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malikfida
Member

May 20, 2012 at 9:29 pm

Post count: 25

#6231 In reply to: Disc bulge causing bilateral neural foramina narrowing & compression |

Respected SIR,
I have an another query regarding my back pain as I had done L4L5 nerve decompresion
SIR my question is when I walk about 20 to 30 mins the next day I feel intense
cutting type pain in my back and it responds well to the NSAIDs, I noticed it so lately
becuase I have no time for walk usually on weekend when I walk little it results into
discomfort on another day,More over the NSAIDs all are heptotoxic and nephrotoxic drugs
and prolonged use ma cause some serious effects,Sir kindly advise over my this sitation,
I will be thankfull to you.
Wish u all the best.

Donald Corenman, MD, DC
Moderator

May 15, 2012 at 9:13 am

Post count: 8660

#6211 In reply to: Back pain and Lumber area |

I am confused by your description of your pain. Do you have intermittent lower back pain and intermittent thoracic pain? How often does the pain occur? To what intensity? Where is the pain and does it radiate? How has this pain affected your job or home life? Give me a history of your disorder.

Many questions to answer.

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

May 13, 2012 at 2:58 am

Post count: 8660

#6189 In reply to: TLIF? |

You note your pain is both lower back pain and leg pain (sciatica). You have minimal to no leg pain while standing but develop leg pain when sitting. The pain occurrence with sitting is gradual and intensity changes intermittently. Your MRI notes DDD of L4-5 and L5-S1.

Some questions. What is the percentage of back vs. leg pain? It seems to change with standing vs. sitting. Would you say that you have 80% lower back pain and 20% leg pain with standing but the percentage changes with sitting? When you sit, does the leg pain always start in your feet and radiate up or does it start in your buttocks and radiate down?

There are some potential different diagnoses for your leg pain. Your back pain is most likely from your degenerative disc disease. If you have a condition called isolated disc resorption (see website) where the disc cushion has completely worn away, as a pilot you are more susceptible to vibration generated by the plane and this will increase your back pain.

The leg pain can occur from spinal nerve irritation but if your MRI notes no significant nerve compression (including lateral recess stenosis which can be missed on some MRIs), the foot pain can be generated by peripheral nerve entrapment. Leg nerves run in tunnels just like the median nerve of the hand runs in the carpel tunnel. This entrapment is also somewhat common with pilots. An EMG/NCV test can help to diagnose nerve entrapment.

By the way, yes I very much like pilots and do take care of many fixed and roto-wing pilots. I am a pseudo-pilot myself (need 10 more hours and better cross-wind landings).

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.

exercise453
Member

May 10, 2012 at 9:11 am

Post count: 53

#6176
Topic: about foraminotomy in forum NECK PAIN |

Hi Doc….Appreciate the site and forum

Why is a posterior foraminotomy done vs an endoscopic posterior foraminotomy? Is it some difference in the position of the herniation/osteophyte? The first Peyton Manning posterior scar looks like it was not an endoscopic procedure.

Can these be done at two consecutive levels-symptoms on one/same side ?
c3-c4…c4-c5

Can they be done to a “posterior-osteophyte complex without evidence of cord compression and mild narrowing of the spinal canal, bilateral lateral extension resulting in moderate neuroforaminal stenoses”…..but the symptoms are all on one side.

Even in the case of a posterior central disc with lateral extension can fusion be avoided if symptoms are only on one side?

Thanks so much

Donald Corenman, MD, DC
Moderator

April 28, 2012 at 11:20 pm

Post count: 8660

#6146 In reply to: Reccuring Back pain (L4-L5 narrowing disc) Lifelong? |

Your pain is most likely from the degenerative disc at L4-5 but an MRI would be more specific for diagnosis. I do not believe in bed rest for longer than two to three days as muscular deconditioning results which increases the biomechanical problems of the spine.

You have had two episodes of incapacitating pain in six years. Each episode has apparently lasted 2-3 months with this last episode finally clearing. What it sounds like you need is management when these episodes occur to short circuit the length of time to recovery.

Management type treatment to reduce the intensity of these spells includes epidural steroid injections, oral medications including oral steroids, a physical therapy rehab program or chiropractic program, a corset or lumbar belt and time.

Is this a life long problem? The answer is yes and no. The disc will alway remain degenerative and flair-ups can recur. However, with proper training and ergonomic education (how to lift and what activities are more detrimental), you can reduce the number of flair-ups and control them when they occur.

If this program does not work and these episodes become more frequent or disabling, a surgical work-up can be undertaken. See section on the website under “Treatment”- “When to have surgery” for further explanation.

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

April 27, 2012 at 7:32 pm

Post count: 8660

#6134 In reply to: Stooped posture, heavy force etc. |

The MRI report notes a synovial cyst at the superior margin of L4-5. The problem is with that statement, the radiologist does not note where the cyst is in relation to the spinal canal. Is the cyst inside the canal or outside in the muscles? That makes a big difference in diagnosis.

A synovial cyst is associated with degenerative facet disease. Did you have standing X-rays with flexion and extension motions (bending forward and backwards) performed? I assume that with a normal disc at L4-5, there would be no slip (spondylolisthesis).

Most likely, the level causing your pain is at the L5-S1 disc. There are two findings that could cause your symptoms. One is the disc hernation on the right. If you have localized pain on the right in the sacroiliac joint, buttocks or posterior thigh, the pain is likely generated from this herniation.

If you have central (axial) lower back pain, this is from the failure of the disc to absorb shock. Vertebral endplates that are “irregular” could be from stress fracturing from overload of the disc and increased strain on the endplates of the vertebra. The overload causes small fractures of the endplates and dull deep achy pain.

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 - 2,005 through 2,010 (of 2,193 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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