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Donald Corenman, MD, DC
Moderator

February 18, 2012 at 11:22 pm

Post count: 8660

#5592 In reply to: Lumbar Spinal Stenosis |

Wow- how much time do you have. Books have been written on this subject. I will give you the Readers Digest version. Lumbar spinal stenosis has many variations including central stenosis, lateral recess stenosis and foraminal stenosis. Most people mean central stenosis when they say lumbar spinal stenosis so we will stick with that.

There are two types of lumbar spinal stenosis- stenosis without slip and stenosis associated with degenerative spondylolisthesis. If there is no slip or instability, a simple decompression surgery like a laminotomy or laminectomy can be performed. There are various versions of the two but the main consideration is to decompress the nerves in the canal.

If there is a slip involved (degenerative spondylolisthesis), then stability of the segments has to be taken into consideration. Flexion/extension X-ray films can indicate how stable or unstable the segments are. If too unstable (and a stability discussion is beyond this forum), then fusion needs to be considered. There are many fusion types and selecting one over the other depends upon the patient and planned activity level 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

February 15, 2012 at 10:37 am

Post count: 8660

#5576 In reply to: C5-C6 Nerve Issues |

Based upon the radiologist noting “severe” foraminal stenosis bilaterally at C5-6 and increased symptoms with head extension, you might be better off with a spine surgeon. Motor weakness needs to be addressed and if from severe foraminal stenosis, a spine surgery consult would make more sense.

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.

MarkL
Member

February 14, 2012 at 4:04 pm

Post count: 3

#5574 In reply to: C5-C6 Nerve Issues |

Thanks doc. I just found the MRI report from 07. I’ll type it up in case that’s helpful. At C5-6 disc space, a 3.8mm broad-based bridging osteophyte creates minimal spinal stenosis with attenuation in the anterior subarachnoid space. A 2.5mm far right lateral protrusion superimposed on hypertrophic change to the right uncovertebral joint contributes to severe right C6 lateral recess and proximal foraminal stenosis. There is additionally severe compromise to the left C6 foramen due to hypertrophic change to the uncovertebral joint and lateral spondylosis. At the C6-7 disc space, a 2.5 mm diffuse bulging annulus and minimal spondylosis is present. At the C7-T1 disc space, a 1mm far right lateral protrusion is not excluded. The resolution and definition of the lateral recess and proximal foramen is somewhat limited. The signal intensity of the cervical chord is normal. The facet articulations are maintained bilaterally. There is no compression fracture deformity of the cervical vertebrae. There is no evidence of cerebellar tonsillar ectopia. Normal flow is demonstrated from both vertebral arteries.

I can’t find the EMG report from 08 but I remember that only 1 side was tested. They had found some weakness that they said was consistent with the neck condition, from the bicep to the wrist flexors. Today I feel weakness in those areas in both arms. At the time of the tests, I was having the paresthesias with head bent back. Flexibility has improved with traction and yoga and I don’t notice paresthesias when bending head back (just stiffness). I get some pain in low bicep/forearm area when sitting with bad posture for extended periods today.

Given this more detailed information, does it sound like I should be seeing a spinal surgeon or neurologist? OR just tough it out? If nerve damage is being done, is time of the essence that I deal with this so as to prevent further damage or bring back any strength that has been lost? Or would that be permanent loss? Thanks so much.

Donald Corenman, MD, DC
Moderator

February 14, 2012 at 1:16 pm

Post count: 8660

#5573 In reply to: C5-C6 Nerve Issues |

You had a motor vehicle accident about 16 years ago and recovered after 6 months. About 5 years ago, you developed neck pain and an MRI demonstrated degeneration of the C5-6 disc. You have been able to manage the pain and live a relatively normal life.

You underwent an EMG which indicated involvement of the C6 nerve (C5-6 level). You have been developing progressive weakness of your biceps to wrists bilaterally.

Normally, foraminal stenosis (see website) is not normally bilaterally symmetrical. Also, there typically are paresthesias (pins and needles) and pain associated with foraminal stenosis and the symptoms typically become worse with neck extension (bending the head backwards) and improve with the chin on chest maneuver. Does that fit with your current complaints?

If you have only weakness without any radiating symptoms, you need to see a neurologist again. If you have the above noted symptoms, you need to see a spine surgeon for a consultation.

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

February 14, 2012 at 9:24 am

Post count: 8660

#5569 In reply to: Can a screw in L4-L5 disc be causing chronic pain? |

Send the latest studies that would include the latest MRI, CT scan, X-rays with flexion and extension views and any clinical consults.

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

February 12, 2012 at 1:37 am

Post count: 8660

#5556 In reply to: What does this mean for me? |

Your spine MRI suggest the condition of Scheuermann’s disease (see website for complete explanation). This condition predisposes the spine for degenerative changes which can cause local spine pain. One of the potential problems with Scheuermann’s disease is an increased kyphosis of the spine (an abnormal forward curve) in the upper lumbar spine or thoracic spine (the chest). This condition makes walking and standing more difficult.

A proper physical examination and standing X-rays would reveal this condition.

If you do have this condition, extension exercises are the order of the day. These exercises induce the muscles of the spine that bend the spine backwards to strengthen. If your problem is degenerative disc disease without increased kyphosis, then core strengthening exercises are important (see video on website from TV 8 to explain these).

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 - 2,065 through 2,070 (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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