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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,

Donald Corenman, MD, DC
Moderator

March 19, 2023 at 1:16 pm

Post count: 8660

#35533 In reply to: Fusion Recovery with Fibromyalgia |

Sorry, but I was out of the country.

Fatty infiltration of the muscles (“My last MRI showed heavy marbling of FAT INFILTRATION in the cervical muscles”) is normally a sign of disuse or even neurological disconnection (nerve loss). It would be the opposite of recovery.

I suspect your current symptoms are possibly from a lack of fusion of a 4-level ACDF. 4 levels is a lot to have to expect that all levels would fuse. Also, the long lever arm on the lowest level (the open C6-7) could wear this level out prematurely.

Your symptoms are more focal and significant that what I would expect from Fibromyalgia (“The muscles are cramping in the right side of my neck. The pain is so severe that I can stand or sit for only about 15 minutes before I have to rest my head back”).

I would say that a new set of x-rays including flexion/extension are necessary and if any questions, a CT scan of your neck could be in order.

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.

elroy1414
Participant

March 16, 2023 at 6:10 pm

Post count: 23

#35526 In reply to: NMES for cervical radiculopathy |

Is TENS different than NMES tho? I see various sources saying they are different.

Donald Corenman, MD, DC
Moderator

March 16, 2023 at 12:43 am

Post count: 8660

#35523 In reply to: NMES for cervical radiculopathy |

There have been TENS units (transcutaneous electrical nerve stimulation) around for the last 40 years (+). They can be effective on occasion.

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.

AMWalker
Participant

March 14, 2023 at 2:37 pm

Post count: 19

#35514
Topic: New Pain After Lifting, Surgery in 2017 in forum BACK PAIN |

I am wondering about how to proceed after a lifting incident has left me with significant back pain and now sciatica on the opposite side that led me to have discectomy and laminotomy almost six years ago. I had a large central tear at L5-S1 and radiographic evidence of impingement on the right side, but all of my symptoms were on the left. I had a mild collapse after my surgery with symptoms on the right side that were treated with oral steroids and periodic mild symptoms on that side since then.

The central pain I am now feeling after a recent lifting incident feels much like the first times I damaged my disc and I am now experiencing pain in the buttock, hip, calf, ankle and toes. It is not constant or severe, but I fear ramping up.

I have really just started to get my life back and my first experience with treatment ws extremely protracted, along with some PT extension exercises that further extruded the disc. Given my surgical history, is there still a likelihood that this will resolve without intervention, or should I be seeking imaging as soon as possible in the interest of hastening the process toward treatment?

It has been a long time since I have posted, but some of my history is here and I’d be happy to answer any questions that might help. Thank you.

LisaE
Participant

March 11, 2023 at 1:18 pm

Post count: 5

#35509
Topic: back pain 5 years post microdisctomy/laminecotomy in forum BACK PAIN |

Hi There
I am 5 years post op for a two disc repair and am at the point where i need to figure out next steps as a day doesn’t go by that I am not in pain. With both L4/L5 issues, is a fusion not worth it given that it would potentially progress to L3? Pain has always been left but is traveling right. I am active and skiing is one of those activities that I do regularly.

Imaging:
X-rays
Study: 2/3/2023
Lumbar spine 4 view
Normal curvature the lumbar spine. She has a stable 2 mm anterolisthesis at L4-5. Her disc heights are well-maintained with the exception of L4-5, L5-S1 which she has moderate loss. She has facet arthropathy L4-S1.

MRI L-spine
Date: 2/8/23

Findings / Impression:
1. No now made of a 5.5 mm right paracentral disc herniation at the L5-S1 level with annular bulging. There is extension of disc material into the right subarticular recess with effacement and impingement of the traversing right S1 nerve root now noted. Left-sided laminotomy defect at this level is noted. There is endplate remodeling. There is mild right foraminal stenosis.
2. Slightly increased prominence of a now 4 mm central protrusion at the L4-L5 level. There is effacement thecal sac. Central canal remains decompressed by left-sided laminectomy. There is minor left foraminal narrowing, unchanged.
3. Slight interval progression of disc degeneration at the L3-L4 level. There is mild facet arthropathy. There is no evidence of localized disc herniation, neural element compression, or stenosis.
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Viewing 6 results - 37 through 42 (of 2,200 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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