and was on blood pressure meds for 6 weeks to ensure that my BP was normal. Since being released the pain and distended abdomen remain. The pain got so bad I went to the ER twice, they ran tests, took 2 MRIs, with and without contrast – both came back normal. I had a colonoscopy, which showed no abnormalities. The gastro doctor and my general surgeon both said that the surgeon could have nicked a nerve during surgery. I went back to my neurologist today who did a nerve test. The results showed a pinched nerve on my left side. I am scheduled for another MRI on December 14 and then it is back to the neurologist to review the results.

I am at a loss of what to do. I am both physically and mentally exhausted. Any idea what may be causing these problems?

Donald Corenman, MD, DC
Moderator

November 5, 2020 at 7:43 am

Post count: 8660

#33354 In reply to: Lumbar facet pain? |

The key to the diagnostic block is relief for the first 3 hours after repeating the actions (extension) that created the pain in the first place. Just like going to the dentist, the anesthesia lasts for about 3 hours then abates. It is not unexpected to hurt 10 hours later as the anesthetic agent has worn off and the steroid is yet to take effect.

Just to be sure, your fusion at L5-S1 has been proven to be solid based upon a CT scan and flexion/extension X-rays. Correct?

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

November 5, 2020 at 7:29 am

Post count: 8660

#33353 In reply to: Assistance Reading Post ACDF MRI |

Actually, your current situation might be somewhat beneficial for you. If you had a solid fusion with continuing nerve and spinal cord compression (and continuing symptoms), then you might have more of a problem solving your issues. However, it seems like you have a pseudoarthrosis (non-fusion) due to the lucency seen on X-ray and the presence of a broken screw. Both are an indication of pseudoarthrosis.

A careful look at the CT scan and review of flexion/extension X-rays will confirm this problem. A non-fusion means you are a candidate for an anterior revision of this level which can solve most of your problems. Removing the plate and graft, revision of the residual bone spur compression of the cord and root and re-fusion could be accomplished. I would advise using your own bone (iliac crest bone graft) if you do have this surgery as this is the best technique to get a pseudoarthrosis to heal from the front. The broken screw tip might have to stay in as sometimes removing it is more destructive than leaving it. As long as it is embedded in bone, it should be OK.

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 - 187 through 192 (of 2,199 total)

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Donald Corenman, MD, DC

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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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