Donald Corenman MD DC | Spine Surgeon Colorado

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Shelton
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January 28, 2015 at 10:15 pm

Post count: 4

in reply to: spinal cord surgery #12104

Thanks so much for clarifying what all of that means.

I do go to the bathroom a lot so I’m doing urodynamic testing soon to check for a neurogenic bladder as requested by my surgeon so I will see what he decides.

Thanks for getting back to me!

Shelton
Member

January 28, 2015 at 10:01 am

Post count: 4

in reply to: spinal cord surgery #12099

Thank you very much for your opinion and insight.

I did end up getting a lumbar MRI to check for tethered cord and wondered if you could give an explanation of what the MRIs mean :

“There is transitional lumbosacral anatomy. The transitional segment is considered to represent S1 based on the presence of iliolumbar ligaments at the segment above the transitional segment. There is a complete L5-S1 disc & a rudimentary S1-S2 disc.

T12-L1: Small central disc herniation with cephaladad migration beneath the posterior longitudinal ligament, exerting mild mass effect on the ventral conus.

The tip of the conus lies at the inferior L2 level and there is lipomatous infiltration of the filum terminale. “

(Everything else is unremarkable.)

I am wondering what to do from here and what all of that means?

Thanks in advance.

Shelton
Member

December 18, 2014 at 5:00 am

Post count: 4

in reply to: spinal cord surgery #11894

Thank you so much for providing your knowledgeable insight.

You are right about my surgical past. I had a 13 mm Chiari malformation, full CSF blockage, and instability from the beginning. The instability was not recognized by my first surgeon. I am now seeing a knowledge neurosurgeon at Georgetown University in DC on all things Chiari. I am concerned that I may need to see a more knowledgeable neurologist and/or surgeon to make sure I’m not missing anything. Do you have any recommendations of an expert you mentioned? I have done tons of research but I haven’t seen many who would fully understand. I have heard of Dr Lebl in New York and have thought of getting his opinion but I’m not sure where to go from here.

What could be the cause of the hemivertebrae at C4? I have researched that it can just go along with Klippel Feil Syndrome and haven’t thought much about it. Is the hemivertebrae a problem that needs to be fixed surgically? What do you mean by “you have more than just KFS because of the hemivertebrae?”

I am getting full spine MRIs soon. If the lumbar shows tethered cord, can the pulling cause autonomic issues since it can pull on spinal cord?

I have listed both post op and pre op results as the surgical fusion does not allow you to see the full results. This is what my MRIs of my neck show:

Surgical Fusion from occipital to C4 level with screws intact
Turbulent CSF flow below cerebellum & distortion of foraminal anatomy related to vertebral anomalies
Mutiple congenital segmentation anomalies
Right C1 is incorporated into the occipital of atlas
C1 : congenital arch
C2- C3 : levels are partially fused across the disc spaces and posterior elements with only rudimentary discs
C2 : level is quite hypoplastic
C4 : has a left hemivertebrae morphology with related levoscolosis
Mild end plate hypertrophic changes at C4-C5
C5-C6: uncovertebral osteophytic spurring with mild diffuse osteophyte complex; mild to moderate left foraminal stenosis (all developing after fusion surgery)
C6- C7: diffuse disc osteophyte complex with uncovertebral osteophytic spurring without significant stenosis; mild left foraminal narrowing is present (developing after fusion surgery)

Could any of this cause compression of the phrenic nerve like you mentioned? The breathing issues may be from the brainstem compression, I just wonder because they got better at first during recovery and now they have worsened again. Also, many of the problems are noted as being on the left side.

Thanks so much for your help.

Hannah

Shelton
Member

December 17, 2014 at 3:35 am

Post count: 4

in reply to: spinal cord surgery #11885

Hi doctor,

I had a decompression for Chiari malformation about a year ago and the surgery made me worse. I ended up getting a second opinion and being diagnosed with Klippel Fiel Syndrome and I am fused from skull to C2. KFS was causing clivo-axial instability and severe brain stem compression so I had another surgery fixing my alignment and fusing me from skull to C3 with my rib bone. I got a lot better but I’m becoming symptomatic again and my surgeon says the KFS is still causing some anterior brain stem compression and turbulent CSF flow. I have breathing difficulty and some heart rate issues. I also have a hemivertebrae as C4 causing leviscolosis, mild stenosis at C5-C6. I have just started diamox for head pressure and enlarged ventricles and am symptomatic for tethered cord. Do all these things go together? Is there anything else that can be done for the anterior brain stem compression? Do you accept MRIs without an appointment? I live in VA but I would like your opinion. I’m not sure what to do from here and none of my doctors have a clue except for my surgeon who I see next month.

Symptoms include:
High heart rate
Chest tightness
Back pain
Leg pain
Urinary frequency
Breathing difficulty
Headaches
Shoulder pain
Fatigue
Hyperreflexive in legs & knees buckle
Brain fog
Gait problems

Thanks in advance.
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Viewing 4 posts - 1 through 4 (of 4 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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Shelton

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