Donald Corenman MD DC | Spine Surgeon Colorado

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Viewing 5 posts - 1 through 5 (of 5 total)

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Jbeans9999
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July 10, 2014 at 2:57 am

Post count: 13

in reply to: Should I get a second opinion….. #11172

thanks for your response Dr. Corenman,

Even more, in the past 3 days since I posted my original comments the pain in my back has decreased to almost nothing and the pain in my outer lower leg has become constant and the pain feels the way it felt in the early days after my l5-s1 herniations. In addition, the top of my foot is now numb in the center of my foot.

I am trying to get in to see my spine doctor to see what he thinks.

Also, I really wanted you to know that I think what you are doing here is amazing, and there are no words that come close to being able to describe how grateful I am that you take time out of your life to help address questions from people like me.

THANK YOU

Jbeans9999
Member

September 24, 2013 at 4:56 am

Post count: 13

in reply to: EMG abnormalities; post p-lif; long-term pain probability? #9458

To answer your questions.

1. The pain is now on the outside of my lower left leg, and now I am having sensations of cold and hot both in my lower left leg and also in the back of my left ankle (started last night and intermittent but I just felt it now as I was typing) and the sensations of heat in my ankle is becoming very strong (comparable to when you have a laptop which has been on for a few hours touching your skin; it is pretty hot but not so bad you scream).

Also, I saw the pain doctor today and asked her what the EMG showed (h-reflext latency…. chronic nerve problems with s1 nerve). I don’t have the exact language but hopefully that is enough.

2. The pain started approximately a week after I stopped all narcotics.

In addition, when I saw the dr. this morning she has started me on the extended release drug for gabapentin (I believe called gralise) so we will see how it goes.

I just want to know the probability of this type of result (h-reflex showing chronic s1 damage) will heal itself or if I am more likely to be dealing with this for my entire life. I know every case is different, but I am looking for more likely than not based on the literature and person experiences.

IS that enough to determine likelihood? If not I can provide more detail, because seems like my drs don’t want to speculate (which I understand) but I need to know the chances for my own sanity.

Thanks so much for any input you could provide.

Jbeans9999
Member

September 12, 2013 at 9:43 pm

Post count: 13

in reply to: Back pain after fusion combination of fusion and herniation? #9362

After my 3 month X-ray my surgeon indicated he did not see much fusion yet, but he indicated it can take up to 6 months to really see the bones fusing. Does that sound right to you?

Also, after my follow-up MRI to check for my pain they did not find any herniation of l4-l5 but apparently they say cervical spondolylosis. Right now, since I did not herniate l4-l5 we are going to do an EMG next week to test my nerves; but if there is no herniation at l4-l5 I am worried something wrong with the nerves because what I am feeling is nerve pain.

They have started me on gabapentin which makes me happy, because narcotics are not what I need I need something specific to nerve pain.

Is it unusual for them to report cervical spondylosis from an MRI of lumbar spine?

Jbeans9999
Member

August 30, 2013 at 1:46 am

Post count: 13

in reply to: 3 month post-op l5s1 fusion; pain lower leg… #9292

I was able to get the surgeon to look at the MRI and these are the findings they gave to me based on his looking (without the final report from the radiologist):

1. The L5-S1 operative level looks OK, no obvious nerve impingement.

2. The next two levels up, L3-4 and L4-5, look the same as before surgery.
Some disc bulging, but no disc herniation, and certainly no NEW nerve compression.

3. So I think this is some nerve inflammation, nothing that would require any further surgery.

Most people would not say this, but I was hoping for herniation because now I am worried about permanent nerve damage. I have probably spent a combined total of a year (if take all time periods from herniation through surgery) dealing with this type of pain/sensation on a continual basis over the past 4 years. Even my physical therapist and I were discussing and based on what hurts vs. does not hurt for different movements it sounds like nerve pain.

Could the continued (and worsening) pain be a sign of permanent nerve damage?

If so, is it even possible that if I had problems at l5-s1 I would be exhibiting pain in areas more commonly associated with l4-l5?

Is there anything you would recommend in terms of tests or literature?

I am at a loss for words and in fear of becoming one of those people with chronic pain issues. Any advice would be greatly appreciated.

Jbeans9999
Member

August 29, 2013 at 7:05 pm

Post count: 13

in reply to: 3 month post-op l5s1 fusion; pain lower leg… #9290

The PLIF at L5-S1 was from a 3rd herniation of that disc (I previously had 2 microdisectomies at the same level; first in 2008 and the second in 2012).

I had the fusion due to pain in the back of my upper left thigh, but really never had back pain.

Now i have pain in my lower left leg (outside) and increased numbness in my foot across more of my foot (with other herniations numbness in foot limited to left 2 toes, now numbness all way to big toe). Also, I now have more pain in my back, but it is hard to know if the pain is from healing of the fusion or this new problem.

I know I can not reherniate after the fusion which is why I suspect herniaton of the l4-l5, especially since it is the same type of pain and very localized.

I saw my surgeon the other day and he ordered an MRI which I got this morning. I guess we will see.

Thanks,
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Viewing 5 posts - 1 through 5 (of 5 total)

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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Jbeans9999

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