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foxylady
Participant

April 21, 2023 at 1:35 am

Post count: 125

#35604 In reply to: Severe Intervertebral Foraminal – Neck |

My MRA showed small Vertebral Artery Loop Formation on left near origin from the left Subclavian artery.
and partially confluent bilateral cerebral subcortical and periventricular white matter T2 hyperintensities, probably secondary to small vessel disease (Fazekas 2)

What does that mean please?

meni learn
Participant

April 9, 2023 at 1:37 pm

Post count: 236

#35579 In reply to: ligamentum buckling or hypertrophy in cervical spine |

in MRI of c spine (2.22) the position of the head are little (very little extension the canal (in for slices of 1 mm axial on the center and left side (canal diameter are 10 mm (their is no CSF in this 4 slices and also it is can cold mild compression (on the cord )
the MRI of c 23 was with the head more neutral (little flex) and in this image *their is also buckling of LF (and in 1 slices very significant ( also canal 9 mm also in more flex (when the ligament buckling less )so it is could to say (the buckling are little more (because the position more flex compared to 22 and it is see canal (pinching )
the radiologic report of c s (not found nothing not lesions on cord )
the LF c3-4 buckling can causes (tingling in the face and also in the back of the head ?(between the eyes also ?
what is your opinion?
thanks

Meni

Donald Corenman, MD, DC
Moderator

March 31, 2023 at 8:16 pm

Post count: 8660

#35565 In reply to: SEVERE LT HIP PAIN |

Is this new type or more intense pain than prior to 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

March 20, 2023 at 11:34 pm

Post count: 8660

#35541 In reply to: Cervical spine ddd |

Based upon your pain intensity, I think a spine surgeon would be a good choice. Make sure he or she is conservative and gives you good answers for your pain causes. Have him or her develop a plan that you can understand.

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

March 20, 2023 at 4:42 pm

Post count: 8660

#35536 In reply to: Loose screw after 3 level ACDF |

Generally, a loose screw in an ACDF means a lack of fusion (pseudoarthrosis). You need a flexion/extension x-ray and a fine cut CT scan to determine what the best surgery for you would be.

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.

SushiCami
Participant

March 20, 2023 at 2:45 pm

Post count: 6

#35534 In reply to: Fusion Recovery with Fibromyalgia |

Dr Corenman,
THANK YOU for your response! Your kindness in starting this forum and continuing to be active on it is overwhelming and touches us all. You allow us to feel that, at least, one person in the world understands. The encouragement we gain here is powerful. I pray that God will give you and your family the same powerful encouragement and that you will not be weighed down by all our constant questioning.
—————

ALREADY HAD XRAYS/MRI
Between the first message (Dec 2022) and the second reminder (Mar 2023), I did have cervical x-rays (including flexion/extension) and an MRI (that’s how we found the fat infiltration). I have not had a CT scan. Results were compared to imaging taken pre- and post- surgery.

XRAY/MRI RESULTS SUMMARIZED
+ According to my neurosurgeon and the reports, fusion at all 4 levels and alignment of cage is still perfect and intact.
+ Lordosis is good, considering.
+ There is no longer impingement of the nerve compared with before surgery.
+ Degeneration at all cervical levels has not changed significantly since surgery.

[FYI – I typed my levels incorrectly before – my fusion is C3-C7. Tried to edit but no option.]

My surgeon did tell me that the levels above and below would eventually degenerate, but I don’t think that would happen within 7 months, especially since I’m not able to do many of the activities I did before (including work).

FOLLOW-UP QUESTIONS
Q1. I am a small-framed 5’1” 110 lb female. Do you think that maybe my muscles were just not strong enough to handle the change in biomechanics of a 4-level fusion?

Q2. My physical therapist said that my cervical muscles were very marbled with fat, so much so that it would be difficult to believe it occurred recently. He also mentioned that fat infiltration is often seen in Chronic Pain patients (of which I am one – Chronic Migraine, Myofascial Pain Syndrome, Fibromyalgia, Bruxism, Major Depressive Disorder, DDD, etc). In your experience, have you seen a significant difference in % Recovery from ACDF between chronic pain patients and non-chronic pain patients?

Thanks again,
Author

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Viewing 6 results - 31 through 36 (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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