Donald Corenman MD DC | Spine Surgeon Colorado

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bitmerkle
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April 29, 2013 at 9:09 pm

Post count: 4

in reply to: Pars Interarticulas fracture-L5 #8537

All I know about the Xrays is that they “looked” fine. Although, three weeks later during my first steriod injections (for diagnosing), they found the extra verterbrae. He then pulled up the xrays again from boulder community and in fact saw the extra vertebrae. Therefore, I’m not sure if he noticed anything else.

I mentioned in an earlier email to you that I had some injections done. THe most recent being the MBBS and L2 L3 L4 L5, etc. last wednesday, still in utter excruciating pain. The first injections were on either side in the “narrowing” areas?? I’d have to look at the exact spot if you are needing that information? He told me that the last thing he would try is the epidural injection if these latests shots did not work. I’m feeling very deflated and I’ts hard to move now, standing no more than 5 minutes, walking no more than 5-10 minutes. Can’t sleep. bending backwards kills!! I can get some relief when I bend over, but only temporary.

I wish I could meet with you, if you were closer..I really would like to know my real options. I can’t continue like this.

What in your opinion, should I do?

bitmerkle
Member

April 29, 2013 at 2:05 am

Post count: 4

in reply to: Pars Interarticulas fracture-L5 #8530

Thank you again, for your reply.
I wanted to give you my “direct report” from the MRI to see with all my pain that I’m having, symptoms that I would be a candidate for some sort of surgery? (TLIF). My concern is that my spine doctor who has been doing all of my injections said that there would be no option of surgery?? I just don’t understand? I can’t live like this much longer.

Okay, so here is the report. Let me know what your professional opinion would be
Findings: The vertebral bodies maintain normal height and alignment. Small foci of bright T1 and T2 signal within the L2 and L3 vertebral bodies corresponding with hemangiomas or focal fat are noted. Bone marrow signal is otherwise w/in normal limits. The conus ends at L1. No evidence of of arachnoiditis. The paraspinal soft tissues are normal.
T11-L4 – No annular buldge, central canal narrowing, or neural foraminal narrowing

L4-L5 Mild annular bulge without central canal narrowing, minor bilateral neural foramina narrowing .

L5-S1- Mild annual bulge without central canal narrowing. Mild bilateral neural foraminal narrowing. A left L5 pars defect is noted on sagittal image 12 w/out marrow edema. The right L5 pars interatricularis is elongated although appears intact. Mild bilateral facet arthropathy.

Impression: 1. Left L5 pars defect w/out marrow edema. Elongation of the right L5 pars interarticularis is intact. mild bilateral facet arthropathy and neural foraminal narrowing at L5-S1. No significant spondylotisthesis or degenerative disc disease at L5-S1.
2. No Disc herniation or central canal narrowing throughout the lumbar spine.

I have been inactive for 9 weeks now, have had all but the ESI injections, a brace on and the spine doctor doesn’t know what to recommend now? With these findings, would TLIF truly be an option or am I stuck with this pain forever?

Thanks again! Sorry to keep bothering you with these questions.

bitmerkle
Member

April 25, 2013 at 10:41 pm

Post count: 4

in reply to: Pars Interarticulas fracture-L5 #8503

Thank you, Dr. Corenman for getting back to me so quickly.

I do have a question though. Are you saying that surgery would only be an option if I had some disc problem in my back and if the vertebral body collapses on the L5 nerve roots that is causing the pain? I had my shots yesterday as explained in my previous email yesterday. he told me the most important thing to note is the first 24 hours to see if any pain goes away 70-80% then he would do the facet rhizotomies..So far, nothing has improved?…
My question is why if I have an L5 fracture that is clearly NOT healing for over 20 years, can’t we fix it now? Something is causing this pain and I’m tired of the PT, the steriod shots, the brace, the not being able to do any day to day activities. How long should I wait to see if these shots I got yesterday should work before contacting a neuro?

How likely is surgery for me with just the info I gave you?
Thanks for you time.
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Viewing 3 posts - 1 through 3 (of 3 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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bitmerkle

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