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l5s2
Member

June 11, 2012 at 6:11 pm

Post count: 4

#6349
Topic: L5S2 Back Pain in forum BACK PAIN |

Hello Doc,
I am suffering on back pain since May 2011 and live in Germany, Duesseldorf. I am 36 years old and my L5S2 intervertebral disk is broken.

I have attached some MRT pictures.
Do you think a DiscoGel threatment could relief me from having pains.
Especially the sciatica on the left side hurts and when I wake up from bed it always takes time to relief me from my pains. I do back swimming and physiotherapy. Especially abdominal muscles training and distension of my sciatica are my current treatments. I also had four injections on my nervs under MRT injections and serveral normal injections from my orthopredic doc.

shrikant_touch
Member

June 11, 2012 at 6:07 pm

Post count: 6

#6348
Topic: loss of bowel bladder control due to cervical pain in forum NECK PAIN |

Dr Corenman
on 12 may 2012 My father age 69 suffered from shooting neck pain started from rightside of the lower neck area and within seconds spread across both the hands ,legs and shoulders .(he felt like paralysis attack) He was brought to hospital and admitted for next 12 days Since that day he has lost his bowel /bladder control (is on catheter and taking anema for clearing bowel) His MRI report is as below 1. loss of cervical lordosis is noted. 2.mild anterior and posterior osteophytosis is noted at c3 to C6 vertebral bodies. 3.Neural foramina and facet joints are normal. 4. Sagittal daimeter of bony spina canal as follows C2 16mm ,C3 14mm, C4 13mm C5 15mm ,C6 14mm C7 15mm 5.Central prostrusion at C3-C4 and C6-C7 are noted causing thecal sac compression. 6.Central extrusion at C4-C5 are noted causing mild cord compression. 7. the thecal sac shows normal signal characterstics. 8.central linear cord hyper intensity on T2WI is noted at C3 to C6 levels. 9.paraspinal soft tissues are normal.

He is taking rest at home with naturopathy /homeopathy meds /massage and is showing some relief from pain but his bowel /bladder problem not solved yet is
Please tell us whether surgery is required for this.

exercise453
Member

June 10, 2012 at 3:37 am

Post count: 53

#6343 In reply to: c2-3 facet |

Hi Doc,

At c3-4 the report says left lateral extension with moderate neuroforaminal stenoses. I do believe it is symptomatic and as you said may be the underlying pathology of painful trigger points. I am confused about the c4 nerve root. It seems to be responsible for radiating into the shoulder via its connection to c5. It also is connected to the c1c2c3 complex radiating upwards. You mentioned the c3-4 facet in your explanation about the c2-3 facet.

Can the c4 root cause pain in both directions (up and down)?
Can it mimic c2-3 facet symptoms. When I press the posterior trigger points or turn slightly there is tingling in the ear.
Can facet pain move around (back-side-front)? Can nerve pain?
Can a c3 nerve be symptomatic even as 2 mri’’s say normal (it does look good)?

At c4-5 (ground zero)…mri posterior disc (wipes out most of the canal but does not touch the cord) and left lateral stenoses. A nerve report was +1 fib and +1psw and the neurologist wrote possible root dysfunction. There is no weakness, there are radicular symptoms.

Did I understand you that injured or dysfunctional roots will not recover even if freed?

Someday I’ll tell you the c7-t1 cubital tunnel saga.

As always thanks from a loyal reader and potential visitor.

egma221
Member

June 9, 2012 at 1:07 am

Post count: 1

#6335
Topic: Neck, shoulder pain and total loss of function in my left hand in forum NECK PAIN |

Hello
A couple of months ago I randomly woke up with pins and needles in my left hand that wouldn’t go away. Each day, I slowly started to lose function in my fingers, particularly my little finger and thumb. But it was an overall weakness – I couldn’t grip or pick anything up. The doctor I saw initially thought I was having a stroke but me being a nursing student decided that I wasn’t and that it was probably to do with a neck injury that I sustained last September. The disc wasn’t herniated when I had that CT scan but it did cause extreme pain, however it was on the right side of my neck.

Since the feeling of tingling and numbness in my left hand went away, I have been left with the most deep, intense pain that feels like it is actually inside the middle of my shoulder trying to claw the bones out. All of the muscles around my arms and into my forearm cramp up like rocks at the end of each day and I am not sure why. I had a CT scan today and they didn’t provide me with a report so I don’t know whether I have a herniated disc, a compressed nerve root or some other sort of neuropathy.

If you could possibly shed some light as to what could be going on that would be great because every doctor I have seen here in Perth has told me to rest and not exercise – that is it! They won’t even listen to me when I tell them how much pain I am in and I am really truly not making it up!!!

Thanks again

Donald Corenman, MD, DC
Moderator

June 8, 2012 at 10:51 am

Post count: 8660

#6331 In reply to: Ligaments damage (or not)? |

Well- I finally understand how to look at your images. I have deleted the link so you remain anonymous.

You have a compression fracture of T11. There is no apparent injury to the posterior ligaments. There is no significant kyphosis of the fracture area (a good finding). There may be a slight burst component to the fracture but this is not important.

If you were my patient, I would put you in an extension TLSO brace or a Jewett brace for 10-12 weeks to prevent deformity when the fracture is healing.

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

June 6, 2012 at 10:46 pm

Post count: 8660

#6319 In reply to: Fusion healing |

Healing time for bone incorporation in a cervical fusion (ACDF) depends upon the type of graft used. There are generally three types of graft used; autograft (your own bone), allograft (cadaver) and PEEK cages (a plastic cage with some of your own bone shavings in the center of the cage).

There are two pieces of information to be concerned with- time to healing and complete healing. If the graft does not heal- this is called a pseudoarthrosis or non-union. The chance of the non-union is higher with PEEK cages and allograft and diminished with autograft.

The time to healing for your own bone is about 6-8 weeks. The time to healing with allograft is about 3-4 months and with PEEK cages about 4 months.

The way to determine healing is with X-rays including flexion and extension films. If there is any uncertainty, then a CT scan can be performed which is much more accurate.

If the fusion does not initially heal, this is called a delayed union. There are various adjuncts to try to increase healing such as a bone stimulator. If the grafts will not incorporate (fuse), this is called a non-union.

Non-unions can be non-painful (stable) or painful. If painful, then redo surgery is required. Most times, this would be a posterior fusion of the non-united level but there are times a repeat anterior surgery would be required.

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 - 1,981 through 1,986 (of 2,193 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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